The science and bioethics concerning bodies within a few hours after death
In recent years, the importance of early postmortem tissue samples for biological and medical research has increased due to the advances in the technology of genetic analysis. In order to obtain high-quality data, the samples must be collected before the RNA and DNA degrade. Therefore, a pathological autopsy and subsequent tissue collection needs to be conducted within a few hours after death.
In the United States, in addition to surgically removed tissues and organs that are judged unsuitable for transplantation, organs and tissues obtained from pathological autopsies have been used for research in accordance with procedures clearly delineated by regulations and guidelines. While there are no clear regulations on the use of early postmortem tissues for research, brain banks*2 began using them in the 1980s under their own guidelines based on relevant regulations. Since the 2000s, rapid research use of postmortem tissues has been widely practiced, especially at cancer centers, and have contributed to important medical research, including immunotherapies*3, which is featured in an article in this issue of the CiRA Reporter.
In Japan, access to postmortem organs and tissues for research purposes has been limited due to regulatory and ethical issues. Japan’s Organ Transplant Law stipulates that organs and tissues left over from organ transplants must be incinerated. Autopsies are mainly classified as systematic autopsies, forensic autopsies, and pathological autopsies. Among them, systematic autopsies, where bodies are donated based on the wish of the donors and their bereaved families, are limited to medical education purposes. Therefore, only a part of postmortem tissues removed for forensic and pathological autopsies are used for research.
Even if people wish to donate their bodies to science, especially for advanced research involving genetic analysis, it is difficult to do so because of ethical issues and the ambiguous regulatory framework in Japan. In addition, there are operational difficulties because medical institutions are not necessarily well-adjusted to resolve the time constraints posed by the rapid postmortem tissue collection process.
In light of this situation, our project*4 is designed to first organize and clarify regulatory and ethical issues related to research using postmortem tissues, with a view to creating institutional guidelines and building a new platform.
We hope to build a responsible system for the use of early postmortem tissues in research by bringing together the findings of ethics and science and discussing them with the public.
*1: Okui is a researcher accepted by the Uehiro Research Division for iPS Cell Ethics at CiRA.
*2: Brain banks perform pathological autopsies with the consent of bereaved families of the deceased persons and preserve brain specimens for research use.
*3: J. E. Hooper, A. K. Williamson (eds.), Autopsy in the 21st Century, Springer (doi: 10.1007/978-3-319-98373-8_10)
*4: An ASHBi Fusion Research Program project led by Okui with the theme, “The research use of fresh postmortem tissues: From a regulatory and ethical perspective.”