Health, Medicine and Bioethics News: Gene Patents, HIV testing and Forcing Parents to Vaccinate their KidsPosted: February 17, 2013
So, I’m thinking of starting a separate blog devoted entirely to health law, medicine and bioethics – but until then here are some news bits from the cyberspace:
- An Australian Federal Court has upheld a patent on the BRCA1 gene linked to breast cancer. Despite Australia having laws against patenting naturally occurring processes., the court took the view that the isolation of the BRCA1 gene was a process of manufacture. This is of considerable concern to researchers in the medical community.
- For those who like reading cases (you sick bastards) here is a doozy which sprung from a claim by the partner of a man who tested positive for HIV, who later ended up contracting the virus. The actual claim by the partner against the doctors who conducted the original tests settled out of court, but fall out led to several cross-claims and disputes about degree of liability (case name: Idameneo (No 123) Pty Ltd v Dr Colin Gross  NSWCA 423).
- Another interesting case from last year is Kingsford & Kingsford  FamCA 889 – which determined whether the Family Court could order a mother to vaccinate her child.
… and now for something completely different. Two recent articles in the Journal of Medical Ethics have presented a novel suggestion to aid in the preservation of organs for donation via elective non therapeutic ventilation (“EV”).
We are all aware of the use of ventilation when somebody is unable to sustain their own breathing within an intensive care setting, however EV differs significantly and is performed when a person is either on their way toward irretrievable brain death (but still capable of breathing) or as soon as possible after formal declaration of death.
This is an ‘elective’ procedure because it requires the patients full consent before any decrease in cognitive capacity or death.
The many ethical conundrums raised by this procedure include:
- ensuring full consent of the patient;
- the risk of the patient surviving in an unacceptably bad state;
- the possibility of changing our perception of organ donation and care in dying;
- the moral distress potentially caused to staff involved;
- the dilemma between the duty to respect a dying patient’s autonomy and the duty not to harm a patient; and
- the possible harm caused to families/caregivers by undertaking the procedure.
**If you would like to see more articles here of a Medico-legal / Medical Ethics genre, let me know!
The Age is reporting that a form of ‘synthetic cocaine’ is being sold in adult stores. I have my doubts that there is anything “cocaine” related about this new drug other than it being a stimulant which falls outside the Victorian legislation. This is a serious problem with attempting to control the use of illicit substances, as there are many ways to synthesise new drugs to have the same effect on neurotransmitter uptake or production to have essentially the same result as cocaine or amphetamines. Regulating the classes of drugs themselves doesn’t achieve much. This is especially true when we are talking about criminalisation which requires a specific list of “criminal vs non-criminal” versions of the drug so that therapeutic use of a derivative isn’t caught up. As for the effect of cracking down on this new substance, Paul Dillon, director of Drug and Alcohol Research and Training Australia said it best:
”What you are going to see is this will get a bit of media attention and it will disappear. Something new will come on the shelves next week.”
When is the right time to declare someone clinically ‘dead’? Nicholas Tonti-Filippini, in a new book, states that current definition of ‘death’ used in Victorian hospitals is at odds with community expectations, he told The Age:
“A new standard has taken hold in intensive care units in which the crucial aspect is absence of consciousness”
Clinically, his means that death can be declared even when the mid-brain and other ‘basic’ regions of the brain are still functioning – ensuring blood flow, and other basic signs of life (although not breathing).
Spokespeople for the clinical criteria stated that the definition preferred by Toni-Filippini – total loss of brain function determined by blood flow- was unsubstantiated, illogically strict and would put patients in need of organ donation at risk.