What Doctors Have Taken for Granted; with Medical Ethics Currently at the Centre of a Furious Debate, Jason Beattie Looks at the Reasons for Organ Removal, and Mel Hunter, below, Examines How Parents Are Dealt With
Beattie, Jason, Hunter, Mel, The Birmingham Post (England)
Like most professions, there is a side to medical practice which we would rather not think about. We know it exists: the rows of glass containers with body parts preserved in formaldehyde, the medical students who learn their trade using corpses donated by some unsuspecting well-wisher for research purposes.
For most of the time we banish such gruesome images to the back of our minds, content there are some realities which are best kept from the public arena.
Then we read about the cases emerging from Birmingham Children's Hospital and shudder with horror.
The Hospital has admitted taking 1,500 hearts from children over a 35-year period. An unspecified number of other organs, including brains and lungs, had also been removed.
The images, already macabre, are now sickening to comprehend: a doctor has performed an autopsy on a child less than a month old and removed the heart and brain.
The baby would have been placed on a slab, doused in iodine and cut open with a scalpel.
Once removed, his or her organs would have been prodded, swabbed and possibly diced up. The parts would then be pickled in a Perspex jar to be placed on a hospital shelf in a dimly-lit repository, tagged and filed for future reference.
For the parents, many of whom were ignorant of what has happened to their child, this truth must be unbearable.
For the doctors it must have been difficult to balance their professional responsibility with their duty towards the feelings of the patient's family.
There will be many who must wonder whether such practices are necessary given the emotional impact it will have on the families.
According to guidelines recently published by the Royal College of Pathologists there are several reasons for retaining tissues (which in practice usually means body parts). These include diagnosis, research and teaching.
The most common is diagnosis. A consultant may ask relatives for permission to conduct a post mortem so he can understand better what killed the patient.
Without such diagnosis, which on occasions amounts to an opportunity to learn from your mistakes, doctors may not be able to build up the knowledge which can prevent future suffering.
The same reasoning may be applied to research and training.
One of the problems which the medical profession has faced is how much of a body should be fixated (removed) to contribute to the sum of knowledge.
In cot death, for instance, which can be caused by failures in any of several organs, the removal of a large number of body parts is often justified.
The Royal College of Pathologists' guidelines argue limited post-mortem examination is no substitute for a full post-mortem.
While it suggests clinicians should be 'flexible' in respecting the wishes of relatives, 'they (the relatives) should understand that valuable information may be lost and the results may be inconclusive.'
It continues: 'In seeking consent for a post-mortem examination or the retention of tissue, there is a duty to provide all relevant information to relatives which might influence their decision. …