§ Mr. Blenkinsopasked the Minister of Health what were the conclusions of the recent conference on transplantation of organs; and whether he intends to introduce legislation to amend the Human Tissue Act.
§ Mr. K. RobinsonI have received a report on the conclusions of the conference, which is reproduced below. These conclusions, which seem right to me, are being communicated to hospital medical staff concerned. The conference wished to meet again to consider the safeguards which would be needed, in any amendment of the Act, for people who would object to the removal of organs from their own bodies after death or from those of their close relatives. I intend to await the outcome of this further meeting before reaching a view on the need for legislation and the form it might take.
Conference on the Transplantation of Organs
Conclusions of the Meeting held on 6th March, 1968
1. The practitioners engaged in kidney transplantation explained that this work is now being held up by the difficulty of obtaining sufficient cadaver kidneys. This was partly because of the difficulty of making the necessary inquiries of relatives in the time available, partly because of lack of co-operation from medical colleagues in charge of potential donors before death on whom the task of making such inquiries would fall. They would like the Human Tissue Act to be amended to dispense with the need for inquiries of the 217W relatives, leaving it to objectors to make their views known in advance.
2. It was pointed out that the removal of organs after death can oscure signs of forensic importance. Recognising that it would not always be possible to consult the coroner or procurator-fiscal in advance of removal, a coroner might be prepared to allow organs to be removed provided that the surgeon effecting removal would undertake to note and report any such signs. The conference endorsed the importance of co-operation between surgeons and coroners of procurators-fiscal in this respect.
3. The conference recognised that the public, and nurses also, were uneasy about the possibility that organs might be removed prematurely. The conference agreed that no attempt should be made to lay down a legal definition of death or rules which doctors should observe in reaching what must be a clinical decision; but that to allay disquiet vital organs should not be removed until spontaneous vital functions had ceased and two doctors, each independent of the transplantation team and one of them being at least five years qualified, had certified that this condition was irreversible. It was moreover essential that the doctors concerned should explain the matter adequately to the nursing staff concerned, especially in those cases where the patient's vital functions were being maintained by artificial means.
4. The conference accepted that in the absence of cadaver kidneys the taking of single kidneys from living donors might still be justifiable but emphasised that there were special consideration affecting young persons under 18 which made it especially difficult to ensure that consent was free from outside influence.
5. The conference accepted that Section 1(2) of the Human Tissue Act restricts the availability of donor organs to an extent which prevents the treatment of patients who will otherwise die. But the conference recognised that there are people, including the members of certain religious groups, who would object to the removal of organs from their own bodies after death or from those of their close relatives. The conference did not reach firm conclusions on the safeguards which would be required for these people, and wished to meet again to consider them.