A Ten-Year Retrospective Analysis of Consent for the Donation of Residual Human Tissue in a Singapore Healthcare Institution: Reflections on Governance

Abstract

© 2017, National University of Singapore and Springer Nature Singapore Pte Ltd. A 10-year (2002 to 2011) retrospective analysis of consent documentation for the donation of leftover or residual human tissue from surgical interventions at a major academic healthcare institution in Singapore was conducted. Findings suggest that demographics like gender, religious belief and socioeconomic status could be indicators of the willingness of a patient to donate residual tissue to a tissue repository or biobank for future research use. Patients in general did not decide to donate based on specific details that were provided to them. Instead, those who donated were of a background that engendered a level of security or confidence that harm would not befall them. It is argued that willingness to donate depended more on this sense or perception of security that arose from systemic trustworthiness than from the rigour of consent-taking. In 2015, changes to the regulation of tissue banking and related activities in Singapore include legislative requirement for a prescribed list of information to be provided to a prospective tissue donor in consent-taking. While this and other legislative changes are important to ensure that tissue donation for research remains informed and voluntary, it is argued that trust and trustworthiness remain an unfinished project. Tissue repositories or biobanks more broadly must be constituted as moral institutions that safeguard the interests and rights of altruistic tissue donors. More critically, they must advance security and trustworthiness through good stewardship that is directed at promoting the common good through accountability, transparency and control.