Thursday, July 31, 2014

What do British fertility tourists choose in America? It's a girl!

The Telegraph reports:  Number of women travelling to America to choose sex of child rises 20%

"The number of British couples having fertility treatment in America so they can choose the sex of their child is increasing by a fifth every year, a leading doctor has said.
Dr Daniel Potter, who runs a large fertility clinic in America, treats 10 patients from Britain a month who want to have IVF treatment only in order to select the gender of the baby.
Eight in ten couples from Britain are choosing to have a girl, he said.
Hundreds more could be travelling to other clinics across America and the numbers are rising by 20 per cent a year, Dr Potter said.
Sex selection is banned in Britain unless done so for medical reasons and an investigation by the Telegraph discovered doctors willing to authorise abortions on the grounds of gender.
Dr Potter who runs the HRC clinic in Newport Beach in California, said 80 per cent of couples from Britain are choosing to have a girl.
It had been feared that allowing sex selection would lead to an imbalance between the genders with fewer girls born for cultural reasons.
However Dr Potter said the women he sees are desperate for a girl having grown up playing with dolls and always imagined they would have daughter.
He told the Telegraph: "Some have only one child but most have two or three of the same gender. The process is driven by the mother who has identified with little girls since her own childhood and has always had a place for a daughter. When they do not have one, it is like a death and they grieve for their little girl."
Dr Potter's patients often do not need fertility treatment in order to conceive but go through the process so that the resulting embryos can be screened and the chosen sex transferred to the womb.
The whole process costs around US$15,000 and requires a 12 day stay near the clinic.
Dr Potter said: "I think that pregnancy termination as a method of gender selection is not acceptable but I also believe that is it not for me to impose my values on other people."

Wednesday, July 30, 2014

Increasing access to transplantation: my talk at the World Transplant Congress

In my talk at the WTC, I focused on increasing access to transplantation.

For increasing access to kidney exchange I proposed
Learn from best practices, and develop new ones
1. Allow non-simultaneous chains to be long when needed
2. Make it safe for transplant centers to enroll easy to match pairs, including compatible pairs
3. Reduce financial barriers to participation by transplant centers (introduce a standard acquisition charge?)
4. Consider International kidney exchange
5. Consider NDD chains initiated by deceased donors

I also spoke about repugnant transactions and how they change over time, and about
Removing disincentives to donation, and providing incentives
Without exploiting the poor and vulnerable
Israeli model: priorities and reimbursed lost wages
Continued discussion of disincentives and providing incentives in ways that will ease the shortage of organs without leading to exploitation

Frank Delmonico, in his Presidential address, spoke about how transplantation emphasizes the common humanity of all people, as we would see if we looked at the earth from the moon:

The auditorium was a big is what it looked like before it filled up:

Here's a video of an interview I gave after my talk.

And here's a video of an interview with clips from my talk, set to music...

Tuesday, July 29, 2014

World transplant congress

Here's the program of the 2014 World Transplant Congress,

Joint meeting of

The logo of ASTSThe logo of TTSThe logo of AST
And here's my part of the working title is "Transplantation: One economist’s perspective," and I'll talk about how changes in the organization of transplantation have increased access to transplants, and how further changes might lead to further improvements.

Here's some background on the meeting:

In 2006, history was made in the field of transplantation medicine. The largest meeting in transplant science was held in Boston, The World Transplant Congress (WTC). This meeting was a joint collaboration of the American Society of Transplant Surgeons (ASTS), The Transplantation Society (TTS), and the American Society of Transplantation (AST) with record breaking attendance. There were over 6500 specialists in this field as well as an additional 1000 exhibit personnel.  
The three societies are joining together again for the Word Transplant Congress 2014, being held July 26 – 31 in San Francisco, California. WTC 2014 will bring together transplant scientists, physicians, surgeons, trainees, nurses, organ procurement personnel, pharmacists and other associated transplant professionals from around the world.  
Also speaking at the conference will by Shinya Yaminaka, who shared the 2012 Nobel Prize in medicine for his work on turning ordinary cells into stem cells. Here's a story in Nephrology News: Nobel Laureates to deliver lectures at Transplant Congress

"Recent progress in iPS cell research towards regenerative medicine
Professor Shinya Yamanaka, MD, PhD, is the Director of the Center for iPS Cell Research and Application (CiRA) at Kyoto University in Japan. In 2012, he was awarded the Nobel Prize in Physiology or Medicine for the discovery of reprogramming and converting mature, specialized cells into pluripotent cells, capable of developing into all tissues of the body.

During his State-of-the-Art address on Wednesday, July 30, Dr. Yamanaka will provide characteristics of induced pluripotent stem cells (iPSCs), which have the ability to proliferate and differentiate into multiple lineages. He will discuss technologies related to iPSC generation, in addition to improvements achieved in iPSC production in terms of both safety and efficiency. These iPSCs and subsequently differentiated target cells/ tissues would provide unprecedented opportunities in regenerative medicine, disease modelling, proof-of-concept studies in drug development, drug screening, and future personalized medicine."

Monday, July 28, 2014

Council of Europe reaffirms opposition to all forms of payment for human organs

Press release - DC085(2014)
A Council of Europe Convention to combat trafficking in human organs
Strasbourg, 09.07.2014 – The Committee of Ministers of the Council of Europe has adopted an international convention to make trafficking in human organs for transplant a criminal offence, to protect victims and to facilitate cooperation at national and international levels in order to prosecute more effectively those responsible for trafficking.
The Convention calls on governments to establish as a criminal offence the illegal removal of human organs from living or deceased donors:
- where the removal is performed without the free, informed and specific consent of the living or deceased donor, or, in the case of the deceased donor, without the removal being authorised under its domestic law;
- where, in exchange for the removal of organs, the living donor, or a third party, receives a financial gain or comparable advantage;
- where in exchange for the removal of organs from a deceased donor, a third party receives a financial gain or comparable advantage.
The Convention also provides protection measures and compensation for victims as well as prevention measures to ensure transparency and equitable access to transplantation services.
Due to its worldwide scope, the Convention will be open shortly for signature by member states and non-member states of the Council of Europe. Spain has offered to host the ceremony for the opening for signature by the end of 2014/beginning of 2015.
Link to the Convention and its explanatory report - For more information see the factsheet

Sunday, July 27, 2014

Debate on organ sales in Journal of Medical Ethics

The March 2014 issue of the Journal of Medical Ethics features a lively (but familiar) debate on whether it should be legal to sell kidneys. All the authors are philosophers.  (I am ready for some empirical evidence, which is of course hard to collect when existing laws are interpreted as preventing experimentation of most sorts.)
Here are the articles:

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