Leader: Respect for people will win informed consent

February 2, 2001

This week's report on the widespread clandestine retention of body parts at Alder Hey hospital and elsewhere uncovers practices aptly described as grotesque by health secretary Alan Milburn. Its significance goes beyond changes needed at the individual institutions criticised.

Collecting human organs from individuals has much in common with collecting genetic information on whole populations. Informed consent is the key and researchers are wise to seek populations where such consent is available. Collecting materials or data without it - like the celebrated Icelandic experiment, which uses an opt-out system - is not only distasteful, it risks legal trouble later.

This is even more important when the issue is not adult blood samples but children's organs. Everyone will share the parents' outrage at the squalid, dishonest practices revealed by the report. But would the parents have refused consent if they had had confidence that keeping organs might help find a cure for the condition from which their child was suffering?

Medical science needs material with which to work. We are increasingly squeamish about using live animals. People, living and dead, are an ever more important source. Researchers in universities, hospitals and the pharmaceuticals industry require access to them. What is necessary in the aftermath of Alder Hey is a protocol to meet this need. Out of humanity and self-interest, its first criterion must be that all participants know of and approve what is done; its second, that it is done decently. There has been too little distinction between active consent and lack of objection and too great a tendency to regard parents as too stupid to be consulted. The 1961 law on human tissue use should be updated and a modern approach to patients and the bereaved made its centrepiece.

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