The Redfern Inquiry: the latest investigation into the removal and retention of human tissue

31 December 2010 by Matthew Hill

November saw the publication of the report of the Redfern Inquiry into human tissue analysis in UK nuclear facilities (read the report, here).

The inquiry was the latest in a number of investigations looking at the post mortem removal, retention and disposal of human body parts by medical and other bodies, and the extent to which the families of the deceased knew of and consented to such practices. The Inquiry chairman, Michael Redfern QC, also chaired the Royal Liverpool Children’s Hospital (Alder Hay) Inquiry.

The Redfern Inquiry, which was established in the spring of 2007, examined a number of institutions that were involved in, or had some knowledge of, the analysis of human body parts as part of scientific studies into the health effects of radiation from the 1950s to the early 1990s. Initially, the investigation concerned the activities of the United Kingdom Atomic Energy Authority and its successor body, British Nuclear Fuels Limited (BNFL), in respect of tissue taken from its own employees. However, following the expansion of its terms of reference, the practices of a number of other organisations – including the National Radiological Protection Board, the Atomic Weapons Establishment and the Medical Research Council – were included within the scope of the Inquiry. Also considered were the actions of the individual pathologists and coroners who were involved in authorising and conducting the post-mortem examinations from which the body parts were harvested.

The Inquiry’s findings (available at pp.570-583) deserve to be read as a whole and, given the breadth of time and institutions concerned, they are not easily summarised. The report is critical of the failure by many involved to have proper regard to the ethical and legal issues arising from the removal and retention of organs without the knowledge or consent of the deceased or his or her family.

The range of those criticised for this failing – eminent scientists and pathologists, some of the companies and institutions that employed them, several coroners and (in one instance, to which there were some mitigating circumstances) a solicitor acting for the family of a dead worker – provide evidence of a culture in which the principles of consent and autonomy and the relevant legal framework were insufficiently prominent. This impression is furthered by the Inquiry’s finding that the impugned practices did not arise from covert and concealed actions. The results of the research obtained were published openly, and there is no suggestion that those involved considered their actions to be untoward. The report reveals complacency rather than conspiracy.

It is perhaps slightly surprising that the report did not generate greater publicity and controversy. This seems to be because the events took place decades ago – the last investigated post-mortem was in 1991, and the last analysis in 1993. Since then, legislation, education and publicity have altered the environment in which organ removal takes place. The previous cultural failings have, it seems, largely been rectified.

The Inquiry itself is a product of this change in attitudes; it owed its existence to concerns about past practices raised by BNFL’s Company Chief Medical Officer, Dr David Macgregor (who was praised in the report for acting in accordance with the highest standards of his profession).

Given this cultural shift, some may question the need for the Redfern Inquiry. While it is easy to be critical of expensive, time-consuming public inquiries, in this area they have played a significant role in identifying past failings, improving legislation and regulation, and contributing to the way in which the individuals and bodies involved approach their work.

Although many of the relevant changes took place before the Redfern Inquiry began, its findings and recommendations provide a reminder of the importance of regularly monitoring and appraising existing practices as a way of preventing abuses from occurring or continuing.

This message is particularly timely in respect of coronial standards. The report criticises several coroners for failing properly to oversee the post mortems that they authorised, and for becoming too close to BNFL’s medical officers. One striking example is that BNFL was asked to prepare expert reports that were used at inquests to determine whether or not it had caused its own employees’ deaths, despite the obvious conflict of interest involved.

Some of the Inquiry’s main recommendations concerned the appointment, training and monitoring of coroners. As is recorded in a footnote, it was envisaged when these recommendations were made that these issues should fall within the remit of the Chief Coroner, a post that has subsequently been burnt on the bonfire of quangos. It is not yet clear what, if anything will emerge to take its place.

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