Practical Ethics

When the heart stops: harvesting organs from the newly (nearly) dead

In the New England Journal of Medicine yesterday, doctors from Denver reported on three controversial cases of heart transplantation from newborn infants. These cases are striking for several reasons. They were examples of so-called ‘donation after cardiac death’ (DCD), an increasingly frequent source of organs for transplantation, but done very rarely in newborns. They are controversial because the transplanted organs were hearts that were ‘restarted’ in recipients after they had stopped in the donor. Transplant surgeons waited only a relatively short period after the donor’s heart had stopped (75 seconds) before starting the organ retrieval process. These transplants raise serious questions about the diagnosis and definition of death.

Art or child porn?

In Australia recently, there has been heated debate about a series of photographs of naked and semi-naked children by photographer Bill Henson. The debate was reignited this month when Art Monthly, a major Australian art magazine, decided to put a picture of a nude 6 year old girl on its front cover. Politicians have attacked the photographs and the magazine’s editors

What’s wrong with the hermaphrodite world?

Making headlines last week, Melbourne bioethicist Rob Sparrow argued that in order to create the best future for their children, parents should select only girl children or hermaphrodites. He imagined a  “post-sex” world in which males are no longer conceived, and women use frozen sperm, or artificial gametes to reproduce.

Activists and acts of mercy

In Germany this week, and in Australia recently, there has been public concern and significant media attention about the actions of euthanasia activists. A former government official and lawyer, Roger Kusch, went public in Germany with a video of an elderly woman who he had helped to die. In Australia, Phillip Nitschke has been criticised for his involvement and subsequent comments about the death of Graeme Wylie a man suffering from Alzheimer’s disease whose partner and close friend have been found guilty of manslaughter.

Opponents of euthanasia have used these cases to argue against liberalisation of laws on assisted suicide or euthanasia.

When autonomy trumps sense: the costs of refusal to allow withdrawal of life support.

In Canada this week, an 84 year old man died after 9 months of treatment in an intensive care unit. He had severe brain damage and multi-organ failure, but his family sought a legal injunction to prevent doctors in the intensive care unit from withdrawing life-support. Over the course of his long intensive care stay, intensive care beds at a major trauma centre were closed so that nurses could used instead to support his care, and three doctors resigned from the hospital in protest at being required to provide what they felt was ‘unethical’ treatment.

Discrimination and infertility treatment

It has been reported in the newspapers today that in many parts of the country smokers have been refused access to in-vitro-fertilisation treatment. This appears to be contrary to the national evidence-based guidelines for fertility treatment. Is this unfair?

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?

Cloning and animal exploitation

The Daily Mail reports this morning that 8 clone-offspring cows have been born in the UK. Also today, the first survey of public opinion on ‘clone farming’ has been released indicating significant unease and opposition to the idea of meat products or milk from cloned sources.

There are strict prohibitions on reproductive cloning for humans in most countries (for example, the recently debated HFEA bill in the UK, and the Human reproductive Cloning Act 2001). However there are few, if any, constraints on the cloning of animals. Is this the start of a new era of animal exploitation?

Viability and the abortion debate - what really matters?

MPs in the House of Commons will debate tomorrow whether the cut-off for legal abortions in the UK should be reduced. Currently abortions are permitted up to the 24th week of a pregnancy, and some MPs have argued that this should be reduced to 20 weeks or below. Advocates and opponents of the change have pointed to scientific evidence about the viability of infants born extremely prematurely at 22, 23 and 24 weeks. They seem to believe that if we can answer the scientific question of whether such infants are viable, that will resolve the question about whether or not abortion is permissible at that stage.
That might be the case if there were a consensus on what viability means, and why it is important in questions about abortion time-limits. But, as this article will highlight, there is no such consensus, and it is not straightforward why viability should matter. So far in this public debate there has been little or no mention of the important questions – what is viability, and why is it important in abortion law?

The viability of fetuses and the abortion debate

A paper has been published online in the British medical journal today suggesting that survival of extremely premature infants (less than 24 weeks gestation) has not improved in the last decade. This comes less than a week before a debate in the House of Commons on the Human Fertilisation and Embryo Authority bill. It has been claimed that this paper “completely blows out of the water” the arguments of anti-abortion MPs who hope next week to push for a reduction in the cut-off for legal abortion (currently 24 weeks).