[NOW SPLIT] Biomedical Treatment Rights

[Mousebumples]

This draft has now been split into two separate proposals:
Biomedical Donor Rights
Biomedical Recipient Rights

Discussion on the details of those proposals is welcome - preferably in those individual threads. Thanks!

So I've had this ... idea for a few months now. Of course, since the "idea" involves FIVE DIFFERENT PROPOSALS ... it took a bit of time to get off the ground. But here's what I have for you right now.

STEP ONE: The Repeals
(1) Organ and Blood Donations Act
(2) Stem Cells for Greater Health

I've been strongly against both for ... ages. I don't know that either repeal attempt (as being done by me) will surprise anyone. I think that the subjects are very similar and should be treated similarly on an international level. And that brings me/us to ...

STEP TWO: The Replacements
I've never replaced anything I've repealed myself. Because of my (IRL/OOC) medical background, this is one exception that I'm looking to make. I personally feel that both of these resolutions tried to do too much and didn't to much of it well, overall. As such, I "combined" the 2 concepts into "biomedical treatments" and covered 3 different arenas on the subject.

(1) Biomedical Treatment Rights - Human Rights, Significant
(2) Biomedical Innovation Organization - Education & Creativity, Education
(3) Biomedical Trade & Treatment - Free Trade, Mild

I'll admit it - my first draft as a replacement was ... a mess. I tried to focus on Free Trade and ended up all over the place - a category violation waiting to happen, probably. I ended up "forgetting that" and starting over - and writing in the order that I indend to submit (see above) - and ... that seemed to work much better. Of course, if both repeals don't pass, I doubt that I could submit any of the replacements. (Maybe - I honestly haven't checked, but it seems likely to conflict with the originals.)

Questions and concerns are certainly welcome. However, please do use the above links to jump easily between the different drafts and offer your thoughts.

VERSION III:

BIOMEDICAL TREATMENT RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, when dealing with treatment using biomedical tissues.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

DETAILS that "biomedical procedures" shall include, at minimum the donation, harvesting, transplantation, or transfusion of biomedical tissues.

DECLARES that prospective donors and recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

REQUIRES that all biomedical procedures shall involve:

1. Techniques that are as humane as is practicable using sterile technique.
2. Testing and typing of the donated tissues to minimize negative transfusion reactions, biomedical tissue rejection, and the transference of disease or infection.

MANDATES that prospective recipients shall be given all medically relevant facts regarding the biomedical tissue(s) and procedure prior to obtaining their uncoerced, informed consent.

1. Legally completed advance health care directives (e.g. living will) shall be followed in order to respect the wishes of the individual in question.
2. In the absence of a legally completed advance health care directive, legal guardians may provide uncoerced, informed consent on behalf of a donor or recipient in the event that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.
3. Individual WA Nations may pass laws allowing an individual’s next-of-kin to act as their legal guardian in the event that the individual in question has been medically classified by one or more qualified medical professionals as being irreversibly “brain dead” without completing an advance health care directive.

INSTRUCTS the WHA to allocate an appropriate portion of their budget to assist with:

1. Providing necessary medications and preventative treatments with regards to biomedical treatments in nations that are otherwise unable to afford such medications and treatments.
2. Engineering a low-cost and effective set of procedures for storing and maintaining previously donated biomedical tissues, which shall include at minimum:
   
   1. Medically relevant details with regards to the results of the typing and testing that has been done.
   2. Procedures to prevent the unintended or incorrect transplant or transfusion of biomedical tissues (e.g. the wrong biomedical tissues, etc.)

ALLOWS for WA member nations and their health care systems to triage of prospective recipients based on geographic location, if the biomedical tissue in question may decrease in quality during the transport process, and/or medically relevant factors (e.g. medical need).

PERMITS WA member nations and their health care systems to delay in biomedical treatments due to a co-existing medical condition, which may place the treatment tissues at risk of rejection or infection.

1. If such a medical condition exists, all reasonable attempts shall be made at treatment so as to allow the transplant to occur.
2. WA member nations may match donors and recipients based on such a medical condition in the event of biomedical tissue shortages, if such a match is determined to be in the best medical interests of the recipient.

CLARIFIES that this resolution shall in no way prohibit further legislation on this subject, provided that it does not contradict with this text or extant international law.

Version II:
(Markup free version within the thread.)

BIOMEDICAL TREATMENT RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, when dealing with the harvesting and transplantation of biomedical tissues.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

INSISTS DECLARES that prospective donors and recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

MANDATES that all prospective donors and recipients agree to the procedure(s) with uncoerced, informed consent prior to any harvesting or transplantation.

REQUIRES that all medical procedures involving biomedical tissues be conducted as humanely as practicable using sterile technique.

INSISTS that legally completed advance health care directives (e.g. living will) shall be followed in order to respect the wishes of the individual in question.

PERMITS the following:

1. In the absence of a legally completed advance health care directive, legal guardians to may provide uncoerced, informed consent on behalf of a donor or recipient in the event of any of the following:that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.
2. CLARIFIES that Individual WA Nations may pass laws allowing an individual’s next-of-kin mayto act as their legal guardian in the event that the individual in question has been medically classified by one or more qualified medical professionals as being irreversibly “brain dead” without completing an advance health care directive.

ALLOWS for the following:

1. Triage of prospective recipients based on:
   1. Medical need.
   2. Geographic location if the biomedical tissue in question may decrease in quality during the transport process.
2. Delay in transplantation due to a co-existing medical condition, which may place the transplanted biomedical tissues at risk of rejection or infection. If such a medical condition exists, all reasonable attempts shall be made at treatment so as to allow the transplant to occur.
3. Passage of national laws regarding the payment and/or reimbursement for lost wages to donors of biomedical tissues.

MEDICAL DONATION RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, when dealing with the harvesting and transplantation of biomedical tissues.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

INSISTS that prospective donors and recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

MANDATES that all prospective donors and recipients agree to the procedure(s) with uncoerced, informed consent prior to any harvesting or transplantation.

PERMITS legal guardians to provide uncoerced, informed consent on behalf of a donor or recipient in the event of any of the following:

1. The individual in question is under the age of majority
2. The individual in question is otherwise unable to understand the information and/or procedure.

CLARIFIES that an individual’s next-of-kin may act as their legal guardian in the event that the individual in question has been medically classified by one or more qualified medical professionals as being irreversibly “brain dead.”

ALLOWS for the following:

1. Triage of prospective recipients based on:
   1. Medical need.
   2. Geographic location if the biomedical tissue in question may decrease in quality during the transport process.
2. Delay in transplantation due to a co-existing medical condition, which may place the transplanted biomedical tissues at risk of rejection or infection. If such a medical condition exists, all reasonable attempts shall be made at treatment so as to allow the transplant to occur.
3. Passage of national laws regarding the payment and/or reimbursement for lost wages to donors of biomedical tissues.

[/list]

I'm not totally sold on including the "passage" clause of the ALLOWS section, so that's definitely up for debate, discussion, or discarding.

Questions and concerns are welcome.

[Linux and the X]

PERMITS legal guardians to provide uncoerced, informed consent on behalf of a donor or recipient in the event of any of the following:

1. The individual in question is under the age of majority
2. The individual in question is otherwise unable to understand the information and/or procedure.

Opposed, for obvious reasons.

[Wheeled States of Bifid]

I also am opposed to that part. Stick to adults and I would consider supporting this.

[Mousebumples]

I also am opposed to that part. Stick to adults and I would consider supporting this.

Are minors in your nation never in car accidents? Do minors in your nation never have aneurysms where their organs could go to save the life of another young child? Do your children never have a need for a kidney transplant - and perhaps one of their minor siblings is the best match, medically speaking?

Are young children (i.e. those who have not yet started school and/or who may not be able to verbally communicate) able to express informed consent to receive a blood transfusion or an organ donation? If not, then by not allowing the WA to legislate in this arena, you may be condemning such unfortunate children to a childhood death.

I understand your objections, but I think it's out of bounds with regards to this subject. This isn't about foreskin or abortion or whatever. This is about saving lives. Further, if I "stick to adults," depending on how it's written, I'd fall afoul of the Patient's Rights Act, which would make this whole resolution Dead on Arrival due to being illegal.

Easy workaround for you guys: don't have an age of majority in your nation. If you don't have anyone whose under the age of majority, those clauses do not apply to you.

[Linux and the X]

I also am opposed to that part. Stick to adults and I would consider supporting this.

Further, if I "stick to adults," depending on how it's written, I'd fall afoul of the Patient's Rights Act, which would make this whole resolution Dead on Arrival due to being illegal.

This is why you should simply use an informed consent standard, which would inherit its definition from PRA. Should PRA be replaced, this would be able to use the new definition, rather than being stuck with an old one.

[Chevalbourg]

This is a draft the Chevalbourgish delegation is willing to support, although we wonder why the Mousebumples delegate seeks to repeal the GA Resolution #175; this looks good enough to be a stand-alone resolution by and of itself. Nevertheless, we will give our opinion.

CLARIFIES that an individual’s next-of-kin may act as their legal guardian in the event that the individual in question has been medically classified by one or more qualified medical professionals as being irreversibly "brain dead."

We believe that there should be a sub-clause to this section that notes that should an individual have given informed and explicit consent prior to the incident that causes irreversible brain death, then the individual's next-of-kin can only act in a limited manner to the personal interests of the patient in regards to his or her body, and its respective tissue, organs, blood, and other components.

Or, in other words, in the case of brain death, the patient's next-of-kin shouldn't have the legal authority to make decisions regarding donation of organs, but should follow the patient's wishes on this matter. We feel this is of sufficient importance to be included in this draft.

MANDATES that all prospective donors and recipients agree to the procedure(s) with uncoerced, informed consent prior to any harvesting or transplantation.

We believe that this clause is, basically, in the same spirit as s. 2 of the GA Resolution #175, which reads

Prohibits the removal of organs, tissues, blood, and components thereof from live patients without informed consent unless otherwise dictated in another one of this Assembly's resolutions;

However, we commend the fact that the Mousebumples delegate has expanded the requirement to the recipients, although we struggle to think of an instance where the recipient would not give consent to the transplantation of an organ to save their lives.

One minor catch here, which is in the same spirit as the repeal of the GA Resolution #175 proposed by the Mousebumples delegate, is that complications arise should the patient or the recipient be unable to give informed consent due to their current state, or when it is unreasonable for them to do so due to the emergency and urgent need of the treatment and transplantation needed to save their lives.

In such cases, whereas the Mousebumples delegate has simply suggested that "an individual's next-of-kin may act as their legal guardian ... [in the case of the individual being] irreversibly 'brain dead'", we feel that it would be appropriate that the receiver's next-of-kin be allowed to give informed consent to the transplant, given that there is no prior legal statement of the receiver to the contrary.

INSISTS that prospective donors and recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

PERMITS legal guardians to provide uncoerced, informed consent on behalf of a donor or recipient in the event of any of the following:

The individual in question is under the age of majority

We agree to these sections of this draft wholeheartedly (the remainder of the last clause, which reads "the individual in question is otherwise unable to understand the information and/or procedure", has been left out due to the concerns expressed by our delegation previously).

We welcome the Mousebumples delegate to review these facts and how they relate to their draft.

[Mousebumples]

This is a draft the Chevalbourgish delegation is willing to support, although we wonder why the Mousebumples delegate seeks to repeal the GA Resolution #175; this looks good enough to be a stand-alone resolution by and of itself. Nevertheless, we will give our opinion.

I notice that your delegation is somewhat new to the World Assembly (OOC: and NS as a whole; if this is a new puppet of an old vet, my apologies, and feel free to disregard this comment), so you may not be fully aware of the many, complicated rules of proposal drafting.

This proposal, as is, would contradict and/or duplicate the 2 resolutions that it is looking to replace. That would make it illegal. Amendments are not allowed, so I am not allowed to amend existing resolutions to improve them. If I wish to "improve" upon a resolution, I need to repeal it and replace it. Which is the plan here.

We believe that there should be a sub-clause to this section that notes that should an individual have given informed and explicit consent prior to the incident that causes irreversible brain death, then the individual's next-of-kin can only act in a limited manner to the personal interests of the patient in regards to his or her body, and its respective tissue, organs, blood, and other components.

Or, in other words, in the case of brain death, the patient's next-of-kin shouldn't have the legal authority to make decisions regarding donation of organs, but should follow the patient's wishes on this matter. We feel this is of sufficient importance to be included in this draft.

I'm considering a "living will" clause in this proposal and probably the education proposal as well. (And maybe the free trade one, but I'm not sure that that would be appropriate or fit as well.) Such a clause would stipulate that a living will would invalidate any decisions being made by a patient's guardian/next-of-kin; however, in the absence of a living will, the aforementioned clause will likely stand.

The education proposal will likely include an educational program for residents of WA member nations to inform them of the importance and advantages of a living will. Such a program should (theoretically) encourage more individuals to draw up a living will, which should minimize the instances in which the next-of-kin or legal guardians are able to make such decisions. Of course, some nations may have age minimums when it comes to drawing up such legal documents, and - in such a circumstance - I would think that allowing legal guardians to make such decisions on behalf of minors is appropriate.

MANDATES that all prospective donors and recipients agree to the procedure(s) with uncoerced, informed consent prior to any harvesting or transplantation.

We believe that this clause is, basically, in the same spirit as s. 2 of the GA Resolution #175, which reads

Prohibits the removal of organs, tissues, blood, and components thereof from live patients without informed consent unless otherwise dictated in another one of this Assembly's resolutions;

However, we commend the fact that the Mousebumples delegate has expanded the requirement to the recipients, although we struggle to think of an instance where the recipient would not give consent to the transplantation of an organ to save their lives.

Biggest example I can think of is potential religious objection. However, organ transplants are generally associated with a lifelong regiment of medications in order to minimize rejection. Some individuals may feel that such a life is not worth living and would rather not go through that process. Again, this is why uncoerced, informed consent is so important.

I thank you for your comments and look forward to discussing this draft with you more in the future.
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[The Dourian Embassy]

Perhaps(and this may be a bit too far, but I don't know) a clause that encourages laws to be enacted that would make living wills easier to establish and further encourages citizens to create one would be appropriate. I'd prefer if the will of the next-of-kin must be used(and in some cases it will have to be used) it only be rarely, and only when the person in question has simply refused to protect his own rights with a living will.

[Mousebumples]

Perhaps(and this may be a bit too far, but I don't know) a clause that encourages laws to be enacted that would make living wills easier to establish and further encourages citizens to create one would be appropriate. I'd prefer if the will of the next-of-kin must be used(and in some cases it will have to be used) it only be rarely, and only when the person in question has simply refused to protect his own rights with a living will.

That's along the lines of what I'm considering, yes.

Another option: a living will could stipulate that they authorize Jo(a)n Doe to make medical decisions on their behalf if they are incapable of doing so. But, obviously, that's up to the individual in question.

I had originally thought such a thing may be better off in its own proposal, but, merging it in here seems like a workable compromise. And, as you say, if an individual fails to protect their own rights with a living will, it's appropriate to defer to the next-of-kin in such a circumstance.

[Mousebumples]

Version II:

MEDICAL DONATION RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, when dealing with the harvesting and transplantation of biomedical tissues.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

DECLARES that prospective donors and recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

MANDATES that all prospective donors and recipients agree to the procedure(s) with uncoerced, informed consent prior to any harvesting or transplantation.

REQUIRES that all medical procedures involving biomedical tissues be conducted as humanely as practicable using sterile technique.

INSISTS that legally completed advance health care directives (e.g. living will) shall be followed in order to respect the wishes of the individual in question.

PERMITS the following:

1. In the absence of a legally completed advance health care directive, legal guardians may provide uncoerced, informed consent on behalf of a donor or recipient in the event that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.
2. Individual WA Nations may pass laws allowing an individual’s next-of-kin to act as their legal guardian in the event that the individual in question has been medically classified by one or more qualified medical professionals as being irreversibly “brain dead” without completing an advance health care directive.

ALLOWS for the following:

1. Triage of prospective recipients based on:
   1. Medical need.
   2. Geographic location if the biomedical tissue in question may decrease in quality during the transport process.
2. Delay in transplantation due to a co-existing medical condition, which may place the transplanted biomedical tissues at risk of rejection or infection. If such a medical condition exists, all reasonable attempts shall be made at treatment so as to allow the transplant to occur.
3. Passage of national laws regarding the payment and/or reimbursement for lost wages to donors of biomedical tissues.

And I still have plenty of characters to play with if there's something else that needs to be added, clarified, etc.

Thanks for your assistance in this matter,
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Glen-Rhodes]

Glen-Rhodes supports this proposal in general, with a few questions/concerns.

Regarding the discrimination clause. Does this address issues like discriminating against homosexual men? Would it allow such discrimination? If so, how broadly? In other words, would a prohibition on donation by homosexual men in general be allowed, or would the prohibition have to be tailored to homosexual men who have had sexual relations with other men in the past X years? (Regarding highly deadly and communicable diseases that statistically homosexual men are more likely to have on average.)

Second, it's probably best to not touch on buying and selling organs. This is a complex issue, with economic, moral and ethical dimensions. There's a high probability that this whole project would be bogged down with debate on but one line of this proposal.

- Dr. B. Castro

[Mousebumples]

Regarding the discrimination clause. Does this address issues like discriminating against homosexual men? Would it allow such discrimination? If so, how broadly? In other words, would a prohibition on donation by homosexual men in general be allowed, or would the prohibition have to be tailored to homosexual men who have had sexual relations with other men in the past X years? (Regarding highly deadly and communicable diseases that statistically homosexual men are more likely to have on average.)

I think that there is some flexibility for nations to determine their own path on that based on the "valid medical rationale" aspect. Someone should not be discriminated against purely by the fact that they are a homosexual male, however. IF they are HIV+, they would likely not be allowed to donate.

However, if they are merely engaging in At Risk activities, the technology available in the nation would likely impact their ability to donate, to be honest. To use RL data, blood donations can be stored for up to 42 days. A simple blood test for HIV may take up to 6 months to "develop antibodies," which is - obviously - greater than the 42 days. However, after about a week, an RNA test (which tends to be more expensive than a blood test IRL, but costs are not necessarily comparable between RL & NS) can be done, and that generally takes 1-2 weeks to get the results back. (Although, the reference I used did say that an "expedited test" is available, if needed, so that time period may be flexible.) I'd expect that nations with similar technology to RL could accept blood donations from an individual engaging in such At Risk activities and then run the associated tests before using their blood/etc. in any patients.

Further, regarding your "X years" question, I'd figure "within the past 6 months" would probably be the threshold for which such an above process could potentially be triggered. However, depending on the culture of the nation in question, it's possible that homosexual males may not be the most at risk. For example, in a nation like South Africa, almost 18% of adults had HIV/AIDS (in 2009). When the disease is so widespread within the population, homosexual males may not be the most at risk; and, in this case, sex workers are those that are most at risk per the latest data.

Of course, there may be other nations who have a cure for HIV/AIDS, so this may be a non-issue for them.

Does that answer your question? If not, let me know what aspect(s) I didn't cover, and I'd be happy to elaborate further.

Second, it's probably best to not touch on buying and selling organs. This is a complex issue, with economic, moral and ethical dimensions. There's a high probability that this whole project would be bogged down with debate on but one line of this proposal.

You may be right. (There's a reason why I've been unsure as to whether or not I want to leave such a line in the proposal.)

I'll be honest: one of the main reasons that it's in there is because of the Free Trade res (which, if you've read and replied to, I haven't read yet), which allows for nations to engage in the sale and trade of excess organs, etc. If Organotopia is getting money from Monetaristan for the organs donated by an individual, why shouldn't that individual (or his family, next-of-kin, etc.) get some share of that?

I'll probably end up including some clause that "ALLOWS for further legislation on unmentioned aspects of this subject." or whatever. That way, if some future GA author wants to tackle that subject, they'd be able to do so.

Thanks for your consideration and provisional support,
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Mousebumples]

Updated draft!

MEDICAL DONATION RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, when dealing with the harvesting and transplantation of biomedical tissues.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

DECLARES that prospective donors and recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

MANDATES that all prospective donors and recipients agree to the procedure(s) with uncoerced, informed consent prior to any harvesting or transplantation.

REQUIRES that all medical procedures involving biomedical tissues be conducted as humanely as practicable using sterile technique.

INSISTS that legally completed advance health care directives (e.g. living will) shall be followed in order to respect the wishes of the individual in question.

PERMITS the following:

1. In the absence of a legally completed advance health care directive, legal guardians may provide uncoerced, informed consent on behalf of a donor or recipient in the event that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.
2. Individual WA Nations may pass laws allowing an individual’s next-of-kin to act as their legal guardian in the event that the individual in question has been medically classified by one or more qualified medical professionals as being irreversibly “brain dead” without completing an advance health care directive.

ALLOWS for the following:

1. Triage of prospective recipients based on:
   1. Medical need.
   2. Geographic location if the biomedical tissue in question may decrease in quality during the transport process.
2. Delay in transplantation due to a co-existing medical condition, which may place the transplanted biomedical tissues at risk of rejection or infection. If such a medical condition exists, all reasonable attempts shall be made at treatment so as to allow the transplant to occur.

CLARIFIES that this resolution shall in no way prohibit further legislation on this subject, provided that it does not contradict with this text or extant international law.

Slight edit to the aforementioned draft. I removed the "letting nations establish reimbursement" whatever stuff, and added in the CLARIFIES clause to allow for further legislation if someone else wants to try to navigate that minefield.

Comments and critiques are, of course, welcome!

[Sciongrad]

This is almost certainly nitpicking, but adding the word "effective" in that clause might not be a bad idea.

2.Delay in transplantation due to a co-existing medical condition, which may place the transplanted biomedical tissues at risk of rejection or infection. If such a medical condition exists, all reasonable and effective attempts shall be made at treatment so as to allow the transplant to occur.

Regardless of whether or not you decide to add that (and I understand if you don't want to - it's, admittedly very nitpicky-esque) I can't see anything wrong with this proposal, and will undoubtably vote for it. Good Luck Ambassador Eberhart!

[Mousebumples]

I changed the title, for starters, and redrafted ... a lot of this. I was too lazy to track all my changes, but they were extensive.

Also, this is waaaay too long, so I'm probably going to end up splitting this into 2 proposals. (Yes, this is quite likely to be come a SIX-part repeal-and-replace endeavor.) However, my drafting brain is already ready for bed, so that'll probably be happening later this weekend sometime. Original thought was to do a DONORS & RECIPIENTS split, but I'm not sure how much that would help. Of course, I'm not that far over the limit, so it may be enough, but I'd probably end up duplicating enough - to protect the overall content in the event of a repeal of one or the other, or one or the other not passing to start with - that ... it could get dicey. But that's a problem for another day. (Not that suggestions aren't welcome!)

BIOMEDICAL TREATMENT RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, when dealing with treatment using biomedical tissues.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

DETAILS that "biomedical procedures" shall include, at minimum the donation, harvesting, transplantation, or transfusion of biomedical tissues.

DECLARES that prospective donors and recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

REQUIRES that all biomedical procedures shall involve:

1. Techniques that are as humane as is practicable using sterile technique.
2. Testing and typing of the donated tissues to minimize negative transfusion reactions, biomedical tissue rejection, and the transference of disease or infection.

MANDATES that prospective recipients shall be given all medically relevant facts regarding the biomedical tissue(s) and procedure prior to obtaining their uncoerced, informed consent.

1. Legally completed advance health care directives (e.g. living will) shall be followed in order to respect the wishes of the individual in question.
2. In the absence of a legally completed advance health care directive, legal guardians may provide uncoerced, informed consent on behalf of a donor or recipient in the event that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.
3. Individual WA Nations may pass laws allowing an individual’s next-of-kin to act as their legal guardian in the event that the individual in question has been medically classified by one or more qualified medical professionals as being irreversibly “brain dead” without completing an advance health care directive.

INSTRUCTS the WHA to allocate an appropriate portion of their budget to assist with:

1. Providing necessary medications and preventative treatments with regards to biomedical treatments in nations that are otherwise unable to afford such medications and treatments.
2. Engineering a low-cost and effective set of procedures for storing and maintaining previously donated biomedical tissues, which shall include at minimum:
   
   1. Medically relevant details with regards to the results of the typing and testing that has been done.
   2. Procedures to prevent the unintended or incorrect transplant or transfusion of biomedical tissues (e.g. the wrong biomedical tissues, etc.)

ALLOWS for WA member nations and their health care systems to triage of prospective recipients based on geographic location, if the biomedical tissue in question may decrease in quality during the transport process, and/or medically relevant factors (e.g. medical need).

PERMITS WA member nations and their health care systems to delay in biomedical treatments due to a co-existing medical condition, which may place the treatment tissues at risk of rejection or infection.

1. If such a medical condition exists, all reasonable attempts shall be made at treatment so as to allow the transplant to occur.
2. WA member nations may match donors and recipients based on such a medical condition in the event of biomedical tissue shortages, if such a match is determined to be in the best medical interests of the recipient.

CLARIFIES that this resolution shall in no way prohibit further legislation on this subject, provided that it does not contradict with this text or extant international law.

So I'm currently at 3700+, character wise. Again, some of this is likely to change next time I look at it anyhow, but further questions and concerns are welcome.

Thanks!

[Mousebumples]

Potential for 2 replacements out of this, but they're fairly similar, in many ways:

BIOMEDICAL DONOR RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, with regards to biomedical treatments.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

DETAILS that "biomedical procedures" shall include, at minimum, the donation, harvesting, transplantation, or transfusion of biomedical tissues.

DECLARES that prospective donors of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

REQUIRES that the donation process for biomedical procedures shall involve:

1. Techniques that are as humane as is practicable using sterile technique.
2. Testing and typing of the donor and/or donated biomedical tissues in order to:
   
   1. Ensure that the donor, if a living donor, is healthy enough to undergo the donation procedure.
   2. Determine whether or not a disease or infection is present in the biomedical tissue.
   3. Simplify the future matching of donated biomedical tissues to recipients so as to avoid negative transfusion reactions, biomedical tissue rejection, and the transference of disease or infection.

MANDATES that prospective donors shall be given all medically relevant facts regarding the biomedical procedure prior to obtaining their uncoerced, informed consent.

1. Legally completed advance health care directives (e.g. living will) shall be followed in order to respect the wishes of the individual in question.
2. In the absence of a legally completed advance health care directive, WA Nations may permit legal guardians to provide uncoerced, informed consent on behalf of a donor in the event that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.

RECOMMENDS that individual WA Nations adopt an opt-out system for biomedical tissue donation from irreversibly "brain dead" donors, in the absence of a legally completed advance health care directive.

PERMITS WA Nations and their health care systems to delay or defer donation of biomedical tissues due to a donor's co-existing medical condition, which may place a potential recipient at risk; if such a medical condition exists, WA nations are urged to make all reasonable attempts at treatment so as to allow the donation to occur.

INSTRUCTS the WHA to allocate an appropriate portion of their budget to assist with engineering a low-cost and effective set of procedures for storing and maintaining previously donated biomedical tissues, which shall include at minimum:

1. Medically relevant details with regards to the results of the typing and testing that has been done.
2. Procedures to prevent the unintended or incorrect transplant or transfusion of biomedical tissues (e.g. the wrong biomedical tissues, etc.)

CLARIFIES that this resolution shall in no way prohibit further legislation on this subject, provided that it does not contradict with this text or extant international law.

Character Count: 3269 It's changed (some cuts, some new additions), so that's not precise anymore, but it's probably stilli n that ballpark.

BIOMEDICAL RECIPIENT RIGHTS
Category: Human Rights | Strength: Significant | Proposed By: Mousebumples

Description:
THE WORLD ASSEMBLY:

BELIEVES that all individuals should be accorded specific rights with regards to medical procedures and, specifically, with regards to biomedical treatments.

SPECIFIES that “biomedical tissues” shall include, at minimum, the following:

1. Blood and blood products, such as platelets and plasma.
2. Organs, such as the kidneys, liver, and heart.
3. Stem cells, such as bone marrow tissue, cord blood cells, embryonic stem cells, and adult stem cells.

DETAILS that "biomedical procedures" shall include, at minimum the donation, harvesting, transplantation, or transfusion of biomedical tissues.

DECLARES that prospective recipients of biomedical tissues shall not be discriminated against without a valid medical rationale, such as blood and tissue typing or the presence of a dangerous contagion.

REQUIRES that the transplant or transfusion process for biomedical procedures shall involve:

1. Ensuring that the recipient is healthy enough to undergo the procedure.
2. Practicing techniques that are as humane as is practicable using sterile technique.
3. Testing and typing of the recipient in order to minimize negative transfusion reactions, biomedical tissue rejection.

MANDATES that prospective recipients shall be given all medically relevant facts regarding the biomedical proecedure and tissue(s) they are to receive prior to obtaining their uncoerced, informed consent.

1. Legally completed advance health care directives (e.g. living will) shall be followed in order to respect the wishes of the individual in question.
2. In the absence of a legally completed advance health care directive, legal guardians or next-of-kin may provide uncoerced, informed consent on behalf of a recipient in the event that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.

INSTRUCTS the WHA to allocate an appropriate portion of their budget to assist with providing necessary medications and preventative treatments with regards to biomedical treatments in nations that are otherwise unable to afford such medications and treatments.

ALLOWS for WA member nations and their health care systems to triage of prospective recipients based on geographic location, if the biomedical tissue in question may decrease in quality during the transport process, and/or medically relevant factors (e.g. medical need).

PERMITS WA member nations and their health care systems to delay in biomedical treatments due to a co-existing medical condition, which may place the treatment tissues at risk of rejection or infection.

1. If such a medical condition exists, all reasonable attempts shall be made at treatment so as to allow the transplant to occur.
2. WA member nations may elect to match donors and recipients based on such a medical condition in the event of biomedical tissue shortages, if such a match is determined to be in the best medical interests of the recipient.

CLARIFIES that this resolution shall in no way prohibit further legislation on this subject, provided that it does not contradict with this text or extant international law.

Character Count: 3104 Added some bits, removed others. The count is probably still close to that, but not exact anymore.

I may be able to cut some more characters and leave them as one draft (as shown in the OP), but when I was separating these, I came up with a few new ideas that I didn't have in here before. So if I add those in, then it's extra-much too long. *sigh* I should probably differentiate the drafts a bit more if I'm going to go this route, so suggestions are (as always) welcome.

Thanks!

[Sciongrad]

Just a few suggestions.

INSTRUCTS the WHA to allocate an appropriate portion of their budget to assist with engineering a low-cost and effective set of procedures for storing and maintaining previously donated biomedical tissues, which shall include at minimum:

1. Medically relevant details with regards to the results of the typing and testing that has been done.
2. Procedures to prevent the unintended or incorrect transplant or transfusion of biomedical tissues (e.g. the wrong biomedical tissues, etc.)

I feel as if this provision could be put in your "Biomedical Innovation Organization" proposal. While I realize that the scope of the other resolution is slightly different, I think that this is more aptly incorporated there.

Also, considering donating organs isn't a medically necessary procedure, wouldn't this clause -

MANDATES that prospective donors shall be given all medically relevant facts regarding the biomedical procedure prior to obtaining their uncoerced, informed consent.

- already be covered by GAR#29?

I also think you could get away with removing some of the duplicative provisions that aren't specific to the donor/recipient dichotomy. For example:

CLARIFIES that this resolution shall in no way prohibit further legislation on the subject of biomedical treatment rights, provided that it does not contradict with this text or extant international law.

This clause also seems to be non-specific to donors/recipients, but is in both drafts:

ALLOWS for WA member nations and their health care systems to triage of prospective recipients based on geographic location, if the biomedical tissue in question may decrease in quality during the transport process, and/or medically relevant factors (e.g. medical need).

I hope that helps a bit! I look forward to seeing some of the new ideas you mentioned. I wish Your Excellency the best of luck in your endeavors.

[Mousebumples]

I feel as if this provision could be put in your "Biomedical Innovation Organization" proposal. While I realize that the scope of the other resolution is slightly different, I think that this is more aptly incorporated there.

You may be right. However, it's getting to be too late to investigate that now, but I'll keep that in mind for tomorrow, perhaps.

Also, considering donating organs isn't a medically necessary procedure, wouldn't this clause -

MANDATES that prospective donors shall be given all medically relevant facts regarding the biomedical procedure prior to obtaining their uncoerced, informed consent.

- already be covered by GAR#29?

Arguably (or loopholeably), donating organs isn't a medical procedure at all. After all, donating biomedical tissues (usually) doesn't treat or cure anything for the donor! (Exception: hemochromatosis, which is treated by giving blood periodically // OOC, RL example Go Packers! )

If/when we can get PRA "fixed" (i.e. another R&R that I have in mind), this won't be an issue. However, PRA is (admittedly) part of the problem with the Stem Cell resolution, so I need to protect potential donors within this resolution. And, since I know I'm aiming at repealing PRA ... eventually ... I want to make sure that the consent rights are maintained even in its (hopefully short-lived) absence.

This clause also seems to be non-specific to donors/recipients, but is in both drafts:

ALLOWS for WA member nations and their health care systems to triage of prospective recipients based on geographic location, if the biomedical tissue in question may decrease in quality during the transport process, and/or medically relevant factors (e.g. medical need).

Good catch! I pulled this one out of the donor version.

I hope that helps a bit! I look forward to seeing some of the new ideas you mentioned. I wish Your Excellency the best of luck in your endeavors.

For new ideas, they're mostly (now) in red above. And, yes, I added in more things when I did a quick redraft on both. *sigh* I swear, this constant redrafting thing is a sickness.

Thanks again!

[Dagguerro]

One small observation:

REQUIRES that all biomedical procedures shall involve:

1.Techniques that are as humane as is practicable using sterile technique.

This may be a little awkward with regard to emergency response scenarios (i.e. disasters) or battlefield medicine as "sterile technique" isn't defined and implies a properly sterile environment. That is to say that given that technically even simple blood transfusions are "biomedical procedures" it is potentially illegal under this resolution to carry out things like emergency blood transfusions on (for example) a battlefield because it isn't a sterile environment. Just a little thing that it may or may not be necessary to do anything about.

[Mousebumples]

This may be a little awkward with regard to emergency response scenarios (i.e. disasters) or battlefield medicine as "sterile technique" isn't defined and implies a properly sterile environment. That is to say that given that technically even simple blood transfusions are "biomedical procedures" it is potentially illegal under this resolution to carry out things like emergency blood transfusions on (for example) a battlefield because it isn't a sterile environment. Just a little thing that it may or may not be necessary to do anything about.

I was figuring that "sterile technique" for blood transfusions may be considered as merely "clean needles, etc." as there's less chance for infection as there's not the same open wound(s) that there are with the surgeries required for organ/tissue transplants.

What about:

1.Techniques that are as humane as is practicable using appropriate sterile technique for the procedure in question.

I think that might resolve the issue. Of course, it's still permissible for set irrational standards for the procedure in question, but that seems unlikely under the Reasonable Nation Theory.

Thanks for the comment - further notes are certainly welcome as well.

Cheers!

[Ossitania]

I understand the provision for irreversibly brain dead patients, but what of, say, comatose patients who will recover eventually but, in the meantime, are suffering deteriorating health that can be reversed with a transplant or transfusion and who haven't made a living will?

[Mousebumples]

I understand the provision for irreversibly brain dead patients, but what of, say, comatose patients who will recover eventually but, in the meantime, are suffering deteriorating health that can be reversed with a transplant or transfusion and who haven't made a living will?

I made an edit to the recipient portion (when I split the replacement into two) to allow for this:

In the absence of a legally completed advance health care directive, legal guardians or next-of-kin may provide uncoerced, informed consent on behalf of a recipient in the event that the individual in question is under the age of majority or the individual in question is otherwise unable to understand the information and/or procedure.

If they're in a coma, presumably, they're otherwise unable to understand the information and/or procedure, right? This provision allows for legal guardians or an next-of-kin to make decisions on their behalf. I believe this is similar to the RL provisions that most nations have. If you're in a coma/etc., or are otherwise unconscious and unable to communicate regarding your medical care, your next-of-kin (or legal guardian if you're under the age of majority in your nation) is generally allowed to sign off on surgeries or other necessary treatment.

My main possible concern is for the nations in this chamber who have more non-traditional family structures. For example, I know Quelesh doesn't really have family units, where children are raised, as they have no "age of majority," if I'm remembering things right. I would figure that they would (hopefully) have some sort of medical guardianship in place for just these situations, but I certainly can't be sure. I'm open to a slight rewording, depending on what's suggested, if there's something that would better fit those sorts of nations as well.

Thanks for the question. I hope that clarifies things a bit.

[Ossitania]

Herp. I guess that's what I get for skimming. I think if you've found more stuff that you deem pertinent to include since you split the draft, then keeping it split it s a safer option than merging the two halves back together and risking leaving out something important.

[Mousebumples]

Herp. I guess that's what I get for skimming. I think if you've found more stuff that you deem pertinent to include since you split the draft, then keeping it split it s a safer option than merging the two halves back together and risking leaving out something important.

Hey, no worries. (Makes me double check that the text says what I think it says, right? ) And, yeah, I'm leaning towards leaving them split (although the idea of linking to 4 props in one campaign TG seems a bit insane ... ), but I'll probably try to differ up some of the intro clauses a bit more so they're not so similar as to make delegates go "Why are we voting on this twice?" (Especially since I'd probably submit them back-to-back, although that's probably negotiable.)

Thanks again!

[Selsada]

I really can't understand something.
Does the resolution prohibit forced/uninformed organs or blood removal ?