{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:41:08Z","timestamp":1767706868016,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Ethics"],"accepted":{"date-parts":[[2019,7,7]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>We draw on the concept of dignity to consider the ethics of the disposal of amputated limbs. The ethics of the management and disposal of human tissue has been subject to greater scrutiny and discussion in recent years, although the disposal of the limbs often remains absent from such discourses. In light of the recent UK controversy regarding failures in the medical waste disposal and the stockpiling of waste (including body parts), the appropriate handling of human tissue has been subject to further scrutiny. Although this scandal has evoked concern regarding procurement and supply chain issues, as well as possible health and safety risks from such a \u2018stockpile\u2019, the dignity of those patients\u2019 implicated in this controversy has been less widely discussed. Drawing at Foster\u2019s (2014) work, we argue that a dignity framework provides a useful lens to frame consideration of the disposal of limbs after amputation. Such a framework may be difficult to reconcile with the logic of business and the \u2018biovalue\u2019 of the medical waste, but would we argue afford more patient-centred approaches towards disposal. It may also facilitate better practices to help mitigate future stockpiling incidences.<\/jats:p>","DOI":"10.1136\/medethics-2019-105554","type":"journal-article","created":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T17:15:53Z","timestamp":1564420553000},"page":"575-578","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Ethics of limb disposal: dignity and the medical waste stockpiling scandal"],"prefix":"10.1136","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0649-6620","authenticated-orcid":false,"given":"Esm\u00e9e","family":"Hanna","sequence":"first","affiliation":[{"name":"Institute of Allied Health Sciences, De Montfort University, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Robert","sequence":"additional","affiliation":[{"name":"Department of Adult Nursing, King\u2019s College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,29]]},"reference":[{"key":"2025092415051928000_45.9.575.1","unstructured":"Carding N , Lintern S , Clover B , et al . Exclusive: trusts alerted as firm stockpiles clinical waste and body parts. Health Service Journal 2018 https:\/\/www.hsj.co.uk\/policy-and-regulation\/exclusive-trusts-alerted-as-firm-stockpiles-clinical-waste-and-body-parts\/7023511.article (Accessed 12 Apr 2019)."},{"key":"2025092415051928000_45.9.575.2","unstructured":"Hanna E . Patient dignity must be central to appropriate disposal of body parts. BMJ Opinion 2018 https:\/\/blogs.bmj.com\/bmj\/2018\/10\/19\/esmee-hanna-patient-dignity-central-appropriate-disposal-body-parts\/."},{"key":"2025092415051928000_45.9.575.3","unstructured":"Carding N , Scott R . Exclusive: patients' body parts were stored dangerously for six months. Health Service Journal 2019 https:\/\/www.hsj.co.uk\/quality-and-performance\/exclusive-patients-body-parts-were-stored-dangerously-for-six-months\/7024171.article (Accessed 12 Apr 2019)."},{"key":"2025092415051928000_45.9.575.4","unstructured":"Matthews- King A . NHS Patient body parts stored unrefrigerated for six months at NHS waste firm, inspection report reveals. The Independent 2019 https:\/\/www.independent.co.uk\/news\/health\/body-parts-scandal-nhs-waste-human-remains-toxic-healthcare-environment-services-hsj-a8730481.html (Accessed 12 Apr 2019)."},{"key":"2025092415051928000_45.9.575.5","unstructured":"Barclay S . The Minister for health. Clinical waste update. Hansard. 2018."},{"key":"2025092415051928000_45.9.575.6","unstructured":"Clover B . Government reviewing procurement process after \u2019human body parts' scandal. Health Service Journal 2018 https:\/\/www.hsj.co.uk\/policy-and-regulation\/government-reviewing-procurement-process-after-human-body-parts-scandal\/7023513.article (Accessed 12 Apr 2019)."},{"key":"2025092415051928000_45.9.575.7","unstructured":"Carding N . Trusts bemoan cost pressures from clinical waste switch. Health Service Journal 2019 https:\/\/www.hsj.co.uk\/finance-and-efficiency\/trusts-bemoan-cost-pressures-from-clinical-waste-switch\/7024526.article (Accessed 12 Apr 2019)."},{"key":"2025092415051928000_45.9.575.8","doi-asserted-by":"publisher","DOI":"10.1177\/0141076814557301"},{"key":"2025092415051928000_45.9.575.9","unstructured":"Quinn B . NHS supplier that kept body parts faces criminal investigation. The Guardian 2018 https:\/\/www.theguardian.com\/society\/2018\/oct\/05\/criminal-investigation-after-nhs-supplier-retained-body-parts (Accessed 12 Apr 2019)."},{"key":"2025092415051928000_45.9.575.10","first-page":"135","article-title":"Where it hurts: Indian material for an ethics of organ transplantation","volume":"128","author":"Cohen","year":"1999","journal-title":"Daedalus"},{"key":"2025092415051928000_45.9.575.11","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2012-100763"},{"key":"2025092415051928000_45.9.575.12","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/1357034X06061192","article-title":"Commodification of body parts: by medicine or by media?","volume":"12","author":"Seale","year":"2006","journal-title":"Body Soc"},{"key":"2025092415051928000_45.9.575.13","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.anthro.29.1.287"},{"key":"2025092415051928000_45.9.575.14","doi-asserted-by":"publisher","DOI":"10.1177\/1357034X0100700207"},{"key":"2025092415051928000_45.9.575.15","doi-asserted-by":"publisher","DOI":"10.1177\/1357034X0100700201"},{"key":"2025092415051928000_45.9.575.16","doi-asserted-by":"publisher","DOI":"10.1177\/136345930200600304"},{"key":"2025092415051928000_45.9.575.17","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/j.1467-9566.2012.01498.x","article-title":"\u2019You don\u2019t need a body to feel a body': phantom limb syndrome and corporeal transgression","volume":"35","author":"Crawford","year":"2013","journal-title":"Sociol Health Illn"},{"key":"2025092415051928000_45.9.575.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7137.1086"},{"issue":"1","key":"2025092415051928000_45.9.575.19","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/BF01564333","article-title":"Psychotherapy of phantom limb pain in two patients","volume":"30","author":"Blood","year":"1956","journal-title":"Psychiatr Q"},{"key":"2025092415051928000_45.9.575.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39534.654711.59"},{"key":"2025092415051928000_45.9.575.21","unstructured":"Jansen B , Baart RI . I am my leg, do I have my leg, where is my leg? Towards radical post-amputative self-determination. Working paper. Forthcoming."},{"key":"2025092415051928000_45.9.575.22","unstructured":"Human Tissue Authority. Code of Practice- Guide A: Guiding principles and the fundamental principle of consent Para 13d [Online]. 2014 https:\/\/www.hta.gov.uk\/sites\/default\/files\/HTA%20Code%20A_1.pdf."},{"key":"2025092415051928000_45.9.575.23","doi-asserted-by":"publisher","DOI":"10.1017\/S0963180114000097"},{"key":"2025092415051928000_45.9.575.24","doi-asserted-by":"publisher","DOI":"10.1080\/03093640008726548"},{"key":"2025092415051928000_45.9.575.25","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7748\/ns2014.04.28.33.28.s30","article-title":"Starting out - a request to cremate an amputated limb raised issue of spiritual care","volume":"28","author":"Rudd","year":"2014","journal-title":"Nurs Stand"},{"key":"2025092415051928000_45.9.575.26","doi-asserted-by":"publisher","DOI":"10.1177\/1357034X10373407"},{"key":"2025092415051928000_45.9.575.27","doi-asserted-by":"crossref","first-page":"215824401985995","DOI":"10.1177\/2158244019859953","article-title":"\u201cWhat Do you want to do with the leg?\u201d a critical narrative review of the understandings and implications of disposal in the context of limb amputations","volume":"9","author":"Hanna","year":"2019","journal-title":"Sage Open"},{"key":"2025092415051928000_45.9.575.28","unstructured":"Goold I . Abandonment of human tissue. In: Persons, parts and property: how should we regulate human tissue in the 21st Century. London: Bloomsbury Publishing, 2014:125\u201355."},{"key":"2025092415051928000_45.9.575.29","unstructured":"Kant I . The Metaphysics of Morals. 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