Returning to the Alder Hey report and its reporting: addressing confusions and improving inquiries.
The Royal Liverpool Children's Inquiry investigated the circumstances leading to the removal, retention, and disposal of human tissue, including children's organs, at the Royal Liverpool Children's NHS Trust (the Alder Hey Hospital). It recommended changes to procedures for obtaining consent for postmortems and retaining organs and tissues for research or education. However, the report contains five areas of confusion. Firstly, it allowed the cultural and historical traditions of horror over the use and misuse of body parts to suffuse the logical analysis of past wrongs and future rights. Secondly, it makes an inappropriate conflation between seeking redress for past wrongs and shaping future policy. Thirdly, the report takes a muddled stance over the value of bodily integrity at burial. Fourthly, the report is inconsistent over the justification for future organ and tissue collections. Fifthly, the notion of "respect" is used with troublesome looseness. The extent to which subsequent policy work has furthered the search for greater ethical clarity over these difficult issues is discussed, together with reflection on three particular improvements that could be made to the process of such an inquiry.
Dewar
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King's Fund, London, UK. sdewar@kehf.org.uk
Boddington
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D026683:Advisory Committees; D002648:Child; D003469:Culture; D008192:Deception; D005201:Fantasy; D006079:Government Publications as Topic; D018594:Human Body; D006801:Humans; D007258:Informed Consent; D010290:Parents / Q000523:psychology; D019724:Presumed Consent / Q000941:ethics; D011640:Public Policy; D015871:Scientific Misconduct / Q000941:ethics; D009927:Tissue and Organ Procurement / Q000941:ethics*; D006113:United Kingdom; D026712:Value of Life