Cunliffe David: Human Tissue Bill — Third Reading 
Cunliffe David: Human Tissue Bill — Third Reading 
[Volume:646;Page:15428] 
Hon DAVID CUNLIFFE (Minister of Health) 
: 
 I move  
That the Human Tissue Bill be now read a third time 
. The bill was introduced in November 2006 to update the Human Tissue Act of 1964. The bill provides a framework for regulating the collection storage and use of human tissue primarily from deceased people. It also regulates trading in tissue the export and import of tissue and the issue of tissue for non-therapeutic purposes—for example research education audit and anatomical examination. The bill was examined by the Health Committee which reported the bill back with some amendments and I take the opportunity to thank the committee for its careful consideration of the bill which I think has resulted in some improvements to the bill. 
Firstly on the consent framework the bill makes informed consent the fundamental principle underpinning the lawful collection and use of human tissue. It replaces the use of lack of objection in the Human Tissue Act 1964 with informed consent which is consistent with the Code of Health and Disability Consumers’ Rights. By specifying who may give consent for the collection and use of human tissue the bill clearly provides for organ and tissue donation and the collection and retention of tissue at a post-mortem examination. 
The bill specifies a hierarchy of people who may give informed consent to the collection and use of human tissue. In general the primary consent will be that of the deceased before he or she died or of someone nominated by the deceased person to consent on his or her behalf. In the absence of consent to donation by the individual or the nominee the decision will be made by the immediate family. The bill provides for decision making by a close available relative of the dead individual if the immediate family is unable to reach a decision. 
The bill as introduced provided that the immediate family could not give consent unless a majority of the immediate family agreed with the decision. The committee recommended that the need for a majority decision be removed. This amendment means that a member of the immediate family may give informed consent or raise an informed objection once it is clear that all capable family members accept—or would if consulted accept—that decision. The amendment allows family members to reach a decision in whatever way is appropriate for them as long as they agree collectively with the decision. 
The bill describes some situations where the consent framework operates slightly differently. The Health Committee recommended the inclusion of flowchart diagrams to aid understanding which I agree has improved the bill. The bill provides some exceptions to the general rule that informed consent is required to collect or use human tissue—for example where tissue is collected or used under the Coroners Act 2006 or for criminal justice purposes. The bill also recognises that there are certain limited circumstances where because appropriate safeguards are in place the public good associated with the use of tissue outweighs informed consent requirements—for example certain research where this is approved by an ethics committee. 
On the matter of informed objection one of the key amendments recommended by the committee is the introduction of informed objection. The amendment recognises the ability of decision makers to object to the use of human tissue as well as to consent to it. Both informed consent and informed objection will now have legal standing and will prevent others from consenting or objecting. Nevertheless there will be situations where it might be appropriate for the collection or use of tissue to not proceed even if a valid consent has been given. The bill now provides that clinicians and researchers need not act on a valid consent as appropriate and that organ donor coordinators transplant surgeons and others should be free to decide not to act on informed consent if the information available indicates that they should not do so without fear of prosecution. 
The committee had a considerable discussion about cultural issues and human tissue collection and use and it recommended two amendments to give greater recognition to the culture of the immediate family. The first requires decision makers to take into account the cultural and spiritual needs values and beliefs of the immediate family. We want to encourage individuals who want to make a decision about the collection and use of tissue after their death to consider the impact of their decision on their family but we also want individuals to retain the right to make a decision that the family does not in the end agree with. 
The second amendment requires the person collecting or using human tissue to take into account the cultural or spiritual needs values and beliefs of the immediate family. It is entirely appropriate for clinicians researchers and others collecting and using human tissue from a deceased individual to do so with the proper recognition and respect for the immediate family. In the Committee stage the Maori Party proposed that families be given the power to veto the consent given by Maori individuals while they were alive. Although it is considered appropriate that cultural issues be adequately considered during this process it was not felt to be appropriate to give families a legal right to override an individual decision. 
I take this opportunity to acknowledge the support this bill has received from both the major and the minor political parties. I commend this bill to the House in order to provide clarity on the consent requirement for the collection and use of human tissue for the public the clinicians and others involved in the collection and use of tissue. In doing so I wish to thank members all around the House who have served on the select committee and who have been involved in the process. I wish to thank the officials and all those who have been consulted on the production of the bill which I now commend to the House for third reading.