Déirdre de Búrca (Green Party)

I congratulate Senator Quinn on his Human Body Organs and Human Tissue Bill 2008. He has taken the opportunity in Private Members' business to advance draft legislation in this House to prompt the Government to accelerate the preparation and enactment of legislation in this area. Judging from other speakers in the House today there is a widespread consensus that such legislation is badly needed. It is to be hoped that the effect of the introduction of Senator Quinn's draft legislation will be to ensure the Government introduces as quickly as possible the necessary legislation in this area.

I congratulate the Senator again because this is bold legislation. It proposes a fundamental change to a system with a presumption in favour of consent to the donation of organs and body parts unless that consent is expressly withheld.

I agree with the sentiments expressed earlier by the Minister of State. Based on practice in Spain and elsewhere, it appears that presumption in favour of consent can and does lead to a much greater level of availability of organs for transplantation. Such a fundamental change would require full consultation with the public and for that reason I withhold my immediate support for the proposition. I support what the Minister of State said about public consultation and having a level of support for that fundamental change. It is a very sensitive area and speakers have highlighted this point earlier. I do not believe it would be fair to introduce legislation containing such a fundamental change without the support of the public. Following a public consultation period, I would be happy, and I believe the Green Party would be happy, to consider legislative change to presumption in favour of consent.

The issue of consent is obviously central to this legislation. In this context consent refers in particular to the removal, retention and disposal of human body organs and human tissue. There have been scandals in this country, specifically the organ retention debacle in which hospitals retained organs of deceased children following post mortems and without the consent of their immediate families. The group, Parents for Justice, has done great work in raising awareness of this issue. The Government set up a non-statutory inquiry, the Dunne inquiry, which was followed by the Madden report in 2006 that outlined a series of recommendations.

Reasons for the removal, retention and disposal of organs and human tissue can vary, ranging from diagnostic purposes, teaching and research and transplantation. What is very helpful in Senator Quinn's draft legislation is the clarification dealing with consent being for "permitted" activities for scheduled purposes. Those kinds of safeguards would be necessary in any legislation because harvesting human organs and tissue is a sensitive issue. Harvesting happens at a time when, typically, people have been recently bereaved and are obviously very emotional and distressed. The circumstances of the death of the deceased person may have been very tragic. It is a difficult time to try to establish consent for a procedure as sensitive as this one and we must have adequate safeguards in place. There is growing public concern about possible trafficking in human body parts and any legislation we may introduce in this area must put safeguards in place to ensure this cannot occur. That would be the greatest fear of many relatives of deceased adults and children. It is possible to imagine a system emerging in which human body parts might be trafficked and we must be very careful that the legislation allows no scope for this to happen.

This Bill touches on a number of important issues, one being the consent of children. It was important to address this issue but I am not sure the Bill has fully resolved some of the dilemmas that would arise in obtaining the consent of children to the harvesting or use of their organs after their death. A young teenager is in a much better position to give informed consent to procedures such as this while a very young child is not. Perhaps some kind of differentiation between categories of children, based on age, might be useful. I would be more comfortable with that.

A helpful part of the Bill concerns qualifying relationships in the context of withholding consent by children and adults. The Bill raises the need for a much greater level of public awareness and education in the area of organ removal and retention. The public must understand to what uses organs are put and there must be much clearer explanation as to the kind of medical research carried out and what some of its possible benefits might be.

We need improved medical education and training in hospitals with a much greater emphasis on communications skills and on the legal and technical issues. Training must be given to personnel in the area of post mortems. One of the reasons the system in Spain is so successful is that there are adequate support services in hospitals for families who find themselves in a position where their consent might be required. We must ensure that if we are to introduce legislation in this area, resources are made available to ensure that proper supports are available.

The issue of disposal of retained organs is very important. The period of retention can often be quite long and we should have very clear protocols around this. The principle of observing the wishes of the family concerning the disposal of organs, and how they should be disposed of, should be established very clearly in any new legislation. There have been difficulties in the past where families have discovered that their children's organs may have been incinerated in the same way that general hospital waste is incinerated. Very often the wishes of families are that these organs would be re-buried with the child's body. While it would be important to establish this principle in any legislation, I wish to conclude by again congratulating Senator Quinn on a timely and welcome item of legislation and by expressing the hope that the Government will follow up with its own legislation as quickly as possible, based on a full public consultation process.