Abstract
This chapter argues that the balancing exercises undertaken between individual interest and public interest in the context of human material procurement are distorted on the basis of unconvincing arguments. It shows different bases for entitlements and makes a clear distinction between live and post-mortem procurement. The destination of the material is also argued to be of pivotal concern: where the material is used to save a life, where it is used to improve a person’s health and wellbeing and where it is used for (potentially commercial) research – all of these scenarios demand different approaches to procurement governance. The text culminates in the proposal of an initial framework for a three-tiered system. Where the procurement is post-mortem and the material to be procured is necessary to save another’s life, it is argued that there is no justification for withholding the material by means of an inter-vivos arrangement and it should be available without consent. Where the material is taken post-mortem and destined to improve another patient’s health or wellbeing, the current system of free and voluntary donation can remain in place with all its limitations. Finally, where the material is taken from a live source and is required for research purposes, the source should be entitled to stipulate conditions (financial or otherwise) for the excision and further use.
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Notes
- 1.
I deliberately make no clear distinction between organs for transplantation and other tissues. Instead, my distinction will centre on whether the material has life-saving potential or not.
- 2.
I will adhere to the donor/donation terminology even though I disagree with the legal implications this has. Technically, a donation is a property transfer. As long as the source of the material is said to have no property interest but is entitled to transfer that non-existent property interest to another, the terminology used is at best incomplete and at worst deliberately inappropriate. James Harris makes this point when he distinguishes between full-blooded ownership and mere property (Harris 1996, 28–29).
- 3.
The classic cases of Moore (793 P 2d 479), Catalona (437 F Supp 2d 985) and Greenberg (264 F Supp 2d 1064) are usually cited here. For a discussion of all three, and the more exotic decision in Yearworth ([2009] EWCA Civ 37), see Hoppe (2009, 107–15).
- 4.
By, for example, making private arrangements for the body to be physically removed before any material can be taken.
- 5.
Directive 2004/23/EC of the European Parliament and of the Council of 31 March 2004 on setting standards of quality and safety for the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells.
- 6.
Moore v. The Regents of the University of California et al. 51 Cal.3d 120 (Supreme Court of California), 9 July 1990.
- 7.
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Acknowledgments
I am very grateful to Jane Kaye, Liam Curren, John William Devine, Naomi Hawkins, Nadja Kannelopoulou and Karen Melham at the Centre for Health, Law and Emerging Technologies at Oxford for their hospitality and stimulation discussions during the drafting of the first versions of this chapter. As ever, all inaccuracies and errors remain my own.
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Hoppe, N. (2011). A Sense of Entitlement: Individual vs. Public Interest in Human Tissue. In: Lenk, C., Sándor, J., Gordijn, B. (eds) Biobanks and Tissue Research. The International Library of Ethics, Law and Technology, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1673-5_4
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