The appalling revelations in the Alder Hey report have left me, and probably many others, reeling. The system that has condoned such practices over such a long time must be closely examined. The activities described, although extreme in Alder Hey, were accepted as custom and practice throughout the country and yet the public is rightly shocked. How can the value systems of those in the medical profession be so at odds with those of the public at large?

These revelations are one more indication that there is no place for paternalism in healthcare, even when the motive is well meaning. It has been claimed that parents were not told about organ removal to protect them from further distress. As a parent whose child suffered a neonatal death, I know that such beneficence misses the point. The worst thing that can possibly happen has happened with the death of my child; any further discussion about post-mortem or research, although upsetting, is relatively insignificant.

Who was being protected? The parent from having to make decisions about their children, or the professionals from having to engage in distressing conversations with upset parents? I do not know if my child's organs were removed;

seven years on I do not want to re-open that chapter. But recent events have forced me to consider the harrowing possibility that my child, too, might have been treated with such little respect. If asked, I, like many other parents, may well have consented to the removal of organs. What is relevant here is the anger I feel at the arrogance of a profession that believes it is justified in making momentous decisions on behalf of others without reference to them, and that this can then be concealed from them, on the assumption that it is better for them not to know.

When needed, I seek medical help for clinical care; I do not seek protection and parenting.

We live in a multi-cultural society with many different beliefs and values. It is arrogant for a profession to think its values take precedence over those of others. It is perhaps because medicine has held such a privileged, self-regulating position for so long that it has lost sight of the fact that society has changed and individuals are no longer prepared to be told what is in their 'best interests'.

The Alder Hey inquiry highlights an era of extremes in practice in one hospital, but it would be a mistake to package this as an aberrant occurrence that can never happen again.

This should provide the impetus for medicine to take a long, hard look at itself and the role that it has to play in the modern world and to examine, and take seriously, the public's expectations. If we fail to take this opportunity, other scandals will inevitably occur. Can medicine afford any further loss of public confidence?

Jan Quallington Senior lecturer in ethics and health studies University College Worcester