A matter of health? Legal aspects of private umbilical cord blood banking

Private umbilical cord blood banking raises a question of special legal regulation. This practice promises the safe storage of biological material on the assumption that it may be useful, at a certain moment in future, for its own donor (or for a donor's close family member) for curing serious blood diseases. Although currently the therapeutic value of umbilical cord blood is confirmed, there are strong scientific doubts and relevant controversies regarding its use in autologous transplantations. This fact produces conditions of legal uncertainty, since the benefit for those wanting to conclude contracts with private umbilical cord blood banks is not clear. The Greek example illustrates this situation of regulatory deficit well, which eventually creates a major problem, given the increasing number of private banks offering relevant services in the country.     

Development of stem cells from umbilical cord blood and blood banking: "non-controversial" and "free of political and ethical debate"?

Opponents of human embryo research have understandably welcomed pluripotent stem cells being derived from body cells including cells from umbilical cords after childbirth. The cord would otherwise be discarded and embryos are not destroyed. However, there are other ethical, legal and political issues in cord blood collection, whether for the child's future use, or a public blood bank. Information and consent procedures may be misleading. Some parents have false hopes about potential outcomes. The right of access to stored blood and other benefits is sometimes uncertain for children and their families. Private stem cell repositories may compete with public ones. People may want to impose conditions on donation. Quality control may be an issue.     

Umbilical cord blood banking and the next generation of human tissue regulation: an agenda for research

The transformation of umbilical cord blood from being a waste product to being a valuable source of stem cells has led to the emergence of significant legal, ethical and social issues. This editorial proposes an agenda for research into the regulation of umbilical cord blood banking which focuses on issues of characterisation, consent, the interplay of public and private services, and the importance of applying property concepts. It concludes by stressing the need for reform to be based on well-informed public debate.     

Umbilical cord blood banking: beyond the public-private divide

Umbilical cord blood is a source of haematopoietic progenitor cells, which are used to treat a range of malignant, genetic, metabolic and immune disorders. Until recently, cord blood was either collected through donations to publicly funded cord blood banks for use in allogeneic transplantation, or stored in commercial cord blood banks for use in autologous transplantation. The line between public and private cord blood banking is being blurred by the emergence of "hybrid" models that combine aspects of both the public and private systems. The authors describe these hybrid models and argue that their emergence is explained by both market forces and public sector policy They propose that the future of the sector will depend heavily on several key developments that will differentially affect public, private and hybrid banking models.     

Predestination and Hierarchy: Vallabh��c��rya��s Discourse on the Distinctions Between Blessed, Rule-Bound, Worldly, and Wayward Souls (the Pu??iprav��hamary��d��bheda)

The Pu??iprav??hamary??d??bheda (PPM) by Vallabh??c??rya (1479?C1531?) is a brief work (25 verses) written in Sanskrit in about the year 1500, which is accompanied by four Sanskrit commentaries and one Hindi (Brajbh????) commentary. The most important and authoritative commentary is by Puru?ottama, written about two centuries after the original text. The article contains a translation of the PPM with long extracts from the commentaries, particularly the one composed by Puru?ottama. After an introduction placing the PPM??s doctrine of the hierarchy of embodied souls (j??vas) and their eligibility to obtain states of devotion (bhakti) in a wider context of Vai??ava sectarian and philosophical schools, the text is presented along with the translation and notes to the text (including extracts from the commentaries). The article concludes with reflections on the PPM??s doctrine of predestination, comparing it with those of other Indian religious sects and within the wider context of predestination in Western religions, where these discussions have been ongoing for more than 1500 years. An extensive bibliography is included at the end.     

借鉴与完善：遏制宗教极端主义的立法研究

我国打击宗教极端主义的立法不够清晰,限制宗教极端主义思想传播的法律制度落后。同时宗教管理也存在一定的缺陷。因此,须完善我国打击宗教极端主义的立法以及相关制度,要准确落实我国的宗教政策,将宗教限制在私人空间。在公共领域宗教并无自由。我国须加强国家意识和国民意识的教育,并完善打击宗教极端主义的相关立法。应当制定反恐法,将宗教极端主义行为及言论作为反恐法管制的对象之一。完善刑法规范以打击宗教极端主义。应当在刑法中增加“领导、组织宗教极端主义组织罪”、“领导、组织宗教极端主义活动罪”等,并完善互联网的相关立法。     

Youth crime victimization and religion: observations from Finland and Switzerland

European nations are undergoing increasing cultural and religious pluralization. Yet, we know little about how crime victimization relates to religion. Different theories suggest that religion might protect from or, on the contrary, be a risk factor for victimization. Drawing on a youth survey (ISRD–3), we examine Finland and Switzerland, two nations with different histories with respect to religious pluralism. We did not observe associations suggesting that membership in minority religions would protect from victimization. The risk of hate crime victimization was elevated among Finnish Muslim youths, while in Switzerland, there appears to be a more general association between ‘other’ religious identification and victimization risk. We conclude by discussing avenues for future research.     

新加坡宗教事务的法律治理

新加坡是东西方文明的交汇之地,妥善处理不同种族、宗教之间的关系至关重要。在对本国多元宗教、多元民族的基本国情充分认知的基础上,新加坡政府采取了务实的宗教政策。通过宪法和宗教自由法确立了政教分离、宗教自由和平等保护原则,制定了维护宗教和谐法,实现了宗教间的和谐与容忍,为世界各国宗教事务的法律治理树立了典范。     

The special case of property rights in umbilical cord blood for transplantation

In this Article, Professor Stephen R. Munzer makes a case for limited property rights in umbilical cord blood. Professor Munzer proposes that the unique nature of cord blood distinguishes it from body wastes and qualifies it as a body part in which property rights vest. Employing a theory of property, based in part on the articulation of the principles of utility and efficiency, justice and equality, and "labor-desert," he explores legal and philosophical arguments that justify the acknowledgment of such rights. He also discusses concerns over alleged generous granting of patents in the area of cord blood stem cells in light of these principles. Significant aspects of health policy are explored with particular focus on the potential value of using cord blood to treat various diseases and disorders. Professor Munzer discusses various difficult cases involving the exercise of property rights in umbilical cord blood with respect to the interests and/or motives of newborns, parents, and other parties. He argues that some of the concerns associated with the commercialization and commodification of cord blood are not serious enough to warrant significant barriers to market exchanges of property rights in cord blood. In addition, he concludes that the particular nature and harvesting of cord blood do not make its commodification morally problematic. Finally, Professor Munzer reinforces his treatment of property rights in cord blood by addressing objections that view property as "propriety," as a pragmatic institution, or as social relations.     

Egg freezing and egg banking: empowerment and alienation in assisted?reproduction

With the development of rapid freezing of human oocytes, many programs have reported IVF success rates comparable to those achieved with fresh eggs and thawed frozen embryos. Egg freezing is now gaining professional and regulatory acceptance as a safe and effective technique for women who wish to avoid discarding excess embryos, who face fertility-threatening medical treatments, or who want to preserve their eggs for use when they are better situated to have a family. This article focuses on the uses of and justification for egg freezing, the path to professional acceptance, the variability in success rates, and the controversy over freezing eggs for social rather than medical reasons. It also addresses the emergence of egg banking as a separate sector in the infertility industry, the regulatory issues that it poses, and its effect on egg donation. Key here is the legal control of stored eggs by banking women and their options when they wish to dispose of those eggs. The analysis is framed around empowerment and alienation. Egg freezing is generally empowering for women, but the donation or sale of unused eggs to infertile women, egg bankers, and researchers also raises issues of alienation.     

Hawala: An underground haven for terrorists or social phenomenon?

In the wake of September 11, authorities have increasingly focused on an age-old method of banking and money transfer known as “hawala.” In this system, a local hawala dealer in one country (or area) takes money from a customer and (for a nominal commission) has an associate in another country (or area) give an equal amount of money to the recipient. This type of underground banking system remains resilient due to several key characteristics. These are: the system's simplicity, its inclusiveness (enabling it to function without any type of external support), and most importantly, its considerable prominence within, and adherence upon specific cultural and religious spheres. This article provides an overview of hawala banking, together with the historical and cultural milieu that gave rise to, and continues to foster it. It suggests that while Islam addresses the issue of debt transfer through the Islamic concept of hawala, the system is widely practiced through many parts of the world by both Muslim and non-Muslims alike. Therefore, to refer to the practice as wholly “Islamic” is erroneous. This study also demonstrates that the initiatives taken towards regulation and/or elimination of hawala are ill suited to deal with the operation of this particular system. This failure particularly reflects the lack of appreciation, on the part of authorities and policy-makers, for the broader social and cultural context in which hawala opearates. A more insightful understanding of the system will address such issues as competing legal paradigms, the local appeal of the system, as well as the likely negative consequences of current regulatory efforts. Thus, any attempts at regulating hawala should ensue with great cultural and religious sensitivity, and should address some of the larger issues that continue to uphold the system, such as the existence of inadequate economic infrastrcture in such nations as Afghanistan and Somalia.     

Laypeople's ethical concerns about a New Israeli organ transplantation prioritization policy aimed to encourage organ donor registration among the public

A new policy recently enacted in Israel promises preferred status in receiving organs for transplantation to individuals who register to be organ donors and to their close family members. Proponents believe it will increase the supply of organs for transplantation from the deceased. Ethical issues were raised in government committees appointed to discuss the policy before its approval, but discussions among laypeople were not solicited. This study aimed to elicit laypeople's views about the policy by conducting thirteen group interviews and thirty-six individual interviews. Participants included religious and nonreligious people, immigrants, and Arabs. Some participants thought the law would contribute to fairness by prioritizing those willing to give, but others articulated ethical concerns that were not emphasized by scholars, in particular that the policy would add to the erosion of social solidarity, increase divisiveness, and enable people to abuse the system. Mistrust in the health care system emerged as a prominent reason for not registering as an organ donor. Implications about the importance of transparency in the organ transplantation system as a basis for an information campaign, social norms regarding organ donation, and the public's involvement in policy issues on organ donation are discussed.     

Urban infant mortality and religion at the end of the nineteenth and in the early twentieth century: the case of Ekaterinburg,Russia

Modern demographers analyse regional and other infant mortality differentials as important factors behind the current life expectancy of Russian citizens. Historically, however, the Russian Empire is simply displayed as one block with high infant mortality rates. Also with respect to cultural background factors, Russia is often perceived as religiously homogeneous with the Orthodox Church dominating the country. In reality, Russia has a long history of coexisting religious traditions. This includes both provinces with a majority of Catholics, Muslims, Buddhists or shamanistic populations as well as territories characterized by religious diversity and significant minority religions. Our project studies minority religious groups in the Urals, a province by the Ural Mountains stretching into Asia. While no territory can claim to be truly representative of this mega-country, we believe that this centrally located province is well suited to show some of the Russian variety, including differential infant mortality among the followers of minority religions, which is the topic of this article. We employ church record microdata to study Catholics, Jews and Old Believers in the main metal-producing city of Ekaterinburg.     

Sacred Spaces,Sacred Words: Religion and Same‐sex Marriage in England and Wales

This article provides an analysis of the ways in which the spatial and illocutionary requirements of English marriage law – which regulate the spaces in which marriages may be solemnized and the words the parties being married must speak – have been used to maintain distinctions between same‐sex and opposite‐sex couples. It shows how religious opponents of same‐sex partnership recognition have relied upon historically entrenched differences between the spatial and illocutionary aspects of ‘civil marriage’ and ‘religious marriage’ to argue in favour of the enactment of law that enables organized religions to exclude same‐sex couples from religious premises and ceremonies that are open to opposite‐sex couples for the purpose of solemnizing marriage. It extends recent international debates about how faith‐based discrimination against same‐sex couples is accommodated by legislators and legitimized by law, and concludes with a consideration of how English law could be amended to end discrimination based on sexual orientation.     

Patterns of breaks in umbilical cords by different mechanisms*

Investigations of perinatal deaths often result in discrepancies between autopsy findings and witness accounts. The mechanism by which the umbilical cord is severed after delivery is a common quandary. Confirming or refuting the mother's stated method frequently has significant investigative importance; however, a surprising paucity of data currently exists to allow an objective opinion about the likely mechanism. Ninety-nine placentas with umbilical cords were examined. By random selection, each cord was severed by one of the following tools or mechanisms: knives, scissors, traction, or crush. Each break was examined and photographed, and a tissue section from the broken end examined microscopically. Differentiation of mechanism was best done grossly based on specific pattern recognition. Umbilical cords severed by blunt force have distinctly different morphology from those severed by sharp force. Even similar-appearing sharp force transections frequently have mechanism-specific distinctive patterns of injury.     

Suicide bombers in Western literature: demythologizing a mythic discourse

In facing the challenge of suicide terrorism today on a global scale, it is tempting to attribute the phenomenon to cultural or religious behavior patterns observed solely in non‐Western countries. Yet recent scholarly research on its possible cultural or religious origins has led less to convincing and satisfactory results than to an unresolved aporia between arbitrariness and contingency. By the same token, little notice is taken of the fact that, in Western history and literature, actions and figures can be found whose development and strategies conspicuously resemble those of today’s suicide bombers. A series of such analogous examples in Western literature from antiquity to the present is explored in order to provide deeper insights into situational and systemic factors at work beyond cultural and religious determinants. To more effectively counter suicide terrorism, alternative policies are proposed with the vision of a peaceful coexistence of diverse cultures and religions.     

Vaccination and other altruistic medical treatments: should autonomy or communitarianism prevail?

The publication of a report into a case where an organ donor's constraints on the race of potential recipients raises questions about whether respect for autonomy or communitiarianism should prevail in altruistic medical procedures. This article briefly reviews how autonomy and communitarianism are balanced in cadaveric and live organ donation, bone marrow donation, gamete donation, blood donation and vaccination. It criticizes vaccination policy for ostensibly respecting patient autonomy yet in practice compromising that autonomy in various ways. Vaccination is properly viewed as an altruistic medical procedure because some vaccines are of more good to society than to the vaccinee, who runs associated health risks. The conclusion is that there is a spectrum of attitudes to the value of autonomy, depending principally upon the invasiveness of the procedure. In most cases the autonomy-communitarianism balance is satisfactory, but this is not so in respect of cadaveric organ donation and vaccination. The article proposes that cadaveric organ donation should be governed by the communitarian law of well-publicised presumed consent. It proposes two alternatives for vaccination: that vaccination should be compulsory or, preferably, that procedures be modified so that parents have real autonomy in their decisions whether to vaccinate their children.     

Current good manufacturing practices for blood and blood components: notification of consignees receiving blood and blood components at increased risk for transmitting HIV infection--FDA. Final rule

The Food and Drug Administration (FDA) is amending the biologics regulations to require that blood establishments (including plasma establishments) prepare and follow written procedures for appropriate action when it is determined that Whole Blood, blood components (including recovered plasma), Source Plasma and Source Leukocytes at increased risk for transmitting human immunodeficiency virus (HIV) infection have been collected. This final rule requires that when a donor who previously donated blood is tested on a later donation in accordance with the regulations and tests repeatedly reactive for antibody to HIV, the blood establishment shall perform more specific testing using a licensed test, if available, and notify consignees who received Whole Blood, blood components, Source Plasma or Source Leukocytes from prior collections so that appropriate action is taken. Blood establishments and consignees are required to quarantine previously collected Whole Blood, blood components, Source Plasma and Source Leukocytes from such donors, and if appropriate, notify transfusion recipients. The Health Care Financing Administration (HCFA) is also issuing a final rule, published elsewhere in this Federal Register, which requires all transfusion services subject to HCFA's conditions of Medicare participation for hospitals to notify transfusion recipients who have received Whole Blood or blood components from a donor whose subsequent donation test results are positive for antibody to HIV (hereinafter referred to as HCFA's final rule). FDA is requiring transfusion services that do not participate in Medicare and are, therefore, not subject to HCFA's final rule, to take steps to notify transfusion recipients. FDA is taking this action to help ensure the continued safety of the blood supply, and to help ensure that information is provided to consignees of Whole Blood, blood components, Source Plasma and Source Leukocytes and to recipients of Whole Blood and blood components from a donor whose subsequent donation tests positive for antibody to HIV.     

Medicare and Medicaid programs; hospital conditions of participation; identification of potential organ, tissue, and eye donors and transplant hospitals' provision of transplant-related data--HCFA. Final rule

This final rule addresses only provisions relating to organ donation and transplantation. It imposes several requirements a hospital must meet that are designed to increase organ donation. One of these requirements is that a hospital must have an agreement with the Organ Procurement Organization (OPO) designated by the Secretary, under which the hospital will contact the OPO in a timely manner about individuals who die or whose death is imminent in the hospital. The OPO will then determine the individual's medical suitability for donation. As well, the hospital must have an agreement with at least one tissue bank and at least one eye bank to cooperative in the retrieval processing, preservation, storage, and distribution of tissue and eyes, as long as the agreement does not interfere with organ donation. The final rule requires a hospital to ensure, in collaboration with the OPO with which it has an agreement, that the family of every potential donor is informed of its opinion to donate organs or tissues or not to donate. Under the final rule, hospital must work with the OPO and at least one tissue bank and one eye bank in educating staff on donation issues, reviewing death records to improve identification of potential donors, and maintaining potential donors while necessary testing and placement of organs and tissues take place. In addition, transplant hospitals must provide organ-transplant-related data, as requested by the OPTN, the Scientific Registry, and the OPOs. The hospital must also provide, if requested, such data directly to the Department.     

Law, Religion, and "Public Health" in the Republic of Brazil

The essay evaluates the general problem that, while most modern republican constitutions follow the U.S. and French models in declaring religious freedom, absolute religious freedom is impossible and undesirable. How are religious freedoms constrained, and how much should they be? The essay evaluates the strategies by which limitations on freedoms of religion are constructed and imposed, especially the powerful isomorphism of law and science described by Boaventura de Sousa Santos. Taking the example of Afro‐Brazilian religions in relation to the Brazilian state since 1890, post‐emancipation, the essay argues that pseudo‐scientific discourses of “public health” constrained the religious practice of former slaves, thus allowing the trompel'oeil of religious freedom to continue in the new republic, even as freedoms were in fact constrained by the state.