Consent conundrum cripples coroner CJD census - August 19, 2009
Potentially vital information on the prevalence of Creutzfeldt-Jakob Disease in the UK is still not being collected, as coroners believe they are unable to test for it.
In a story now getting wide pickup, the BBC this morning reported that coroners are refusing to routinely test for CJD during post mortems, arguing that their job is only to discover the cause of death and not to collect such data.
The government wants routine tests but Michael Powers, a coroners’ law expert, told the Today programme, “This is a function which is outside the coroner’s statutory authority, because they are not – those tests – directed to ascertaining the [cause of] death in an individual case. If you step outside the coroner’s authority different considerations apply, most particularly of course consent.”
To date there have been 168 ‘definite and probable’ cases of vCJD in the UK, according to the Spongiform Encephalopathy Advisory Committee (pdf).
John Collinge, of University College London, told Today, “There is a concern that what we’ve seen so far may be the first wave … and that there may be more people silently infected in the community than the number of clinical cases would suggest.”
Powers said he would welcome a change to the law to enable testing and the Department of Health is running a pilot project to obtain samples from post-mortem examinations later this year (Daily Mail).
The issue is not entirely a new one however. In February last year the Guardian reported on the same issue, and was told by coroners’ society secretary André Rebello that “Coroners want to avoid any misapprehension that they might be ordering a post-mortem examination for access to research material rather than our statutory function ... Even if this was not inappropriate, coroners have neither the resources nor the time to be involved."
Posted by Daniel Cressey on August 19, 2009
I am a Pathologist and HTA designated individual for my trust. To retain tissue not part of the investigation into the cause of death without explicit consent from relatives would a. be beyond the authority of the Coroner to request and b. be illegal under the Human Tissue act 2004 .
Posted by: Dr Steve Milkins August 19, 2009 05:08 PM
>>> a. be beyond the authority of the Coroner to request and b. be illegal under the Human Tissue act 2004
poor excuse considering the monumental importance of finding out just how many have become exposed to TSE, to help combat further exposure and needless death via the friendly fire and or pass it forward routes.
if that's the case, the human tissue act of 2004 must be revised asap, and the authority of the coroner revised. this is a cop out. just more of the same political bureaucracy, the same that's been going on since 1985 when blood would never transmit cjd, until it did, in the nvCJD, and we know sCJD transmits via many different tissues. Dr. Collinge is very much correct in his assessment of the first wave, and the second wave may not come in the form of the nvCJD only phenotype.
also, it's very odd, here in TEXAS, after 4 hours, a medical examiner can donate tissue without _any_ consent what-so-ever $$$
and then there is another statute to back that statute up, that would exonerate them of any litigation there from.
(c) If a person listed in Section 693.004 cannot be identified and contacted within four hours after death is pronounced and the medical examiner determines that no reasonable likelihood exists that a person can be identified and contacted during the four-hour period, the medical examiner may permit the removal of a nonvisceral organ or tissue.