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Running head: HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM UK REGULATIONS RELATING TO THE USE OFHUMANTISSUE IN RESEARCH Name of the Student Name of the University Author note
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1HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM Human tissue is the mass of cells that represents an internal environment of the human body and researchers uses this human environment to find out different facts about diseases, their treatment and their signs and symptoms (Lonsdale et al. 2013). The first human cell line used in the research is HeLa in 1951 and it was derived from Henrietta Lacks, a patient suffering from cancer. Biologist George Otto Gey found her cell line appropriate for research purpose because of its immortal nature(malignant cell property) and this way the invention of immortal cell line was created (Adey et al. 2013). Usage of human tissue for medical research and development raises many ethical and law related problems around the state of European Union. The procurement, storage, and allocation of human tissue for research purposes have posed noteworthy questions over recent years, and a different high profile scandal in the UK encouraged the publication of the Madden Report on PostMortemExerciseandTrialsinIrishhospitalsin2006.Moreover,tissue-related investigation tends to be most encouraging if samples and material are shared through domestic borders, but the heterogeneity of present rules and strategies within the member states of the European Union and the United Kingdom calls all the more for explanation (Best and Kahn 2016). This essay will be reviewing the different rules and regulations of the Human Tissue Act (HT) 2004 of United Kingdom and the human tissue quality and safety regulation (2007) in detail. This HT act 2004 covers the entire England, Northern Ireland and Wales with the exclusion of the provisions regarding the use of DNA and this applies to the Scotland as well. This act establishes the authority of Human Tissue (HTA) to regulate different concerns about the storage, removal and disposal of the human tissue. However, Scotland has a separate legislation for that and it is termed as the Human Tissue (Scotland) Act 2006 (Human Tissue
2HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM Authority 2017) because it is a part of Scottish parliament. The European Union Tissue and Cell Directives (EUTCD) have implemented another act for the Human Tissue (Quality and Safety for human application) Regulation 2007 (The Human Tissue Q and S Regulations, 2017). Therefore, HTA is termed as the competent authority in the UK regarding the use of human tissue in research and development. The strength of this human tissue act is its integrity and widespread nature. It also allows the honest and ethical distribution of organs around the UK and the chances of corruption are less because of its ability to crosscheck the donation procedure (Whitburn, Marsden and Sooriakumaran 2017). The HTA is also the Capable Authority in the UK for the application of the European Union Directive 2010/53/EU on the ethics of quality and safety of human organs envisioned for. These requirements of the directive are transferred into the UK law through the regulations of the Quality and Safety of those organs, which are intended, to relocation Regulation 2012. This act is generally termed as Quality and Safety of Organs Intended for Transplantation Regulations 2012. These ethics for use of human tissue in research falls under twenty-nine code of ethics (The Human Tissue Q and S Transplantation Regulations, 2017). The important points of these codes are- Consent. donation of solid organs for transplantation, examination for post mortem, anatomical examination, human tissue disposal, donation of allogeneic bone marrow and peripheral blood stem cells for organ transplantation, public display, export import of human bodies, parts and tissues and finally research. There are several strengths and weaknesses, which are associated with the human tissue and many more acts that deals with human organ or tissue transplantation in UK. The strengths are decrease in the number of human organ trafficking. Patients in need are easily applying for the organ requirement after the formation of the transplantation act 2012. Finally, the major
3HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM strength is the research sector is able to conduct their research on cell lines, which are with complete details and consent letter. The weaknesses are also associated with it and people are complaining that surgeons are extracting the organs of their loved ones who are on deathbeds and are providing fake consent letter in return. The Organ transplant act 2012 need to be more strong and harsh on such medical institutions where such practices are followed. Procedure The first procedure of using human tissue for research is taking consent of the patient before using his bone marrow or tissue and it falls under the code of ethics by the Human Tissue act 2004. However, it is not important to collect the consent letter of the donor always, if the tissue is existing holding or is kept with the researcher before September 2006. In this case, the researcher do not need any consent to continue with his research (The Human Tissue Q and S Regulations, 2017). The reason is the law was implemented after the researcher collected the tissue and therefore, consent is not required. Furthermore, if the tissue is imported or the researcher is not been able to identify the donor of the tissue and the recognized Research Ethics Committee (REC) approved the research, then the consent is not necessary as per the code of ethics (Health Research Authority, 2017). The following flow chart describes the process of consent and the consequences of not receiving it from the donor. This flowchart also describes the process in which the consent is required or not required. Detailed flowchart has been added in the appendix section.
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4HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM From the above flow diagram, it is quite evident that the role of Recognized Ethical Committee is commendable in the entire procedure of the ethical rules and regulations. Further, under the rules and regulations of the Human Tissue Act, approval on ethical ground can be given by the REC. these RECs need to be approved by the United Kingdom Ethics Committee Authority(UKECA)(Brissonetal.2012).Undertheclinicaltrialregulation,anyREC recognized by UKECA can approve the use of human tissue throughout the England, Northern Ireland, and Wales. All these Recs work under the roof of the government driven Governance Arrangements for Research and Ethics Committee (GAREC). Hence, screening of all these RECs are made possible in the United Kingdom.
5HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM However, the prime concern is about those tissues that are being imported from different locations and RECs approve those tissues without any consent letter. The risk factor associated with it is the unidentified resource from which the tissue has been taken. This process can also be debatable, as the researcher does not know the collecting procedure of the tissue. Hence, ethical regulations can be violated using this procedure, because it is important to know the source of the tissue used in the research as per the HT act code of research (Medical Research Council 2017). Hence, the HT act talks about these issues as well in its first code, which is consent and ethics. According to the provision, the tissue bank that provides the researcher with the imported tissue, need to collect the consent letter from the donor and it is the bank’s responsibility to collect it. . The License gives right to store the tissue for research. Any obligation for ethical support rest on the policy of the association storing the tissue (HTA code of Practice and Standards, 2017). The positive and negative outcomes of the ethical procedure to use human tissue in research are- The first positive outcome of the procedure to use human tissue in research is the consent letter. Thisletter allows the researcher to know about the donor and his or her health complication. As the tissue is the part of the donor’s body, complication of the donor can affect the research as well. Secondly, presence of recognized ethics committee to approve the use of human tissue in research. Third strength is the provision of storage that let the researcher store the cell line for future uses. However, there are negative outcome as well. A single application can be made for ethical review of several human tissue line. However, the chances of corruption are less, but researchers can generate fake reviews in the case. Second negative outcome is drastic as well, in which if a hospital bears a license for research, the tissue collected by it will
6HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM not require consent letter. this unethical rule affects the research as the donor information is not always correct. Storage of the Human Tissue is also covered in the HT act 2006 and according to the section 16(7); storage does not include the incidental to transportation. It is defines as incidental to transportation if the tissue is stored for an hour or day. In this situation license is not required. However, if the researchers store the tissue for a scheduled purpose, requires a license that has to be given by the HTA or the RECs (Human Tissue Authority 2017). Hence, from the above review of the sections of the Human Tissue Act 2006, it is quite evident that the use of human tissue in UK is regulated strongly to allow the ethical use of tissues in the research for the beneficiary of the humankind.
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7HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM References Adey, A., Burton, J.N., Kitzman, J.O., Hiatt, J.B., Lewis, A.P., Martin, B.K., Qiu, R., Lee, C. and Shendure, J., 2013. The haplotype-resolved genome and epigenome of the aneuploid HeLa cancer cell line.Nature,500(7461), pp.207-211. Best,J.W.andKahn,J.V.,2016.Researchineducation.PearsonEducationIndia. https://scholar.google.co.in/scholar? hl=en&as_sdt=0%2C5&as_ylo=2012&as_yhi=2017&q=Best%2C+J.W.+and+Kahn%2C+J.V. %2C+2016.+Research+in+education.+Pearson+Education+India.&btnG Health Research Authority (2017).Use of human tissue in research. [online] Health Research Authority.Availableat:https://www.hra.nhs.uk/planning-and-improving-research/policies- standards-legislation/use-tissue-research/ [Accessed 10 Nov. 2017]. HTA code of Practice and Standards (2017).HTA Codes of Practice and Standards | Human Tissue Authority. [online] Hta.gov.uk. Available at: https://www.hta.gov.uk/hta-codes-practice- and-standards-0 [Accessed 23 Oct. 2017]. Human Tissue Act (2017).Human Tissue Act 2004. [online] Legislation.gov.uk. Available at: http://www.legislation.gov.uk/ukpga/2004/30/contents [Accessed 23 Oct. 2017]. Human Tissue Authority (2017).Find out what the HTA can do for you | Human Tissue Authority. [online] Hta.gov.uk. Available at: https://www.hta.gov.uk/ [Accessed 23 Oct. 2017]. Lonsdale, J., Thomas, J., Salvatore, M., Phillips, R., Lo, E., Shad, S., Hasz, R., Walters, G., Garcia,F.,Young,N.andFoster,B.,2013.Thegenotype-tissueexpression(GTEx) project.Nature genetics,45(6), pp.580-585.
8HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM Medical Research Council (2017).Human tissue - Research - Medical Research Council. [online]Mrc.ac.uk.Availableat:https://www.mrc.ac.uk/research/facilities-and-resources-for- researchers/regulatory-support-centre/human-tissue/ [Accessed 23 Oct. 2017]. The Human Tissue Q and S Regulations (2017).The Human Tissue (Quality and Safety for HumanApplication)Regulations2007.[online]Legislation.gov.uk.Availableat: http://www.legislation.gov.uk/uksi/2007/1523/contents/made [Accessed 23 Oct. 2017]. Whitburn, J., Marsden, G. and Sooriakumaran, P., 2017. The Human Tissue Act: a guide for clinical researchers.Journal of Clinical Urology, p.2051415817719838.
9HUMAN TISSUE REGULATORY ACT OF UNITED KINGDOM Appendix