Complications following cell therapy

So far, the law in the Federal Republic of Germany still allows the injection of fresh-cell preparations from animals as a roborant to increase the vitality of the organism and to strengthen the body's immune defense system. The use of "sicca-cell" preparations was provisionally forbidden in 1987 by the Federal Health Organization (Bundesgesundheitsamt; BGA). Prohibition of fresh-cell injections would have exceeded the authority of this office, although the same serious reservations also applied in the case of this treatment method. Several publications that have appeared since 1955 have reported serious complications of this therapy, some life-threatening and some even lethal. Two further cases are now added: (1) A woman aged 69 had been receiving treatment with cell injections for 9 years. Immediately after an injection of sicca cells she collapsed and was hospitalized; 7 days thereafter she developed an ascending paralysis with increasing inability to swallow or breathe. She died 25 days after the injection as a consequence of central and peripheral respiratory failure. Autopsy revealed the alterations typical for acute Landry-Guillain-Barré-Strohl syndrome. (2) A 76-year-old healthy woman had been receiving treatment with fresh-cell preparations for several years. After an injection of cell suspensions a painful local swelling was observed. The symptoms were interpreted as the consequence of an iatrogenic local hematoma, and repeated punctures were performed to obtain blood. The patient was transferred to a surgical department for further therapy. Two days after the injection she suddenly died with signs of acute cardiovascular failure. Autopsy revealed the signs of a fulminating clostridial infection and also the characteristic signs of Landry-Guillain-Barré syndrome with involvement of the autonomic nervous system. In both cases the development of an inflammatory process in the peripheral nervous system could be interpreted as an immune-mediated allergic disease, related to the repeated injection of heterologous antigenic material containing nervous tissues. This hypothesis would also explain the two other cases already published and would be consistent with the observed perivenous leukoencephalopathy of the central nervous system. The human disease pictures correspond to the well-established animal models of EAEM (experimental allergic encephalomyelitis) and EAN (experimental allergic neuritis). The pathogenesis is discussed; the major role of the central and peripheral nervous system is stressed, with special reference to the risk of acute autonomic failure. The need for specific autopsy techniques for the investigation of the entire nervous system, including spinal cord, roots, spinal ganglia and peripheral nerves with sympathetic chains, is raised.     

Empathic emotions and justice in society

Empathy is defined as an affect more appropriate to another's situation than to one's own. The paper (i) summarizes different modes of empathic affect arousal; (ii) shows how empathic affect may interact with social-cognitive development, to produce four levels of empathy development; (iii) suggests that causal attributions may transform empathic affect into sympathy, guilt, and empathic anger, which are major moral affects; (iv) discusses how these affects may influence moral judgment and behavior; (v) points up empathic morality's limitations and the need to embed empathy in relevant moral principles; (vi) discusses possible links between empathy and justice principles, with special focus on Rawls; (vii) illustrates the interplay of empathy, moral judgment, and justice; and (viii) suggests that moral principles may become hot cognitions.     

Morgentaler v. The Queen in the Supreme Court of Canada.

In Morgentaler v. R., the Supreme Court of Canada struck down the abortion provisions in the Criminal Code. In a five to two split, a majority of the Supreme Court judges found that section 251 offended a pregnant woman's constitutionally protected right not to be deprived of her "life, liberty, and security of the person." Sheilah Martin reviews the three majority judgments and focuses on the decision written by Madame Justice Wilson. She believes that Madame Justice Wilson's opinion merits special attention in several regards: her conclusions on the constitutional rights of pregnant women; her recognition and validation of women's perspectives on abortion; and her approach to balancing women's interests in reproductive self-determination against the state's interest in regulating reproduction. Sheilah Martin concludes that this decision will reverberate far into the future. Even though it fails to establish clear guidelines concerning governmental power to control access to abortion, its principles outline the legal framework in which future litigation will occur, and it will limit and shape the terms of any ensuing political debate. In addition, Madame Justice Wilson's judgment holds great promise for those looking to the Court to promote the rights of women and other historically disadvantaged groups.     

The cutaneous ink sign: a tipoff to suicide or suicide notes

The presence of smeared or unsmeared ink on the skin resulting from the writing process has been observed in a number of suicide victims who have left suicide notes. The authors report a case of a palmar "cutaneous ink sign" and discuss its forensic science import.     

Research and Social Security policy in the United States

This article is adapted from a paper presented at a conference that investigated the role of policy research in shaping public policy. The conference focused on how studies of economic and social forces and their relationship with public problems and programs affect the decisions of public policymakers. The author contends that research has the potential to inform policy-making in any of its five stages: problem identification, option development, passage of new laws or development of new procedures, implementation, and evaluation. She notes that different players in the policy-making process use research differently, from the senior government official who needs a quick review of what is known relating to a "hot" issue to the interest group lobbyist who wants access to raw data. The article concludes that research can best achieve its potential when (1) it anticipates policymakers' information needs, (2) it is disseminated in an accessible form understandable to nonresearchers, and (3) the policy analyst is willing to engage in the policy process as an advocate for efficiency.