Showing posts with label law. Show all posts
Showing posts with label law. Show all posts

Thursday, March 14, 2024

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Well, people born in 2008 are turning 16 this year, and New Zealand just repealed that law, for reasons that New Zealand's prime minister Christopher Luxon says include concerns about black markets.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"As part of the newly elected coalition government's rush to tick 49 "actions"  off its 100-day list by March 8, it has repealed  the Smokefree Environments and Regulated Products Amendment Act of 2022.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


Wednesday, March 6, 2024

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."*

#########

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

Friday, March 1, 2024

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."

#########

Earlier:

Friday, January 12, 2024

Tuesday, February 20, 2024

Frozen embryos are children: Alabama Supreme Court ruling

 The Washington Post has the story, which emphasizes the implications this ruling could have on in-vitro fertilization (IVF).  That would also impact surrogacy, and possibly deceased donor transplantation (depending on how it impacts the definitions of who is alive and who isn't...) 

Frozen embryos are children, Ala. high court says in unprecedented ruling. By Dan Rosenzweig-Ziff, February 19, 2024 

"The Alabama Supreme Court ruled Friday that frozen embryos are people and someone can be held liable for destroying them, a decision that reproductive rights advocates say could imperil in vitro fertilization (IVF) and affect the hundreds of thousands of patients who depend on treatments like it each year.

"The first-of-its-kind ruling comes as at least 11 states have broadly defined personhood as beginning at fertilization in their state laws, according to reproductive rights group Pregnancy Justice, and states nationwide mull additional abortion and reproductive restrictions, elevating the issue ahead of the 2024 elections. Federally, the U.S. Supreme Court will decide this term whether to limit access to an abortion drug, the first time the high court will rule on the subject since it overturned Roe v. Wade in 2022.

"The Alabama case focused on whether a patient who mistakenly dropped and destroyed other couples’ frozen embryos could be held liable in a wrongful-death lawsuit. The court ruled the patient could, writing that it had long held that “unborn children are ‘children’” and that that was also true for frozen embryos, affording the fertilized eggs the same protection as babies under the Wrongful Death of a Minor Act.

...

"The push for defining personhood has even affected tax law: Georgia now recognizes an “unborn child” as a dependent after six weeks of pregnancy.

Friday, January 26, 2024

The DOJ on competition for workers

 A lot of market design is done by regulators, and some of that is done to enforce existing laws.  Here's a report from the Department of Justice, focusing on four cases involving payment to workers (including authors of books).

Athey, Susan, Mark Chicu, Malika Krishna, and Ioana Marinescu. "The Year in Review: Economics at the Antitrust Division, 2022–2023." Review of Industrial Organization (2024): 1-20.

"In this review article, we report on five enforcement matters that expanded the scope of enforcement by the Division. The first four enforcement matters highlight a number of the Division’s actions to protect labor market competition in criminal and civil merger and non-merger cases. These include: criminal enforcement against a provider of contract health care staffing services that allocated nurse employees through a no-poaching agreement and agreed to fix the wages of those nurses; civil enforcement to stop an e-Sports league from effectively imposing a salary cap on its players; civil enforcement to stop a conspiracy among poultry processors to share information about worker compensation; and the successful challenge of a merger between two of the largest book publishers in the U.S., which preserved competition for books that will benefit authors."

Friday, January 12, 2024

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

 The Oxford blog Practical Ethics considers medical aid in dying (MAID), and the slippery slope arguments that accompany current debates on the subject in Britain.

Medical assistance in dying: what are we talking about? By Alberto Giubilini, Oxford Uehiro Centre for Practical Ethics

"Medical assistance in dying  – or “MAiD”,  to use the somehow infelicitous acronym – is likely to be a central topic in bioethics this year. That might not be true of bioethics as an academic field, where MAiD has been widely discussed over the past 40 years. But it is likely true of bioethics as a wider societal and political area of discussion. There are two reasons to think this.  First, the topic has attracted a lot of attention the last year, especially with “slippery slope” concerns around Canada’s policies. Second, MAiD has recently been in the news in the UK, where national elections will take place in 2024.  It is not hard to imagine it will feature in the heated political polarization that always accompanies election campaigns

...

"Canada is often taken as the best example in support of ‘slippery slope’ arguments against legalizing MAiD. According to these arguments, even assuming MAiD was acceptable in some form, legalization would open the door to clearly wrong or problematic practices down the line. For instance, legalizing physician-assisted suicide in cases of “unbearable suffering” for someone whose death is reasonably foreseeable in the short term might lead to relaxing our attitudes towards MAiD for those suffering only from mental illness. In the bioethics literature, slippery slope arguments against MAiD have often been put forward and traditionally been dismissed as fallacious, overly cautious, or easily addressable (for an overview and a critical appraisal, see Fumagalli 2020).  However, contrary to the prevailing view, they are not necessarily fallacious in nature (Walton 1992). To many people, Canada is a case in point, calling for a more nuanced take.

"Canada started off by decriminalizing medical assistance in dying in 2016. In 2019, the Superior Court of Quebec found the “reasonable foreseeability of natural death” unconstitutional as an eligibility criterion for MAiD. The criterion was removed in 2021, making MAiD available for patients without terminal illness. From March 2024, patients suffering solely from mental illness will also be able to legally access MAiD. According to Government data, nearly 45,000 people died through MAiD in Canada from 2016 to 2022. Between 2020 and 2022, the number of requests for MAiD increased on average by 28% per year. At the same time, the number of patients found ineligible consistently declined from 8% in 2019 to 3.4% in 2022.

...

"One question is about whether suicide is morally permissible. As mentioned, many religious  and non religious views consider suicide in most cases morally impermissible. However, the moral impermissibility of suicide is not a decisive reason against legalizing MAiD. More important is whether suicide is a right and, if so, what type of right it is. That is a different type of question, because arguably we often have the right to do morally wrong things (Waldron 1982). I might have a right to kill myself even if suicide is morally wrong.

...

"I have not provided any answer to any of these questions here. I just want to point out that some of the differences in ethical and religious views about suicide or about the right to end one’s own life are less relevant to a debate on MAiD than one might initially assume.

"At the same time, many concerns around slippery slopes are more relevant than one might initially assume. As a matter of fact and of logic, MAiD legislations tend to expand by extending their eligibility criteria. When debating MAiD legislations, we need to ask if we are prepared for that."

Thursday, August 10, 2023

Ned Brooks on Coalition to Modify NOTA

Ned Brooks (about whom I've often blogged) is putting his eloquence and organizational skills to the task of increasing organ donation by allowing organ donors to be compensated. Below is a short video of an address he gave to the National Kidney Donation Organization (NKDO) which he founded, about his new effort, the Coalition to Modify NOTA.

 

Here's a copy of the email that came with the video:

 

To the NKDO Membership:

 

Thank you for your responses to the survey asking if NKDO should support the Coalition to Modify NOTA (CMN), formed by non-directed donors Ned Brooks, Elaine Perlman and Cody Maynard.

 

87% of our membership supports the mission statement of CMN as follows:

 

The Coalition to Modify NOTA (ModifyNOTA.org) is created in response to the inability of the current system to adequately address the crisis of kidney failure in the United States. The National Organ Transplant Act of 1984 prohibits the compensation of organ donors.

 

The current system of deceased donations and voluntary living donation is grossly inadequate to the task of completely ending the shortage of transplant kidneys and saving the lives of patients in kidney failure who are dying unnecessarily each year. 

We believe that the solution to this crisis is to have the government compensate donors in a manner that is neither exploitative nor coercive. The Coalition to Modify NOTA seeks the modification of the National Organ Transplant Act to allow such government compensation.

 

Watch this presentation on the Coalition to Modify NOTA by Ned Brooks.

 

To sign your name in support of the Mission Statement, please go to Join the Coalition.

 

Kind regards,

 

Matt Cavanaugh, CEO and President


Saturday, July 22, 2023

Modify NOTA: a new effort

 Ned Brooks, who has been a force in promoting living kidney donation, is turning his efforts towards a new organization, dedicated to modifying the National Organ Transplant Act (NOTA) of 1984, to allow some compensation of kidney donors.

Here's the organization's website:  Join the Coalition to Modify NOTA

The website starts off with a quote with which I'm in full agreement:

“It’s long past time to modify the 1984 National Organ Transplant Act.”   - Al Roth

*********

Recent related post:

Monday, July 10, 2023

Friday, July 21, 2023

The Cost of Inaction and the Urgent Need to Reform the U.S. Transplant System: participant statements

 Yesterday's Senate Finance committee hearings on The Cost of Inaction and the Urgent Need to Reform the U.S. Transplant System are on video, and the following witness statements (delivered beforehand) are now also available.

If you only have time to read one, I'd recommend clicking on the testimony of Matthew Wadsworth, the President And CEO of the OPO, Life Connection of Ohio.

Witnesses 


  1. LaQuayia Goldring
    Patient
    Louisville , KY
  2. Molly J. McCarthy
    Vice Chair & Region 6 Patient Affairs Committee Representative
    Organ Procurement and Transplantation Network (OPTN)
    Redmond , WA
  3. Matthew Wadsworth
    President And CEO
    Life Connection of Ohio
    Kettering , OH
  4. Raymond J. Lynch, MD, MS, FACS
    Professor Of Surgery And Director Of Transplantation Quality And Outcomes
    Penn State Health Milton S. Hershey Medical Center
    Hershey , PA
  5. Donna R. Cryer, JD
    Founder And CEO
    Global Liver Institute
    Washington , DC
**********

Saturday, July 15, 2023

Marijuana and military recruitment

 Here's a proposal for a bit pf reality-based legislation that has some bipartisan support. DefenseOne has the story:

Proposed marijuana waivers acknowledge blunt recruiting truths. Lawmakers on both sides of the aisle want to remove a barrier to joining the U.S. military.  by LAUREN C. WILLIAMS 

"As the military services struggle to meet recruiting goals, lawmakers in the divided House seem united on a proposed fix: relaxing the Pentagon’s policies on marijuana use.

“I do not believe we should be testing for cannabis [in] people who want to join the military,” Rep. Matt Gaetz, R-Fla., told the House Rules Committee during a hearing on Tuesday. “We should be thinking about cannabis more in terms of alcohol.”

Gaetz testified in support of his amendment that would ban drug testing for marijuana as a condition of enlistment or to become a commissioned officer. 

“We are having a recruiting crisis,” he said, noting that many “people use cannabis under the color of state law.” So far, 23 states and Washington, D.C. have legalized the recreational use of marijuana.

"The Florida lawmaker stressed that his amendment wouldn’t preclude DOD from prohibiting marijuana use for individuals actively serving in the military, but that cannabis testing is “an unnecessary gate” for recruitment. In 2021, Gaetz sought to overturn U.S. election results."

Wednesday, July 12, 2023

The harmful human rights impact of unjustified criminalization of individuals and communities: ICJ statement

 The International Commission of Jurists (ICJ) has published a set of legal principles  for a human rights-based approach to criminal laws proscribing conduct associated with sex, reproduction, drug use, HIV, homelessness and poverty.

The 8 March Principles for a Human Rights-Based Approach to Criminal Law Proscribing Conduct Associated with Sex, Reproduction, Drug Use, HIV, Homelessness and Poverty

It opens with a foreword by Edwin Cameron, Retired Justice, Constitutional Court of South Africa, Inspecting Judge, Judicial Inspectorate for Correctional Service.  The first paragraphs are:

"From long years in the law, and as a proudly gay man, I know profoundly how criminal law signals which groups are deemed worthy of protection – and which of condemnation and ostracism. In this way, the criminal law performs an expressive function – and it has dramatic consequences on people’s lives. It sometimes entails a harshly discriminatory impact on groups identified with the disapproved or stigmatised conduct.

"To add to this, criminal proscriptions may reinforce structural inequalities; they may codify discrimination, invest them with the law’s power and may foster stigma. All this may wreak terrible harm.

"Criminal law may thus impel hostility, exclusion, inequality, discrimination and marginalization of individuals and groups, sometimes to the point of violence. As a result, human rights, democratic values and social inclusiveness all suffer." 

...

"The Principles are based on general principles of criminal law and international human rights law and standards. They seek to offer a clear, accessible and workable legal framework – as well as practical legal guidance – on applying the criminal law to conduct associated with:

sexual and reproductive health and rights, including termination of pregnancy;

consensual sexual activities, including in contexts such as sex outside marriage, same-sex sexual relations, adolescent sexual activity and sex work;

gender identity and gender expression;

HIV non-disclosure, exposure or transmission;

drug use and the possession of drugs for personal use; and

homelessness and poverty. 

***********

And here are the first paragraphs of the Introduction:

"Criminal law is among the harshest of tools at the disposal of the State to exert control over individuals. As such, it ought to be a measure of last resort, where other less restrictive means of achieving legitimate interests are insufficient. However, globally, States have exhibited a growing trend towards overcriminalization.

While retribution, deterrence, incapacitation and rehabilitation are generally considered to be its main purposes, criminal law may also perform an expressive function, through public condemnation of certain conduct seen as deserving reprobation and punishment. The desire to harness this expressive function is a critical factor contributing to the proliferation of criminal law.

The unjustified criminalization of individuals and sometimes entire communities is increasingly impeding progress in advancing human rights in many areas, including: racial and gender equality; reproductive autonomy; disability; economic justice; civil liberties; sexual orientation; gender identity; education; youth development; and public health.

Moreover, in recent years, in some quarters, there has been a backlash against human rights, especially against sexual and reproductive health and rights and the human rights of women, lesbian, gay, bisexual, transgender, non-binary, gender diverse and intersex persons, as well as against sex workers, people who use drugs and people experiencing homelessness and/or living in poverty.

"In particular, there has been continued use and, in some cases, a new proliferation of arbitrary criminal laws proscribing conduct associated with sex, reproduction, drug use and the possession of drugs for personal use, HIV, homelessness and poverty. These laws have led to egregious human rights violations, including by engendering and perpetuating stigma, harmful gender stereotypes and discrimination based on grounds such as sex, sexual orientation, gender identity, gender expression and other protected fundamental characteristics. 

"Unless criminal laws proscribing the above-mentioned conduct are directed at coercion or force or otherwise at the absence of consent, their mere existence – let alone their threatened or actual enforcement – violates human rights."

**********

See Saturday's post, concerning Canada's "The Protection of Communities and Exploited Persons Act," which is designed to protect sex workers.



Sunday, July 9, 2023

Sex work contracts are enforceable in small claims court, in Canada

 In Nova Scotia (where selling sex is legal but buying it is not), a sex worker sued a delinquent client for her fee and won (despite his argument that contracts requiring a party to commit a crime were unenforceable).

Former sex worker's victory in small claims court sets precedent, lawyer says. Decision clarifies that contracts for sex work are enforceable. by Moira Donovan · CBC News 

"A former sex worker in Nova Scotia has successfully sued a client in small claims court for non-payment of services. She and her advocates hope the decision will change the legal landscape for sex work in Canada.

"The case relates to an incident in January 2022 when Brogan, whom CBC News is only identifying by her first name because she is a survivor of human trafficking, spent an evening with a client.

"Afterward, the client refused to pay the agreed-upon fee.

"Brogan then turned to small claims court to recover the money — in what advocates believe is the first time such a case has come before the courts in Canada — and won a judgment that she was entitled to the unpaid amount, plus interest and costs.

...

"Brogan met the client in question, ... through a website called LeoList that's used by sex workers and their clients. After some discussion about rates and services, Brogan travelled to Samuelson's apartment, where she spent the evening.

...

"There was offer, there was an acceptance of the offer, there was certainty of terms, so all the hallmarks of an enforceable contract were there," said Jessica Rose, Brogan's lawyer.

"But the central question in the case was whether contracts for sex work are enforceable — a question that relates to the legislation governing sex work in Canada. 

"The Protection of Communities and Exploited Persons Act, which passed in 2014, is supposed to protect people from the risks involved in sex work. It amended the Criminal Code to remove the criminal penalty for individuals who sell their own sexual services, and eliminated criminal charges for those who support sex workers, such as drivers or security personnel.

"But aspects of that work remained criminalized, including the purchase of services.

"In this case, the defendant argued that contracts for sexual services were not enforceable because you could not have a contract in which one party — in this case, the client — had to do something illegal.

...

"adjudicator Darrel Pink concluded that because sex work is legal and the business arrangements supporting sex work are legal, it follows that the benefits of commercial law apply, including access to a civil claim — the same as any other service provider.

...

"Failure of the court to provide a remedy for a wrong or a breach of duty owed by a client would contribute to the very exploitation the legislation was designed to prevent," he wrote."


HT: Kim Krawiec

Monday, July 3, 2023

Representatives Matsui and Wilson have introduced legislation that, if passed, could allow pilot programs involving compensation of organ donors.

  Congresswoman Doris Matsui (D-CA) and Congressman Joe Wilson (R-SC)  have introduced legislation that, if passed, could allow pilot programs involving compensation of organ donors.

Here's the press release:

WASHINGTON, D.C. – Today, Congresswoman Doris Matsui (D-CA) and Congressman Joe Wilson (R-SC) introduced the Organ Donation Clarification Act, a bipartisan bill to reduce barriers to organ donation and increase the supply of organs for transplantation.

Every day, 17 Americans die waiting for a lifesaving organ transplant. As of this month, over 114,000 Americans are on the national waitlist. In 2022, although over 42,000 patients received a transplant, over 68,000 additional patients were added to the national waitlist.

With over 95,000 patients in need of a kidney transplant, the average wait time is between three to five years. Those delays cause tens of thousands of Americans to go through lifesaving yet burdensome and disruptive dialysis treatments in the hope that they live long enough for a kidney to become available.  However, thousands of Americans every year will become too sick to receive a transplant and die waiting for one. Not only can thousands of lives be saved, but getting everyone the lifesaving transplant they need can also save billions of dollars a year in dialysis costs.

“Every day that our country suffers from an organ donation shortage means more preventable loss of life,” said Congresswoman Matsui. “By removing disincentives and barriers for prospective donors, we can reach more patients and save lives. The Organ Donation Clarification Act is a bipartisan solution that will help us bridge the gap in organ donations and give hope to patients and families waiting for a lifesaving transplant.”

“I am grateful to introduce this bipartisan bill with Congresswoman Matsui to address the severe organ donation shortage in our country,” said Congressman Wilson. “An average of 17 people in the U.S. succumb to their illnesses every day because they could not survive the wait for a viable organ. In certain parts of the country, the waitlist can be over five years for a kidney. Current law lacks clarity and prevents potential organ donations. This legislation addresses those issues by removing the hurdles for potential donors and allowing new, innovative ways to increase organ donation. This would not only save taxpayer dollars but, most importantly, it would save lives.”

“We appreciate Congresswoman Matsui’s leadership on this bill, which improves the chances that a living donor can make the choice to save a life,” said Dr. David Lubarsky, CEO of UC Davis Health. “UC Davis Health is enormously proud of our Transplant Center, which is one of the largest in the country and has saved more than 5,000 lives in its 38 years of operation.”  

Organ transplantation is governed by the National Organ Transplant Act (NOTA) of 1984. This law prohibits buying or selling organs for “valuable consideration.” Confusion about what constitutes valuable consideration has hampered donation by scaring people away from reimbursing living organ donors for things like medical expenses and lost wages. Both are legal under NOTA, but the law's lack of clarity and its criminal penalties have created uncertainty and prevented reimbursements in many cases.

Moreover, current law does not allow for any entity to test the efficacy of providing benefits to encourage donation. The bill would allow for government run pilot programs to test the provision of non-cash benefits in order to increase organ donation, subject to ethical review, and mandates a report so the broader transplant community can understand best practices for encouraging additional organ donation. These benefits could include funeral benefits for deceased donors and health insurance, tuition assistance, or other proposals to increase the number of living donors. A 2019 American Economic Review survey indicates that between 65 and 80 percent of Americans would support such a program to encourage additional donation.

Finally, when determining eligibility for reimbursements for donation expenses such as travel and medical costs, current law requires the government to take into account the income of the recipient, rather than solely focusing on the income of the donor. This often disqualifies potential donors by creating additional financial burden.  

The Organ Donation Clarification Act would:

  • Clarify that certain reimbursements are not valuable consideration but are reimbursements for expenses a donor incurs;
  • Allow government-run pilot programs to test the effect of providing non-cash benefits to promote organ donation;
  • Clarify that the National Living Donor Assistance Center (NLDAC) can’t consider the organ recipient’s income when determining whether to reimburse a donor’s expenses.

This bipartisan legislation is endorsed by the Americans for Tax Reform, American Transplant Foundation, Foundation for Kidney Transplant Research, National Kidney Donation Organization, Transplant First Academy, Chris Klug Foundation, Flood Sisters Kidney Foundation, American Liver Foundation, National Kidney Donation Organization, Kidney Transplant Collaborative and Wait List Zero.

Text of the legislation can be viewed here.

**********

HT: Frank McCormick

Friday, May 19, 2023

The Comstock Act returns from the dead, post Roe

 While there's no agreement about whether life begins at conception, it appears that the Comstock Act has risen from the dead to play a role in contemporary legal duels about abortion.

CNN brings it all back:

The 150-year-old chastity law that may be the next big fight over abortion By Tierney Sneed

"A law passed 150 years ago that banned the mailing of contraceptives, lewd materials and drugs that induce abortions could provide a pathway for effectively banning abortion nationwide – even in states where the procedure is legal.

"When the Supreme Court last summer reversed Roe v. Wade and eliminated constitutional protections that guaranteed abortion rights nationwide, the conservative majority fashioned its ruling as returning the matter of abortion policy-making to elected officials, particularly in state legislatures.

"But the battle lines now being drawn around the Reconstruction-era federal law – the Comstock Act – are an example of how the picture after Roe v. Wade is far more complicated as abortion opponents are challenging the means of abortion, such as the drug mifepristone, in court.

"The most sweeping Comstock Act arguments from anti-abortion activists could at the very least end the availability of medication abortion, which make up the majority of abortions in the US today, and could have the effect of eliminating surgical abortions as well by restricting the shipment of medical instruments and supplies used in the procedure.

...

"The Comstock Act, first passed in 1873, is named after Anthony Comstock, who was a special agent of the US Postal Service and an anti-vice crusader.

...

"Prosecutions under the law were bought in the first few decades after its passage, but by the 1930s, courts began whittling down some of its provisions and enforcement of the law ceased. Congress meanwhile amended it in the 1970s to remove its ban on mailing birth control.

...

"The Biden administration, in an internal advisory opinion released by the Justice Department’s Office of Legal Counsel, argues that the law does not apply to the mailing of abortion pills if they’re not being sent with the intent of unlawful use. The opinion pointed to how 20th century courts had interpreted it narrowly as excluding drugs mailed with legitimate intent."

*********

Earlier:

Monday, April 10, 2023

Wednesday, May 17, 2023

Human trafficking conviction in England, in kidney case-""the consent of the person trafficked is no defense."

 The BBC has the story, which is apparently the first such conviction for kidney trafficking under Britain's anti-slavery law. Reading the previous stories, it sounds like the young man in question was being deceived.  But even informed consent apparently wouldn't be a defense under British law...

Kidney-plot politician Ike Ekweremadu jailed By Tom Symonds

"A wealthy Nigerian politician, his wife and their "middleman" have been jailed for an organ-trafficking plot, after bringing a man to the UK from Lagos.

"Senator Ike Ekweremadu, 60, and his wife Beatrice, 56, wanted a new kidney for their 25-year-old daughter Sonia, the Old Bailey heard.

"The pair and Dr Obinna Obeta, 50, were previously convicted of conspiring to exploit the man.

"It is said to be the first such case under modern slavery laws.

...

"Lynette Woodrow, deputy chief crown prosecutor and national modern slavery lead at the Crown Prosecution Service (CPS), said it had been "our first conviction for trafficking for the purposes of organ removal in England and Wales".

"She said it highlighted an important legal principle which made it irrelevant whether the trafficking victim knew he was coming to the UK to provide a kidney.

"With all trafficking offences," Ms Woodrow said, "the consent of the person trafficked is no defence. The law is clear; you cannot consent to your own exploitation."


HT: Dr. Jlateh Vincent Jappah

Tuesday, May 9, 2023

How much compensation for U.S. kidney donors would end the kidney transplant shortage?

 Here's a paper with a forbidding title but an important message (and an eye-catching first paragraph...:)

McCormick, Frank, Philip J. Held, Glenn M. Chertow, Thomas G. Peters, and John P. Roberts. "Projecting the economic impact of compensating living kidney donors in the United States: cost-benefit analysis demonstrates substantial patient and societal gains." Value in Health Volume 25, Issue 12, December 2022, Pages 2028-2033

"Abstract:

Objectives: The aim of this study was to show how the US government could save approximately 47 000 patients with chronic kidney failure each year from suffering on dialysis and premature death by compensating living kidney donors enough to completely end the kidney shortage.

Methods: Supply and demand analysis was used to estimate the number of donated kidneys needed to end the kidney shortage and the level of compensation required to encourage this number of donations. These results were then input into a detailed cost-benefit analysis to estimate the economic value of kidney transplantation to (1) the average kidney recipient and their caregiver, (2) taxpayers, and (3) society in general.

Results: We estimate half of patients diagnosed with kidney failure each year—approximately 62 000 patients—could be saved from suffering on dialysis and premature death if they could receive an average of 1½ kidney transplants. However, currently there are only enough donated kidneys to save approximately 15 000 patients. To encourage sufficient donations to save the other 47 000 patients, the government would have to compensate living kidney donors approximately $77 000 (±50%) per donor. The value of transplantation to an average kidney recipient (and caregiver) would be approximately $1.5 million, and the savings from the recipient not needing expensive dialysis treatments would be approximately $1.2 million.

Conclusions: This analysis reveals the huge benefit that compensating living kidney donors would provide to patients with kidney failure and their caregivers and, conversely, the huge cost that is being imposed on these patients and their families by the current legal prohibition against such compensation."


and here's the first paragraph:

"Economics Nobel Laureate Alvin Roth has played a crucial role in developing paired kidney donation, which is currently saving >1100 US patients with kidney failure per year from suffering on dialysis and dying prematurely. Nevertheless, Professor Roth often points out that this is a victory in a war that we are losing.1 The number of patients diagnosed with kidney failure each year in the United States is not only much greater than the number who receive kidney transplants; it is rising at a faster rate.2,3 Thus, the number of patients diagnosed with kidney failure who are fated to suffer on dialysis for an average of 4 to 5 years while their health steadily deteriorates until they die prematurely has trended upward and is now >100 000 per year."

Sunday, May 7, 2023

Supervised drug use sites to be banned in Pennsylvania

 Statnews has the story:

Pennsylvania set to ban supervised drug use sites, in setback for harm reduction  By Lev Facher

"Pennsylvania lawmakers are set to pass a new ban on supervised drug consumption, effectively ending a Philadelphia nonprofit’s long-running effort to offer a sanctioned substance-use site meant to prevent overdose and death.

"A bill outlawing sites that “knowingly” provide a space for drug consumption passed a committee vote by a wide margin on Tuesday. It now advances to the full state senate, where it is also expected to pass. Gov. Josh Shapiro, a Democrat, has expressed strong opposition to supervised injection sites in the past, and is expected to sign the legislation.

...

"While the Biden administration has expressed unprecedented support for harm reduction, many Americans remain hostile to the approach.

"Some harm-reduction tools, like syringe exchanges and fentanyl test strips, have gained a degree of acceptance, but supervised consumption is still largely taboo. Pennsylvania advocates had high hopes for a planned site in Philadelphia, however, and say the legislation would deal a demoralizing blow to local efforts to avert overdoses and save lives.

...

"Offering medical supervision as people consume drugs that can cause overdose, like heroin and fentanyl, is among the most controversial tactics employed to prevent overdoses. But in recent years, as U.S. drug deaths have surpassed 100,000 annually, the strategy has gained support among some public health advocates. While critics argue that supervised injection condones drug use, studies from cities including Vancouver and Barcelona show that offering the service can lead to a marked reduction in overdose deaths.

...

"Currently, only a few supervised consumption sites are in operation around the U.S. — and none have formally received the federal government’s blessing. Most notably, the nonprofit OnPoint NYC opened two supervised consumption sites in Manhattan late last year. Rhode Island has legalized supervised consumption sites as well, though it’s unclear when a planned site in Providence will open. "

Friday, May 5, 2023

New York doesn't ban Menthol cigarettes, amid controversy

 The NYT has the stories, first about the proposed ban, and then about the budget compromise that defeated it:

Black Smokers at Center of New York Fight to Ban Menthol Cigarettes. A proposal to make New York the third state to ban menthol cigarettes has created a furious and expensive lobbying war, and has divided Black leaders. By Luis Ferré-Sadurní

"A push by Gov. Kathy Hochul to ban menthol-flavored cigarettes in New York has become the focal point of a fierce and expensive lobbying fight, pitting Big Tobacco against the medical community.

"Caught in the middle are Black smokers, who smoke menthol cigarettes at higher rates than white smokers, and are the main group the ban is meant to help. Decades of aggressive marketing by tobacco companies have caused Black smokers to consume menthol cigarettes, whose cooling sensation on the throat makes them more appealing and addictive.

...

 "Well intentioned as the ban may be, it has angered some Black leaders, including a group of ministers who have rallied against Ms. Hochul’s proposal because they worry it could increase encounters between Black people and the police if menthol cigarettes were to go underground and authorities crack down on sellers.

"Other Black opponents of the ban suggest it may be discriminatory, a heavy-handed crackdown on the preferred nicotine fix of Black smokers, even if African American men have the highest rates of lung cancer, according to the Centers for Disease Control and Prevention. 

...

"Although lawmakers have signaled their support for the tax increase, the menthol ban’s prospects are far less certain, according to four officials familiar with the negotiations.

The issue has divided Black lawmakers, leaving the measure hanging by a thread in the State Capitol "and potentially forcing Ms. Hochul to weigh how much political capital she should expend on the ban, as opposed to other policy priorities."

********

And here's a story saying that the governor abandoned the proposed ban in a set of budget compromises:

New York Would Change Minimum Wage and Bail in $229 Billion Budget Deal. After weeks of dissension, leaders in Albany reached a handshake agreement on a budget that saw Gov. Kathy Hochul fall short on some of her key objectives. By Luis Ferré-Sadurní and Grace Ashford

"Lawmakers managed to knock down other divisive ideas, including ... a ban on the sale of menthol cigarettes that was opposed by Big Tobacco and had divided Black leaders. Lawmakers did agree, however, to raise taxes on cigarettes to $5.35 a pack, up from $4.35."

**********

All posts so far on menthol

Monday, April 10, 2023

Comstockery and abortifacients, on the way to the Supreme Court

 The Comstock Act of 1873 made it a Federal crime to distribute information or medicines for contraception or abortion, and more generally on material judged to be for "any indecent or immoral purpose."  The 1965 ruling in Griswold vs. Connecticut found the bans on contraception to be unconstitutional, and the bans on pornography were strictly limited the year before in the case Jacobellis v. Ohio.  But the Act reared its head again when it was cited by a Federal judge in Texas, Matthew J. Kacsmaryk, in his ruling that the abortion inducing drug mifepristone was illegal to distribute anywhere in the U.S., including in states where abortion is legal.

Michelle Goldberg in the NYT writes about "The Hideous Resurrection of the Comstock Act"

"suddenly, the prurient sanctimony that George Bernard Shaw called “Comstockery” is running rampant in America. As if inspired by Comstock’s horror of “literary poison” and “evil reading,” states are outdoing one another in draconian censorship. In March, Oklahoma’s Senate passed a bill that, among other things, bans from public libraries all content with a “predominant tendency to appeal to a prurient interest in sex.” Amy Werbel, the author of “Lust on Trial: Censorship and the Rise of American Obscenity in the Age of Anthony Comstock,” described how Comstock tried to suppress photographs of cross-dressing women. More than a century later, Tennessee has banned drag performances on public property, with more states likely to follow.

"And now, thanks to a rogue judge in Texas, the Comstock Act itself could be partly reimposed on America. Though the act had been dormant for decades and Congress did away with its prohibitions on birth control in 1971, it was never fully repealed. And with Roe v. Wade gone, the Christian right has sought to make use of it. The Comstock Act was central to the case brought by a coalition of anti-abortion groups in Texas seeking to have Food and Drug Administration approval of mifepristone, part of the regimen used in medication abortion, invalidated. And it is central to the anti-abortion screed of an opinion by Matthew J. Kacsmaryk, the judge, appointed by Donald Trump, who on Friday ruled in their favor.

...

"On Friday a Washington State judge issued an opinion directly contradicting Kacsmaryk’s and ordering the F.D.A. to continue to make mifepristone available. The dispute now is likely headed to the Supreme Court."