AT VOTE: Repeal "Organ and Blood Donations Act" [Complete] [Complete]

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Eluvatar

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Zemnaya Svoboda
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Category: Repeal
Resolution: GA#175
Proposed by: Mousebumples

Repeal "Organ and Blood Donations Act":
Description: WA General Assembly Resolution #175: Organ and Blood Donations Act (Category: Social Justice; Strength: Significant) shall be struck out and rendered null and void.

Argument: THE WORLD ASSEMBLY:

REALIZES that repealing GAR#175, "Organ and Blood Donations Act,” will not outlaw organ and blood donations and transplants within WA member nations,

BELIEVES, additionally, that the shortcomings of the resolution require its repeal in order to allow WA member nations to most effectively perform life-saving organ and blood transplants.

HIGHLIGHTS the wording of Clause 7, which states: Forbids transplantation or transfusion of infected and/or diseased blood, organs, tissues, or components thereof from one person (a donor) to another person (a recipient).

RECOGNIZES that the wording of this clause does not allow for any flexibility with regards to such transplants, even if such a transplant would be consented to by the prospective recipient.

UNDERSTANDS that some infections, such as Human Immunodeficiency Virus (HIV), Cytomegalovirus (CMV), and Hepatitis B & C (HBV & HCV) may be spread from donor to recipient during a transplantation or transfusion process, which means that individuals with these diseases shall be considered “infected and/or diseased” under the terms of this resolution.

DETAILS the following:

  • CMV is a disease that may affect a substantial portion of a given nation's population.
    • CMV-positive blood and components can be safely transfused into otherwise healthy recipients, even though such transfusions are likely to spread the disease to CMV-negative recipients.
    • CMV-positive organs and tissues can and have been transplanted safely to CMV-negative recipients in need when associated with appropriate anti-viral treatments.
  • Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency (HIV) viruses are diseases that affect varying amounts of individuals within a given population.
    • HBV, HCV, and HIV-positive donors can and have successfully donated organs to a recipient who tests positive for the same disease that they have.
    • Many individuals who are in need of organ transplants may be willing to take an organ that is HBV, HCV, or HIV-positive as receiving an organ would prolong their life even if they were to contract a new disease in the process.
  • Clause 7 “forbids” the transplantation of organs from individuals who test positive for CMV, HBV, HCV, and HIV, which means that each of the above examples are currently prohibited under WA law.

REGRETS that the unfortunate wording of this clause does not allow for flexibility in the handling of donations and transplants, which prevents member states from instituting common-sense practices that do not harm public health and may provide a net benefit for individual patients.
LAMENTS that the scarcity of resources available for transfusion and transplantation is adversely impacted by this resolution and increases the possibility that those patients in need of an organ transplant will die prior to receiving an organ that can save their lives.

DECLARES that individual recipients, in coordination with informed recommendations from their health care provider(s), should be allowed to give their informed consent for such procedures that are outlawed by this resolution.

HOPES that the WA will consider future legislation on this subject to rectify the aforementioned flaws while still assuring the safety and availability of blood, blood components, organs, and tissues in order to save lives of individuals in all WA member nations.

REPEALS GAR#175, "Organ and Blood Donations Act."
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Mousebumples:
Dear President Minister Kerenskij of The Respublika of Zemnaya Svoboda, WA Delegate for The North Pacific:

I write to you today to ask for your support on the first part of a fairly involved repeal and replace project that I have on-going - and one that I know we've discussed previously on your regional forums. Notably, I seek your approval on 2 repeals: One & Two

  1. Repeal “Organ and Blood Donations Act” (Please approve!)
    • WA nations are actually more restricted in the availability of organs and blood products than RL nations are today due to the wording of this resolution.
    • Individual patients, in coordination with their doctors, should be able to determine if “infected or diseased” organ or blood donations are something they are willing to accept. This decision should not be made by the WA as a whole, especially given the diversity of nations within the WA.
    • Further evidentiary links, should you be interested in reviewing such details, can be found here: viewtopic.php?p=10767642#p10767642
  2. Repeal “Stem Cells for Greater Health” (Please approve!)
    • The WA is mandated to fund stem cell research, even if more advanced technologies are developed.
    • Informed consent is not required, which may lead to the exploitation of stem cell donors.
  3. Pass three complementary replacements, which are all drafted and are currently up for debate on the NS forums, should you wish to contribute to the discussion. The proposal threads link to each other atop each, and the first can be found here: viewtopic.php?f=9&t=193536

In Real Life, I come from a “medical family.” (I’m a pharmacist, for one.) I know a lot about organ, blood, and stem cell donations and transplants, and I really think that the present resolutions are actively harmful to our national populations. I really feel that we need to start from scratch on both of these topics and pass smart, intelligent, and life-saving resolutions to replace them. Given the similarity of the topics, setting logical standards for organ, blood, and stem cell therapies (as a whole) makes sense.

Please give your approvals (here and here) both now and when they (hopefully) reach a vote. With your help, we can get these repealed and replaced with much more effective legislation.

Feel free to contact me with any questions. I’m fairly confident that a counter-campaign may be run, so if there’s concerns you may have, please feel free to telegram me. Thanks again for your consideration and support.

Yours sincerely,
Nikolas Eberhart
Ambassador from The Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island
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Since this will be At Vote next, I figured I'd offer up some general information - in addition to what's already been posted that I had TGd to your lovely Delegate. I've gotten some questions via TG after my campaign, so here's some additional information - complete with RL sources!

Cytomegalovirus (CMV) is really the main "problem" with what's outlawed under the current resolution. With the research I've done, less than 10% of RL transplants involve transplanting a CMV-negative organ to a CMV-negative recipient. (Source) That's a significant portion of organ transplants that are now outlawed by NS law.

CMV is totally safe when it comes to blood donations and transfusions when its given to otherwise healthy individuals. CMV-negative blood is generally "saved" for use in babies (Source) since they have a weaker immune system and may be more susceptible to complications from contracting CMV at such a young age. As CMV affects between 50-80% of people throughout the course of their lifetime (Source), that is a significant portion of the population that is no longer able to donate blood under this resolution. The lack of blood stocks for transfusion would likely result in more deaths.

I'm also planning to do some updating to the replacements based on some feedback I've gotten, so look for those changes to come sometime this weekend. Further questions and concerns are, of course, welcome. I'm heading off to work an hour or so after this goes to vote, but I'll be sure to come back and check things out later tonight.

Thanks for the consideration, TNP!
 
I suspect that one might counter-argue by arguing that CMV-positive would not count as diseased under the current resolution.
 
Eluvatar:
I suspect that one might counter-argue by arguing that CMV-positive would not count as diseased under the current resolution.
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I guess that depends on what you consider "diseased." For me, the most basic question that needs to be answered is whether or not the transplant (or transfusion) will spread the infection or disease from the donor to the recipient.

That does and will happen with CMV-positive to CMV-negative donations. Of course, the details regarding that are much less easy to cite, but I did some PubMed (journal article resource) searching. I have more detailed quotes and stat referencing on the NS forums (this post), but here's a quick recap with sources cited:
Source: Slifki M, Doron S, Snydman DR. Viral Prophylaxis in Organ Transplant Patients. Drugs 2004; 64 (24): 2763-2792.
This data is in line with the estimates on the percentage of the general population who would test CMV+ (50-75% are the numbers that I've found most consistently in my research and reading), which would seem to indicate that whether or not the CMV infection is latent or not is irrelevant to the likelihood of CMV transmission during transplantation.

However, another shortcoming of this resolution is the fact that while doctors are certainly allowed to prescribe prophylactic treatments, it is not mandated (or even encouraged) by this resolution, which would permit nations/health systems to "cheap out" and not act in the best interests of their patients.

Of course, considering the fact that this resolution fails to acknowledge that there may be any circumstances in which transplantation with a diseased or infected organ may be in the best (medical) interests of the patient, I suppose that the inclusion of such a clause could have been quite problematic if actually included within the text itself.

Source: Singh N , Dummer JS, Kusne S, et al. Infections with Cytomegalovirus and Other Herpesviruses in 121 Liver Transplant Recipients: Transmission by Donated Organ and the Effect of OKT3 Antibodies. J Infect Dis. 1988 July; 158(1): 124-131.
I know this is an old article, but I think it's especially useful in proving my point, in part due to its age. This study was one of the first to really analyze how and why CMV infection spread during organ donation. The most important point, in my mind, is the following: Of the 14 CMV-negative recipients who received a liver from a CMV-positive donor, THIRTEEN (!!!) of them contracted CMV. Conversely, only one of twelve CMV-negative recipients who got an organ from a CMV-negative donor contacted CMV. As the study indicated, that is definitely statistically significant. There is only a 1 in 1,000 chance that those results could have happened by coincidence.

Both of these articles indicate that a latent CMV infection still infects the organs being transplanted and still places organ recipients at significant risk for contracting CMV without the necessary prophylactic treatments.

Bottom line, honestly: This resolution restricts the choice of patients and medical decision making of doctors and other health care professionals to work in the best interests of their patients.
 
GA Resolution at Vote: Repeal "Organ and Blood Donations Act"
http://forum.thenorthpacific.org/topic/6953118/

1 for (Cormac); 0 against; 0 abstain; 0 present

I vote for if most of the votes are in for, and against if most of the votes are against. I don't count "present" votes as votes for this. This means that a vote for abstain is a vote against my voting either way.

Zemnaya Svoboda's vote for "Repeal "Organ and Blood Donations Act"" has been noted.
 
HOPES that the WA will consider future legislation on this subject to rectify the aforementioned flaws while still assuring the safety and availability of blood, blood components, organs, and tissues in order to save lives of individuals in all WA member nations.
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I have no real problem with the rest of it as long as an accurate and accommodating set of proposals are in queue that creates a more realistic regime through WA legislation. But I do have a problem with this wishy-washy clause which could have easily called for submission of proposals to replace the current WA legislative regime with a more comprehensive, flexible and balanced regime.''

FOR with reservations.
 
Grosseschnauzer:
HOPES that the WA will consider future legislation on this subject to rectify the aforementioned flaws while still assuring the safety and availability of blood, blood components, organs, and tissues in order to save lives of individuals in all WA member nations.
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I have no real problem with the rest of it as long as an accurate and accommodating set of proposals are in queue that creates a more realistic regime through WA legislation. But I do have a problem with this wishy-washy clause which could have easily called for submission of proposals to replace the current WA legislative regime with a more comprehensive, flexible and balanced regime.''

FOR with reservations.
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I already have 3 proposals drafted to replace this (and the next repeal in the proposal queue). They're also posted on this forum for your persual, if you want to check them out. I do have some ideas for minor edits to those proposals (after getting feedback on the repeal so far), but they should be close to ready to go after both repeals (hopefully) pass.

If only one passes, I'll have to do some edits since all 3 replacement proposals current group organ, blood, tissue, and stem cells as "Biomedical Tissues" and cover rights, standards, etc., for the topic as a whole.

Thanks for the support, and I hope that alleviates some of your concerns. :)
 
mowa-seal.png

The Ministry of the World Assembly has analyzed the facts presented in the repeal, and believes them to be true. The Ministry of the World Assembly agrees that this repeal would not outlaw organ and blood donations, and would protect and promote individuals’ choice. So long as nations are sure to get consent from the patients and to treat these type of situations carefully, the Ministry of the World Assembly can see how the resolution would be constricting.

The Ministry of the World Assembly therefore encourages nations to vote for this resolution.
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Repeal "Organ and Blood Donations Act" was passed 8,832 votes to 1,241.

Voting on this resolution has ended.

Thanks to those nations who cast their votes. Your participation is a great help to the region.

This topic has been locked and sent to the Archives for safekeeping. If you would like this topic to be re-opened for further discussion, please contact the WA Delegate, a Global Moderator, or an Administrator for assistance. Thank you.
 
Voting on this resolution has ended.

Thanks to those nations who cast their votes. Your participation is a great help to the region.

This topic has been locked and sent to the Archives for safekeeping. If you would like this topic to be re-opened for further discussion, please contact the WA Delegate, a Global Moderator, or an Administrator for assistance. Thank you.
 
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