BMA issues organ guidance

Permission is needed to retain organs

The British Medical Association has told doctors to be more aware of relatives' feelings when asking to keep body tissues.

The guidance comes in response to revelations that hospitals around the country were either not fully asking relatives for permission, or not explaining what was happening.

However, relatives of patients whose organs have been retained have said the guidance will be worthless unless it is given the force of law.

Today our patients rightly expect that doctors will be completely open with them

Dr Michael Wilks, BMA

At Alder Hey hospital in Liverpool, hundreds of families were unaware that brains, hearts, and other organs had been retained from the bodies of children and babies who died after surgery.

The practise of retaining organs first came to prominence during the public inquiry into the deaths of babies with heart disease at the Bristol Royal Infirmary.

The new guidelines set down how doctors should seek permission for a post-mortem examination and consent for organs and tissue to be retained for teaching and research.

They state that doctors should be much more frank with relatives about the reason for post-mortem examinations.

The Royal College of Pathologists - which sets official standards for the doctors who carry out post-mortems - has already introduced its own guidance on this issue.

The BMA rules have been drawn up in consultation with the Department of Health and the government's Chief Medical Officer, Professor Sir Liam Donaldson.

Professor Donaldson is bringing out his own guidelines on the issue shortly.

The BMA guidance stresses that relatives should always be properly consulted, even if official consent is not required.

In many places, the permission to remove tissues is combined with the permission to operate on the same consent form to be signed either by the patient or, if a child, the parents.

'Times have changed'

Dr Michael Wilks, chairman of the BMA's Medical Ethics Committee, said: "I have spoken to parents whose [children's] organs were kept without their knowledge and, despite their anger and distress, they all support the continuation of research which could help future patients.

"They simply want to be fully informed and treated with care and respect.

We are told that doctors would be disciplined if they do not adhere to them, but I don't necessarily accept that

Ed Bradley, Alder Hey families' support group

"Times have changed. Today our patients rightly expect that doctors will be completely open with them.

"The desire to protect relatives from distress is an understandable motive, but nowadays that must be achieved by talking to people with sensitivity, not by avoiding the issue, and certainly not by acting without consent."

Ed Bradley, of Alder Hey families' support group Pity2, said he was concerned that doctors would ignore the guidelines and called for them to be enshrined in law.

He said: "We welcome what is in the guidelines, they are frank and clear and it is an improvement. But that is all they are - guidelines.

"We are told that doctors would be disciplined if they do not adhere to them, but I don't necessarily accept that.

"The only way would be to have them introduced under an act of parliament, so they become law. Otherwise they are worthless."