The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)

The international context of the last fifty years of modern bioethics have been significant in establishing health-care ethics or bioethics as a common parlance - an ideology of our times, achieving near universal acceptance, with little dissent. Most international health organizations have developed important declarations that have become the credo of their daily practice and long-term commitments. However, in the last decade in particular, bioethicists and other health-care practitioners and scholars have worried about the persistence of health-care inequities and the (...) inadequate realization of bioethics, particularly in low-to-middle income countries. Global bioethics, now well into the new millennium, has entered a regulatory crisis: it needs to confront not just global bioethical commitments around major scientific revolutions such as genomics, but further, a regulatory crisis about the persisting national public law silences and health inequities, especially in low-to-middle income countries. (shrink)

The international context of the last fifty years of modern bioethics have been significant in establishing health-care ethics or bioethics as a common parlance - an ideology of our times, achieving near universal acceptance, with little dissent. Most international health organizations have developed important declarations that have become the credo of their daily practice and long-term commitments. However, in the last decade in particular, bioethicists and other health-care practitioners and scholars have worried about the persistence of health-care inequities and the (...) inadequate realization of bioethics, particularly in low-to-middle income countries. Global bioethics, now well into the new millennium, has entered a regulatory crisis: it needs to confront not just global bioethical commitments around major scientific revolutions such as genomics, but further, a regulatory crisis about the persisting national public law silences and health inequities, especially in low-to-middle income countries. (shrink)

Human reproductive cloning has become the most palpable example of the globalization of science. Throughout the world, events and conjectures in the media, such as the birth and death in the United Kingdom of the cloned sheep Dolly and projects to clone human beings by Korean scientists, by members of the Canadian-based Raelian cult, and by the Italian physician Antinori in an undisclosed country, have galvanized the political will of individual countries to ban human reproductive cloning.Yet, international attempts to harmonize (...) policies in the area of biomedical ethics and human research, such as the 1997 Council of Europe’s Convention on Human Rights and Biomedicine, and most recently, the United Nations’ efforts to adopt an international convention against human reproductive cloning, have been insufficient to trigger a substantial global policy design process on issues relating to these new technologies. (shrink)

Many global health issues, almost by definition, do not recognize state borders and therefore require bi-lateral, or more often multi-lateral international solutions. These latter solutions are articulated in international instruments (declarations, conventions, treaties, constitutions of international bodies, etc). However, the gap between formal adoption of such instruments by signatory states and substantive implementation of the articulated solutions can be very wide. This paper surveys a selection of international legal instruments, including those where the sought after positive outcomes have been achieved, (...) and those that have been ineffective, with little or no real progress being made. The paper looks for commonalities, both in the nature of the problems and the forms of the international legal instruments, to seek answers as to why some instruments ultimately succeeded where others failed. It also provides some guidance to law/ treaty makers to help ensure that they frame future instruments in such a way as to maximize the probability that those instruments will have a substantive positive impact on global health and health rights. (shrink)

In this paper we review selected international legal instruments, the effect, if any, that they have had on global health, and how these instruments might have contributed to the realization of health rights. We consider a number of instruments from the international health law field as well as two from the field of international environmental law.1 The latter two, in addition to the considerable link between health and climate/environment, are considered with the purpose of drawing more generalized lessons about what (...) contributes to the success or failure of an international legal instrument; the lessons are then applied to our analysis of the health law instruments that are the primary focus of our paper. (shrink)

This series of responses was commissioned to accompany the article by Singer et al, which can be found at http://www.biomedcentral.com/1472-6939/2/1. If you would like to comment on the article by Singer et al or any of the responses, please email us on [email protected].

_A provocative examination of how unequal access to reproductive technology replays the sins of the eugenics movement_ Eugenics, the effort to improve the human species by inhibiting reproduction of “inferior” genetic strains, ultimately came to be regarded as the great shame of the Progressive movement. Judith Daar, a prominent expert on the intersection of law and medicine, argues that current attitudes toward the potential users of modern assisted reproductive technologies threaten to replicate eugenics’ same discriminatory practices. In this book, (...) Daar asserts how barriers that block certain people’s access to reproductive technologies are often founded on biases rooted in notions of class, race, and marital status. As a result, poor, minority, unmarried, disabled, and LGBT individuals are denied technologies available to well-off nonminority heterosexual applicants. An original argument on a highly emotional and important issue, this work offers a surprising departure from more familiar arguments on the issue as it warns physicians, government agencies, and the general public against repeating the mistakes of the past. (shrink)

In recent years, courts have increasingly found them-selves arbiters of disputes in the emotionally charged area of assisted reproductive technologies. Legal disputes are hardly surprising in the world of infertility medicine, where millions of patients spend billions of dollars in efforts to have a child. Increasingly, these efforts produce embryos that are frozen for later use, at once maximizing a couple's chances for success and minimizing the medical intrusiveness that necessarily accompanies most forms of assisted reproductive technologies. But with over (...) 100,000 embryos in frozen storage in the United States and a divorce rate of 40 to 50 percent, it is not surprising that disputes over the disposition of these embryos are arising, causing the legal landscape surrounding these technologies to continue to expand. (shrink)

In this paper, we argue for the importance of incorporating a gendered perspective for the effective development of sustainable agricultural biotechnology systems in sub-Saharan Africa. Priority setting for agricultural policy and project development requires attention to gender issues specific to the demands of agricultural biotechnology. This is essential for successfully addressing food security and poverty reduction in sub-Saharan Africa (SSA). There has been a great deal of debate and literature on the implications of gender in agricultural development and policy. However, (...) the implications of gender in agricultural biotechnology and have received relatively less attention, especially in SSA. Based on interviews with key stakeholders in agricultural biotechnology across SSA, review of pertinent literature and field observations, we have found that incorporating a gendered perspective is critical for the sustainable development of agricultural biotechnology and requires attention in five areas: the inclusion of women, particularly women farmers, in decision-making around biotech/genetically modified (GM) crop and trait selection; equal representation of women as men in education for agricultural science and in agricultural biotechnology research and development professions; greater involvement of women in extension services and farmers’ associations for successful delivery of information about biotech crops equality between men and women in access to resources for biotech/GM crop cultivation; and increased control for women farmers over biotech/GM crop management and income generation. We explain the consequences of failing to include such gender-responsive considerations into priority setting for agricultural biotechnology development and policy in SSA and provide recommendations for how policy makers and project partners of development initiatives can avoid such oversights. (shrink)

Research collaboration beyond national jurisdiction is one aspect of the globalisation of health research. It has potential to complement researchers in terms of research skills, equipment and lack of adequate numbers of potential research subjects. Collaboration at an equal level of partnership though desirable, may not be practicable. Sometimes, human research specimens must be transported from one country to other. Where this occurs, there should be clear understanding between the collaborating research institutions regarding issues of access and control of the (...) specimens as well as the duration of storage of specimens. The researchers have the duty to inform the research participants about specimen storage and transport across national boundaries. While obtaining informed consent from study subjects if specimens are to be stored beyond the life of the present study could be the ideal, there still remains significant challenges in a multi-cultural world. (shrink)

Decisions by industry sponsors to end clinical trials early for commercial reasons have been the subject of controversy. I argue that the principal consideration in assessing these decisions ought to be the way in which the termination would affect the trial’s risk–benefit relationship. If there is not yet sufficient benefit to be gained from the study to offset the risks to which participants were exposed and it is expected that important scientific information would be obtained if the trial were continued, (...) early termination constitutes an unethical alteration of the risk−benefit relationship. This violates the grounds on which permission is given to conduct human research, patients consent to participate, and investigators agree to conduct studies. These knowable and avoidable changes in risk–benefit relationship should generally be seen as impermissible. (shrink)

The United States Court of Appeals for the Third Circuit has followed the prevailing view in the federal courts by holding that state Medicaid funds must cover the same kinds of abortions as provided for under the 1994 Hyde Amendment. On July 25, 1995, the court held that a Pennsylvania law was preempted to the extent that it restricted Medicaid funding for abortions beyond the limits set by federal law ) by imposing additional procedures not prescribed by the Hyde Amendment.Particularly, (...) the court held that the Pennsylvania Abortion Control Acts ), whch requires victims of rape and incest to report the crime to law enforcement officials before Medicaid abortion funding is made available, exceeded the reporting requirements set by the Hyde Amendment, which provides a waiver for patients who are physically or mentally unable to comply with the reporting requirement. (shrink)