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“Reanimation” and Taking Organs from Living People

One of the greatest fears associated with organ transplantation is that the person from whom organs are taken is not really dead.

That nightmare was almost realised in France last week when a French patient “came back to life” after 30 minutes of unsuccessfully heart massage. In 2007, in order to address the shortage of organs for transplantation, French authorities allowed the trial of using people whose hearts have stopped beating, but who have not met brain death criteria for being dead, as organ donors. These are called Non-Heart Beating Donors. Organs can also be taken from such donors in the UK. Such patients’ hearts have stopped beating but they have not met brainstem criteria for death.

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My Genes, not a Doctor’s

California has sent cease-and-desist letters to firms offering Web gene tests to consumers. The legal reason is that California law requires a licenced physician to order any lab tests. This follows from a similar crackdown in New York. Wired responds by top 10 reasons that regulators should not hinder genetic testing. Is there any good reason to limit public access to genetic testing besides protecting incumbents and gatekeepers?

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Setting a Minimum Price for the Sale of Organs

Professor Maqsood Noorani, a leading surgeon made the headlines asking for legalisation of the sale of organs to prevent the exploitation that exists in the black market. Yet his comments show that he is uneasy with the concept of a market in organs. He believes that the sale of organs in richer nations would ‘tarnish the process’, and suggests that even in poorer countries accommodation or education should be offered in exchange instead of cash. 

When two people want to freely exchange some good or service, we need good reasons in a free market to prevent the exchange. Moreover, when it comes to a market in organs, the good in question is life saving. Why then should we prevent such exchanges when there are willing buyers and sellers?

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A pill-full of sugar helps the medicine go down

A medicine for children that has been shown to be effective in a wide range of conditions is to be released soon in the UK and is already available in the US. It has been exhaustively studied, and has no side effects. It is extremely cheap to produce, and will be readily available. Yet GPs, academics and ethicists are up in arms about the new drug. What is all the fuss about?

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Preventing Polka-Dot Problems: Should Measles Vaccination be Compulsory?

Jim Todd reports about his measles experience at BBC News. A number of years back such a report about how a case of adult measles feels would have been absurd, since so many had suffered it. A few years back it would have been absurd because measles was rare thanks to vaccination. But now, due to a reduction in vaccinations, the risk of measles is rising. Health chiefs in London are stepping up the vaccination program to try to stave off the rising number of cases. The key problem is that in many areas of London only 62% of toddlers
have been immunised, compared to the 95% that is needed to achieve herd immunity.
Vaccinated people act as firebreaks: if enough people are immune to a
disease long chains of infection become improbable, and epidemics do
not occur. Given this, should measles vaccination be compulsory?

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The Choice to Have Artificial Blood: Less than the Best?

Controversy has erupted around whether experiments to test artificial blood should stop. Experimental blood substitutes raised the risk of heart attack and death, yet U.S. regulators allowed human testing to continue despite warning signs, says a scathing new report.

Blood substitutes, or artificial blood, could be stored for years without refrigeration, and be used in battlefield situations. It would carry no risk risk of infection with hepatitis or HIV. It would be an acceptable alternative to Jehovah’s Witnesses who refuse life saving blood transfusions.
In a new report, researchers pooled data from 16 separate studies of five different blood substitutes, involving over 3,700 patients. Researchers found a 30 percent higher risk of death overall for patients who received transfusions using the blood substitutes. The risk of heart attack was nearly tripled in the groups receiving blood substitutes.

“Experts speculate that hemoglobin in the blood substitutes scavenges nitric oxide from the blood, causing blood vessels to constrict and sticky platelets to build up. That increases the risk of heart attacks.”

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Reverse Prostitution: cognitive biases and conditional cash transfers

Stuart Rennie writes a thoughtful blog on bioethics.net, Can
you buy changes in health behaviours? on how the World Bank backs an anti-AIDS experiment paying
young people to not contract sexually transmitted infections. The basic idea is not new, conditional cash transfer
programs in poor countries have had successes in improving health and education but applying it to sexual health moves it into more
controversial territory. Is there anything wrong with “reverse prostitution”?

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New hope or false hope for vegetative patients?

A BBC documentary screening this evening on the ‘Inside Out’ program reports on what it describes as a breakthrough for patients in a vegetative state. It is based upon research by a group of neuroscientists in Cambridge, who have used sophisticated brain scans (functional magnetic resonance imaging (fMRI)) to look for signs of consciousness in patients who have previously been thought to be completely unaware of their surroundings.

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Do we own our bodies? Should we?

There was a sad story last week about a young woman who died unexpectedly at the age of 19.   She was on the organ donor register, and her own mother was on the waiting list for a kidney donation, but the mother was refused one of the kidneys.  Even the transplant coordinator was ‘crying her eyes out’, but there was apparently no escape.  Rules were rules.  Cadaveric donations must go impartially and anonymously to the most compatible people at the top of the waiting list, and the authorities decreed that these organs must go to three strangers – whose identity the mother will never even know.

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