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posted by cmn32480 on Monday October 24 2016, @07:19AM   Printer-friendly
from the viruses-not-of-the-computer-variety dept.

In 1976, at the behest of a U.S. government panel, Myron "Mike" Levine of the University of Maryland School of Medicine in Baltimore began intentionally giving humans V. cholerae. He is still doing so today.

Forty years ago Levine was one of a tiny cadre of researchers doing so-called human challenge studies—intentionally infecting people with V. cholerae and other pathogens to test drugs and vaccines. But in the past few decades, this practice, which has a long and checkered past, "has become much more mainstream," Levine says. Stricter safety procedures and new ways to weaken pathogens to reduce their risks are leading investigators in industry, universities, and government to take a new look at human challenge trials, which offer a powerful tool for studying diseases and potential therapies. There's even a commercial company, hVIVO in London, that specializes in human challenges. Today, people are being deliberately infected with malaria, influenza, shigella, dengue, norovirus, tuberculosis, rhinovirus, Escherichia coli, typhoid, giardia, and campylobacter.

[...] So there was considerable concern when NIAID's Matthew Memoli proposed new human challenge studies with influenza in 2011, which ultimately aimed to test novel treatments and vaccines. Some of his colleagues were so wary that the ethics department at the National Institutes of Health (NIH), NIAID's parent, was asked to conduct a formal review of the protocol. "We went through a lot of steps," Memoli says. The ethicists were particularly concerned about the proposed "high levels of payment"—up to $4000—but deemed this was not an "undue influence" because no one had an obligation to accept the offer.

I wonder how many people who proclaim that they "never get sick" would be willing to test their claim.

http://www.sciencemag.org/news/2016/05/studies-intentionally-infect-people-disease-causing-bugs-are-rise

The dengue vaccine trial mentioned in TFA was discussed here earlier this year:
https://soylentnews.org/article.pl?sid=16/03/18/199234


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  • (Score: 0) by Anonymous Coward on Monday October 24 2016, @04:00PM

    by Anonymous Coward on Monday October 24 2016, @04:00PM (#418191)

    Ahh yes, money.... Making the immoral into the moral ever day.

    So what would you propose?
    1) We never test any drugs or vaccines?
    2) Test only in "live" situations (which makes the experiments that much less reliable, and that much less rapid).
    3) Only test on unpaid volunteers (which dramatically reduces the number of people available).
    4) Test on the unwilling?

    If a person's life state is such that they would rather be infected by cholera than not have the money, who are you to say that they should be FORCED to go with the option they dislike more? Alternatively, if a person is so noble as to want to advance the state of medicine at their own personal suffering, why would you prevent them from making that sacrifice?

    I'll agree that certain things are unconscionable and should be illegal, but in my mind that's a pretty high bar to meet. Why is somebody choosing to become infected while under medical supervision such so immoral (or have a slippery slope) to warrant undermining their self-determination?

  • (Score: 1) by Francis on Monday October 24 2016, @07:39PM

    by Francis (5544) on Monday October 24 2016, @07:39PM (#418259)

    The issue with paying for it is that it's mostly going to be poor people signing up. Especially if they make it a lot of money.

    Now, if you're in a part of the world with a mandatory minimum income, that might not be as much of an issue, but these kinds of programs have a tendency to exploit the poor.

    That being said, actual human test subjects are essential if we're going to actually treat a lot of these things as the models necessary to do it without human test subjects aren't anywhere near good enough in many cases.

    • (Score: 1) by khallow on Monday October 24 2016, @10:44PM

      by khallow (3766) Subscriber Badge on Monday October 24 2016, @10:44PM (#418310) Journal

      The issue with paying for it is that it's mostly going to be poor people signing up. Especially if they make it a lot of money.

      And the problem with that is? Is paying poor people a lot of money bad?

      Now, if you're in a part of the world with a mandatory minimum income, that might not be as much of an issue, but these kinds of programs have a tendency to exploit the poor.

      How high does the "mandatory minimum income" have to be before it's ok for poor people to help make all of our lives better?

      • (Score: 3, Funny) by jimshatt on Tuesday October 25 2016, @09:14AM

        by jimshatt (978) on Tuesday October 25 2016, @09:14AM (#418448) Journal

        Is paying poor people a lot of money bad?

        If you live you're no longer poor, if you die you're no longer poor. It's a win-win situation, really.

      • (Score: 1) by Francis on Tuesday October 25 2016, @03:04PM

        by Francis (5544) on Tuesday October 25 2016, @03:04PM (#418569)

        Paying poor people to do things that are potentially extremely dangerous in order for the wealthy to derive the benefits is wrong.

        Paying who are about to be homeless or have their power shut off aren't exactly in a position to make sound decisions about their future welfare when presented with a large check. To a lesser extent people living with minimal life savings are in a similar boat where they can't necessarily afford to say no the way that somebody of means would.

        I don't think this is at all hard to grasp and it's why it's one of the reasons why it's generally illegal to sell body parts.

        • (Score: 1) by khallow on Tuesday October 25 2016, @05:53PM

          by khallow (3766) Subscriber Badge on Tuesday October 25 2016, @05:53PM (#418641) Journal

          Paying poor people to do things that are potentially extremely dangerous in order for the wealthy to derive the benefits is wrong.

          Like working a dangerous job? Sorry, I don't buy that starving someone is better than paying them good money for a risky job or task.

          Paying who are about to be homeless or have their power shut off aren't exactly in a position to make sound decisions about their future welfare when presented with a large check. To a lesser extent people living with minimal life savings are in a similar boat where they can't necessarily afford to say no the way that somebody of means would.

          What's unsound about the decision? No different than the choice of being a taxi driver. Most people of means wouldn't choose it, but it would be foolish to outlaw taxis rather than give another avenue for poorer people to better themselves.

          I don't think this is at all hard to grasp and it's why it's one of the reasons why it's generally illegal to sell body parts.

          I agree, just as it's not hard to grasp that a lot of people die because it is illegal to sell body parts. It's real easy to be moral when you ignore the harmful consequences of your code of morality.

          • (Score: 2) by butthurt on Wednesday October 26 2016, @11:24AM

            by butthurt (6141) on Wednesday October 26 2016, @11:24AM (#418928) Journal

            > [...] it is illegal to sell body parts. It's real easy to be moral when you ignore the harmful consequences of your code of morality.

            A lot of poor people end up doing long stints in jail because they can't pay their bail. If they could sell their organs, they could make some quick cash, get out of jail, and maybe save someone's life. Those convicted of crimes could defray the cost of their incarceration. The knowledge we've gained by using prisoners and the mentally ill as subjects for medical experimentation has been invaluable. Let's use their organs too.

            A lot of poor people end up doing long stints in the military because they can't find other work. When they are killed, the organs often go to waste. If soldiers agreed, upon joining the military, to give up their organs when they die, the proceeds could be paid (in part) to living soldiers, and could also defray the cost of conducting wars.

            People who seek medical treatment but can't afford to pay for it could be another great source of organs. To pay for the treatment they want, they could agree to have organs removed. There's a synergy to it because these people are already in the hospital, and some of them are already getting incisions. For example, someone with lung cancer could have a cancerous lung removed, and use the other lung as payment for the procedure.

            further reading (not sure how much truth there is to these--the Epoch Times is biased against the Chinese Communist Party):

            http://www.theepochtimes.com/n3/1482698-chinese-doctor-admits-to-falun-gong-organ-harvest/ [theepochtimes.com]
            http://www.scoop.co.nz/stories/WO1401/S00014/forced-organ-harvesting-from-living-falun-gong-practitioners.htm [scoop.co.nz]

            • (Score: 1) by khallow on Wednesday October 26 2016, @08:45PM

              by khallow (3766) Subscriber Badge on Wednesday October 26 2016, @08:45PM (#419137) Journal
              I guess you feel obligated to remind us yet again what an embarrassment you can be. Please don't be, we don't forget that easily no matter how much we'd like to.

              First, your stories about Falun Gong ignored that such things would be less profitable with a legal market in human organs. It's the illegality in the developed world of paying for organs that allows such enterprises to thrive. So the example shows the opposite of what you intended.

              None of the other three examples have anything to do with the problems of a market in human organs and far more to do with a punitive bail system, lack of rights in a military, or overpriced health care. None of those things will be fixed by making human organs legal or illegal to purchase on a market.
              • (Score: 2) by butthurt on Saturday October 29 2016, @11:14AM

                by butthurt (6141) on Saturday October 29 2016, @11:14AM (#420088) Journal

                I guess you feel obligated to remind us yet again what an embarrassment you can be. Please don't be, we don't forget that easily no matter how much we'd like to.

                If my comments aren't to your liking, the Slash software can help you to avoid reading them. I assume you know how to do that, so there was no real need for the ad hominem.

                First, your stories about Falun Gong ignored that such things would be less profitable with a legal market in human organs.

                The scoop.co.nz story doesn't use the word "market" but does use the words "sale" and "profit":

                Detained Falun Gong practitioners were held there for the purpose of having their organs harvested for sale.

                [...] Falun Gong practitioners are not sentenced to death by any court but are executed solely because their organs meet transplantation requirements and yield profit.

                The actions of the central government, if not explicitly legal, may as well be. It isn't the sort of market in organs that you seem to be advocating, but it is, de facto if not de jure, a legal market in organs.

                It's the illegality in the developed world of paying for organs that allows such enterprises to thrive.

                What you seem to be advocating is presently in existence in Iran and nowhere else. A few other countries have tried it. I wouldn't call them part of the developed world; is that significant to you? A 2009 Time story also made that distinction:

                Most sales take place in developing countries, where a kidney can often be purchased for the price of a high-end TV. In Iran — the only country in the world where organ sales are legal — a healthy kidney retails for about $6,000. The going rate is less than half that amount in India, which has an abundance of doctors capable of performing the procedure and destitute masses often unable to raise cash any other way. In January 2008, police busted an organ racket outside New Delhi that allegedly conned or forced poor laborers to relinquish their kidneys to wealthy clients.

                -- http://content.time.com/time/health/article/0,8599,1912880,00.html [time.com]

                Do you view the programmes in Iran, or formerly in India and the Philippines, as successful? If not, what about a developed country would make for a successful programme--greater wealth, more advanced medical technology, or what?

                In those stories about the Falun Gong, the supposition is that the prisoners are kept alive until a recipient is found. I think it's fair to assume that the heirs of those prisoners are not being paid compensation, although there will be costs for room and board for the involuntary donors. I imagine that the expense of keeping someone in a Chinese prison camp is modest. The cost structure sounds as though it would be competitive to the cost structure of buying organs from someone, then sewing the donor up in such a way as to permit survival (if that's what we're talking about?). The Chinese, I think, could compete on price if it came to that. If prices drop drastically, wouldn't that imply, under your scheme, that people selling their organs would receive smaller payments from those buying them? Or do you envision some middleman who would pay handsome prices for organs, then give them away, or discount them for the recipients?

                Of all countries, China's population is the largest (around 1.3-1.4 billion) and its GDP is the second largest. That ought to make for a robust market, even aside from medical tourism.

                None of the other three examples have anything to do with the problems of a market in human organs and far more to do with a punitive bail system, lack of rights in a military, or overpriced health care. None of those things will be fixed by making human organs legal or illegal to purchase on a market.

                When something is legal, a person may do it voluntarily. Also, a court may order it. You exhorted us to consider consequences. Things like I suggested might come to pass. What my suggestions have in common is that people now find themselves in extremis financially; with your proposal, they would have the option of selling parts of their bodies in addition to the options they now have. That possibility will, I would think, appeal especially to those who are in difficult circumstances. Since it's already legal in many places to give away one's organs, the essence of your proposal is to add that financial appeal. Your proposal could also raise the possibility of a court order that someone sell body parts, for example in bankruptcy or tax proceedings.

                • (Score: 1) by khallow on Saturday October 29 2016, @04:55PM

                  by khallow (3766) Subscriber Badge on Saturday October 29 2016, @04:55PM (#420156) Journal

                  First, your stories about Falun Gong ignored that such things would be less profitable with a legal market in human organs.

                  The scoop.co.nz story doesn't use the word "market" but does use the words "sale" and "profit":

                  So do stories [cnbc.com] about legal marijuana markets.

                  By many measures, 2015 was a bellwether year for marijuana, as states like Colorado and Washington paved the way for new business models and growth. Entrepreneurs have opened spa-like retail shops for adult users and medical cannabis sales. The social experiment to abolish cannabis prohibition in some instances is melding with a for-profit corporate culture.

                  Marijuana used to be illegal to grow everywhere in the US and now that it isn't, we see a lot of the same market dynamics that I think we'd see in a legal human organs market. The present of words in a story doesn't imply that we'll see an increase in forced human organ harvesting.

                  We don't see an increase in illegal marijuana growing in Colorado when it's so easy to legally grow it, for example. Nor for that matter, do we see an increase in illegal marijuana growing in neighboring states either because it's just too easy to transport it over rather than grow it in those other states. I believe the same effect would happen for paid human organs. It'll encourage people who are sitting on the fence about transplants, both saving lives and delivering wealth to poor people and their inheritors.

                  When something is legal, a person may do it voluntarily. Also, a court may order it. You exhorted us to consider consequences. Things like I suggested might come to pass. What my suggestions have in common is that people now find themselves in extremis financially; with your proposal, they would have the option of selling parts of their bodies in addition to the options they now have. That possibility will, I would think, appeal especially to those who are in difficult circumstances. Since it's already legal in many places to give away one's organs, the essence of your proposal is to add that financial appeal. Your proposal could also raise the possibility of a court order that someone sell body parts, for example in bankruptcy or tax proceedings.

                  The "financial appeal" is an obvious advantage of the approach since it means money going to people who need it. After all, we wouldn't want people to make decisions that benefit themselves or their inheritors while saving lives, would we? While part of what you wrote is a valid concern, we can solve that by making it illegal and simply excluding human body parts and the revenue that can come from then from bankruptcy considerations.

                  In those stories about the Falun Gong

                  Legal organ markets in the developed world aren't going to magically fix Chinese government tyranny and greed, but it will create alternatives. Being able to compete on price is vastly different than having little competition in a very inelastic demand market. The latter is far more profitable for whoever is getting away with this. And the less profit there is in this activity, the more likely we can stop it.

                  If my comments aren't to your liking, the Slash software can help you to avoid reading them. I assume you know how to do that, so there was no real need for the ad hominem.

                  Why should they be to anyone's liking, including your own? Keep in mind that of the four examples you gave, three were irrelevant to a legal market in human organs and one problem would actually be improved (since there would be a legal alternative). That poor aim is unfortunately typical of your arguments. Sure, I could just not read them, but I think engaging you has turned out to be more positive. Perhaps, you will think before posting next time?

                  • (Score: 2) by butthurt on Monday October 31 2016, @06:54PM

                    by butthurt (6141) on Monday October 31 2016, @06:54PM (#420978) Journal

                    Legal organ markets in the developed world aren't going to magically fix Chinese government tyranny and greed, but it will create alternatives.

                    I asked you to explain your emphasis on "the developed world, but you haven't answered that. There is already the sort of market you tout, in Iran. It is an alternative. Yet when I asked for your comment on it, you ignored that. The market in Iran doesn't matter, only a hypothetical market in developed countries matters?

                    Being able to compete on price is vastly different than having little competition in a very inelastic demand market. The latter is far more profitable for whoever is getting away with this. And the less profit there is in this activity, the more likely we can stop it.

                    Little competition, you say? India is the world's second most populous country.

                    India was a commonly known organ-exporting country, where organs from local donors are regularly transplanted to foreigners through sale and purchase.

                    -- http://www.who.int/bulletin/volumes/85/12/06-039370/en/ [who.int]

                    The note is attached to a tree trunk across from the Central Hospital in Chennai (formerly Madras) [...] the note advertizes its author's "top notch kidney" for 30,000 rupees, the equivalent of €500 ($664).

                    -- http://www.spiegel.de/international/world/a-pound-of-flesh-organ-trade-thrives-in-indian-slums-a-488281.html [spiegel.de]

                    Dodgy doctors exploit those same factors — illiteracy and poverty — to buy cheap organs on the black markets. There are millions of poor young men in India, desperate for a job and only too ready to travel to India's big cities at the promise of a quick buck. And even if they're not willing, they're still potential fodder. The Associated Press reported that while some donors sold their kidneys willingly, some were forcibly brought to clinics, held at gunpoint and then forced to undergo operations that they didn't want.

                    -- http://content.time.com/time/world/article/0,8599,1709006,00.html [time.com]

                    Like many Indians who struggle to make ends meet, Kala is constantly in debt, despite selling pretty much everything she has, including her own kidney.

                    "I went to a broker. He told me that I could sell my kidney. I agreed because I was in a bad situation and my children were small. We did not even have any food to eat,” she said.

                    -- https://www.rt.com/news/india-organ-trade-red-market/ [rt.com]

                    So in India, there are people willing to illegally sell a kidney of their own for €500. Under your proposal, such sales would become legal in developed countries. So if someone is flown from India to a developed country, that person's kidney could be harvested in a state-of-the-art hospital, and the developed country's laws would not be broken. I should think that that would be preferable, for the recipients, to travelling to China, India, Iran or another developing nation for their surgeries. Indeed, the chances of surviving the surgery ought to be better for the donors as well. Brokers could operate freely in the developed world. Better surgeries for recipients and donors and no chance of prosecution for doctors or organ brokers would make for smiling faces all round The world's best medical talent and equipment would be harvesting from a huge pool of the world's most desperate people. And some, I'm sure, would be first-worlders with a gambling addiction, or facing foreclosure, or the other examples I gave: to repeat myself, people who find themselves in extremis financially.

                    Regarding "very inelastic demand," you've not proven that. Demand, of course, consists of people who have been advised by a doctor that they ought to have an organ transplant. If, as you seem to hope, the supply of organs were to increase substantially, people might be expected to engage more freely in behaviours that put their organs at risk. Doctors might tend to recommend transplantation more often. In Iran, according to some, transplants are under-prescribed for people who could benefit from them:

                    “The Iranian prevalence of renal failure may not be completely assessed,” said Dr Delmonico. We do not know the total numbers who are in need but not able to afford to buy a kidney.

                    Dr Broumand, had the same insight two years earlier: “Although there has not been a waiting list for kidney transplantation since 1999, one should consider the fact that many dialysis patients are still not scheduled for renal transplantation and continue chronic hemodialysis.” Other research suggests that women, in particular the unemployed, are less likely to be listed.

                    -- http://europepmc.org/articles/PMC1819484 [europepmc.org]

                    Your central point, it appears to me, is the claim that letting people sell their body parts can benefit others who need those parts. Yet in the one place where the kind of organ market you want now exists, "many" people who could benefit from transplants aren't getting them. Of course, it wouldn't necessarily work out that way in the developed world.

                    So do stories [cnbc.com] about legal marijuana markets.
                    [...]
                    Marijuana used to be illegal to grow everywhere in the US and now that it isn't, we see a lot of the same market dynamics that I think we'd see in a legal human organs market.

                    From the story you linked:

                    Wholesale and retail market prices have increased "significantly."
                    [...]
                    "There is also a robust illicit market competing for the same business," according to the report.

                    However, it appears to me that your analogy is flawed to the point of uselessness. After someone grows and sells marijuana, that person can readily grow some more, hence the appellation "grower." Growing marijuana requires investments of capital and time, but is unlikely to cause serious harm to one's health. While some people do buy marijuana for health reasons, you specifically chose as your examples places where it's legal for recreational use: in that context it's a luxury good, not a necessity. Furthermore, in much of the world transplantation has been permitted from its inception.

                    A closer analogy would be blood plasma. Some people donate for altruistic reasons; others are paid for it. Commenters on a Web forum
                    (http://talk.collegeconfidential.com/parent-cafe/931154-is-selling-plasma-safe.html [collegeconfidential.com]) wrote that donors tend to be "down and out, desperate, jobless" and that "regular sellers are often derelicts with substance abuse problems...plasma centers are usually located near skid row." Another wrote about fainting after donating plasma.

                    A New York Times blog post says of kidney donations in the United States:

                    Donors must also be able to take a month or more off work to recover from surgery, and no system of compensation exists for that.

                    -- http://opinionator.blogs.nytimes.com/2015/07/31/need-a-kidney-not-iranian-youll-wait/ [nytimes.com]

                    I would guess that liver donation necessitates a similar recovery period. The jobless could deal with that more readily than working people.

                    The presen[ce] of words in a story doesn't imply that we'll see an increase in forced human organ harvesting.

                    I didn't mean to suggest that the stories I quoted in my previous post implied that. They do, however, support the idea that there is a legal market in organs in China. The harvesting of organs from Falun Gong practitioners as they are killed, if it indeed is occurring, is part of that market. In the developed world, people aren't executed, but they can find themselves in other, less extreme but still dire, circumstances. Offering money to such people in exchange for body parts is coercive.

                    It'll encourage people who are sitting on the fence about transplants, both saving lives and delivering wealth to poor people and their inheritors.
                    [...]
                    The "financial appeal" is an obvious advantage of the approach since it means money going to people who need it. After all, we wouldn't want people to make decisions that benefit themselves or their inheritors while saving lives, would we?

                    I do expect that the uptake would mainly be among the poor. When you speak of "inheritors" I can't tell whether you're talking about a scheme to pay a dead person's estate for the person's corpse, or whether you're implying that payments for body parts could be enough to lift a living donor out of poverty, such that the person could later bequeath something substantial. If it's the latter, I'll repeat that Der Spiegel found someone in India attempting to illegally relinquish a kidney in exchange for €500. You say that under your regime, prices would fall from what they are. If that happened, the amounts paid to donors could fall (I asked why they wouldn't, and you didn't respond to that). While €500 could be enough to bail oneself out of jail, or pay for an abortion, it isn't the sort of sum that, in the developed world, a young and careful investor may expect to retire on. In the case of living donors, money would go, I expect, to people who need it desperately enough to risk their health. While that's less coercive than housing someone in a prison camp, then killing that person for organs, it's still coercion.

                    Keep in mind that of the four examples you gave, three were irrelevant to a legal market in human organs and one problem would actually be improved (since there would be a legal alternative).

                    It's not clear to me which situations you deem irrelevant and which you think would be improved.

                    As I explained in a previous post, what my suggestions have in common is that people now find themselves in extremis. Your proposal would extend the possibilities for them to legally sell parts of their bodies. It's directed toward the penniless, the disempowered and the ill-informed. I'm sceptical that it would do much to advance their interests.

                    • (Score: 1) by khallow on Monday October 31 2016, @07:21PM

                      by khallow (3766) Subscriber Badge on Monday October 31 2016, @07:21PM (#421002) Journal

                      I asked you to explain your emphasis on "the developed world, but you haven't answered that. There is already the sort of market you tout, in Iran. It is an alternative. Yet when I asked for your comment on it, you ignored that. The market in Iran doesn't matter, only a hypothetical market in developed countries matters?

                      Where again is it illegal to buy and sell human organs? Where again is the money for buying human organs? In the developed world. And Iran has under 80 million people. They don't have the market size [nih.gov] to satisfy developed world needs.

                      Currently, the World Health Organisation estimates that of the 660,000 people in the world who require any form of transplant, 10% receive one each year (4). Of these, 10% receive their transplant through commercial ‘transplant tourism’ (4). The lack of donors and the rise of ‘transplant tourism’ have recently forced regulatory organisms throughout the world to act. The European Union tried to boost organ donations by suggesting a Europe-wide donor card, and has formed a regulatory body to standardize quality and safety within transplantation in an effort to reduce commercial transplants. The People’s Republic of China, which performs more transplants per year than any other country except the USA (5), has recently introduced tougher restrictions and penalties for commercial transplantation (5).

                      Right there, that's half a million people who need organs versus 80 million people who can supply some of those needs. There are other obstacles as well. While this article [hindawi.com] paints it in a rosy manner, it remains that physicians can be liable for transplant tourism. I believe the article ignores traditional law enforcement approaches such as sting operations which can be very effective at catching doctors who steer patients to human organ markets in other countries. And they only need to be caught once.

                      The rights and duties of physicians confronted with transplant tourism will most likely be affected in the pretransplant process if the patient asks the physician for support, such as providing medical records and/or drafting a medical report prior to the patient’s departure to obtain an organ from a potentially paid donor. Mediation or facilitation of commercial organ donations by third parties is often prohibited. This means that physicians who support patients or donors with the purchase or sale of organs could be held criminally accountable. Such provisions, however, cannot be automatically applied to cross-border organ purchase. Furthermore, potential accountability under criminal law of the physician is further diminished by the difficulty to establish whether the patient will or has indeed committed a crime.

                      In addition to criminal law, health law regulations also affect the legal responsibility of physicians. Rights and obligations of physicians commonly include the duty to provide medical care, the professional secrecy oath, and the privilege of nondisclosure [8]. These rights and obligations are firmly entrenched in health care rules and regulations. In the Netherlands, for example, the forthcoming Patients’ Rights (Care Sector) Act [9] represents the current development towards further strengthening of patient rights and stricter responsibilities of health care professionals. These responsibilities are clearly directed towards increasing the safety and quality of patient care.

                      Considering the weight of health care regulations that generally aim towards protecting and strengthening patients’ rights, it is unlikely that physicians can be held liable for supporting patients who opt for medical care abroad, even when this care possibly involves support of an allegedly purchased organ. On the contrary, physicians may be in breach of (binding) health regulations and, therefore, could be held accountable if they refuse to give such care to patients. Furthermore, doctors’ oath of secrecy and privilege of nondisclosure of patient information exempt them from the legal duty to report alleged crimes committed by their patients.

                      So how does someone on a really long waiting list for kidneys in the developed world find a reputable physician in Iran?

                      • (Score: 2) by butthurt on Wednesday November 02 2016, @11:54AM

                        by butthurt (6141) on Wednesday November 02 2016, @11:54AM (#421601) Journal

                        Where again is it illegal to buy and sell human organs?

                        Only in Iran is it legal to sell one's own organs to a stranger.

                        Where again is the money for buying human organs? In the developed world.

                        Do you mean personal wealth? Nearly all of the wealthiest people are indeed in developed countries. However, China has a large middle class:

                        [...] the number of middle class adults in North America has fallen below the number in China (see Table 3). Adding those with wealth beyond our middle class range raises the North American share from 16% to 18% and overtakes the number in China, but otherwise makes little difference to the regional ranking.

                        The middle class is so closely associated with North America – and with the United States in particular – that some of our results for individual countries may come as a surprise. The pattern displayed in Table 3 shows that China now has the largest number of middle class adults by a wide margin – 109 million compared to 92 million in the United States (although this ranking is reversed when those above the middle class upper threshold are added).

                        -- https://publications.credit-suisse.com/tasks/render/file/?fileID=F2425415-DCA7-80B8-EAD989AF9341D47E [credit-suisse.com] (PDF)

                        A 2012 London Times story [telegraphindia.com] said that an illegally obtained kidney could be bought for "as little as £4,500" in the UK. Credit Suisse defines middle class as $10 000 to $100 000 in assets; such a purchase could be within their means.

                        And Iran has under 80 million people. They don't have the market size [nih.gov] to satisfy developed world needs.

                        I was mistaken: for Iranians to sell their organs to foreigners has always been forbidden. What was allowed was for a donor and recipient to both come to Iran from abroad so that the surgeries could be legally performed at an Iranian hospital. Even that is no longer allowed:

                        [...] recipients are matched with liveunrelated donors through the Iran Kidney Foundation and the recipients are compensated dually by the government and the recipient. In this model regulations were adopted to prevent transplant tourism: foreigners were not allowed to receive a kidney from Iranian donors or donate a kidney to Iranian patients; however, they could be transplanted from donors of their own nationality, after full medical workup, with the authorization of the Ministry of Health. This was first considered as a humanitarian assistance to patients of the countries with no transplant program and limited and low quality dialysis. However, the policy of "foreign nationality transplant" gradually established a spot where residents of many countries, where living-unrelated donor transplant was illegal, could bring their donors and be transplanted mainly in private hospitals, with high incentives for the transplant teams. By June 2014, six hundred eight foreign nationality kidney transplants were authorized by Ministry of Health for citizens for 17 countries.

                        -- https://www.ncbi.nlm.nih.gov/pubmed/25894134 [nih.gov]

                • (Score: 1) by khallow on Saturday October 29 2016, @05:07PM

                  by khallow (3766) Subscriber Badge on Saturday October 29 2016, @05:07PM (#420162) Journal

                  so there was no real need for the ad hominem.

                  That was a sloppy and wrong accusation. Here's why. First, it's not what "ad hominem" [google.com] means.

                  (of an argument or reaction) directed against a person rather than the position they are maintaining.

                  At worst, my comment could be considered an insult. But really, it's my opinion about your recent posting behavior on SN. I don't use that opinion to rebut your arguments since I subsequently wrote:

                  First, your stories about Falun Gong ignored that such things would be less profitable with a legal market in human organs. It's the illegality in the developed world of paying for organs that allows such enterprises to thrive. So the example shows the opposite of what you intended.

                  None of the other three examples have anything to do with the problems of a market in human organs and far more to do with a punitive bail system, lack of rights in a military, or overpriced health care. None of those things will be fixed by making human organs legal or illegal to purchase on a market.

                  Notice my argument above doesn't depend on the poor quality of your argument or a past history of delivering the same. That's why my argument was not an ad hominem.

                  • (Score: 2) by butthurt on Monday October 31 2016, @03:53PM

                    by butthurt (6141) on Monday October 31 2016, @03:53PM (#420906) Journal

                    > At worst, my comment could be considered an insult.

                    Yes, you can generally expect people to be insulted when you call them "an embarrassment."

                    I don't use that opinion to rebut your arguments since I subsequently wrote: [...]

                    Notice my argument above doesn't depend on the poor quality of your argument or a past history of delivering the same. That's why my argument was not an ad hominem.

                    Check the definition you posted. It doesn't say that ad hominem remarks must be the sole support offered for an argument. When you include in your comments vaguely disparaging remarks about my posts on other subjects, it gives the appearance that your motivation is to get readers to dismiss my comments on this subject. You seem to be denying that you had that intention.

                    • (Score: 1) by khallow on Monday October 31 2016, @05:43PM

                      by khallow (3766) Subscriber Badge on Monday October 31 2016, @05:43PM (#420945) Journal
                      No, I explained why it' not an ad hominem. Maybe you could do better than to confirm my opinion?
                      • (Score: 2) by butthurt on Wednesday November 02 2016, @12:06PM

                        by butthurt (6141) on Wednesday November 02 2016, @12:06PM (#421609) Journal

                        I don't know what your intentions are. Apart from that, your explanation is erroneous.

                        • (Score: 1) by khallow on Wednesday November 02 2016, @02:07PM

                          by khallow (3766) Subscriber Badge on Wednesday November 02 2016, @02:07PM (#421660) Journal
                          Words have meaning, butthurt. I can't help you any further.