Re: returning tissue blocks to relatives

From:=?iso-8859-1?q?Steve=20Machin=20UK?= <>

I've seen a few comments from The USA which prompt me to say a few things about
which I fell strongly.
As explained previously, in the UK we are replying to inquiries from relatives
of those who have had post mortem examinations. They are asking us what
material have we removed from the body, what have kept and what happened to the
bits we didn't keep.
The problem was prompted by incidents where relatives, mostly parents realised
that, in some cases, large portions of internal organs were removed and not
returned to the body before funeral.  They didn't realise this would happen
when they signed a consent form.  Some find this very distressing.  Imagine if
your child had died from a terminal illness, had suffered deteriorating health
and pain.  You have spent months hoping that a cure will be found but to no
avail.  You have to sit by and watch your child die. Then, years later, you
find out the body was chopped up and their heart or brain was kept in jar or
burnt in an incinerator as waste.
Some parents are lucky enough to get the tissue back and can dispose of it
respectfuly, others are waiting to find out what was missing from the body.
Some of us profesionals become hardened to the reality of post mortem
examinations but the majority of everyday people are not.
The comments made by some on this site demonstrate insencitivity.
The type and level of emotion felt by the relatives varies greatly.  Some just
don't want to know; they want to put their loss behind them.  Others are
furious that this could happen.  They want ALL the material back; blocks,
slides, fixed tissue, slides cut and sent for a second opinion, everything.  We
have to take this variation into account because its natural.
I understand those who say that blocks and slides are small parts of a body and
that it's unreasonable to believe that they are a significant part of it.  I
also understand that returning post mortem blocks and slides will remove a huge
asset from research but the ratio of inquires from relatives to post mortems is
low.  In my estimation it is about 3% in a childs post mortem and much lower
from adults. If the post mortem consent forms are made clearer and we regain
the confidence of the public, especially convincing them that we will not keep
tissue without consent, we may be able to keep tissue for research.
I have had a few personal emails saying how awful it must be for us in the UK
at the moment.  It is pretty poor just now.  The is a widspread shortage of
staff, especially at the basic grade and consultant pathologist.  The national
pay scale means it is difficult to find staff willing to work in areas which
have high a cost of living.  On top of this the press are having a great time
publishing stories from angry parents saying "they stole my babys heart".
Sorry for the long sob story but I just had to get it off my chest.

Best Wishes
Steve Machin UK

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