Audit of organ retention and post-mortem practices in Irish hospitals points to deficiencies in clinical and corporate governance

The Health Service Executive (HSE) in Ireland has published two reports relating to retained organs and post-mortem practices in Irish hospitals.

The first is an independent national audit of retained organs and post-mortem practices in Irish hospitals. Organs or tissues are sometimes removed and retained as part of a post-mortem examination, primarily to allow for analysis of the cause of death. In hospital post-mortem services, this follows a detailed information and consent process with families. Consent processes underwent significant change and improvement following public outrage in 1999 and 2000 about post-mortem and organ retention practices in the UK and in Ireland.

The national audit was led by Ms. Michaela Willis MBE, a former member of the Human Tissue Authority in the UK and former member of the Retained Organs Commission, which previously oversaw similar audits in England. Ms Willis conducted an independent audit of currently retained organs in the State both pre and post 2000 to assist the HSE in identifying areas of good practice and highlighting areas for improvement.

The audit found many examples of good practice in clinical governance relating to post-mortem services. In the course of the audit, however, specific issues arose at the Rotunda Hospital, Dublin, which required a separate investigation and report. This was undertaken on behalf of the HSE by a team chaired by Mr. Ian Carter, Chief Executive, St. James’s Hospital.

The Carter report found a range of issues at the hospital, which included weakness in consent policy and documentation, variations between the terms of the consent given by families and the post-mortems carried out, delays in carrying out examinations and delays in implementing family instructions for respectful burial of organs or tissues.

The report found that the issues at the hospital arose from individual professional practice, poor post-mortem systems and processes and weak management and governance oversight.

The Board of the Rotunda have assured the HSE that the clinical and corporate governance of post-mortem practice have been significantly strengthened in response to the investigation.

Download the audit and Carter reports here.

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