Abstract
The use of human tissue raises ethical issues of great concern to health care professionals, biomedical researchers, ethics committees, tissue banks and policy makers because of the heightened importance given to informed consent and patient autonomy. The debate has been intensified by high profile scandals such as the “baby hearts” debacle and revelations about the retention of human brains in neuropathology laboratories worldwide. Respect for patient’s rights seems, however, to impede research and development of clinical knowledge in contemporary health care. The Common clinical endeavour argument and a Presumption for beneficial use argument suggest that the use of tissues for research and teaching in contemporary health care can respect patients and their values in multicultural communities where there are provisions for oversight and for opting not to contribute, both of which should respect the diverse views of different ethnic or cultural groups.
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Notes
It has been argue that, given the shortage of organs, we should have an “opt-out” system: individuals can indicate their wish not to donate, and that wish would be respected; but otherwise, eligibility for tissue or organ donation is assumed. There is an extensive literature devoted to this topic but the arguments clustered around it are beyond the scope of the present discussion. The arguments are related to those surrounding the use of tissue, but significant post-mortem organ donation is a major intrusion into a dead body which would be presumed to be of material concern to the person themselves and their living relatives so that robust consent seems to be required (even though we may want to give a special status to the person’s pre-mortem wish to be a donor).
I have argued elsewhere that this can be managed at the coal face by the approach to families of health care professionals involved conveying firmly that the expected thing is to do what the person wished unless the family has some powerful reasons why that should not be done.
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Gillett, G. The Use of Human Tissue. Bioethical Inquiry 4, 119–127 (2007). https://doi.org/10.1007/s11673-007-9057-2
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DOI: https://doi.org/10.1007/s11673-007-9057-2