Humane Research: Human Tissue - The Neglected Resource
Few aspects of contemporary science are more obscene than the destruction of hundreds of thousands of animals every year simply so that their tissues can be used in research programmes, when an inexhaustible quantity of human material is currently being destroyed. Unlike the nearly three million animals subjected to painful procedures under the 1986 Animals (Scientific Procedures) Act, these 'body part animals' do not show up in any official statistics. They are science's forgotten victims.
Human tissue, as this report points out, produces more reliable results and without the suffering. It can be donated by patients undergoing biopsy or surgery. Or arrangements can be made for samples to be put to use after a person's death.
Animal Aid has been promoting the use of human tissue for medical research since 1991 when we launched our Humane Research Donor Card (HRDC). Those carrying the card signify that they are willing, after their death, for part or all of their body to be used for research. More than 400,000 cards have been distributed to the general public.
In another demonstration of popular support we were recently able to present a 200,000-signature petition to Health Secretary Frank Dobson, endorsing our call for the use of donated human tissue. The petition signatories also urged the government to 'establish and co-ordinate a national network of human tissue banks to overcome the shortage of suitable human material'.
This new report, Human Tissue: the neglected resource, hardens our case further.
At its core are the results of a survey of hospitals, drug companies and research institutes across the UK. We were looking to answer two main questions. Firstly, how can the supply of and demand for human tissue be married up? And secondly, how much support is there amongst these professional respondents for a new Department of Health donor card, one that allows carriers to consent to their organs being made available for transplantation, or to their tissues used for medical research, or to both?
The responses more than vindicate our long-held view: that it is mainly the lack of a proper, government-supported network that has hampered the switch from animal to human tissue. Equally, there was strong support for a joint donor card of the type described above.
Also in our report is a comprehensive picture of the wasteful animal tissue research that's going on around the country, with labs named and typical experiments described. The pro- and anti-vivisection arguments often get hopelessly entangled in competing views about good and bad science, and about what constitutes moral behaviour. But even by the pro- animal experimenters' own criteria, it makes no sense to breed and kill so many animals each year for tissue research when an alternative exists that can actually be trusted.
In laboratories throughout the land, animals are killed simply to provide parts of their bodies for research.
Scientists use the tissues to investigate disease, learn how the body works, and develop and test new drugs. Although the number of animals is thought to be substantial, most do not appear in any official statistics. Furthermore, the slaughter is unnecessary for there is an obvious alternative - human tissue. This can be obtained from healthy volunteers, biopsies, surgical operations (where waste tissue would normally be thrown away) and postmortem samples.
In this report we estimate how many animals are killed as tissue 'donors' and examine published reports to see how these animals are exploited by academic and industrial laboratories. Scientists usually cite lack of availability of human tissue as the chief obstacle to its more widespread use, and we reveal survey findings from hospitals and research institutes, carried out to understand and find solutions to the problem of tissue supply. Finally, we look at other incentives which would accelerate the switch to human tissue.
Summary of findings
Every year in Britain an estimated 400,000 animals are bred and killed simply to provide parts of their bodies for research. Specific examples from 30 laboratories are listed. The experiments are funded by the Medical Research Council, medical research charities, drug companies and government departments.
These animals could be saved if only scientists switched to using human tissue for their experiments.
Human tissue research has the added advantage that results are directly relevant to human medicine, unlike experiments on animals where there is always the risk of misleading predictions. Despite this, most laboratories report that less than 20% of their tissue studies utilise human material.
Most laboratories say their use of human tissue is limited by availability. Sources of human tissue include surgical waste and tissue donation after death, and some laboratories have working contacts with hospitals to obtain supplies. However, many hospitals have no such facilities in place, nor is it clear who potential donors should contact for advice.
Most research laboratories are in favour of a nationally co-ordinated system of collection, storage and distribution of human tissue for research, as there is for transplant purposes.
The great majority of hospitals and research laboratories support the idea of a new, single donor card introduced by the Department of Health, giving people the option of leaving body tissues for transplantation and/or research.
Conclusions and recommendations
by Dr Robert Sharpe, Scientific Consultant
It is a poor reflection on the scientific community that every year hundreds of thousands of animals die as tissue donors when an inexhaustible quantity of human material is thrown away. It is not only the destruction of animals which is to be condemned. The overwhelming advantage of human tissue is its relevance and so the continued use of animals must be regarded as bad science. Yet for the majority of laboratories answering our survey, use of human tissue for in vitro studies was the exception rather than the rule.
Most laboratories say that research with human tissue is limited by availability, and certainly many hospitals do not have the facilities in place to collect, process, store and distribute human material. Although there are some specialised tissue banks, there is no national infrastructure as there is when human organs are needed for transplantation. Furthermore there seems confusion about who potential donors should contact for advice on leaving body tissues for research, with some hospitals having no protocol in place at all. Individual researchers and laboratories have to make strenuous efforts to forge links with hospital staff to secure the necessary supplies, which may be irregular. In such circumstances many scientists obviously feel it is easier to use animals, who can be manipulated as required and killed when convenient.
These problems could be remedied by establishing a nationally co-ordinated system of collection, storage and distribution of human tissue for research, an idea that received widespread, majority support from research laboratories responding to our survey. Such a process should be accompanied by guidelines to hospitals to ensure that potential donors are offered consistent and positive advice, so they are not deterred from leaving body tissues for research.
Another option, also supported by a large majority of research laboratories and hospitals in our survey, is to introduce a new donor card giving people the choice of leaving body tissues for transplantation and/or research. This would give human tissue researchers access to the same efficient system which deals with organs for transplant.
Although responsibility for such action lies with the Department of Health, much could be done by funding organisations and the Home Office to promote human tissue as an alternative to animal experiments. The Medical Research Council, medical research charities and other funding agencies should give preference to human rather than animal tissue for in vitro experiments. In the competitive search for grants, this would soon switch the emphasis to human tissue. In addition, the government's Animal Procedures Committee should institute a wide-ranging enquiry into the potential of human tissue as a humane alternative.
The number of animals bred and killed as tissue 'donors' should in future feature in published government statistics.
Above all, the switch to human tissue will depend upon a real desire by the scientific community to stop killing animals.
Sources of donated human tissue
Human tissue can be removed from living persons in the course of medical treatment, from healthy volunteers and from cadavers. In each instance, prior consent must be obtained. Some tissues are readily available, e.g. blood, placenta and umbilical cord; others are available as waste from surgical operations (e.g. cosmetic surgery, mastectomy, circumcision) or from biopsies for the diagnosis of disease (e.g. from liver and kidney). Postmortem tissues may be removed from cadavers for immediate use or to be frozen for future use. These post-mortem tissues could include almost any part of the body - brain, heart, lung and other organs, skin, blood vessels and bone. They should be removed as soon as possible after death, as certain tissues will lose their viability very quickly.
The Human Tissue Act 1961 regulates the removal of parts of the body after death "for therapeutic purposes or for the purposes of medical education or research". Section 1 provides that:
- If any person, either in writing at any time or orally in the presence of two or more witnesses during his last illness, has expressed a request that his body or any specified part of his body be used after his death for therapeutic purposes or for purposes of medical education or research, the person lawfully in possession of his body after death may, unless he has reason to believe that the request was subsequently withdrawn, authorise the removal from the body of any part or, as the case may be, the specified part, for use in accordance with the request.
- Without prejudice to the forgoing subsection, the person lawfully in possession of the body of a deceased person may authorise the removal of any part of the body for use for the said purposes if, having made such reasonable enquiry as may be practicable, he has no reason to believe a. that the deceased had expressed an objection to his body being so dealt with after his death, and had not withdrawn it; or
- b. that the surviving spouse or any surviving relative of the deceased objects to the body being so dealt with.
The Humane Research Donor Card was introduced by Animal Aid in 1991 to signify that its carrier had given her or his consent for tissues to be removed after death for the purposes of medical research.
Support from the scientific and medical community
Professor Colin Berry
St. Bartholomew's and the Royal London School of Medicine and Dentistry
"I think it would be extremely helpful if there were a single donor card issued by the Department of Health giving people the option of donating body material for transplantation and/or research."
Dr P J Wand, FRCP, FRCR
Consultant in Palliative Medicine, Marie Curie Centre, Caterham, Surrey
"I fully support the concept that people should have the opportunity to express the wish that their tissues might be used post-mortem for research purposes and if such wishes were declared we would try to facilitate this."
Dr R A J Challiss
Dept. of Cell Physiology & Pharmacology, University of Leicester
"If metabolically viable human tissue were more easily available many researchers within this department would preferentially work on this material. Therefore any scheme which makes it easier to obtain biopsy and/or post-mortem tissue is to be welcomed."
Pathology Services Manager, Addenbrooke's Hospital, Cambridge:
"Because of numbers of specimens, types of tissues, number of collection points and numbers of potential users, we suggest that the development of tissue banks should be encouraged on a local basis, serving the local research community including appropriate ethically approved commercial research. Support for such developments shall, ideally, come from government sources, by block grants from commercial organisations or from research charities. The widespread use of a donor card would be very helpful at the time tissues were taken for transplantation or during a coroner's autopsy, when it is very difficult to raise the question of consent with relatives. It would be useful if names of potential donors were held centrally, with their permission, so that a national computer [could be] checked and then a current card sought before proceeding with tissue collection."
"It is usually most difficult for us to obtain normal human tissue which is needed to measure selectivity in comparison with diseased tissue. A better co-ordinated system which would allow for the procurement of good quality human tissue would facilitate our medicines discovery process. In addition, a system which allowed for the donation of tissues for research purposes would enable our scientists to carry out more useful studies because rapid access provides better quality material."
"There is no doubt that obtaining human tissue, both diseased and normal, remains an unreliable undertaking. We would encourage steps that led to national guidelines that would clarify and facilitate the process bearing in mind the ethical and other issues involved. While humane donor cards might undoubtedly play a role in certain circumstances, especially with regard to making clear the deceased's intentions, of more immediate concern to us at present is that hospitals are given the encouragement and guidance they need to establish tissue banks with which companies can collaborate."
Support from scientists at the time of the Humane Research Donor Card's introduction in 1991
University of Manchester Medical School
"I have always strongly supported the view, on both scientific and humane grounds, that the use of human tissue for research is preferable to the use of animals. I therefore wholeheartedly welcome your introduction of the Humane Research Donor Card, and hope it will be successful in obtaining an adequate flow of human tissue for research. I wish you every success with the card and hope that it is widely taken up."
Professor W R Keatinge
Dept. of Physiology, University of London's Queen Mary & Westfield College
"The scheme for the Humane Research Donor Card seems to me an excellent one and I am happy to support it."
Professor Li Wan Po
Director of the School of Pharmacy, Queen's University, Belfast
"I fully endorse your scheme. One of the major difficulties we have is obtaining sufficient quantities of human tissue to perform our research on. Any scheme which attempts to reduce the use of animals is clearly worthwhile."
Professor P K Thomas
Royal Free Hospital School of Medicine, London
"I was most interested in the Humane Research Donor Card that you have produced. In my laboratory we regularly use specimens from human donors for research purposes obtained at the time of organ donation for transplant purposes. However, supplies are limited and anything to improve this situation is to be commended."
Royal Postgraduate Medical School, London
"We have had difficulties from time to time in obtaining human tissues for research and therefore would like to support the scheme."
Paul Townsend, Plastic Surgeon
Frenchay Hospital, Bristol
"I still believe strongly that wherever possible human tissue is available for research, this should be used preferentially to the use of animals, and would certainly recommend your new initiative of a Humane Research Donor Card."