Please note: This is an extract from Hansard only. Hansard extracts are reproduced with permission from the Parliament of Tasmania.

ANATOMICAL EXAMINATIONS BILL 2006 (No. 39)

Second Reading


[6.09 p.m.]


Ms GIDDINGS (Franklin - Minister for Health and Human Services - 2R) - I move -


That the bill be now read the second time.

The purpose of the bill is to repeal and replace the Anatomy Act 1964 and to update the law to reflect the current practices relating to the donation of bodies for anatomical examination to the Faculty of Health Science Body Bequest Program at the University of Tasmania. The bill also applies provisions of the National Code of Ethical Autopsy Practice as relevant, and in particular, states that anatomical examinations are to be undertaken with due regard to the dignity of the deceased persons.

Some provisions in the Anatomy Act relating to post-mortem examinations have been placed into the Human Tissue Amendment Bill 2006 so this bill only deals with anatomical examinations - that is, 'the examination of the body of a deceased person for the purpose of the study or practice of anatomy'.


The bill places responsibility for managing the process solely with the head of the Faculty of Health Science, currently Professor Allan Carmichael. However, the bill also retains the inspection provisions in the current act so that departmental inspectors may inspect the faculty at any time to ensure compliance with the act.

In keeping with current law and practice, the head of the faculty may authorise students and teaching staff to perform anatomical examinations. At present only medical, nursing and medical research students study anatomy, but in future, if other courses such as dentistry are offered at the university, those students will also be authorised. An appropriately qualified person may also apply to the head for an individual authorisation if the person has a valid reason for wanting to undertake an anatomical examination - for example, to participate in a surgical skills workshop.


The bill sets out in a straightforward way the mechanism whereby a person may consent, in writing, to his or her body being used for anatomical examination by the faculty after the person's death. While the bill does not give the next of kin the right to veto a valid consent, it should be noted that the faculty goes out of its way to avoid accepting bodies where members of the family are adamantly opposed. A potential donor is encouraged to discuss his or her intentions with the family at the time he or she fills out the consent form to minimise the possibility of family distress later.


After the death of a potential donor, the head of the faculty decides whether the body of the deceased is suitable for examination. Once the body is accepted, the head of the faculty has ongoing responsibility for the body and must register the death of the person with the Registrar of Births, Deaths and Marriages. The head of the faculty is required to keep proper records and must ensure that when the body is no longer required for examination, the body is either released to the next of kin for burial or cremation, or is cremated in accordance with the Burial and Cremation Act 2002.


The current act limits the period for which the faculty may retain a body for teaching purposes to 30 months. This period has created difficulties on occasion, so the bill provides that a person may consent to his or her body being retained indefinitely, or for a fixed period, or if no period is specified, a body may be retained for a maximum of five years. There is also provision for an extension of a fixed period, if the deceased's next of kin consent. This will overcome some of the problems of undersupply and will also allow better coordination with the teaching year.


To further assist the supply problems, the bill also recognises the practice that bodies may be transferred from an anatomy school in another State or Territory to Tasmania; or from Tasmania to an equivalent faculty interstate, subject to proper procedures being complied with and as long as it is not contrary to the wishes of the deceased or the deceased's next of kin.


The bill has received the support of key stakeholders, including the university, medical colleges, the AMA and the statewide Pathology Services Committee.


To quote from the School of Medicine web site:

'The Body Bequest Program is run by the University of Tasmania Medical School to enable people to "donate their body to science".'


The program is used for the teaching of human anatomy for medical professionals. Even in these days of sophisticated computer technology, there is still no substitute for the direct, practical teaching of human anatomy that this program enables. The university and the medical professionals of tomorrow depend on this vital and highly personal gift for the completion of their training as doctors and nurses. I commend the bill to the House.


[6.15 p.m.]


Mrs NAPIER (Bass) - Mr Speaker, this side of the House supports the bill. Whilst there was a considerable amount of debate on some matters relating to the human tissues bill, this one is more straightforward. As was indicated by the minister, this bill repeals and replaces the Anatomy Act 1964. This bill provides a legislative framework for the donation of bodies for anatomical examinations, which are conducted by the Faculty of Health Science at the University of Tasmania for research and educative purposes, commonly referred to as donating a body to science.


We see this bill as an update to the act to reflect the current practices relating to the donation of bodies to the body bequest program. The bill provides that a person may consent to his or her body being used for anatomical examinations by the faculty after death. That consent, as I understand it, must be in writing and it must have been lodged with the head of faculty. It is recommended, although my understanding is that it is not actually a legislative requirement, that the person who is going to donate their body has consulted with their next of kin.


One of my questions to the minister is whether it is anticipated that on the form with which a person actually bequests their body there would be an indication that the person has fully consulted with at least their immediate next of kin. What is the current practice and what is the intended future practice? That is one question.

Only a person authorised by the head of faculty may undertake the anatomical examination. That includes students and other health professionals, subject to conditions.

The head of faculty is also required to register the death of a person whose body has been accepted for examination, to keep proper records and to ensure that when the body is no longer required, it is either released to the next of kin for burial or cremation or is cremated in accordance with the Burial and Cremation Act 2002 and the various other specifications associated with that.


We have consulted with the university, particularly with Professor Carmichael. They are quite happy with the bill and they are saying that this really just reflects their current practice. I have also contacted the AMA to see whether they had any concerns. They did not come back to me with any. But I have one question and it may be that we do not need to go into committee if we can deal with this issue. I noticed that the head of faculty could ask for medical records and information about the person whose body they have received. And I was just interested as to whether the AMA has considered the issue, given that normally there is some reticence by individuals about releasing for general use what might otherwise be personal and private information.


I just wonder if the minister could clarify how this bill overcomes what might otherwise be required under the Privacy Act and whether GPs and AMA have specifically indicated their willingness that private medical records might then be available to the head of faculty. It is under part 2, Consent to Anatomical Examinations, clause 8. It talks about access to medical records. Under (1) 'The Head of Faculty may request access to medical records of any deceased person for whom the Head of Faculty holds a valid consent form'. Thus request may be made of a person who the head of faculty believes may hold medical records of the deceased person. Presumably that could be right back to any of the GPs that have been dealing with them, let alone the specialists or other medical practitioners that might be associated with hospitals, including the private hospital sector. Clause 8(3) says that -


'The request is authority for its recipient to provide the Head of Faculty with -


(a) access to the medical records ... and

(b) ... copies of the medical records of the deceased person.'


Then 8(4) says that 'It is the duty of the recipient of the request to comply with it as far and as soon as practicable'. I wonder whether that includes specific discussion about that matter, just to put it on the record?


The other question I had about this relates to part 6 and that deals with the point that authorised officers can, without advance notice, visit the head of faculty and presumably any site being used by the Faculty of Medicine of the university where deceased persons are being held and anatomical examinations are being undertaken, to have a look at the records relating to anatomical examinations. They have a right under clause 22(1)(b) to 'search for, examine, take possession of, make copies of or take extracts from any document that may be held by the Faculty'. They can require people to open containers, require people employed at the faculty or those in charge of courses or storage to answer questions, and they can 'take notes, photographs, films, audio recordings or video recordings' and can ask that such information be provided.


Minister, is this current practice on the part of authorised officers? What changes are envisaged under the section that is now described as clause 22? If it is already current procedure, how often does this occur? How many incidences, if any, have arisen whereby it has been identified that perhaps inappropriate practices or activities may have been occurring and what actions have been taken as a consequence? I think it is basically those three questions that I wanted to ask.

Interestingly, when I was working at the university one of my areas of special interest was motor learning and some of the areas of psychology. I did do a neuro physiology course with the second year med students. They handled the terminology and the work on various brains that we were dissecting and analysing much better than I might. It was a fascinating experience. I did not follow it fully through because I was too busy at work at the time but it was a very interesting and valuable course and I was very appreciative of the university for allowing me to take it on. I found that at all times they dealt with the brains with great respect and a number of times people were reminded that these were bodies that had been provided for future learning and that they should be treated with respect. I did get the impression that those brains had been there a hell of a lot longer than five years though. Certain measures needed to be taken to make sure that you got your sense of smell back within a reasonable time after having done so. That is just an aside in terms of having a teensy bit of experience in terms of the work that the university does in trying to train future doctors and specialists within the area.


Minister, if you can satisfactorily answer those issues, then I would not necessarily see that we need to move into dealing with the particular elements in committee because otherwise I tend to think that it is a relatively straightforward bill.


[6.23 p.m.]


Ms PUTT (Denison - Leader of the Greens) - The Greens will also be supporting this bill and I do not intend to go over in detail the areas that have been covered by the minister or the other speaker because we are late and I do not think there is a lot of benefit to be had from repetition. Clearly, when people decide to donate their body to science, that is something that they do thoughtfully. It is an important contribution that I think only some people can actually bring themselves to contemplate and actually carry out. We really should be putting on the record our appreciation that people are prepared to take this action at the same time that we support that the legislation that covers this area is upgraded to reflect current practices in relation to the donation of bodies for anatomical examination in the Faculty of Health Science at the University of Tasmania.


I also had a question that I would like to ask the minister. It is in relation to the requirement to fill out a consent form. I understand why it would be necessary that the person consent in writing and also that it will assist members of the family in understanding what has gone on. How will potential donors know that that is the process they need to go through? There seems to be an assumption that somebody who wants to donate their body to science is going to get in touch with the university before they die and I do not know whether that is necessarily the case.


I have spoken to people who have said to me that they do intend to donate their body and I had the impression and did not know any better that in at least one of those instances the person thought that if they put the wish in their will and told their next of kin, that would do the trick. Now, according to what is provided for here, it would not; there would actually be a necessity to have already gone through a process with the correct form and so on. Is there going to be some advertisement of this requirement? Is there going to be a circular to the legal profession that when they are drawing up wills, if a person wants to make this type of determination, that they will need to acquire and fill out a consent form and, if they have not done so, this wish will not be able to be brought to fruition?

I imagine that would be the way to go about it. If solicitors and people engaged in the drawing up of wills at least have that information supplied, then there is more chance that we are going to be able to catch the person who intends to do the right thing such that they are enabled to donate their body. As I say, I am not clear as to how members of the general public otherwise know that they have to get in touch with the faculty and get a consent form in advance.

In the second reading speech, Minister, you said that the head of faculty has to keep proper records and ensure that when the body is no longer required for examination, the body is either released to the next of kin for burial or cremation or is cremated in accordance with the Burial and Cremation Act 2002. I did not go back to that act to check up, so I guess this is why I am asking you. I am presuming that there is a requirement to contact the next of kin and keep them informed as to what is going to happen with the body, unless there is no existing next of kin. If that is not the case, could you explain to me whether there is a process that ensures the next of kin will be informed, or is this a bit of a hit-and-miss process? It is just not clear to me from that paragraph; although, as I say, it may be provided for in the Burial and Cremation Act, I just do not know. Those were the two matters that I wanted to follow up. As I say, the Greens do support the legislation; I just wanted a bit of clarity around those two matters.


[6.30 p.m.]


Ms GIDDINGS (Franklin - Minister for Health and Human Services) - I will endeavour to answer those questions. In relation to the last question, I am just getting some further advice. I thank both members for their contribution today and for their support of the bill.


The first question that Mrs Napier raised was in relation to the form, asking if we anticipate that we would put something on the form that says that the person has fully consulted with the next of kin. The form that we have - and it might change slightly, but this will not in that respect - currently reads:


'Please read carefully before you sign.'

The first point says:

'Please complete the four copies of this form and return one copy to the medical school, give one copy to your solicitor if you have made a will, give one copy to your next of kin or executor and keep one copy at home with your personal papers'.


So in that sense we do try, through this form, to make sure that people do provide a copy of this form to their family, their next of kin or the appropriate person, and the executor of their estate. It is clearly showing that there has been some consultation with the family.


In terms of the second question the member raised about the medical records, we have on this form, since the enactment of the Privacy Act, added a sentence to the bottom of the consent form. At the moment it reads:

'To whom it may concern,

This is to acknowledge that I have read the above information and, having done so, confirm that it is my wish that my body after death be made available to the Medical School, University of Tasmania, under the provision of the Anatomy Act 1964, to be used in whatever way shall be deemed most beneficial for the advancement of medical students in education.'

We have gone on to add this next sentence:

'I also hereby authorise the University of Tasmania to have full access to my medical records.'


We have consulted with the AMA in relation to this. We have of course consulted with the university and medical colleges; we have consulted with the Statewide Pathology Services Committee and the Registrar of Births, Deaths and Marriages, and everybody has been supportive of the legislation as it is.


The third question the member asked was in relation to the authorised officers and section 22, and whether it is current practice that we go in on site et cetera? The advice I have here is that the act currently provides for inspection, however there have not been any recent inspections. There has been no concern about practices that we are aware of, and certainly nothing has been drawn to our attention from anybody who believes that a body has not been treated with the dignity it should be have been. There has been no alarm raised by anyone who has been involved in this area.


Mrs Napier - And that would normally cause you to bring in the authorised officers, if someone raised the issue?


Ms GIDDINGS - I would expect, if there was alarm raised, that we would bring in an authorised officer to do an investigation in relation to that. I have a further bit of advice here: the secretary is the inspector, as per section 7 of the Anatomy Act.


Mrs Napier - On the next of kin, has consideration been given to having a next of kin sign off to say, 'I am aware of this'?


Ms GIDDINGS - At this point, no, it merely says that you must give one copy to your next of kin or executor, but that is something we could consider. I will not, on my feet, right here and now say we will definitely do it, but I am certainly happy to have that considered in how the form is written up.


Mrs Napier - I think that might be a good idea, or at least worth looking at, especially when you consider the debate we had on the human tissue bill and the organ donation element. Great weight was given to the kin's view and therefore it is not unreasonable that they should at least be required to sign off on this.

Ms Putt - It is actually the person's body, not the kin's body.


Ms GIDDINGS - Please correct me if I am wrong, but I think when the next of kin are very concerned about the body being used, that is taken into account as well, which is a similar discussion we had with the other bill.


In relation to the questions Ms Putt put forward about the consent form and how people know how to get in touch and donate their body, we currently have 1 700 donors who are on our list. I think those people who are really committed to supporting medical science and want to donate their bodies also know who uses those bodies. That would indicate that quite a few people realise you would go straight to the university. If you go straight to the university and say, 'I am interested in talking to you about donating my body' - it is actually on the university web site as well - you will automatically be provided with the consent forms and assisted through that process. We can talk about it publicly and try to get the message out widely. One-off television campaigns are effective for a point in time but it is a much -


Ms Putt - I would have thought something like a notice around solicitors who do wills would be more useful, because that is the time someone would discuss it, I would presume.

Ms GIDDINGS - I am surmising a bit here, as you are, but I would think that the sort of person who is interested in doing that would raise that with their solicitor. It is a natural progression, I believe, to go to a university and have that process started. We recently have had an active campaign with GPs in relation to this as well, I have just been informed.

The question after that was in relation to your body not being required and what you need to do in terms of getting in touch with the next of kin. The advice I have here is that the disposal is agreed at the time the body is accepted, so if you want to be cremated or however else disposed then that is how it is accepted. If the next of kin wish the body to be returned, the end date is noted and the next of kin are advised and the body is then released to them. The university keeps very detailed records and knows exactly when the time finishes and it keeps in contact with the next of kin.


I support the comments made by both members, but particularly Ms Putt when she effectively patted on the back those who have committed to donate their bodies to medical research. I think it is critical, particularly for medical students going through university, that they have the opportunity to dissect and perform surgical procedures, to practise on these bodies to see what different diseases do to a human body. I do not know if any of the members saw it but I was fascinated by the series recently on SBS which was looking at the anatomy of the body and dissecting a human body. It was quite interesting seeing that, as a layperson. I encourage people to consider this as another way that you can contribute to the community for the longer term. I commend the bill to the House and thank members for their contribution.


Bill read the second time and taken through the remaining stages.