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A presumed consent system for organ donation

Earlier this month, Gordon Brown, writing in the Sunday Telegraph, voiced his support for a presumed consent system for post-death organ donation in the UK. At present, organs may be procured from a dead body without the family’s consent if the deceased had actively opted-on to a national organ donation register. Under a presumed consent system, all would be included on the register unless they had actively ‘opted out’.

Objecting to Brown’s proposal, the economist and journalist Irwin Stelzer writes in the Telegraph this week:

90 per cent of us favour organ donation, but only 25 per cent make advance arrangements to become donors. From that, the opt-out advocates conclude that most of the non-donors are merely negligent: they forget to register. Really?

It is equally plausible that non-participants have no objection to the procedure, but simply do not want to participate, just as many (most) people have no objection to elections, but choose not to participate, for reasons sufficient unto themselves.

This objection strikes me as unpersuasive.

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To push or not to push? Choosing to deliver by caesarean section.

Research published this week in the British Medical Journal shows that babies born by elective caesarean section are more likely to have breathing trouble after birth. This is especially the case for babies who are mildly premature (1 to 3 weeks early).

These results are important, since the rates of elective caesarean sections are high in the UK (as in many countries). These rates are higher in middle class mothers, a group  that has been labelled “too posh to push”.  But how should doctors respond to a request for a caesarean section by a mother (where there is no medical indication)? Do the increased risks of caesarean section justify placing restrictions on maternal choice?

Read More »To push or not to push? Choosing to deliver by caesarean section.

Private genetic tests, and the case for ‘Genetic education’

An advisory body to the UK government, the Human Genetics Commission has called for more regulation of genetic tests that are available for the public to buy privately.

The completion of the human genome project, and the advances (and economies) in genetic technology have led to a burgeoning industry in private genetic tests. In the US especially, but increasingly also in Europe it is possible to order a wide range of tests for genes associated with risk of disease.

It is argued that tests with significant health implications should not be advertised to the public, and should be available only through a medical practitioner. But is this attitude to testing unduly paternalistic? Is greater regulation a realistic response?

Read More »Private genetic tests, and the case for ‘Genetic education’