VIEWPOINT By Martin Wilkinson

Allowing the sale of organs will cut waiting lists

The demand for organ donors far outstrips the supply.

In this week"s Scrubbing Up, Martin Wilkinson, a visiting professor at Keele University and former chairman of the New Zealand Bioethics Council, argues that selling organs is the way forward.

When people"s organs fail, their best hope - sometimes their only hope - is a transplant.

Transplants are not only effective treatment, they are worth the money too. But there are not enough organs.

Tinkering with the rules for consent, using less-than-pristine organs, and more donations by living people have still left a big gap between supply and demand.

Should the law be changed so that people could sell their organs? I think it should.

Permitting sale would mean more people could get the organs they need. People should not be stopped from selling their organs because they have a right to do what they want with their bodies when they would not be harming others.

And would allowing sale make more organs available?

The most basic economics lesson says that supply increases with price.

Organs currently have a price of £0. Give people money for their organs and you will get more of them.

Basic economics is a bit too basic though. Perhaps few people would want to sell; perhaps people who would have donated now would not because, for instance, they are offended by the idea of money changing hands. In theory, the supply of organs could even fall if sales were allowed.

However, when Iran gave generous compensation to live kidney `donors", it not only met demand but cleared the backlog on its waiting list.

Of course, people in the UK may not behave like people in Iran, so it would be sensible to do some research into people"s willingness to take money for their organs. Still, if the aim is to increase the supply of organs, it would be worth giving sale a try.

What about the ethical objections? Many take pride in the system of altruistic donation.

They do not want to replace altruism with commerce and they think society would find commerce repulsive. But the extent to which we have altruistic donation is greatly overrated.

Many people die without giving any serious thought to donation. It is their families who agree and, when they agree, they are not donating their organs.

In any case, if organ sales would increase supply, it would not be altruistic to say: `we like altruism so much we will not allow sale even though more people will die as a result."

As for society finding sale repulsive, there is no serious evidence that it would. Even if it did, people do all sorts of things with their own bodies that other people do not like.

Punishing people for trying to sell their organs - which has happened in the UK - infringes on a right to decide what to do with one"s own body.

People should be able to choose for themselves whether to sell their organs. But surely, the argument goes, it is the poor who would sell, and what choice would they have?

Well, the poor do have bad options, but it is a pretty strange policy that takes away the one option they may think the best, and punishes them for trying to use it. And that is what criminalising organ sales does.

The critics have a point, though. People who are desperate lay themselves open to exploitation and deceit, and organ sellers are exploited and deceived in black markets now.

But the answer is to regulate the market, not to drive it underground. Selling an organ should no longer be a criminal offence.

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

The foothill yellow-legged frog is one potential source of antibiotics, say researchers

Frog skin may be an important source of new antibiotics to treat superbugs say researchers.

So far, more than 100 potential bacteria-killing substances have been identified from more than 6,000 species of frog.

The team at the United Arab Emirates University are now trying to tweak the substances to make them less toxic and suitable for use as human medicines.

The work was presented at the American Chemical Society meeting.

Drug resistant bacteria, such as MRSA, are becoming an increasing problem worldwide.

Yet there is a lack of new treatments in the pipeline.

Among the substances found by the researchers are a compound from a rare American species that shows promise for killing MRSA.

Another fights a drug-resistant infection seen in soldiers returning from Iraq.

The idea of using chemicals from the skin of frogs to kill bacteria, viruses and other disease-causing agents is not a new one.

But it is not a straightforward process to use these chemicals in humans because they are either destroyed in the bloodstream or are toxic to human cells.

After identifying the key chemicals, the researchers have altered their molecular structure to make them less dangerous to human cells while retaining their bacteria-killing properties

They hope their work means some of the substances could be in clinical trials within five years.

They are also investigating how to help the chemicals resist breakdown by the body before they have a chance to act.

Experiments have shown the changes they have made so far do make the antibiotics last longer in the bloodstream.

Study leader Dr Michael Conlon said: "Frog skin is an excellent potential source of such antibiotic agents.

"They"ve been around 300 million years, so they"ve had plenty of time to learn how to defend themselves against disease-causing microbes in the environment.

"Their own environment includes polluted waterways where strong defences against pathogens are a must."

The work underscored the importance of preserving frog diversity, he added.

"Some frog species, including those that may contain potentially valuable medicinal substances, are in jeopardy worldwide due to loss of habitat, water pollution, and other problems."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Drilling of the escape tunnel could take until Christmas

The 33 Chilean miners trapped far underground have now been told that it could take months to get them out.

Knowing that a huge rescue effort is underway must offer a certain degree of comfort but how will the men come to terms with the fact they will not see daylight for weeks to come? And what mental resilience will they require?

Dr James Thompson, a senior psychology lecturer at University College London, said the news may not have come as a massive shock.

"The miners will have already had an understanding that there is a major task ahead.

"To have it confirmed will have been a bit of a blow but as specialists they will have known it would take time to get them out.

"Compared to the initial shock of the collapse of the mine, which must have been ghastly, this is a different ball game."

There have been reports that the men are being sent anti-depressants along with other medical supplies.

But Dr Thompson says he finds that idea a bit odd and actually the best way to help the men cope mentally is to give them practical tasks and to get a routine in place.

"What they need is food and supplies and then systems building up and then to be given tasks to keep them busy.

"Maybe send down some equipment to give them something to do and to keep them involved."

He says communication with the ground will be vital for keeping the men motivated and up -to-date but also once they have the ability to set up light they need to organise their time into day and night.

"The practical is also the psychological.

"In a disaster, if someone gives you a blanket, it"s not just a blanket, it"s an act of human caring.

"Ordinary first aid is an enormous psychological boost."

NASA is being called upon to offer advice on how to best care for the miners in their state of isolation and confinement, their mental health is obviously being considered.

There are a lot of parallels with space missions, which can sometimes leave astronauts stranded for unexpectedly long periods of time, says Dr Kevin Fong from the Centre for Altitude, Space and Extreme Environment Medicine at University College London.

"This is as extreme as it gets and actually far more austere than for astronauts - I can"t even begin to imagine it.

"They are isolated in a hazardous environment and the psychological stress will be quite impressive."

But he says, although they were unlikely to be prepared for spending such a long time trapped underground they are probably psychologically quite resilient.

"They are likely to be quite tough characters to be doing that job."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

In 2008 Patrick Joyce was diagnosed with motor neurone disease (MND), a condition which attacks the ability to send signals to and from the brain.

Despite this, he describes himself as an incurable optimist. Incurable because there is no known cure for MND, but also because he is making sure his last months alive are upbeat.

He has decided to try to paint 100 portraits of people who inspire him before he dies. As his condition deteriorates, it will become harder and harder to achieve his goal.

For BBC World Service"s Outlook programme, Matthew Bannister spoke to Patrick from his home in South West England.

Listen to the entire interview on Outlook from the BBC World Service.

Produced by Paddy Maguire. Slideshow production by Dave Lee. Publication date 26 August 2010.

Related links

Patrick the Optimist

The BBC is not responsible for the content of external internet sites.

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.