title: Informed consent should be obtained from patients to use products (skin substitutes) and dressings containing biological material.
abstract: BACKGROUND
  Biological products (tissue engineered skin, allograft and xenograft, and biological dressings) are widely used in the treatment of burns, chronic wounds, and other forms of acute injury. However, the religious and ethical issues, including consent, arising from their use have never been addressed in the medical literature.
  
  
  OBJECTIVE
  This study was aimed to ascertain the views of religious leaders about the acceptability of biological products and to evaluate awareness among healthcare professionals about their constituents.
  
  
  METHODS
  The religious groups that make up about 75% of the United Kingdom population were identified and a questionnaire on 11 biological products was sent to its leaders. Another questionnaire concerning 17 products (11 biological and 6 synthetic dressings) was sent to 100 healthcare professionals working in seven specialist units in the UK.
  
  
  RESULTS
  All religious leaders (100% response rate) replied, some after consultation with international bodies. Among them, 77% said that patients should be informed of the constituents of the biological products and consent obtained. Some leaders expressed concerns about particular products including the transmission of viral and prion diseases, cruelty to animals, and material derived from neonates. None of the healthcare professionals (73% response rate) surveyed knew the constituents of all the products correctly.
  
  
  CONCLUSIONS
  Ignoring religious sensitivities and neglecting consent in the usage of biological products could have very serious implications, including litigation. Hospitals and manufacturers should take immediate measures to enlighten healthcare professionals of the constituents of these products so that they can obtain informed consent from patients.
authors.affiliation: Department of Plastic Surgery, University Hospitals of South Manchester, UK. enochstuart@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Enoch
authors.forename: H
authors.initials: H
authors.lastname: Shaaban
authors.forename: K W
authors.initials: KW
authors.lastname: Dunn
mesh_terms: D001294:Attitude to Health; D001458:Bandages; D001672:Biocompatible Materials; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D012068:Religion and Medicine; D017768:Skin, Artificial; D006113:United Kingdom
chemical_list: D001672:Biocompatible Materials