Children's organ retention at the Royal Liverpool Hospital (Alder Hey) is frequently muddled and unclear

The report into children's organ retention at the Royal Liverpool Hospital (Alder Hey) is frequently muddled and unclear, which has made it hard to draw up remedial policy and foster balanced debate about the issues.

Writing in the Journal of Medical Ethics, Steve Dewar, Director of Health Policy at the health policy think tank, the King's Fund, says that the report had "an unenviable task," grappling with the immensely difficult issues of child death and the treatment of the dead.

The report, which was published in January 2001, appropriately focused attention on the "crucial and overwhelmingly important issue of consent."

But he concludes: "?it has also been unclear about the basis for many of its (often implied) judgements?" These include key issues around the process of consent, the value of bodily integrity after death, the circumstances that justify organ retention, and definitions of respectful treatment of human tissue.

Policy makers, he contends, are "still grappling with the need for clarity - both ethical and practical - in these areas."

Mr Dewar also highlights the emotive language used in the report, and its tendency to succumb to the tradition of the macabre.

"Its presence in the report adds a layer of sensationalism, something that blurs the edges of the logical analysis required to address such problematical ethical issues," fostering "the assumption of wicked intent in the very process of examining, removing, storing, and using material from the dead," he contends.

When it comes to public policy, inquiries should positively seek out alternative perspectives, he says. "Now that time has passed since the publication of the Alder Hey report, and the stifling atmosphere of horror that surrounded it, a broader debate framed by emerging policies on consent?needs to flourish," he concludes.

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