Bioethical Policymaking for Advanced Medical Technologies: Institutional Characteristics and Citizen Participation in Eight OECD Countries1

Organizational characteristics of public institutions, councils, committees, and panels for bioethical deliberations were examined in eight OECD countries, that is, the United Kingdom, Germany, France, the Netherlands, Denmark, the United States, Canada, and Japan. Their jurisdiction, membership composition, modes of agenda setting, and appraisal systems were examined, as was their utilization of public involvement measures. Questionnaire surveys and structured interviews were conducted with representatives of parliamentary offices, ministries, and other institutions for ethical deliberations, both public and private, in the eight countries. Confirmation of survey results was made by close follow‐up communications. Since the early 1980s, all the countries studied have established public institutions for policy deliberation on bioethical issues. While legislatures, for example, Parliament, sometimes convene special commissions or expert panels on an ad hoc basis, most of the permanent institutions are affiliated with ministries of health, science, or technology. The composition of core panel members was quite similar across institutions as well as among countries, generally composed of 10 to 15 experts. Many institutions have experimented with some forms of public involvement measures, although public involvement is not routinely incorporated in the policy process, except in Denmark, the Netherlands, and Canada. The study describes the current public institutions and their practices for bioethical policy deliberations. Exchange of experience and knowledge among the institutions is advisable to improve their performance.     

Japan's Economy and the Global Financial Crisis

After the prolonged stagnation that followed the post-Bubble economic collapse at the end of the 1980s, from 2002 onwards the Japanese economy exhibited its longest period of economic expansion (albeit gradual) since World War Two. As this expansion came to an end and the economy was on the verge of the downward curve of the economic cycle, it was confronted with the current financial and economic crises, which originated in the USA. Nevertheless, Japanese financial institutions had invested little in sub-prime-related financial products, and with the lessons learned from the issue of bad loans in the 1990s, Japan's financial system enjoyed greater stability than that of any other major nation. However, in the period from the end of 2008 to early 2009, Japan experienced the sharpest economic decline of any major nation.

Yet, with the worst period having ended in the spring of 2009, the International Monetary Fund (IMF) has predicted in its October 2009 forecasts that Japan will experience real economic growth of 1.7% in 2010—a higher rate than the USA (with 1.5%) or the Euro Zone (with 0.3%). Despite forecasts of a protraction of excessive US imports as a direct result of excessive US consumption, Japan is being forced to reduce its degree of reliance on exports to the USA and to make major adjustments to its export structure—both in terms of the regions to which it exports and the products that it exports. Japan also faces the task of setting itself on the path to economic growth, using the twin drivers of foreign demand and domestic demand, and this will necessitate the cultivation of domestic demand. Now, the long-term strategy for Japan is to promote the expansion of regional demand in Asia, to couple this regional demand with domestic demand, and to latch on to Asia's economic dynamism.     

On-column derivatization for determination of amphetamine and methamphetamine in human blood by gas chromatography-mass spectrometry

A simple determination method of amphetamine (AP) and methamphetamine (MA) in human blood was developed using on-column derivatization and gas chromatography-mass spectrometry (GC-MS). AP and MA were adsorbed on the surface of Extrelut and then derivatized the N-propoxycarbonyl derivatives using propylchloroformate. Pentadeuterated MA was used as an internal standards. The recoveries of AP and MA from the spiked blood were 89.7 and 90.3%, respectively. The calibration curves showed linearity in the range of 12.5-2000 ng/g for AP and MA in blood. The coefficients of variation of intraday and interday were 0.42-4.58%. Furthermore, this proposed method was applied to some medico-legal cases of MA intoxication. MA and its metabolite AP were detected in the blood samples, and the correlation of the blood level of amphetamines and the behaviors of the victims was in good agreement with the criteria proposed by Nagata [Jpn. J. Legal Med. 37 (1983) 513].     

Association between LDLR polymorphism and diseases in the Japanese population: aging and distribution of the polymorphism

A number of DNA polymorphisms have been found to be associated with the pathophysiology of some common disease. If the LDLR polymorphism is directly or indirectly related to some fatal disease, the distribution of the polymorphism may vary with age. We therefore investigated the aging-associated distribution of the LDLR polymorphism. Blood samples were collected from Japanese cadavers (aged 0-91) at autopsy. The LDLR polymorphism was detected using a AmpliType PM PCR Typing kit. When the LDLR genotype was examined in cadavers divided according to age into 0-29 year group, 30-59 year group, and 60-91 year group, there were significant differences in genotype among the three age groups and between the 0-29 year group and 60-91 year group. The LDLR-A genotype tended to be lower in the older cadavers. The present study revealed that there were aging-dependent differences in the distribution of the LDLR polymorphism in autopsy samples, suggesting that a common mutation involved in the occurrence of fatal diseases may be present near the LDLR-A polymorphism locus.     

Identification of fetal blood stains by radioimmunoassay of alpha 1-fetoprotein.

Radioimmunoassay of alpha 1-fetoprotein(AFP) for medico-legal identification of fetal blood stains using a commercial kit is described. The AFP content in fetal blood stains on filter paper ranged from 21--320 ng/9 mm2. The protein was detected in stains of adult blood and retroplacental blood in only negligible amounts. Aging of the blood stains did not influence the values up to 1 month. The method is simple and sensitive enough for application to medico-legal-practice.     

An autopsy case of imipramine poisoning

We present a fatal imipramine poisoning. Quantitative analysis of imipramine and its metabolite, desipramine, was performed by high-performance liquid chromatography. The concentrations of imipramine and desipramine were 18.67 microg/mL and 6.21 microg/mL in heart blood and 6.90 microg/mL and 1.77 microg/mL in the femoral venous blood, respectively. We concluded that the cause of death was due to imipramine poisoning.     

Miniaturized sample preparation method for determination of amphetamines in urine

A simple and miniaturized sample preparation method for determination of amphetamines in urine was developed using on-column derivatization and gas chromatography-mass spectrometry (GC-MS). Urine was directly applied to the extraction column that was pre-packed with Extrelut and sodium carbonate. Amphetamine (AP) and methamphetamine (MA) in urine were adsorbed on the surface of Extrelut. AP and MA were then converted to a free base and derivatized to N-propoxycarbonyl derivatives using propylchloroformate on the column. Pentadeuterated MA was used as an internal standard. The recoveries of AP and MA from urine were 100 and 102%, respectively. The calibration curves showed linearity in the range of 0.50-50 microg/mL for AP and MA in urine. When urine samples containing two different concentrations (0.50 and 5.0 microg/mL) of AP and MA were determined, the intra-day and inter-day coefficients of variation were 1.4-7.7%. This method was applied to 14 medico-legal cases of MA intoxication. The results were compared and a good agreement was obtained with a HPLC method.     

Evidence of hexavalent chromium ingestion

We describe the application of histochemical demonstration of chromium in a case of fatal ingestion of potassium dichromate in a suicide attempt. Using 2-(8-quinolylazo)-4,5-di-p-tolylimidazole (QTI), we could demonstrate chromium in the erythrocyte of the victim, in situ. This finding provides a means of proving the hexavalent chromium ingestion.     

C7 typing of blood stains using isoelectric focusing and immunoblotting

By means of isoelectric focusing and immunoblotting C7 types were clearly demonstrated from bloodstains which had been stored at 37 degrees C for up to three weeks, at room temperature for up to six weeks and at 4 degrees C for over ten weeks. The C7 typing is practically useful in medicolegal individualization of unknown bloodstains.