No consent should be needed for using leftover body material for scientific purposesForAgainst

doi:10.1136/bmj.325.7365.648

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Papers p 634

In Britain the Alder Hey scandal brought to public attention the fact that body material left over after diagnostic procedures may be used for teaching and research—usually without the patient's consent. Paul van Diest argues that, Alder Hey apart, this practice has not caused protest, mainly because the alternative would be to discard the material. He argues that self determination is not an overriding principle in the case of material that is otherwise thrown away. Julian Savulescu, however, cites cases where patients have felt “used” when their tissue has been kept without their consent. He argues that the best way to retain tissue for research is through educating and encouraging people to donate their redundant tissues, not by taking them without their knowledge

For

Paul J van Diest (pj.vandiest@vumc.nl), professor of oncological pathology

Department of Pathology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, Netherlands
University of Oxford, Oxford OX1 3LZ

During diagnostic procedures larger samples of body fluids and tissues are usually collected than strictly necessary for primary testing, “just in case.” The big advantage is, of course, that the patient does not need to be bothered if further testing is required. Furthermore, therapeutic surgical procedures usually yield large samples from which only a part is needed for diagnostic confirmation. All this leads to a vast volume of leftover samples, which are usually stored in laboratories for a period to serve the direct interest of the patient. Consent for this use is implicit in the consent obtained from patients for the diagnosis and treatment of their disease.

However, when the current disease period has ended a dilemma emerges with regard to this leftover body material: to discard or to keep? To discard saves costs and space, but to keep the material has many advantages, not least for patients themselves. During the course of a disease the pathologist often has to return to such material for additional or new diagnostic procedures or prognostic tests. This …