This item was published during the term of a previous administration that ended in April 2007
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Final report of Organ Retention Group
24/11/2003
The final report of the Independent Review Group on
Retention of Organs at Post Mortem is published today.
The group, chaired by Professor Sheila McLean, was
established in September 2000 to review matters arising
from the retention of organs at post-mortem without valid
parental consent.
In this third report the Group has focused on three
particular issues:
- developing standard information leaflets and
authorisation forms;
- addressing issues about Procurator Fiscal
post-mortem examinations; and
- drawing up criteria for local Research Ethics
Committees (RECs) when considering research involving
human tissue retained at post-mortem
Announcing the recommendations Professor McLean
said:
"From the beginning of our Inquiry our concern has been
to ensure that the wishes of the deceased or - where
relevant - the wishes of parents should be decisive in
terms of post mortem examinations.
"In this final report, we have produced authorisation
forms which will reflect this primary intention. We have
already explained our preference for the use the language
of authorisation rather than consent, and are pleased that
this has been accepted by the Minister. Obtaining
authorisation is a central aspect of the lawfulness of the
post mortem examination process.
"This final report represents the culmination of more
than three years work. I would like to thank the family
support groups and individuals who gave evidence to us and
those who have worked with us throughout this period of
time.
"It is our dearest hope that the reports we have
produced over the three years of our existence will have
persuaded them of the seriousness with which their concerns
have been taken and that they may now feel that their
struggle has been satisfactorily concluded."
Professor McLean set out some of the main conclusions of
the final report.
They included:
Authorisation Forms
As drafted forms contain a single authorisation covering
research, medical education, training and audit purposes.
Any consultation on the report should specifically ask for
views on whether families should be able to consider as a
separate issue the question of authorising the research use
of tissue blocks and slides or organs retained at
post-mortem examinations.
All hospital staff who will be involved in seeking
authorisation must be properly trained, and the
authorisation forms should act as a focal point for the
training.
There needs to be greater public awareness of the
hospital post-mortem examination process. The Executive
should explore the possibility of developing an equivalent
of the Teaching Resource Pack which has been produced on
organ donation and transplantation.
Procurator Fiscal Post-Mortem
Examinations
The Crown Office and Procurator Fiscal Service (COPFS)
should some time within the next 12-18 months arrange for
an audit of the effectiveness of the arrangements it has
now put in place for communications with families. The view
of families as users of the service, must be canvassed.
There should be a designated person in each Fiscal's
office with the responsibility for dealing with families,
along the model of the death unit co-ordinator in
Edinburgh.
The Review Group is more convinced than ever of the need
for the appointment of Bereavement Officers, whose duties
should be clearly defined to include speaking to relatives
in cases of death in hospital resulting from medical
mishap.
Past experience suggests that there needs to be closer
liaison between doctors and Fiscals.
Once the tissue blocks and slides derived from a Fiscal
post-mortem examination are no longer needed for the
Fiscal's purposes, families should be given the same
opportunity to authorise their use in the same way, and for
the same purposes, as can be authorised following a
hospital post-mortem examination.
Ethical Review of Research Projects Involving
Human Tissue Retained at Post-Mortem
Examination
Provided the family has not objected, certain research
on organs and tissue retained under past practice (prior to
December 2000) can already be carried out, following
earlier recommendations from the Review Group.
The research must be likely to result in significant
outcomes and must also be non-destructive. Research Ethics
Committees (REC) in such cases should have available to
them a statement from the relevant Trust as to the
"consent" policy which was in place at the time of the
removal of the organs or tissue, and should carefully
scrutinise these to ensure that consent for what is
proposed was indeed obtained.
Once the new authorisation forms are in place the REC
should require all research applications to contain a copy
of the form.