[Locked] Repeal "Organ and Blood Donations Act"

[Mousebumples]

Before I can submit the 3 replacements that I posted up here for your perusal, I need to repeal 2 different resolutions. This is the first, and I think I've taken a different approach from the one that is currently failing At Vote.

Argument:
THE WORLD ASSEMBLY:

LAUDS the intent of GA#175, "Organ and Blood Donations Act" to provide access to blood and organ donations.

BELIEVES, however, that a number of faults in this resolution's text may limit the effectiveness of the resolution in question.

UNDERSTANDS the meritorious intent 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);

DOCUMENTS that as the resolution in question fails to differentiate between life-threatening infections and diseases, as there are some infections and diseases that will not put recipients at risk. However, due to the unfortunate wording of this clause, individuals with some non-life threatening diseases or infections would be prohibited from donating as signs of their condition(s) may be detected in blood, organs, tissues, and/or components.

DETAILS that cytomegalovirus (CMV) is such infection that affects well over half of most adult populations.

• CMV is a virus that periodically re-activates throughout an individual's lifetime after they have been exposed. Most healthy individuals do not have any symptoms when they have an active CMV infection.
  
• CMV-positive blood can be safely donated to otherwise healthy individuals, but such blood donations would be prohibited under this resolution.
  
• CMV-positive organs can and have been safely donated to those in need of transplants when associated with appropriate preventative anti-viral treatments. However, such transplants would be prohibited under this resolution.
  
• Many individuals in need of a transplant may have already been exposed to CMV, which puts them at risk for future re-activation of CMV whether or not their newly transplanted organ was CMV-positive or CMV-negative.

RECOGNIZES that because such a large segment of the population is prohibited from donating blood, organs, tissues, and/or components due to their CMV-positive status, the scarcity of resources for transfusion and transplantation is adversely affected by this resolution and makes it more likely that those in need of an organ transplant will die prior to receiving an organ that can save their life.

REALIZES, additionally, that there are some infections that could be safely transplanted from one diseased individual (the donor) to another with the same disease (the recipient). These may include: Hepatitis B, Hepatitis C, and Herpes Simplex Virus – among others.

REGRETS that such organ transplants, for example from a Hepatitis B-positive donor to a Hepatitis B-positive recipient, are outlawed under this resolution, which may result in wasting organs that could otherwise have gone to help save the lives of those in need.

HOPES that the WA will consider future legislation on blood and blood component donation and organ and tissue transplantation to rectify the aforementioned flaws.

REPEALS GA#175, "Organ and Blood Donations Act."

Another argument that I'm thinking of adding is regarding the fact that the "informed consent" in the resolution in question does not have to be uncoerced. Arguably, an "evil" nation could coerce their citizens (or next of kin, etc.) to donate organs, blood, etc., when the individual in question may not really want to do so. However, I'm not sure what people's thoughts are on that, so opinions would be welcome!

Also, this is a bit more ... technical than most of my repeals tend to be, so if there's anything that's unclear, PLEASE let me know!

Thanks for checking this out.

 

[Eluvatar]

I wouldn't add that argument, I think it's fairly clear that informed consent can't be coerced, or it's no longer consent.

The CMV argument is certainly interesting. I suspect that counter-arguments will be made that question whether HCMV infection counts as disease.

The idea of transplanting diseased organs between people who share the same disease is somewhat worrisome to me, though I can't figure out why.

 

[Mousebumples]

I wouldn't add that argument, I think it's fairly clear that informed consent can't be coerced, or it's no longer consent.

The CMV argument is certainly interesting. I suspect that counter-arguments will be made that question whether HCMV infection counts as disease.

The idea of transplanting diseased organs between people who share the same disease is somewhat worrisome to me, though I can't figure out why.

On some level, regarding the transplanting of diseased organs - it's a bad idea.

For example, diseases like HIV/AIDS and tuberculosis frequently mutate and develop drug resistance. The strain of a given disease that the donor has may not match the strain that the recipient has. I may end up cutting out that part entirely, as well. I think the CMV argument is the strongest, but - so long as I was revamping the arguments anyhow, I thought I'd toss it in there. I can toss it out easily enough as well.

Regarding HCMV infection not counting as disease ... it doesn't matter. The resolution says: "Forbids transplantation or transfusion of infected and/or diseased ... " Infection counts. And as I tried to explain, it's nearly impossible (and likely quite expensive) to determine accurately whether or not someone who is asymptomatic has an active infection at a given point in time.

Thanks for the feedback!

 

[unibot]

I think this argument overall is much stronger than the ones previously considered in the repeal, I don't have time at the moment to give you a full review (MUST GO TO WORK), but I'd probably support this version.

 

[Mousebumples]

I think this argument overall is much stronger than the ones previously considered in the repeal, I don't have time at the moment to give you a full review (MUST GO TO WORK), but I'd probably support this version.

Thanks, Uni. If you're interested in reading more information about the details provided, I have a number of links in the NS forum thread. I can copy them over here, but I mostly just included them there to refute the partial truths that are being forwarded by those in opposition to the repeal.

I feel kinda bad that you did all that detailed research (with citations!) on the original draft in the NS forums ... and then I must have updated the draft before you had a chance to finish compiling your response and ... yeah. Lots of confusion there, me thinks.

 

[unibot]

I guess my question is in regards to this section:

REALIZES, additionally, that there are some infections that could be safely transplanted from one diseased individual (the donor) to another with the same disease (the recipient). These may include: Hepatitis B, Hepatitis C, and Herpes Simplex Virus – among others.

REGRETS that such organ transplants, for example from a Hepatitis B-positive donor to a Hepatitis B-positive recipient, are outlawed under this resolution, which may result in wasting organs that could otherwise have gone to help save the lives of those in need.

I can see blood transmitting Hepatitis, but organs too? I guess the organs aren't exactly clean during transplantation or something?

 

[Mousebumples]

I guess my question is in regards to this section:

REALIZES, additionally, that there are some infections that could be safely transplanted from one diseased individual (the donor) to another with the same disease (the recipient). These may include: Hepatitis B, Hepatitis C, and Herpes Simplex Virus – among others.

REGRETS that such organ transplants, for example from a Hepatitis B-positive donor to a Hepatitis B-positive recipient, are outlawed under this resolution, which may result in wasting organs that could otherwise have gone to help save the lives of those in need.

I can see blood transmitting Hepatitis, but organs too? I guess the organs aren't exactly clean during transplantation or something?

Hepatitis is ... complicated. It is possible for some individuals to "clear" their Hepatitis infection and develop antibodies against ... whatever variation they had. IRL, those people are able to donate. I'd think that if nations want to allow such individuals to donate organs. (Heck, it's possible that their blood could be used as potential treatments for those with active Hepatitis infections due to the antibodies, but I don't believe that's part of current/MT treatments.)

However, even if the liver is the only organ "officially" infected/affected by the disease, transplanting other organs can (and generally does) spread the disease to otherwise uninfected individuals.

CDC case study:
(Summary: a man passed away and his organs were donated. It was not known that he had HBV and was not detected prior to transplantation.)

On March 23, 2010, six organs from the donor were transplanted into five recipients in multiple states; no tissues or blood vessel conduits were procured. The investigation revealed that three of the five organ recipients had evidence of acute HBV infection posttransplantation; all three were infected with a genetically identical virus. The two recipients who were not infected had serologic evidence of immunity resulting from vaccination or past infection.

Again, I'm by no means advocating the donation of HBV positive to an otherwise HBV negative recipient. However, if a prospective recipient already has HBV and needs a kidney or something, why shouldn't an HBV donor be considered? Due to the scarcity of organs, I doubt any doctor/system is going to decide to waste an otherwise healthy organ on someone who already has a pretty serious disease.

Does that help to explain things a bit more? *sigh* I kinda hate that this repeal is so technical, but ... it is what it is. :-\

 

[Mousebumples]

It doesn't look like I can edit the OP to work in my updated (and hopefully final?) draft, but any comments or critiques would be helpful. I'm hoping to have time to submit/campaign tomorrow and Thursday, so that's probably what I'm looking at as a timeline. (Provided there's no major issues that are pointed out to me.) I'm working on making the rounds to various boards with this draft, but I'm planning to edit in links/evidence on the NS thread, so if you're looking for research/sources, check there in an hour or two or three ....

Also, my apologies, but something is going wonky with the coding, and I don't know where I messed up, but ... yeah. *sigh* Help? ETA: The wonkiness is apparently only with the preview adding <br></br> (visible) tags instead of having carriage returns, so ... never mind ...

THE WORLD ASSEMBLY:

REALIZES that repealing GA#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 necessitate 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).

ACCEPTS 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 mean that those with these diseases shall be considered “infected and/or diseased.”

OFFERS the following details regarding the shortcomings of Clause 7:

• CMV is a disease that may affect a substantial portion of a given nation's population.
  (a) CMV-positive blood and components can be safely transfused into otherwise healthy donors, even though such transfusions are likely to spread the disease to CMV-negative recipients.
  (b) CMV-positive organs and tissues can and have been safely donated to CMV-negative recipients in need of transplants 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, depending on many factors.
  (a) 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.
  (b) 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 presently 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 currently outlawed.

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

REPEALS GA#175, "Organ and Blood Donations Act."

 

[Eluvatar]

Looks pretty solid to me, at cursory examination.

 

[Mousebumples]

Looks pretty solid to me, at cursory examination.

Awesome, thanks for the feedback. This is one of those things that I've edited so many times that I'm half-afraid I'm missing some major copy/paste error from moving things around.

Like I was talking about how I'd love to go see Did you notice how much that sparkles? ... or something else like that. Anyhow: the read-through is much appreciated. Thanks again!

 

[Simone]

Locked as resolution passed