Times change and, with them, practices, perceptions and procedures. It is important that this truism be borne in mind as communities try to come to terms with the recent revelations that tissues and organs have been retained in hospitals following postmortem examinations on loved ones. There is scarcely a medical school or teaching hospital in the world which does not have an anatomy department or a pathology department in which shelf upon shelf is filled with specimens of both healthy and diseased organs preserved in glass containers, used for the edification and academic examination of students. There is scarcely a research institution which does not have specimens of human tissue stored for the purpose of discovering the causes and effects of human disease and disorder.
Much of this vast bank of human tissue has been harvested from post-mortem examinations conducted through the 19th and 20th centuries, and earlier, by doctors intent on finding out more about the conditions that might affect patients so that better and more effective means of treating and managing diseases could be found. Much of it was harvested when the medical profession was more authoritarian and more paternalistic even than it is now, and it is likely that most of it was harvested without the consent of the patients or their next of kin. Yet its contribution to the advancement of medical care for sick people cannot be gainsaid.
This is not to try to set aside the sense of hurt experienced by to-day's patients and parents of babies who have learned in recent months of the removal, without their consent, of organs and tissues from either adult relatives or infant or still-born children. It is to try to outline the historical context from which today's society is only now emerging. The very concept of "informed consent" has emerged only in the past few decades and has come with remarkable rapidity to be not only accepted but expected in all medical transactions, including the matter of postmortem examinations.
There is every reason to proceed with the public inquiry to be set up by the Minister for Health, Mr Martin. If the Minister is right about the fact that the inquiry need not be statutorily established, so much the better. There is an amount of reconciliation to be achieved between those have been hurt and those who have acted without consent. An educative effort to demonstrate the need to continue exhaustive postmortems for the benefit of both doctors and patients is essential. The article in today's editions by Professor Ciaran O'Boyle of the Psychology Department in the Royal College of Surgeons in Ireland might even be made compulsory reading for all parties to bridge that gap between fact-finding and fraught feelings which clearly must inform the hearings.