The subtle politics of organ donation: a proposal.

Organs available for transplantation are scarce and valuable medical resources and decisions about who is to receive them should not be made more difficult by complicated calculations of desert. Consideration of likely clinical outcome must always take priority when allocating such a precious resource otherwise there is a danger of wasting that resource. However, desert may be a relevant concern in decision-making where the clinical risk is identical between two or more potential recipients of organs. Unlikely as this scenario is, such a decision procedure makes clear the interdependence of organ recipient and organ donor and hints at potential disadvantages for those who are willing to accept but unwilling to donate organs (free-riders). A combined opting-out and preference system weakens many of the objections to opting-out systems and may make the decision to donate organs on behalf of their deceased relatives easier for families.     

Philosophical medical ethics. Conclusion: the Arthur case revisited

Throughout his British Medical Journal series of 25 articles on medical ethics, Gillon frequently used the Arthur case (which involved a British physician who faced criminal charges for allowing a Down's syndrome newborn to die) to illustrate moral arguments concerning approaches to clinical dilemmas. He returns to the Arthur case in this essay on the obligations of physicians toward all patients with Down's syndrome. Gillon asks what implications one's view of the moral permissibility of allowing infants with this handicap to die has for the care of adults with the same condition. He concludes that the issue turns on the question of personhood, in particular that of newborns. If newborns are not accorded personhood status, then allowing those with severe handicaps to die may be justified but should not be considered morally different from actively killing them.     

Symposium on diarrhea. 1. Definition and mechanisms of diarrhea.

Diarrhea, an increase in frequency of evacuation and in water content of the stool, is the result of three categories of mechanism--solute malabsorption, secretion of fluid and motility disturbance. Before diarrhea is considered an abnormal condition, any alteration in stool frequency and content must be related to an individual person's normal bowel habit and to norms for the population, but more than three bowel movements or the passage of liquid stools exceeding 300 g daily should, in general, be considered abnormal. A useful way of understanding the mechanism of diarrhea is to become familiar with the normal functions of the bowel in regard to water and electrolyte absorption and motility, and then to relate these functions to solute malabsorption, fluid secretion and motility disturbance.