Italy criminalizes surrogacy from abroad

 Italy has banned its citizens from accessing surrogacy in other countries where it is legal.  It will be interesting to see how they enforce this. (But of course gay couples will have fewer opportunities to skirt the law than couples who could pretend to have had a pregnancy..)

The NYT has the story:

Italy Criminalizes Surrogacy From Abroad, a Blow to Gay and Infertile Couples. The new law was pushed by the party of Giorgia Meloni, Italy’s conservative prime minister. by Emma Bubola

"Italy passed a law on Wednesday that criminalizes seeking surrogacy abroad, a move the country’s conservative government said would protect women’s dignity, while critics see it as yet another crackdown by the government on L.G.B.T. families, as the law will make it virtually impossible for gay fathers to have children.

"Surrogacy is already illegal in Italy. But the government of Prime Minister Giorgia Meloni has vowed to broaden the ban to punish Italians who seek it in countries where it is legal, like in parts of the United States."

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Earlier:

Thursday, August 22, 2024  Surrogacy under continued attack in Italy

Medical Aid in Dying Laws in the U.S.

 JAMA has a review of the current state of medical aid in dying in the 12 U.S. jurisdictions (if Delaware proceeds) that now allow it.

Medical Aid in Dying Laws: More Accessible in More States by Thaddeus Mason Pope, JD, PhD, JAMA. 2024;332(14):1139-1140. doi:10.1001/jama.2024.15925

"Delaware may soon become the 12th US jurisdiction to authorize medical aid in dying. The Ron Silverio/Heather Block End-of-Life Options Law1 becomes a statute as soon as the governor acts and takes effect once the Delaware Department of Health and Social Services promulgates regulations to implement the statute. Delaware could follow 11 other US jurisdictions that have authorized medical aid in dying; more than 15 000 patients have received prescriptions for medical aid in dying since 1998 in California, Colorado, Hawaiʻi, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, Washington, and Washington, DC.

...

"Medical aid in dying has become an increasingly prominent end-of-life option. More than 20 states considered new medical aid in dying legislation in 2024, and most of the 11 jurisdictions that previously authorized medical aid in dying have amended their original statutes during the past 5 years (eTable in the Supplement).2-6 When enacting or amending medical aid in dying statutes, state policymakers have been carefully recalibrating the balance between safety and access

...

"Medical aid in dying is only available to terminally ill adults with decision-making capacity. They must have an “incurable and irreversible illness” with a prognosis of 6 months or less. If patients can navigate the other eligibility requirements and safeguards, they can get a prescription for lethal medications that they might later self-ingest to hasten their death.6

"Hospice and palliative care are often sufficient to address the suffering of patients, and one-third of those who receive medical aid in dying prescriptions never obtain them from the pharmacy or ingest them.3,4 Most of the remaining patients administer the prescriptions by mixing the powdered drugs with 2 oz to 3 oz of apple juice or push a plunger on a feeding or rectal tube. The patients fall asleep within minutes and usually die within an hour. There is never intravenous administration of the prescriptions or clinician- or third-party administration of the prescriptions.

...

"The Delaware end-of-life options law would require the patient to make 3 requests, 2 of which must be separated by at least 15 days.1 A waiting period has been a requirement in all jurisdictions that have authorized medical aid in dying. However, significant evidence showed that many patients either died or lost decision-making capacity before expiration of the waiting period.4 Many states (California, Colorado, Hawaiʻi, New Mexico, Oregon, and Washington) have either shortened their waiting periods or permit the waiting period to be waived when the patient is likely to die or lose decision-making capacity.

"The Delaware end-of-life options law would be limited to residents of Delaware1; however, for nonresidents, Delaware residency can be established by renting an apartment in Delaware.4 Residency requirements remain an additional hurdle in a long list of obstacles that terminally ill patients must navigate to become eligible. Within the past 2 years, both Oregon and Vermont removed their residency requirements.2,4,6 And the constitutionality of New Jersey’s residency requirement is being challenged in federal court.6 Nationwide, many bills proposed in 2024 omitted residency preconditions.

...

"Commentators regularly express concerns about the use of medical aid in dying in Canada7 and in Europe. It is important to protect vulnerable populations from coercion, duress, and inadequately considered choices; patients should not be steered toward choosing to request medical aid in dying. In addition, the adverse effects of orally ingested medications must be mitigated.4 In California, SB 1196 would have probably solved that problem by permitting (self-administered) intravenous administration of the end-of-life prescriptions. However, any change that would allow intravenous administration and other new and imminent expansions for medical aid in dying raise their own set of novel challenges for US clinicians.

"Given the number of bills and other indicators of interest, medical aid in dying is likely to be authorized in more states over the next few years, and the use medical aid in dying is likely to increase with more accessible terms and conditions. Although medical aid in dying continues to be used by less than 1% of dying patients,2 it is becoming a more integral part of end-of-life care."

California Bans Legacy Admissions at Private Universities.

 The NYT has the story:

California Bans Legacy Admissions at Private Universities. The change will affect Stanford University, the University of Southern California and other private colleges in the state. By Shawn Hubler and Soumya Karlamangla, Sept. 30, 2024

"California will ban private colleges and universities, including some of the nation’s most selective institutions, from giving special consideration to applicants who have family or other connections to the schools, a practice known as legacy admissions.

"Gov. Gavin Newsom signed legislation on Monday that will prohibit the practice starting in the fall of 2025.

...

"The University of California, the California State University System and other public California campuses have banned legacy admissions for decades. But private colleges continued to give some preference to the descendants of alumni or major donors.

...

"Only one other state, Maryland, bans legacy preferences at both private and public institutions. Illinois, Virginia and Colorado ban legacy admissions, but only at public universities and colleges.
...

"After the Varsity Blues scandal in 2019, in which parents seeking to win spots in top-ranked schools for their children were found to have paid bribes and falsified their children’s credentials, Mr. Ting tried to push through a bill banning legacy preferences in California. That effort fell short.

"But he did succeed with a measure requiring private colleges to report to the Legislature how many students they admit because of ties to alumni or donors. Those reports showed that the practice was most widespread at Stanford and U.S.C., where, at both schools, about 14 percent of students who were admitted in the fall of 2022 had legacy or donor connections. At Santa Clara University, Mr. Newsom’s alma mater, 13 percent of admissions had such ties.

"Republicans as well as Democrats in the California Legislature voted for Mr. Ting’s latest proposal, which will punish institutions that flout the law by publishing their names on a California Department of Justice website. An earlier version had proposed that schools face civil penalties for violating the law, but that provision was removed in the State Senate."

Anticipating kidney exchange in Germany in the Frankfurter Allgemeine Zeitung

  Here's an op-ed in the Frankfurter Allgemeine Zeitung, celebrating the anticipated beginning of kidney exchange in Germany.

Der Volkswirt Hoffnung durch Tausch  by Ágnes Cseh, Christine Kurschat, Axel Ockenfels und Alvin E. Roth

Here's the English translation (from a slightly earlier draft):

Hope through exchange

Germany's new draft law on kidney donation

Imagine this: Your child needs a kidney transplant, but due to tissue incompatibility you cannot be a donor yourself. And it's the same for me. What if you donated a kidney to my child and I donated a kidney to yours in return? Through this ‘cross-donation’ we could give our children the chance of a longer life with a better quality of life.

In Germany, such cross-donations are not usually permitted. Only people who are ‘obviously close in a special personal relationship’, such as relatives and spouses, are allowed to donate kidneys. This is now set to change. The Federal Cabinet has presented a draft bill to amend the Transplantation Act, which would allow cross-donations and other forms of living kidney donation. These include ring exchanges with more than two participating couples as well as longer donor chains initiated by a non-directed, anonymous donation.

People who hear about cross-donation for the first time are sometimes skeptical. However, these concerns can be dispelled on closer inspection. In our neighboring countries and in many other countries, such donations have long been successfully established in compliance with the highest ethical standards.

In cross-donation, no prices are paid for kidneys and there is no trading in kidneys. A system in which potential cross-donors are registered and referred centrally can be implemented in an abuse-proof manner, as experience abroad has shown. The Ministry of Health's draft calls for a close relationship to continue to exist between donor and recipient who register together in the kidney donation program, but no longer necessarily between the donor of an organ and the recipient of the same organ. The couples involved can be guaranteed anonymity, so that mutual influence can be ruled out and at the same time the altruistic motive for donating to the next of kin remains unchanged.

But what happens if the donor has already donated their kidney, but the cross-donor suddenly cancels? To avoid such situations, the two kidneys are removed from the two donors at the same time, and the two patients also receive the two organs at the same time. The four surgical teams communicate in order to coordinate the procedure safely.

The argument that authorizing cross-donation could increase the pressure on potential donors does not stand up to closer scrutiny either. The option of cross-donation does not create any additional pressure that is not already exerted on compatible donors. Instead, cross-donation merely expands the pool of potential donors. 

Incidentally, cross-donation also shortens the waiting list for post-mortem donations, so that patients without donors can also be helped. At the same time, cross-donation can protect the legitimate interests of those people who do not wish to donate if it is implemented in a suitable institutionalized manner and the best possible information is provided.

Germany now has the opportunity to learn from the existing systems in Europe in order to avoid mistakes in the regulations and their implementation for the benefit of organ recipients and donors. This applies, for example, to the establishment of a nationwide kidney donation program, from funding and equipment to biomedical expertise. The Federal Ministry of Health is making important proposals here. The large gaps in data on potential donors and recipients could soon be closed, the option of enabling international coordination of cross-donations is being considered from the outset, and the transplant centres are being encouraged to register all donor-patient pairs centrally for referral. Without such regulations, individual clinics could be incentivized to only selectively register pairs, with the result that fewer transplants can be carried out overall.

Other aspects of the draft should be reconsidered. For example, it is not advisable that couples can only participate in the kidney exchange program if donor and recipient are incompatible. Compatible couples can receive a more suitable kidney through participation and at the same time other patients can be helped, as more cross-donations are made possible through participation. This in turn can shorten the waiting list for all patients who do not have their own donor and therefore cannot participate in the kidney exchange program.

It is good news that new forms of living organ donation are now also to be made possible in Germany. The precise organization of these new forms of organ donation is crucial to their success. It can be modelled on the experiences of other countries and at the same time adapted to the specific legal, historical and ethical framework conditions in Germany. The initial investment would be amortized very quickly through the savings in treatment costs for expensive dialysis. 

In view of the draft law, we are optimistic that the wish of many potential donors to help can be fulfilled in the future, thus improving the care situation for kidney patients in Germany.

Ágnes Cseh (University of Bayreuth), Christine Kurschat (University of Cologne), Axel Ockenfels (University of Cologne and Max Planck Institute for Research on Collective Goods in Bonn) and Alvin E. Roth (Stanford University)

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Here's the (rather opaque) graphic the newspaper created (maybe it's a celebration by kidneys):

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Here's a link to what I think was my first op-ed in German on allowing kidney exchange there...

Thursday, March 17, 2016

German organ transplant law should be amended or reinterpreted to allow kidney exchange: my op-ed in Der Tagesspiegel

Oregon ends decriminalization of drugs, continues to experiment

 Here's the story in the Washington Post

Hard drugs illegal again in Oregon as first-in-nation experiment ends

"Sunday marks the end of an experiment that drug-reform advocates called a pioneering and progressive measure to better help people. Oregon legislators reassessed Measure 110 this year and decided to again make it a misdemeanor to possess a minor amount of drugs — essentially anything besides marijuana. Selling and manufacturing illicit drugs was and is still illegal in Oregon.

...

"On Feb. 29, the Oregon House of Representatives voted 51-7 to recriminalize drugs, with bipartisan support. The Oregon Senate did the same by a vote of 21-8 the next day. Gov. Tina Kotek (D) signed recriminalization into law April 1.

"Data shows how the [decriminalization] law was used in practice. The Oregonian reported that circuit court data collected by the Oregon Judicial Department from when the law went into effect Feb. 1, 2021, to Aug. 26, 2024, showed that the state’s circuit courts imposed just under $900,000 in fines under the measure but collected only $78,000 of those fines.

"The conviction rate for the 7,227 people cited was 89 percent, with most of those because people didn’t show up to court, the Oregonian reported. Data showed that 85 people completed the substance abuse screening in lieu of a conviction.

"The most commonly cited drug was methamphetamine, accounting for 54 percent of citations. Fentanyl and other Schedule II drugs, the Oregonian reported, ranked second at 31 percent."

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And here's the Guardian's coverage:

Oregon: drug possession to be a crime again as decriminalization law expires. First-in-nation trial comes to an end, as new law gives those caught with hard drugs option of charges or treatment

"The new recriminalization law, HB4002, will give those caught with illicit drugs – including fentanyl, heroin and meth – the choice to either be charged with possession or treatment, which includes completing a behavioral health program and participating in a “deflection program” to avoid fines.

"Personal-use possession would be a misdemeanor punishable by up to six months in jail. It aims to make it easier for police to crack down on drug use in public and introduced harsher penalties for selling drugs near places such as parks.

"The recriminalization law encourages, but does not mandate, counties to create treatment alternatives to divert people from the criminal justice system and toward addiction and mental health services."

End Kidney Deaths Act intoduced in Congress

 Here's the press release from the Congressional sponsors:

Malliotakis Introduces Bipartisan End Kidney Deaths Act, August 12, 2024

"(WASHINGTON, DC) - Today Congresswoman Nicole Malliotakis (NY-11) joined Reps. Don Bacon (NE-02), Josh Harder (CA-09) and Joe Neguse (CO-02) in introducing the End Kidney Deaths Act, bipartisan legislation that would provide a refundable tax credit to living kidney donors who donate kidneys to strangers, specifically those waiting the longest on the kidney waitlist.

"Specifically, the End Kidney Deaths Act will provide a $10,000 refundable tax credit per year for five years ($50,000 total) to living kidney donors who donate kidneys. If enacted, this legislation is expected to save up to 100,000 Americans currently on the waitlist and save taxpayers an estimated $10 to $37 billion."

...

VIEW THE BILL TEXT HERE

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And here's the Coalition to Modify NOTA 's press release(which includes quotes from some of their long list of supporters...)

LIFE-SAVING END KIDNEY DEATHS ACT INTRODUCED TO CONGRESS; PROJECTED TO SAVE 100K LIVES AND $37 BILLION OVER 10 YEARS

Washington DC – The End Kidney Deaths Act (H.R. 9275) has just been introduced by Congressional Representative Malliotakis (R-NY) and Representative Harder (D-CA). This bill will save up to 100,000 American lives and $37 billion tax dollars over the next decade by offering refundable tax credits to encourage living kidney donation in this ten-year pilot program. The End Kidney Deaths Act will provide all Americans who donate kidneys to strangers at the top of the kidney waitlist with a refundable tax credit of $10,000 each year for five years, totaling $50,000."

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Earlier:

Saturday, July 22, 2023

Modify NOTA: a new effort

Kidney exchange in Germany: draft of a proposed law

 Yesterday the German Federal Cabinet published the draft of a law that would allow kidney exchange in Germany. Below is the text of the press release from the Ministry of Health,  via Google Translate. (Prof. Dr. Karl Lauterbach is the Federal Minister of Health.)

Lauterbach: Überkreuzspende gibt Nierenkranken Hoffnung  Cross-donation gives hope to kidney patients

July 17, 2024

"In the future, kidney donations should also be possible between two different couples. This is the aim of the draft of a third law amending the Transplantation Act - amendment of the regulations on living organ donation, which was approved by the Federal Cabinet today.

This makes it possible for a donor's kidney to go not only to their partner, but also to a recipient from a second couple who in turn donates a kidney (living cross-donation). At the same time, the law ensures increased protection for donors, who should receive better information and medical and psychosocial support.

Dying on the waiting list must come to an end. In the long term, we therefore need the opt-out solution. In the short term, we can make more organ donations possible through cross-donation: those who donate themselves can be helped more quickly in their personal environment. Up to now, living donations have only been possible between partners. In the future, it should also be possible between couples who are not so close. This initially gives hope to many kidney patients.

Federal Minister of Health Prof. Karl Lauterbach

The main changes

Cross-living kidney donations are made possible

Donation and receipt of a kidney “crosswise” by another organ donation partner in medically incompatible organ donation couples.

In the case of a cross-donation, the two couples no longer have to know each other - but the close relationship between the incompatible partners remains mandatory.

Regulation of non-directed anonymous kidney donations.

The tasks of the transplant centers in the context of a cross-living kidney donation and a non-directed anonymous kidney donation are regulated. The transplant centers decide on the acceptance of incompatible organ donation pairs and non-directed anonymous kidney donations from donors and transmit the data required for the placement to a central office for the placement of kidneys in the context of the cross-living kidney donation. After the placement decision has been made, the transplant centers concerned organize the removal and transfer jointly.

Establishment of a national program for the arrangement and implementation of cross-living kidney donations. A body for the arrangement of kidneys within the framework of cross-living kidney donations will be established or commissioned. The arrangement procedure will be laid down by law.

Distribution of kidneys in the context of cross-living kidney donations exclusively according to medical criteria and while maintaining anonymity. The authorization of the German Medical Association to determine the state of medical science in guidelines is expanded to include the rules for accepting and distributing kidneys from incompatible organ donation pairs and from non-directed anonymous kidney donations in the context of cross-living kidney donations.

The previously applicable principle of subsidiarity in Section 8 Paragraph 1 Sentence 1 Number 3 TPG is repealed in order to also enable preemptive kidney transplants.

Previously: removal of organs from a living person only if no post-mortem organ was available.

Donor protection is further strengthened

Expansion of the regulations to clarify and specify donor suitability.

Introduction of compulsory psychosocial counseling and evaluation. The necessary knowledge and skills for the

Psychodiagnostic evaluation and psychotherapeutic treatment can only be carried out by medical or psychological specialists with specific training or further education in psychological, psychosomatic or psychiatric issues (so-called mental health professionals). The independence of the expert ensures that the consultation and evaluation is not influenced by the transplant medical managers in the transplant center, that there are no professional dependencies with these managers and that the expert is solely committed to the interests of the donor. The requirements for the qualifications of the independent expert will in future be set out in the guidelines of the German Medical Association.

Individual support for donors through the introduction of a living donation companion who accompanies and advises the donor throughout the entire donation process in the transplant center. The living donation companion must be a doctor, nurse or person experienced in psychological or psychotherapeutic issues and must be professionally experienced and independent of the specific transplant process. He or she may not be involved in the removal or transfer of the organs, nor be subject to instructions from a doctor who is involved in these measures.

Introduction of federal legal requirements for the activities of living donation commissions.

Granting of additional points

Living kidney donors who themselves require a kidney transplant later in life due to an illness should receive additional points when kidneys are arranged, the amount of which should be determined in the guidelines of the German Medical Association."

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Axel Ockenfels writes:

" I took a quick look at the draft bill that was passed by the federal cabinet in Germany today and that would allow kidney exchange. There are many good aspects in the bill, such as the mandatory participation of hospitals in a national exchange program and the possibility of non-directed donations (which was more controversial), as we suggested to the Ministry in a paper by Ashlagi, Cseh, Manlove, Ockenfels and Pettersson.   

"I am happy to see that the draft seems to agree that the details of matching should be delegated to experts and not overly specified in the law, as suggested by Tayfun Sönmez, Utku Ünver and me in a comment on the previous draft, as well as by others.  

"One consequence of the previous draft would have been that non-directed donations would almost always have gone to patients on the waiting list and would not have been included in the kidney exchange. We advised against this and are happy to see that the draft bill document now states that "a non-directed anonymous kidney donation is in principle initially made in favour of a recipient of an incompatible organ donor pair" (p. 67, DeepL translation), and that it also allows chains of kidney donations initiated by non-directed donors (although I find the wording of the draft somewhat unclear in this respect).  

"We also strongly recommended that compatible pairs be allowed to participate in kidney exchanges, yet the bill would still make this impossible: "Participation as a pair of compatible organ donors and organ recipients in a crossover living kidney donation, on the other hand, is not envisaged, as a living organ donation would be immunologically possible in these pairs. There is therefore no need to enable cross-living kidney donation for these couples as well" (p. 66, DeepL translation). 

"This is unfortunate because the inclusion of compatible pairs has many benefits and can sometimes make everyone better off, including the patient in the compatible pair, additional donor-patient pairs, and patients on the waiting list. However, this may not be the last word, as there is still room for change in the upcoming legislative process. 

"The document also comments on the possibility of cross-border exchanges: "Commissioning the institution that already handles the procurement of post-mortem donated organs [namely Eurotransplant] also opens up the option of establishing an international programme - comparable to the exchange of post-mortem donated organs - within the Eurotransplant Network" (p. 31, DeepL translation)."

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Here are all my posts on Germany and kidney exchange.

Repugnance doesn't establish standing in court: Supreme Court reverses Kacsmaryk on medical abortion

  Yesterday the Supreme Court ruled unanimously that (for the time being at least) the medical abortion pill mifepristone should remain legal and widely available.  This reverses the decision of judge Matthew Kacsmaryk of the Federal District court in Amarillo Texas, who ruled that the FDA's authorization of the drug was illegal. (That decision was stayed pending appeal, which has now reversed it.)

The Supreme Court left open the underlying legal issues, but ruled against Judge Kacsmaryk's decision that the plaintiffs in the case, a consortium of medical associations and physicians had standing to bring the case. They say clearly that finding a law repugnant doesn't give a plaintiff standing:

“standing screens out plaintiffs who might have only a general legal, moral, ideological, or policy objection to a particular government action.” 

More colorfully, they say

"As Justice Scalia memorably said, Article III [standing] requires a plaintiff to first answer a basic question: “‘What’s it to you?’” A. Scalia, The Doctrine of Standing as an Essential Element of the Separation of Powers, 17 Suffolk U. L. Rev. 881, 882 (1983). For a plaintiff to get in the federal courthouse door and obtain a judicial determination of what the governing law is, the plaintiff cannot be a mere bystander, but instead must have a “personal stake” in the dispute."

Here is the full opinion:

SUPREME COURT OF THE UNITED STATES, “ FOOD AND DRUG ADMINISTRATION ET AL. v. ALLIANCE FOR HIPPOCRATIC MEDICINE ET AL. CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT No. 23–235. Argued March 26, 2024—Decided June 13, 2024, https://www.supremecourt.gov/opinions/23pdf/23-235_n7ip.pdf 

Kidney exchange in Germany?

 A draft law to make kidney exchange legal in Germany, and to allow nondirected donation, is making some progress: here (with the help of Google Translate) is a news story on the proposed new law.

Living kidney donation should be made easier

"In order to reduce the organ shortage in Germany, Federal Health Minister Karl Lauterbach (SPD) wants to make living kidney donations easier. This emerges from a draft amendment to the Transplantation Act. The Star first reported.

"According to the draft, the previously prescribed “proximity ratio” for so-called cross donations will no longer apply in the future. To date, couples in which one person wants to donate a kidney to the other but this is not possible due to incompatibility are only allowed to “cross-donate” with another couple in a comparable situation if there is a close relationship between the couples. This is intended to prevent organ trafficking and commercialization.

"In the future, this cross donation could be made without proximity, thereby significantly expanding the circle of recipients. According to the draft bill, the donation should be anonymous and organized by transplant centers. The aim of anonymity is to prevent money from being paid for an organ.

"Anonymous kidney donations should also be possible in principle. In the future, people in Germany could donate a kidney for selfless reasons without knowing who it is going to. In countries like the USA, this option has existed for a long time."

HT: Dorothea Kubler

Menthol cigarettes get a reprieve

 The WSJ has the story:

Biden Administration Shelves Plan to Ban Menthol Cigarettes. White House had been weighing health benefit of ban against angering some Black voters   By Jennifer Maloney, Liz Essley Whyte, and Andrew Restuccia

"The Biden administration is reversing course on its plan to ban menthol cigarettes, after the White House weighed the potential public-health benefits of banning minty smokes against the political risk of angering some Black voters in an election year. 

...

Menthols account for more than a third of all cigarettes sold in the U.S. each year and are predominantly used by Black and Hispanic smokers. Some 81% of Black smokers used menthols in 2020, compared with 30% of white smokers and 51% of Hispanic smokers, according to a Wall Street Journal analysis of data from the National Survey on Drug Use and Health.

Some Black community leaders had fought the measure, saying a ban would expand the illicit market for cigarettes and lead police to racially profile Black smokers. The American Civil Liberties Union and some members of the Congressional Black Caucus expressed similar concerns.

...

"By contrast, Rep. Robin Kelly (D., Ill.), chair of the Congressional Black Caucus Health Braintrust, said she was “deeply disappointed that the FDA has chosen to abandon its established plan to ban menthol cigarettes… This is a common-sense plan which could have saved hundreds of thousands of lives.”

"Political considerations have swayed the Biden administration’s thinking on this public-health issue, said Mitch Zeller, who served as director of the FDA’s Center for Tobacco Products until 2022. “The science is clear that there will be a massive health benefit from removing menthol cigarettes,” he said."

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All my posts on menthol here.

Proposed age-adjusted smoking ban in the U.K.

 The BBC has the story, about a proposal to ban smoking for everyone currently under the age of 18. (What could go wrong?)

What is the UK smoking ban, how will it work and when will it start? By Aurelia Foster, BBC News

"Prime Minister Rishi Sunak effectively wants to ban smoking in the UK.

MPs have voted to back the government's plans to create a "smoke-free generation", and reduce the number of smoking-related deaths.

What is the smoking ban?

The restrictions will apply to the sale of cigarettes in the UK rather than the act of smoking itself.

Under the new law, each year the legal age for cigarette sales - currently 18 - will increase by one year.

It means that people born in or after 2009 will never be able to legally buy cigarettes, leading to an effective ban.

The law will not affect those who are allowed to buy cigarettes now.

To crack down on under-age sales, the government says it will introduce £100 on-the-spot fines for shops in England and Wales which sell tobacco and vapes to under-age people.

Local authorities will retain the proceeds to reinvest into enforcement of the law.

This would be on top of £2,500 fines that courts can already impose.

The government says it will spend £30m on enforcement, which will include tackling the availability of cigarettes on the black market.

The new rules will apply in all duty free shops in the UK, but anyone buying cigarettes abroad would be able to bring them back to the UK as long as they were legally acquired elsewhere.

The government aims to have the new system in force by 2027.

Mr Sunak wants to work with the governments of Wales, Scotland and Northern Ireland to introduce the legislation across the UK."

HT: Oğuzhan Çelebi

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Earlier: 

Thursday, March 14, 2024

New Zealand repeals anti-smoking law that would have prevented tobacco sales to anyone born after 2008

The Ethical Limits of Markets by Kim Krawiec

 Here's a new summary by one of the leading scholars of "taboo trades."

Kimberly D. Krawiec, "The Ethical Limits of Markets: Market Inalienability," Forthcoming, The Research Handbook On The Philosophy of Contract Law (edited by Mindy Chen-Wishart and Prince Saprai)   3 Apr 2024

Abstract: Although ethical critiques of markets are longstanding, modern academic debates about the “moral limits of markets” (MLM) tend to be fairly limited in scope. These disputes center, not on the dangers of markets per se, but on the dangers of exchanging particular items and activities through the marketplace. Proponents of MLM theories thus do not want to eliminate markets entirely, but instead seek to identify the moral and ethical boundaries of the marketplace by considering which goods and services are inappropriate for market trading. This chapter summarizes and categorizes some of the more important arguments within this debate, with a focus on recent research, controversies, and applications. The goal is to provide an overview of these debates, highlighting some of the topics that have generated robust discussion, particularly when relatively recent empirical or theoretical work may shed new light on a topic. Specifically, I focus on crowding out, corruption, leaving a space for altruism, equality, and a trio of related debates regarding paternalism (coercion, unjust inducement, and exploitation).

Here's her opening paragraph:

"Markets have limits—even the staunchest libertarian agrees with that idea.1 But the consensus ends there. There is no agreement on what those limits should be or why, as demonstrated by the vast variation in legal regimes around the world. For example, markets in sex are legal in much of the world and illegal in most of the United States.2 Markets in gametes and surrogacy services are legal and thriving in most of the United States and illegal in much of the rest of the world.3 Most of the world prohibits payments to plasma donors and, as a result, are forced to meet their domestic plasma needs by importing plasma-derived products from the United States, which in turn meets demand by paying plasma donors.

New York is about to end its legal ban on adultery

A 1907 New York state law criminalizing adultery (as a misdemeanor) looks likely to be repealed.

New York adulterers could get tossed out of house but not thrown in jail under newly passed bill  by MAYSOON KHAN, Associated Press/

"A little-known and rarely enforced law from 1907 that makes adultery a crime in the state of New York could soon be a thing of the past, after lawmakers passed a bill Wednesday to repeal it.

"The state Senate approved the bill almost unanimously. It's now up to New York Gov. Kathy Hochul, who is in the midst of budget negotiations, to make the ultimate decision. Her office said she'd review the legislation. The state Assembly passed the measure last month.

"Laws banning adultery still exist in several states throughout the country, but they are seldom enforced. The New York law was initially implemented to bring down the number of divorces at a time when adultery was the only way to secure a legal split.

Adultery, classified as a misdemeanor in state penal code and punishable by up to three months behind bars, is defined in New York as when a person “engages in sexual intercourse with another person at a time when he has a living spouse, or the other person has a living spouse.”

...

"Adultery is still a crime in several other U.S. states, mostly as a misdemeanor, though Oklahoma, Wisconsin and Michigan treat it as a felony offense."

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Here's the bill that is awaiting the Governor's signature. 

Still illegal in Idaho

 Here's a map from The Hill of places where marijuana will be legal to various degrees by the end of this year. Grey states are where marijuana is still entirely illegal.  Despite the best attempts of the previous presidential administration to make America grey again, Idaho is one of only three states that remain grey: they are surrounded by states in which cannabis is legal in some form, and most of Idaho's neighbors have legalized marijuana (even) for recreational purposes (bright green on the map).

But Idaho is holding the line, which seems to be politically popular there.

The NYT has the story:

A Legal Pot Pioneer Was Busted in Idaho With 56 Pounds. He Has a Plan.  By Corey Kilgannon

"In retrospect, the Idaho shortcut might have been a bad idea.

...

"Idaho is surrounded mostly by pot friendly states and is strict about people driving through with the stuff. The authorities are especially vigilant in “corridor counties” along Interstate 84, of which Gooding County — where Mr. Beal encountered the state police — is one.

"Under state law, carrying more than 25 pounds of marijuana is a felony with a mandatory minimum sentence of five years; the maximum is 15 years, with a maximum fine of $50,000.

“It’s one of the worst places in the country to possess marijuana, definitely,” Michelle Agee, Mr. Beal’s court-appointed lawyer, said. “Idaho is stuck in the 1950s as far as marijuana goes. It’s definitely the wrong place, wrong time for a person to be accused of having marijuana.”

...

"Reached for comment, Idaho’s attorney general, Raúl R. Labrador, a former Republican congressman who helped found the conservative House Freedom Caucus, said that legalization in neighboring states had done nothing to deter the strict enforcement of the laws in Idaho.

“We’ve watched how those decisions to legalize drugs have ruined other states, and Idaho demands just a bit better for our citizens and communities,” he said. “If you are trying to transport marijuana across state lines through Idaho, take the long way instead. It’ll save us money on your incarceration.”

Cannabis in US airports

 An anomaly of US Federal law is that marijuana is illegal on airplanes (interstate commerce) even when the airports involved are in states where marijuana is legal.

The WSJ has the story and a picture:

Don’t Put Your Stash in the Overhead Bin. A ‘Cannabis Amnesty Box’ at Chicago’s Midway Airport.  By Bob Greene

Mexico’s Law Suit Against US Gun Dealers

U.S. gun dealers are protected against lawsuits stemming from crimes committed by their customers. by the Protection of Lawful Commerce in Arms Act (PLCAA), But that law doesn't protect them from lawsuits resulting from their own actions, and a U.S. judge has permitted a suit by Mexico to go forward which accuses five Arizona gun dealers of violating American laws.

Law.com has the story:, 

Federal Court in Arizona Allows Mexico’s Case Against US Gun Dealers to Proceed. The federal gun industry shield law should not keep the suit from moving forward, U.S. District Court Judge Rosemary Márquez ruled. by Amy Guthrie 

"A federal district court judge in Arizona has ruled that a lawsuit filed by the government of Mexico against five Arizona firearm dealers alleged to be engaging in weapons trafficking should be allowed to proceed.

"U.S. District Court Judge Rosemary Márquez held that the federal gun industry shield law, the Protection of Lawful Commerce in Arms Act (PLCAA), should not prevent the suit from advancing. 

...

"The complaint “adequately alleges that defendants’ knowing violation of firearm-specific statutes proximately caused plaintiff’s injuries for purposes of the predicate exception to the PLCAA,” she wrote in her ruling, dated March 22.

"Mexico’s lawsuit seeks to hold the dealers accountable for “reckless and unlawful business practices,” alleging they facilitated gun trafficking across the border into Mexico and contributed to gun violence in that country. "

New Zealand repeals anti-smoking law that would have prevented tobacco sales to anyone born after 2008

 In an earlier blog post, I wrote about a New Zealand anti-smoking law, saying "And now there's a law that cuts nicotine content of cigarettes, and (get this) "bans the next generation of New Zealanders — anyone born after 2008 or currently 14 years old or younger — from ever buying cigarettes in the country. " (That's going to be a complicated age restriction to administer in, say, 10 years from now...)  

Well, people born in 2008 are turning 16 this year, and New Zealand just repealed that law, for reasons that New Zealand's prime minister Christopher Luxon says include concerns about black markets.

Here's an article from Medpage today, reporting on the change in the law. However the article takes the point of view that black markets are just a smokescreen thrown up by tobacco companies.

Up in Smoke: What Happened to New Zealand's Tobacco Ban Plan?— It appears the new government is making an embarrassing attempt to fend off a budget shortfall. by Eric Trump, March 6, 2024

"As part of the newly elected coalition government's rush to tick 49 "actions"  off its 100-day list by March 8, it has repealed  the Smokefree Environments and Regulated Products Amendment Act of 2022. This act, passed by the previous Labour government, would have banned selling tobacco products to those born on or after January 1, 2009, reduced the nicotine in tobacco products to non-addictive levels, and slashed the number of outlets allowed to sell tobacco by 90%, from 6,000 to 600. Overall tobacco use was predicted to drop from the current 8% to lower than 5% by 2025, and the act was expected to create a tobacco-free generation.

...

"Why would New Zealand's new coalition government, an alliance opens in a new tab or window

of the conservative National Party along with the libertarian ACT and populist New Zealand First parties, repeal data-driven and life- and money-saving legislation? Without a shred of evidence, Prime Minister Christopher Luxon and his coalition partners have repeatedly claimed restricting tobacco and reducing nicotine levels is experimental (as though that were a bad thing), leading to black marketsopens in a new tab or window and a proliferation of crimeopens in a new tab or window. ACT's health spokesperson Todd Stephenson, for example, said thatopens in a new tab or window the "radical prohibitionism" of creating a smoke-free generation would "push smokers into the arms of gang members."

"This rhetoric uncannily echoes the tobacco lobby. Public health experts at the University of Otago recently released a damning reportopens in a new tab or window showing that the coalition government's arguments in favor of a repeal closely mirror the tobacco industry's own narratives on this subject.

"So suspicious are the similarities between the flimsy remarks of coalition partners and tobacco companies' talking points that the report's authors are calling on all members of parliament to declare any past associations with tobacco companies.

######

 

Here's the story about the Prime Minister's concerns, from Radio New Zealand (RNZ):

Smokefree legislation would have driven cigarette black market - Christopher Luxon

France amends its constitution to protect access to abortion

 The decision of the U.S. Supreme Court to overturn Roe v.Wade and end a constitutional right to abortion in the U.S. prompted France to amend its constitution to guarantee access to abortion.

Here's the WSJ story:

France becomes first country to explicitly enshrine abortion rights in constitution  By Karla Adam

"With the endorsement of a specially convened session of lawmakers at the Palace of Versailles, France on Monday became the first country in the world to explicitly enshrine abortion rights in its constitution — an effort galvanized by the rollback of protections in the United States.

"The amendment referring to abortion as a “guaranteed freedom” passed by a vote of 780 in favor and 72 against, far above the required threshold of support from three-fifths of lawmakers, or 512 votes.

"French President Emmanuel Macron announced that a “sealing ceremony,” a tradition reserved for the most significant laws, would take place Friday, coinciding with International Women’s Day.

“We’re sending a message to all women: Your body belongs to you, and no one can decide for you,” Prime Minister Gabriel Attal told lawmakers assembled in Versailles."*

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Le Monde has the story, in an editorial supporting the amendment:

Enshrining abortion access in the French Constitution is a win for feminism and democracy, EDITORIAL, Le Monde, March 4

"The joint session of both houses of Parliament convened in Versailles on Monday, March 4, to enshrine access to abortion in the French Constitution, marks an important moment in the life of the nation. And a proud moment, too. A few days before International Women's Rights Day on March 8, women's freedom to control their own bodies should be anchored in French law. It also comes at a time when abortion, once thought to be a widely accepted procedure, is being undermined in a number of democracies, most notably the United States.

...

"The three-fifths majority required in Parliament means that a consensus has been reached, despite the fact that abortion still disgusts some on the right and far right. It's a sign that democracy works, despite the distress signals it is sending out.

"At every stage of the lengthy procedure initiated in November 2022, the drafting of the Constitutional reform constantly required perseverance and tact. First in the Assemblée Nationale, where, in response to the shockwave caused in June 2022 by the US Supreme Court's decision to revoke the federal right to abortion, the radical-left La France Insoumise party and the center-right presidential majority agreed to work together on a common cause.

"Then the fight continued in the Sénat, where, in loyalty to Simone Veil's 1975 battle to decriminalize abortion, a number of right-wing Les Républicains elected representatives fought hard to ensure that the debate, which they had reframed, could continue against the advice of their group's president, Bruno Retailleau, and Sénat President Gérard Larcher. Finally, in the government, Justice Minister Eric Dupond-Moretti facilitated the drafting and adoption of the final text. The compromise consists of enshrining the notion of "guaranteed freedom" for women to have access to abortion, without introducing an enforceable "right" to abortion as demanded by the left."

#######

*Regarding the Prime Minister's remark to women that "no one can decide for you" I note that surrogacy remains illegal in France.

Friday, October 18, 2019

Will IVF become more widely legal in France?

Medical aid in dying--the ongoing debate in Britain

 The Guardian has this opinion piece, connected to the current debate in England about medically assisted dying, and the slippery slope:

I’m glad the debate on assisted dying is forging ahead. But few understand why it frightens so many  by Frances Ryan

"On Thursday, MPs published the findings of a 14-month inquiry into assisted dying. The inquiry – which attracted more than 68,000 responses from the public – made no conclusive statement but instead collected evidence as a “significant and useful resource” for future debates.

That debate is no longer abstract. Legislation is making its way through the parliaments of Scotland, Jersey and the Isle of Man that, if passed, would enable competent adults who are terminally ill to be provided at their request with assistance to end their life.

...

"And yet it also feels a disservice to pretend that any of this is simple or that giving autonomy to some would not potentially harm others. It is deeply telling that among the many voices calling for a new assisted dying law, I have heard no human rights groups, celebrity or politician mention concerns – as advocated by many disability activists – that a law change could lead to disabled people being coerced into euthanasia, or feeling they had no other option.

We only need look to the countries that have legalised assisted dying in recent years to see these fears realised. One study reported the euthanasia of a number of Dutch people who were said simply to have felt unable to live with having a learning disability or autism. Many included being lonely as a key cause of unbearable suffering.

...

"This is not to say that the UK shouldn’t go down the path of legalising assisted dying, but we must at least do so with eyes wide open. The right to die does not exist in a vacuum: it fundamentally alters the doctor-patient relationship, and risks making members of society who are already vulnerable that little bit more insecure. Perhaps that is a price worth paying to end some terminally ill people’s suffering. Perhaps it is too much to ask. There are no black and white boxes to tick labelled “right” and “wrong” – just the messy, painful grey of being human.

In the coming months, politicians will correctly dedicate hours to discussing the right to a good death. Imagine, though, if they were to give equal attention to the right to a good life: from building social housing, exploring a basic income, investing in mental and physical health services, to – as the inquiry recommends – funding universal coverage of palliative care and more specialists in end-of-life pain."

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Earlier:

Friday, January 12, 2024

Medical aid in dying, and slippery slopes--the debate in Britain