| This
investigation
is
primarily
concerned
with
the
retention
of
brains
for
research
after
post
mortems
ordered
by
the
Coroner,
but
brains
were
also
retained
for
teaching
purposes.
|
|
|
|
| Sources
of
information |
|
|
|
| This
chapter
is
based
on
contemporaneous
records
from
Sheffield
and
Manchester
Universities
and
the
recollections
of
those
involved.
|
|
|
|
History
|
|
|
|
| In
the
1950s
most
medical
students
dissected
the
brain
as
part
of
their
anatomy
course.
For
these
courses
large
numbers
of
brains
were
obtained
from
both
hospital
and
Coroners'
post
mortems.
|
|
|
|
Human
Tissue
Act
1961
|
|
|
|
| Following
the
enactment
of
the
Human
Tissue
Act
in
1961
it
should
have
been
routine
for
relatives
to
be
asked
if
they
had
objections
before
any
brain
was
retained
for
medical
education.
In
order
to
continue
brain
dissection,
some
medical
schools
introduced
post
mortem
consent
forms
that
referred
specifically
to
retention
of
tissues
for
medical
education.
|
|
|
|
The
Medico
Legal
Centre
and
the
Anatomy
Department
of
Sheffield
University
|
|
|
|
| An
incident
at
Sheffield
Medico
Legal
Centre
in
December
1986
brought
the
retention
of
brains
for
medical
education
to
public
notice.
The
following
paragraphs
describe
this
incident
which
was
widely
reported
in
the
local
and
national
media
at
the
time.
A
full
investigation
was
carried
out
by
Sheffield
City
Council,
and
a
debate
in
the
Council
chamber
followed.
This
closed
the
incident.
|
|
|
|
December
1986
|
|
|
|
| Just
before
Christmas
1986,
a
telephone
call
was
received
by
the
manager
of
the
Medico
Legal
Centre
from
the
Department
of
Anatomy
at
Sheffield
University.
|
|
|
|
| The
manager,
who
had
recently
been
appointed,
was
surprised
to
receive
a
request
for
a
further
supply
of
brains
for
teaching
medical
undergraduates.
|
|
|
|
| The
caller
from
the
Anatomy
Department
was
put
through
to
the
Coroner's
Officer,
who
then
informed
the
Coroner,
Dr
Popper,
who
was
concerned
to
know
whether
consent
had
been
given.
|
|
|
|
| The
manager
of
the
Medico
Legal
Centre
also
informed
Sheffield
City
Council
headquarters
as
the
Council
had
responsibility
for
the
Centre
which
serves
as
the
public
mortuary
for
the
whole
city.
|
|
|
|
The
Coroner's
investigation
|
|
|
|
| Dr
Popper
made
immediate
enquiries.
These
revealed
that
in
1983
his
predecessor
as
Coroner,
the
late
Dr
Pilling,
had
agreed
to
the
removal
of
heart
valves
for
transplantation
from
bodies
under
his
jurisdiction
but
only
with
the
written
consent
of
the
relatives
of
the
deceased.
|
|
|
|
| Dr
Pilling
had
also
agreed
that
the
Department
of
Anatomy
could
receive
blocks
of
tissue
to
make
slides
for
teaching
purposes,
but
only
from
those
bodies
for
which
the
relatives
had
given
consent
for
heart
valves
to
be
removed.
|
|
|
|
| At
some
stage
between
1983
and
December
1986
the
terms
of
Dr
Pilling's
agreement
had
been
extended
from
the
supply
of
blocks
and
tissue
for
slides
to
include
whole
brains.
This
had
not
been
Dr
Pilling's
intention.
|
|
|
|
January
1987
|
|
|
|
| Staff
of
Sheffield
City
Council
arranged
a
meeting
on
9
January
to
investigate
'the
apparent
unauthorised
removal
of
organs
during
post
mortems
and
organs
being
sent
to
the
University'.
The
City
Council
were
particularly
concerned
by
the
suggestion
that
mortuary
staff
were
receiving
payments
for
brains
transferred
to
the
Anatomy
Department.
This
was
in
clear
breach
of
the
Council's
policy.
|
|
|
|
| At
that
meeting
Dr
Popper
reminded
those
present
that
'removal
of
human
tissue
may
only
be
done
under
the
provisions
of
the
Human
Tissue
Act'.
|
|
|
|
| Dr
Popper
stated
that,
as
Coroner,
he
was
'not
aware
of
the
removal
of
any
organs
or
tissues,
except
the
heart
valves
which
his
predecessor
had
allowed
to
be
removed
with
the
consent
of
the
relatives.
The
only
other
tissue
or
organs
that
could
be
removed
were
those
required
for
the
purpose
of
establishing
the
cause
of
death'(1).
|
|
|
|
| Professor
Usher,
Professor
of
Forensic
Pathology
at
Sheffield,
is
recorded
as
saying:
'All
practices
are
traditional
and
the
inherited
situation,
which
had
been
long-standing
between
the
Chief
Technician
of
Anatomy
at
Sheffield
University
and
the
Senior
Technician
in
the
Public
Mortuary
…'(1).
|
|
|
|
Action
taken
|
|
|
|
| Dr
Popper
gave
immediate
instructions
that:
'He
would
not
agree
to
the
removal
of
organs
without
consents,
but
would
approve
of
any
agreed
system,
which
could
be
devised
within
the
law'(2).
|
|
|
|
| He
ordered
that
all
transfers
of
brains
should
cease
and
wrote
to
all
pathologists
to
say
that:
'No
tissue
was
to
be
taken
without
consent'.
|
|
|
|
20
January
1987
|
|
|
|
| The
Sheffield
Star
reported
the
brain
transfers
on
the
front
page.
There
was
further
publicity
in
the
national
media.
|
|
|
|
| The
City
Council's
investigation
proceeded.
A
full
report
was
prepared
which
was
submitted
to
and
debated
by
the
City
Council.
|
|
|
|
| Since
January
1987,
Dr
Popper
and
Mr
Dorries,
who
succeeded
him
as
Coroner
for
Sheffield
in
1991,
have
followed
a
policy
that
no
organs
or
tissues
should
be
retained
without
the
consent
of
relatives.
The
only
exception
to
this
rule
is
the
retention
of
those
organs
or
tissues
that
are
needed
for
diagnostic
purposes
and
the
examination
of
which
will
bear
on
the
cause
of
death.
|
|
|
|
| Further
investigations
were
started
to
discover
how
many
brains
from
Coroners'
autopsies
had
been
transferred
from
the
Medico
Legal
Centre
to
the
Anatomy
Department
at
the
University,
and
over
what
period
of
time,
but
this
information
was
not
forthcoming.
|
|
|
|
Wider
implications
|
|
|
|
| When
the
irregular
and
unconsented
transfer
of
brains
from
the
Medico
Legal
Centre
to
the
Department
of
Anatomy
was
discovered,
the
late
Dr
Paul
Mason,
who
was
then
HM
Inspector
of
Anatomy,
was
informed.
On
27
January
1987
Dr
Mason
wrote
to
anatomy
departments
to
tell
them
to
review
the
arrangements
through
which
they
obtained
brains
for
teaching
and
to
ensure
that
these
arrangements
complied
with
the
Human
Tissue
Act.
|
|
|
|
Anatomy
Department
of
Manchester
Medical
School
|
|
|
|
| In
reply
to
Dr
Mason's
letter,
Professor
P
F
Harris,
Professor
of
Anatomy,
drew
attention
to
the
arrangements
he
had
introduced
in
the
1970s.
All
brains
obtained
by
his
department
for
medical
education
were
collected
with
the
consent
of
the
relatives.
|
|
|
|
| Professor
Harris'
letter,
which
by
coincidence
was
written
on
27
February
1987
(the
day
after
Mr
Isaacs'
death),
states:
'We
have
two
sources
of
supply
to
the
Manchester
Medical
School
and
in
both
instances
the
position
is
very
clearly
covered
by
the
wording
on
the
postmortem
declaration
form
which
is
signed
by
a
relative.
Our
established
practice
has
worked
well
over
many
years'.
|
|
|
|
| In
fact,
the
practice
had
been
in
operation
for
the
previous
12
years.
|
|
|
|
| The
post
mortem
declaration
form
includes
the
words:
'I
understand
that
this
examination
is
carried
out
(a)
to
verify
the
cause
of
death
…'
and
'(b)
to
remove
amounts
of
tissue
for
the
treatment
of
other
patients
and
for
medical
education
and
research'.
|
|
|
|
| The
consent
form
clearly
states
that
the
relative
could,
if
they
so
wished,
delete
paragraph
(a)
or
(b).
The
relative's
signature
on
the
form
was
required
to
be
witnessed.
|
|
| The
form
includes
a
further
note:
'A
relative
of
the
deceased
should
not
be
invited
to
sign
this
form
if
the
hospital
is
itself
aware
of
objections
on
the
part
of
other
relatives'.
|
|
|
|
Brains
collected
by
anatomy
departments
|
|
|
|
| I
have
made
enquires
in
other
anatomy
departments
to
see
if
any
records
remain
available
of
brains
collected
for
medical
education.
I
have
not
been
able
to
identify
any
extant
records.
|
|
|
|
|
| A
significant
factor
in
the
ending
of
brain
dissection
by
medical
students
was
the
recognition
in
1992
that
Creutzfeldt
Jacob
disease
could
be
transmitted
by
contact
with
brain
tissue.
A
direct
result
of
this
discovery
was
the
removal
of
brain
dissection
from
the
curriculum
by
those
medical
schools
that
had
maintained
brain
dissection
up
to
that
time.
|
|
|
|
|
Summary
|
|
|
|
| Before
the
Human
Tissue
Act
1961
it
was
common
practice
for
medical
schools
to
obtain
brains
for
teaching
purposes
from
hospital
and
Coroners'
post
mortems.
|
|
|
|
| The
use
of
brains
in
medical
education
continued
largely
unchanged
through
the
1960s
but
thereafter
diminished,
although
in
some
locations
brain
dissection
continued
until
the
early
1990s.
|
|
|
|
| In
the
1970s
Manchester
University
Medical
School
introduced
a
consent
form
for
tissue
retention
for
research
and
education,
for
relatives
to
sign.
Though
not
explicit,
the
form
was
considered
as
providing
consent
for
brain
retention.
No
brains
were
accepted
for
teaching
purposes
in
Manchester
unless
this
consent
form
had
been
signed.
|
|
|
|
| The
incident
at
the
Medico
Legal
Centre
in
Sheffield
in
December
1986
showed
that
brain
retention
for
medical
education
was
continuing
without
the
knowledge
or
consent
of
the
relatives
and
outwith
the
requirements
of
the
law.
|
|
|
|
| Steps
were
taken
by
HM
Inspector
of
Anatomy
in
1987
to
remind
all
anatomy
departments
that
brains
(and
other
organs)
must
not
be
used
for
teaching
purposes
without
the
consent
of
the
relatives.
|
|
|
|
| Anatomy
departments
are
required
by
the
Anatomy
Regulations
1988
to
keep
records
of
the
body
parts
they
hold.
The
records
of
individual
brains
now
held
in
anatomy
departments
in
England
do
not
identify
the
deceased
or
when
and
where
the
brain
was
retained.
|
|
|
|
| References |
|
|
|
| 1. Records
of
the
Medico
Legal
Centre. |
|
| 2. Records
provided
by
Dr
Popper.
|
|
