Thematic report on organ retention

This is the 20th thematic report of the Inspectorate of Prosecution in Scotland. It deals with the particularly sensitive and emotional issue of organ retention. The distress caused to bereaved relatives who learn that a family member was buried or cremated without a significant organ cannot be overstated.

The public must have confidence that the examination of a body after death is conducted in a respectful manner and the nearest relatives are informed if an organ or significant body part has to be retained and of the reasons for the retention.

The importance of liaising with nearest relatives in an appropriate and timely manner and ensuring that post-mortem examinations are dealt with professionally and sensitively has been embedded in internal Crown Office and the Procurator Fiscal Service (COPFS) guidance on the investigation of deaths and organ retention for a number of years and was revised following the implementation of the Human Tissue (Scotland) Act 2006. The guidance not only addressed legal obligations but ethical and emotional considerations.

There was, therefore, concern when it emerged that an organ had been retained without the nearest relatives being informed. The Lord Advocate instructed a national audit to ascertain if there were any other cases where COPFS procedures had not been followed. A review of the procedures and processes relating to organ retention was also undertaken.

The audit identified six cases between 2007 and 2012 where the nearest relatives had not been made aware that an organ had been retained for further examination at the conclusion of a post-mortem examination instructed by the Procurator Fiscal. It also identified a further 10 cases where the nearest relatives had been advised that an organ had been retained but their views on the steps they wished to be taken once such retention was no longer required had not been obtained. In all of the cases identified, COPFS has made contact with the nearest relatives and sought their views on the burial or cremation of the organs.

Recognising the distress caused if a nearest relative was not informed that an organ had been retained, the Lord Advocate also commissioned the Inspectorate of Prosecution (IPS) to undertake an independent review of COPFS procedures and systems. The purpose of the review was to identify any weaknesses in the systems governing organ retention and make recommendations that would provide assurance that the procedures implemented by COPFS are professional, effective, sensitive and critically that they provide sufficient safeguards to prevent any further instances of nearest relatives not being informed of organ retention following a post-mortem authorised by the Procurator Fiscal.

This report makes a range of recommendations designed to achieve that over-arching aim.

During the review it was evident that there was a commitment from all parties involved in the investigation of deaths, to deliver an effective and coherent system governing organ retention, and to provide the public with confidence that their deceased relative will be dealt with respectfully and that they will always be informed if an organ has to be retained.

To ensure that the system of organ retention is robust and working effectively, IPS will undertake an audit and test the procedures six and 12 months after the publication of this report.

Michelle Macleod
HM Chief Inspector