This report is a most comprehensive review of autopsy practice in Ireland and clearly shows that enormous progress has been made over the past ten years. Ms Willis identifies many institutions that are exemplars of best practice.
This progress has been achieved because of the determination of all concerned to work in a positive and collaborative way to ensure that the errors of the past could not be repeated.
We hope that this report will provide some degree of comfort to patients and families that changes for the better can be made and that their active involvement has made a real difference.
While many positives can be taken from the report, it is important for us all to realise that this progress must be sustained and further developed. Perhaps the greatest improvement that has occurred has been a change in the culture of so many organisations – there is now a much greater awareness of and sensitivity to the needs of family members and next of kin.
The Faculty was very supportive of the Madden Report and since its publication in 2006, has striven for continuous improvement. Ms Willis was commissioned by the HSE to carry out, on the specific recommendation of the Madden Report, an independent audit of currently retained organs in all hospitals in the state. The audit, at the request of the HSE, was expanded to include: consent to post-mortem examination; organ removal and retention; storage, use and disposal; facilities for bereaved people; communication with bereaved people; provision of bereavement services and training provided to staff in a range of areas.
The Faculty, in conjunction with the National Cancer Control Programme (NCCP) and the National Hospitals Office (NHO), is currently implementing a National Quality Assurance Programme in Histopathology, including Autopsy. This programme builds on the guidelines issued in 2000 by the Faculty, and will provide national benchmarks in critical areas such as authorisation for post mortem examinations, information for relatives, guidelines for retention of tissue and organs, and guidelines for disposition of tissue and organs.
The Faculty is also engaged with the NHO in relation to developing a Code of Practice for policies, procedures and guidelines in this area.
The Faculty has engaged with the Coroners Society of Ireland, Department of Justice (DOJ) and other stakeholders on this and other matters in the interest of improving practice. (Review of Coroners Services, DOJ 2000; Coroners Rules Committee, DOJ 2001)
A recent Report on Paediatric & Perinatal Pathology Services in Ireland was undertaken by the Faculty and released in June 2009.
The Faculty has been involved in consultation with the Department of Health & Children (DOHC) in relation to the Human Tissue Act and has contributed to the Steering Committee.
Finally, we would like to reaffirm that as the professional body for Pathologists in Ireland, the Faculty is fully supportive of the initiatives that have been taken and continue to be taken in the area of autopsy, consent and organ retention. Autopsy is essential for the purposes of medical education and research and future generations of patients will benefit from knowledge and expertise gained from its practice. However, we as professionals and the system in general, must always place respect for the individual patient and their families at the centre of all we do. Most importantly we must ensure that we continue to listen to patients and the families of the deceased so that we can fulfil our mission of high quality patient care.
For further information please contact:
Annemarie Murphy
Royal College of Physicians of Ireland
Direct : +353 1 863 9728
Mobile : +353 86 845 6646
Main Ph: +353 1 863 9700
annemariemurphy@rcpi.ie
www.rcpi.ie