Returning to the Alder Hey report and its reporting: addressing confusions and improving inquiries

• Published in: Journal of medical ethics Vol. 30; no. 5; pp. 463 - 469
• Main Authors: Dewar, S, Boddington, P
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Institute of Medical Ethics 01.10.2004; BMJ Publishing Group; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Advisory Committees; Alder Hey report; Anatomy; autonomy; Bioethics; Body tissues; Child; Children; Children & youth; Cholera; consent; Culture; Deafness; Deception; Families & family life; Fantasy; Fear; Genetic screening; Government Publications as Topic; Hospitals; Human Body; Human organs; Humans; Informed Consent; Law, Ethics and Medicine; Medical ethics; Medical genetics; Moral judgment; organ retention; Parents - psychology; post mortems; Postmortem changes; Presumed Consent - ethics; Professional ethics; Professionals; Public Policy; Respect; respect for the dead; Retention; Scandals; Scientific Misconduct - ethics; Tissue and Organ Procurement - ethics; Traditions; United Kingdom; Value of Life; Health Care and Public Health
• ISSN: 0306-6800; 1473-4257
• DOI: 10.1136/jme.2002.002774

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.