[PASSED] Repeal "Organ and Blood Donations Act"

[Mousebumples]

Firstly, the resolution does not mandate a "beyond a shadow of a doubt" standard. It prohibits the transplantation of an organ that is infected. If an infection in the organ itself cannot be proven (nations are free to adopt whatever standards they want), then the resolution does not prohibit the organ's transplantation to a new individual. The resolution does not require doctors to prove a negative (i.e., this organ is not infected). It merely prohibits the transplantation of an organ that is proven to be infected (proving a positive, i.e., this specific organ is infected). Unless a given organ is proven to be infected, transplantation of that organ is allowed under the terms of the resolution.

Secondly, does the solution in which an organ is washed after it is removed from the body not kill whatever could be infecting that organ (that is, an infection potentially transferable to the future recipient)?

Hahaha, not even close to being true with regards to the second. As stated by Krioval above, the CMV virus persists - in a latent manner - throughout an individual's body. "Washing the organ" does not magically remove a virus from organs or tissues. Viruses, especially compared to other bacteria, are especially skilled at protecting themselves from complete eradication. This is why there is no "cure" for CMV - or HIV/AIDS, for that matter. Yes, the infections can be managed and treated, but they cannot be "cured."

So far as to the first point, are you honestly now arguing that negligence is acceptable in your mind in complying with your resolution? "Hey, we don't think that this heart is infected." (2 months pass and the recipient now tests positive for HIV.) "Yeah, we didn't do any tests to see if there was an infection. After all, if there was an infection we couldn't have used that heart." That's completely ridiculous and honestly shows how desperate you are to keep your resolution on the books - despite the horrendous flaws contained within it.

Yours in disappointment,
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Christian Democrats]

My second point was an actual question. Thank you for answering it despite your laughing at what I said.

Your second point on my first point is nonsensical because the resolution clearly says:

6. Requires that all donated blood, organs, tissues, and components thereof be tested for transferable infections and diseases

What I am contending is this. There is no prohibition on the transplantation of an organ, tissue, or blood unless the doctors affirmatively can say that the organ, tissue, or blood itself is infected or diseased.

You, on the other hand, argue that a prohibition exists if the doctors cannot prove a negative. (The doctors affirmatively can say that the organ, tissue, or blood itself is not infected or diseased.)

Your standard is much less possible to reach; and, in my opinion, it is not a reasonable way to interpret the resolution.

[Mousebumples]

Your second point on my first point is nonsensical because the resolution clearly says:

6. Requires that all donated blood, organs, tissues, and components thereof be tested for transferable infections and diseases

What I am contending is this. There is no prohibition on the transplantation of an organ, tissue, or blood unless the doctors affirmatively can say that the organ, tissue, or blood itself is infected or diseased.

You, on the other hand, argue that a prohibition exists if the doctors cannot prove a negative. (The doctors affirmatively can say that the organ, tissue, or blood itself is not infected or diseased.)

Your standard is much less possible to reach; and, in my opinion, it is not a reasonable way to interpret the resolution.

To clarify, your resolution contains these two clauses:

6. Requires that all donated blood, organs, tissues, and components thereof be tested for transferable infections and diseases;

7. Forbids transplantation or transfusion of infected and/or diseased blood, organs, tissues, or components thereof from one person (a donor) to another person (a recipient);

The first requires that all donated products be tested. My understanding is that merely testing the tissue of the organ itself will likely not register a positive for HIV/AIDS, among other diseases. Unless you are advocating for not doing a full and complete test for HIV/AIDS in potential organ transplants, a blood test will be necessary to test for HIV/AIDS in the prospective donor. So long as a blood test is being conducted, why would the test be limited to only HIV/AIDS or HBV or HCV or whatever else? Why would CMV not be included, when it is typically included in such a test?

Further, you may not be able to technically "prove" that HIV/AIDS has infected a specific organ - depending on the severity of the disease - so even if it shows up in the blood work, logically (by your own aforementioned argument) the organs are still able to be donated, even with the risk to the recipient in question. Accidental transplants of organs from an unknown HIV-positive donor are very likely to result in the recipients becoming HIV-positive themselves. (Link to example case of both HIV and HCV being transmitted, NYT article)

I said it above, and I'll say it again. Viruses - such as HIV/AIDS, CMV, etc. - are sneaky bastards. They know how to hide themselves to evade detection and/or eradication. I will not allow you to set one standard for CMV and another for HIV/AIDS. Yes, it's much more convenient for you to do so, but it's intellectually dishonest - and I think you know it just as well as I do.

Yours in disappointment,
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Mousebumples]

As an update, I've been doing further research to see if a latent CMV infection is still capable (and/or likely) to cause an active infection in cases of organ transplants. Here's what I've discovered so far ...

Source: Slifki M, Doron S, Snydman DR. Viral Prophylaxis in Organ Transplant Patients. Drugs 2004; 64 (24): 2763-2792.

In the [Solid Organ Transplant] population, activation of CMV infection is directly related to the transplant process. CMV is acquired as a primary infection or a secondary superinfection from a latently infected donor organ or, much less commonly, from blood products. Latent CMV infection is reactivated and/or upregulated by immunosuppressive medications. ... CMV can affect virtually any organ system. ... CMV hepatitis is common after liver transplantation, pneumonitis is a frequent complication of lung and heart-lung transplantation, and enteritis occurs after intestinal transplantation.

...

Different types of [Solid Organ Transplants] carry different risks for CMV-associated consequences. ... Intestine, lung and pancreas transplantation confer the highest risk for direct and indirect CMV-related problems, liver and heart transplantation confer moderate risk, and kidney allografting confers the lowest risk. It should be noted that in the case of a multi-organ transplant procedure, the risk of CMV disease is related to that of the highest-risk organ.

The aforementioned article also had a chart comparing results of various placebo-controlled studies in preventing CMV infection in various types of transplants.

• There were 2 studies regarding kidney transplants (involving 50 patients and also 42 patients) in which 54% and 61% of the control group (i.e. no prophylaxis was conducted) contracted CMV.
• There were 3 studies regarding pancreas transplants (involving 40, 46, and 53 patients) in which 56%, 74%, and 50% contracted CMV.
• There were 2 studies involving lung transplants (involving 22 and 24 patients) in which 75% and 64% contracted CMV.

Of course, prophylactic regimens did work to decrease those numbers within each study in the other experimental group.

Relevant Analysis:This data is in line with the estimates on the percentage of the general population who would test CMV+ (50-75% are the numbers that I've found most consistently in my research and reading), which would seem to indicate that whether or not the CMV infection is latent or not is irrelevant to the likelihood of CMV transmission during transplantation.

However, another shortcoming of this resolution is the fact that while doctors are certainly allowed to prescribe prophylactic treatments, it is not mandated (or even encouraged) by this resolution, which would permit nations/health systems to "cheap out" and not act in the best interests of their patients.

Of course, considering the fact that this resolution fails to acknowledge that there may be any circumstances in which transplantation with a diseased or infected organ may be in the best (medical) interests of the patient, I suppose that the inclusion of such a clause could have been quite problematic if actually included within the text itself.

Source: Singh N , Dummer JS, Kusne S, et al. Infections with Cytomegalovirus and Other Herpesviruses in 121 Liver Transplant Recipients: Transmission by Donated Organ and the Effect of OKT3 Antibodies. J Infect Dis. 1988 July; 158(1): 124–131.

One hundred twenty-one adult liver transplant recipients were studied for the incidence, risk factors, and morbidity associated with herpesviruses infections after transplantation. The overall incidence of infection was 59% for cytomegalovirus (CMV) ... Primary CMV infection occurred in 46% and reactivation CMV infection in 67% of the susceptible recipients. ... The donor organ appeared to be the only important source of CMV infection in seronegative recipients.

...

In addition, the type of transplant operation is an important determinant of the morbidity due to CMV. For instance, both bone marrow and heart-lung transplant recipients have higher rates of CMV pneumonia than do kidney recipients.

...

Fifty-five (59%) of 93 patients developed CMV infection. These included 17 (46%) of 37 seronegative recipients and 38 (67%) of 56 seropositive patients.

...

The association between receiving a liver from a donor positive for CMV antibodies and subsequent development of CMV infection was analyzed. Thirteen (92%) of 14 seronegative recipients who received livers from CMV-seropositive donors had evidence of CMV infection after transplantation, whereas only one (8%) of 12 seronegative recipients who received a liver from a CMV-seronegative donor developed CMV infection. This difference in infection rate was highly significant (P < .001).

Relevant Analysis: I know this is an old article, but I think it's especially useful in proving my point, in part due to its age. This study was one of the first to really analyze how and why CMV infection spread during organ donation. The most important point, in my mind, is the following: Of the 14 CMV-negative recipients who received a liver from a CMV-positive donor, THIRTEEN (!!!) of them contracted CMV. Conversely, only one of twelve CMV-negative recipients who got an organ from a CMV-negative donor contacted CMV. As the study indicated, that is definitely statistically significant. There is only a 1 in 1,000 chance that those results could have happened by coincidence.

Bottom line: both of these articles indicate that a latent CMV infection still infects the organs being transplanted and still places organ recipients at significant risk for contracting CMV without the necessary prophylactic treatments.

I think I shall have to update this repeal draft (yes, again) and make a few more changes in the replacements drafts as a result. So I suppose I owe the representative from Christian Democrats a big THANK YOU for compelling me to do further research on this subject to counter his groundless arguments against this repeal text.

[Mousebumples]

New draft! I think this is clearer, but - as always - questions for clarification are more than welcome. (As are suggestions )

Repeal "Organ and Blood Donations Act"
Category: Repeal | Resolution: #175 | Proposed by: Mousebumples

Argument:
THE WORLD ASSEMBLY:

LAUDS the intent of GA#175, "Organ and Blood Donations Act" to provide access to blood and organ donations.

BELIEVES, however, that a number of faults in this resolution's text may limit the effectiveness of the resolution in question.

UNDERSTANDS the meritorious intent of Clause 7, which states: Forbids transplantation or transfusion of infected and/or diseased blood, organs, tissues, or components thereof from one person (a donor) to another person (a recipient).

ACCEPTS that some infections, such as Human Immunodeficiency Virus (HIV), Cytomegalovirus (CMV), and Hepatitis B & C (HBV & HCV) may be spread from donor to recipient during a transplantation or transfusion process.

DETAILS the following shortcomings of Clause 7:

• Cytomegalovirus (CMV) is a disease that may affect a substantial portion of a given nation's population.
  
  1. CMV-positive blood and components can be safely transfused into otherwise healthy donors.
  2. CMV-positive organs and tissues can and have been safely donated CMV-negative recipients in need of transplants when associated with appropriate anti-viral treatments.
• Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency (HIV) viruses are diseases that affect varying amounts of individuals within a given population, depending on many factors.
  
  1. HBV, HCV, and HIV-postive donors may each successfully donate organs to a recipient who tests positive for the same disease that they have.
  2. Many individuals in need of organ transplants may be willing to take an organ that is HBV, HCV, or HIV-positive as receiving an organ would prolong their life.
• Clause 7 “forbids” the transplantation of organs from individuals who test positive for CMV, HBV, HCV, and HIV, which means that each of the above examples are presently prohibited under WA law.

REGRETS that the unfortunate wording of this clause does not allow for flexibility in the handling of donations and transplants, which prevents member states from instituting common-sense practices that do not harm public health and may provide a net benefit for individual patients.

LAMENTS that the scarcity of resources for transfusion and transplantation is adversely affected by this resolution and increases the possibility that those patients in need of an organ transplant will die prior to receiving an organ that can save their lives.

DECLARES that individual recipients, in coordination with informed recommendations from their health care provider(s), should be able to give their informed consent for such currently outlawed transplants.

HOPES that the WA will consider future legislation on blood and blood component donation and organ and tissue transplantation to rectify the aforementioned flaws while still assuring safety and availability of blood, blood components, organs, and tissues.

REPEALS GA#175, "Organ and Blood Donations Act."

I'm not quite sure where to put the DECLARES clause. I'm thinking either before or after LAMENTS, but ... that's certainly up for discussion, if anyone has any suggestions or preference.

Thanks!
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Mousebumples]

Updated draft!

(Again, no editing notes. I'm getting lazy ... )

Repeal "Organ and Blood Donations Act"
Category: Repeal | Resolution: #175 | Proposed by: Mousebumples

Argument:
THE WORLD ASSEMBLY:

REALIZES that repealing GA#175, "Organ and Blood Donations Act,” will not outlaw organ and blood donations and transplants within WA member nations,

BELIEVES, additionally, that the shortcomings of the resolution necessitate its repeal in order to allow WA member nations to most effectively perform life-saving organ and blood transplants.

HIGHLIGHTS the wording of Clause 7, which states: Forbids transplantation or transfusion of infected and/or diseased blood, organs, tissues, or components thereof from one person (a donor) to another person (a recipient).

ACCEPTS that some infections, such as Human Immunodeficiency Virus (HIV), Cytomegalovirus (CMV), and Hepatitis B & C (HBV & HCV) may be spread from donor to recipient during a transplantation or transfusion process, which mean that those with these diseases shall be considered “infected and/or diseased.”

OFFERS the following details regarding the shortcomings of Clause 7:

• CMV is a disease that may affect a substantial portion of a given nation's population.
  
  1. CMV-positive blood and components can be safely transfused into otherwise healthy donors, even though such transfusions are likely to spread the disease to CMV-negative recipients.
  2. CMV-positive organs and tissues can and have been safely donated to CMV-negative recipients in need of transplants when associated with appropriate anti-viral treatments.
• Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency (HIV) viruses are diseases that affect varying amounts of individuals within a given population, depending on many factors.
  
  1. HBV, HCV, and HIV-positive donors can and have successfully donated organs to a recipient who tests positive for the same disease that they have.
  2. Many individuals who are in need of organ transplants may be willing to take an organ that is HBV, HCV, or HIV-positive as receiving an organ would prolong their life even if they were to contract a new disease in the process.
• Clause 7 “forbids” the transplantation of organs from individuals who test positive for CMV, HBV, HCV, and HIV, which means that each of the above examples are presently prohibited under WA law.

REGRETS that the unfortunate wording of this clause does not allow for flexibility in the handling of donations and transplants, which prevents member states from instituting common-sense practices that do not harm public health and may provide a net benefit for individual patients.

LAMENTS that the scarcity of resources available for transfusion and transplantation is adversely impacted by this resolution and increases the possibility that those patients in need of an organ transplant will die prior to receiving an organ that can save their lives.

DECLARES that individual recipients, in coordination with informed recommendations from their health care provider(s), should be allowed to give their informed consent for such procedures that are currently outlawed.

HOPES that the WA will consider future legislation on this subject to rectify the aforementioned flaws while still assuring safety and availability of blood, blood components, organs, and tissues in order to save lives of individuals in all WA member nations.

REPEALS GA#175, "Organ and Blood Donations Act."

Thoughts and critiques are, as always, welcome.

Cheers!

[Mousebumples]

Evidentiary links of support:

• A New Push to Let H.I.V. Patients Accept Organs That Are Infected
• Should Ban On Transplants Of HIV-Infected Organs Be Dropped?
• Frequently Asked Questions about Organ Donation - Notable questions "Who can be a donor?" (HBV and HCV patients are specifically referenced),
• Religious Viewpoints on Organ Donation (admittedly, not terribly relevant to this repeal, but I still thought it was interesting)
• Wikipedia - Blood Donation: Blood testing - details which diseases/infections are most commonly screened for when looking at donated blood
• CMV: Infection that Every Organ Transplant Patients Should Know About
• Wikipedia - Human Cytomegalovirus: Diagnosis (The last line is specifically relevant regarding blood donation)
• Baby Donors (a.k.a. CMV-negative individuals with regards to blood donation)
• Four Transplant Recipients Contract H.I.V. (The 4 recipients also contracted HCV from the donor. Only 4 organs - and no tissue - were taken from the donor, which is a 100% infection rate.)
• My own research (with citing of sources) re: the spreading of CMV infection through organ transplants

Next question for consideration:
How should I best include these links/evidence within the OP/repeal draft? I fully expect a misleading and semi-truthful counter-TG to circulate, targeting those who approve my repeal whenever I get it submitted. I'd like to have a good reference for people to check out if they're hearing conflicting information so they can make an educated decision on the subject.

Options:
(1) Create links within the repeal text itself to Articles 1, 2, 3, etc., that are relevant to particular clauses.
(2) Create ^{footnote-style links} down to anchored ACTUAL links below the repeal text. (Coding-intensive, but perhaps worthwhile.)
(3) Create a FAQ with commonly asked questions and frequently confused facts about organ & blood donation, the diseases in question, and the resolution I'm targeting. (Mostly pulled from this thread or the previous failed attempts.)
(4) ... Something else?

I split this into its own post for easier linking/reference. Nothing new to see here, I'm afraid ...

[Bears Armed]

Options:
(1) Create links within the repeal text itself to Articles 1, 2, 3, etc., that are relevant to particular clauses.
(2) Create ^{footnote-style links} down to anchored ACTUAL links below the repeal text. (Coding-intensive, but perhaps worthwhile.)

OOC: I'm fairly sure that that wouldn't actually be possible, not technically (in terms of what the game's coding will allow) and not "legally" either because of the rule every resolution has to be able to stand on its own: The risk of any outside pages to which you tried linking from within the proposal's own text later becoming inaccessible would effectively be a 'House of Cards' problem.

[Sciongrad]

Options:
(1) Create links within the repeal text itself to Articles 1, 2, 3, etc., that are relevant to particular clauses.
(2) Create ^{footnote-style links} down to anchored ACTUAL links below the repeal text. (Coding-intensive, but perhaps worthwhile.)

OOC: I'm fairly sure that that wouldn't actually be possible, not technically (in terms of what the game's coding will allow) and not "legally" either because of the rule every resolution has to be able to stand on its own: The risk of any outside pages to which you tried linking from within the proposal's own text later becoming inaccessible would effectively be a 'House of Cards' problem.

OOC: I think she meant that she'd include links or footnotes in the OP here, not in the actual resolution.

Which, by the way, is probably a good idea, so long as you mention it as a possible reference in your own campaign TGs. Anyways, after reading through it, I think it's pretty solid. Good luck!

[Mousebumples]

Options:
(1) Create links within the repeal text itself to Articles 1, 2, 3, etc., that are relevant to particular clauses.
(2) Create ^{footnote-style links} down to anchored ACTUAL links below the repeal text. (Coding-intensive, but perhaps worthwhile.)

OOC: I'm fairly sure that that wouldn't actually be possible, not technically (in terms of what the game's coding will allow) and not "legally" either because of the rule every resolution has to be able to stand on its own: The risk of any outside pages to which you tried linking from within the proposal's own text later becoming inaccessible would effectively be a 'House of Cards' problem.

Yeah, you're right on the money here. I just figure that most people accept RL evidence for NS-based arguments, it would make sense to have such evidentiary support so it doesn't just look like I'm making stuff up. (Because, you know, I'm not. )

Thanks for the concern, though, but it would just be in the posts here.

Which, by the way, is probably a good idea, so long as you mention it as a possible reference in your own campaign TGs. Anyways, after reading through it, I think it's pretty solid. Good luck!

Thanks for the support! I hope I have as much luck as you've had as of late. *fingers crossed*

[Damanucus]

At the moment, my main concern with this repeal comes in the safeguards that were implemented in the original resolution. While I'm sure your facts are correct, and it is possible for such transplants to occur, I would prefer to see these safeguards in place. This concern comes about because of the likelihood, however small it may be, of information mix-up, which could cause a perfectly healthy recipient to receive a diseased organ (and we know what can happen if a recipient receives a diseased organ).

At this time, I must stand against the repeal.

Stephanie Orman
Representative, Nomadic Peoples of Damanucus

[Mousebumples]

At the moment, my main concern with this repeal comes in the safeguards that were implemented in the original resolution. While I'm sure your facts are correct, and it is possible for such transplants to occur, I would prefer to see these safeguards in place. This concern comes about because of the likelihood, however small it may be, of information mix-up, which could cause a perfectly healthy recipient to receive a diseased organ (and we know what can happen if a recipient receives a diseased organ).

At this time, I must stand against the repeal.

In RL (and one of the sources I linked gives evidence of this), such mistakes have even happened with HIV transplants - which are currently prohibited in the US. How does this resolution "safeguard" against such events any differently than what is already currently in practice IRL?

I think I understand your concern, but I guess I'm not seeing the "safeguards" that this resolution has in place. If a mixup can occur with a perfectly healthy recipient could receive a diseased organ without this resolution ... what does this resolution do to prevent that?

Yours in confusion,
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

EDIT: As an update, perfectly healthy people CAN (and do, IRL) get CMV-positive blood and organs. Heck, perfectly healthy people are great candidates for CMV-positive blood donations. While transplants of CMV-positive organs into CMV-negative recipients involves extra precautions (anti-viral medications, for one), it can be safely done.

Further, as some of my "evidence links" indicate, depending on what the availability of organs is like in your nation, it's quite possible that people are dying without a transplant. If the only heart transplant they can get is infected with CMV (or HBV or HCV or, heck, even HIV) ... wouldn't that be better than the alternative? Sure, in a perfect world, we'd like for all organ transplants to be disease free. But unless your nation (or anyone else's nation) has come up for cures for these all-too-common diseases, that's not necessarily an option.

I just realized that that may not have been clear, and that probably leads to a lot of the confusion that I have over your objections.

[Mousebumples]

This proposal has been submitted! Delegates, please approve!

And I realized that after submitting last night, I forgot to update this thread with the latest draft:
SUBMITTED VERSION:

Repeal "Organ and Blood Donations Act"
Category: Repeal | Resolution: #175 | Proposed by: Mousebumples

Argument:
THE WORLD ASSEMBLY:

REALIZES that repealing GAR#175, "Organ and Blood Donations Act,” will not outlaw organ and blood donations and transplants within WA member nations,

BELIEVES, additionally, that the shortcomings of the resolution require its repeal in order to allow WA member nations to most effectively perform life-saving organ and blood transplants.

HIGHLIGHTS the wording of Clause 7, which states: Forbids transplantation or transfusion of infected and/or diseased blood, organs, tissues, or components thereof from one person (a donor) to another person (a recipient).

RECOGNIZES that the wording of this clause does not allow for any flexibility with regards to such transplants, even if such a transplant would be consented to by the prospective recipient.

UNDERSTANDS that some infections, such as Human Immunodeficiency Virus (HIV), Cytomegalovirus (CMV), and Hepatitis B & C (HBV & HCV) may be spread from donor to recipient during a transplantation or transfusion process, which means that individuals with these diseases shall be considered “infected and/or diseased” under the terms of this resolution.

DETAILS the following:

• CMV is a disease that may affect a substantial portion of a given nation's population.
  
  1. CMV-positive blood and components can be safely transfused into otherwise healthy receipients, even though such transfusions are likely to spread the disease to CMV-negative recipients.
  2. CMV-positive organs and tissues can and have been transplanted safely to CMV-negative recipients in need when associated with appropriate anti-viral treatments.
• Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency (HIV) viruses are diseases that affect varying amounts of individuals within a given population.
  1. HBV, HCV, and HIV-positive donors can and have successfully donated organs to a recipient who tests positive for the same disease that they have.
  2. Many individuals who are in need of organ transplants may be willing to take an organ that is HBV, HCV, or HIV-positive as receiving an organ would prolong their life even if they were to contract a new disease in the process.
• Clause 7 “forbids” the transplantation of organs from individuals who test positive for CMV, HBV, HCV, and HIV, which means that each of the above examples are currently prohibited under WA law.

REGRETS that the unfortunate wording of this clause does not allow for flexibility in the handling of donations and transplants, which prevents member states from instituting common-sense practices that do not harm public health and may provide a net benefit for individual patients.

LAMENTS that the scarcity of resources available for transfusion and transplantation is adversely impacted by this resolution and increases the possibility that those patients in need of an organ transplant will die prior to receiving an organ that can save their lives.

DECLARES that individual recipients, in coordination with informed recommendations from their health care provider(s), should be allowed to give their informed consent for such procedures that are outlawed by this resolution.

HOPES that the WA will consider future legislation on this subject to rectify the aforementioned flaws while still assuring the safety and availability of blood, blood components, organs, and tissues in order to save lives of individuals in all WA member nations.

REPEALS GAR#175, "Organ and Blood Donations Act."

The submitted version has some wonky spacing, but why I c/p'd it in here, the spacing was fine. That leads me to think that perhaps it's a "display" issue versus a ... user error on my part.

Questions and concerns are, as always, welcome. Thanks again!

[Mousebumples]

This should be going to vote, then, at the next minor update. Thanks to all approving delegates for their support!

[Mousebumples]

Getting ready for the vote, and I "reconfigured" this version of the submitted draft with some of my source links worked in.

Repeal "Organ and Blood Donations Act"
Category: Repeal | Resolution: #175 | Proposed by: Mousebumples

Argument:
THE WORLD ASSEMBLY:

REALIZES that repealing GAR#175, "Organ and Blood Donations Act,” will not outlaw organ and blood donations and transplants within WA member nations,

BELIEVES, additionally, that the shortcomings of the resolution require its repeal in order to allow WA member nations to most effectively perform life-saving organ and blood transplants.

HIGHLIGHTS the wording of Clause 7, which states: Forbids transplantation or transfusion of infected and/or diseased blood, organs, tissues, or components thereof from one person (a donor) to another person (a recipient).

RECOGNIZES that the wording of this clause does not allow for any flexibility with regards to such transplants, even if such a transplant would be consented to by the prospective recipient.

UNDERSTANDS that some infections, such as Human Immunodeficiency Virus (HIV), Cytomegalovirus (CMV), and Hepatitis B & C (HBV & HCV) may be spread from donor to recipient during a transplantation or transfusion process, which means that individuals with these diseases shall be considered “infected and/or diseased” under the terms of this resolution.

DETAILS the following:

• CMV is a disease that may affect a substantial portion of a given nation's population. ^[Source]
  
  1. CMV-positive blood and components can be safely transfused into otherwise healthy receipients, even though such transfusions are likely to spread the disease to CMV-negative recipients. ^[Source]
  2. CMV-positive organs and tissues can and have been transplanted safely to CMV-negative recipients in need when associated with appropriate anti-viral treatments. ^[Source]
• Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency (HIV) viruses are diseases that affect varying amounts of individuals within a given population.
  
  1. HBV, HCV, and HIV-positive donors can and have successfully donated organs to a recipient who tests positive for the same disease that they have. ^{[Source: Who can be an organ donor?] & [Source: HIV+ transplants]}
  2. Many individuals who are in need of organ transplants may be willing to take an organ that is HBV, HCV, or HIV-positive as receiving an organ would prolong their life even if they were to contract a new disease in the process. ^[Source]
• Clause 7 “forbids” the transplantation of organs from individuals who test positive for CMV, HBV, HCV, and HIV, which means that each of the above examples are currently prohibited under WA law.

REGRETS that the unfortunate wording of this clause does not allow for flexibility in the handling of donations and transplants, which prevents member states from instituting common-sense practices that do not harm public health and may provide a net benefit for individual patients.

LAMENTS that the scarcity of resources available for transfusion and transplantation is adversely impacted by this resolution and increases the possibility that those patients in need of an organ transplant will die prior to receiving an organ that can save their lives.

DECLARES that individual recipients, in coordination with informed recommendations from their health care provider(s), should be allowed to give their informed consent for such procedures that are outlawed by this resolution.

HOPES that the WA will consider future legislation on this subject to rectify the aforementioned flaws while still assuring the safety and availability of blood, blood components, organs, and tissues in order to save lives of individuals in all WA member nations.

REPEALS GAR#175, "Organ and Blood Donations Act."

I've also gotten some questions via TG since I started my TG campaign, so here's a "less official" synopsis, complete with allowable RL stats (with sources linked) for further clarity:

• Cytomegalovirus (CMV) is really the main "problem" with what's outlawed under the current resolution. With the research I've done, less than 10% of RL transplants involve transplanting a CMV-negative organ to a CMV-negative recipient. (Source) That's a significant portion of organ transplants that are now outlawed by NS law, which will likely result in more patients dying while they wait for a transplant.
• This resolution restricts the choice of patients and medical decision making of doctors and other health care professionals to work in the best interests of their patients.
• CMV is totally safe when it comes to blood donations and transfusions when its given to otherwise healthy individuals. CMV-negative blood is generally "saved" for use in babies (Source) since they have a weaker immune system and may be more susceptible to complications from contracting CMV at such a young age. As CMV affects between 50-80% of people throughout the course of their lifetime (Source), that is a significant portion of the population that is no longer able to donate blood under this resolution. The lack of blood stocks for transfusion would likely result in more deaths.

I'm also looking to make some revisions to the replacements over the next few days based on some feedback I've gotten.

A recap of my proposed replacements:

1. Medical Donation Rights is a Human Rights resolution
2. Biomedical Innovation Organization is an Education resolution, focused on research & development
3. Biomedical Trade & Treatment is a Free Trade resolution

Optimally, I'd like to submit them all at once, after I get BOTH repeals passed. (As of right now, if both repeals don't pass, I'd have to make significant revisions since I "combined" the 2 topics into 3 replacement proposals.) However, I feel the first two are closer to being submission-ready, so it's possible that BT&T will be delayed a bit longer for additional revisions and debate. If that's the case, I'd probably submit that with the CPA repeal in a month or so.

Feedback is more than welcome on any of those replacements. If there's something you wish was covered (or covered more explicitly) or ... whatever, please let me know. I can't read minds (OOC: I joke at work that I did not get ESP with my PharmD degree since patients often expect me to just know what they're thinking.), but I do want to make these new replacements the best they can be.

Thanks for your consideration, and please do vote in favor in a few short hours!
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Knootoss]

Supported and approved!


Ambassador Aram Koopman
World Assembly representative for the Dutch Democratic Republic of Knootoss

[Mousebumples]

Supported and approved!

(Image)
Ambassador Aram Koopman
World Assembly representative for the Dutch Democratic Republic of Knootoss

Thanks for your support King/Ambassador Koopman!

[Mousebumples]

At vote bump!

My delegation would certainly appreciate it if your delegation would vote IN FAVOR.

Yours in thanks,
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Zemnaya Svoboda]

Morozova rose cautioustly from her seat, "Having received overall support in high-level discussions in the regional forum of The North Pacific following close discussions during drafting with the author, Zemnaya Svoboda lodges an interim vote in support of this resolution."

On her way out she stopped and remarked, "If the regional position changes though, expect our vote to change as well."

[Mousebumples]

Morozova rose cautioustly from her seat, "Having received overall support in high-level discussions in the regional forum of The North Pacific following close discussions during drafting with the author, Zemnaya Svoboda lodges an interim vote in support of this resolution."

On her way out she stopped and remarked, "If the regional position changes though, expect our vote to change as well."

I've appreciated the feedback that I've received from you and your regionmates during the drafting phase of this repeal, and I appreciate your support while awaiting your final regional vote.

Yours,
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Skyrim Diplomacy]

I agree with the reasoning posted in the repeal attempt. The extensive replacement proposals that the esteemed ambassador from Mousebumples has prepared shows a staggering (if not slightly neurotic ) head for a re-implementation of the most crucial parts of the original bill. As such, I have cast my vote FOR this repeal. I would like to personally wish the delegation from Mousebumples all the best with their repeal attempt.


Elias T. Greyjoy
WA Delegate, Skyrim

[Mousebumples]

I agree with the reasoning posted in the repeal attempt. The extensive replacement proposals that the esteemed ambassador from Mousebumples has prepared shows a staggering (if not slightly neurotic ) head for a re-implementation of the most crucial parts of the original bill. As such, I have cast my vote FOR this repeal. I would like to personally wish the delegation from Mousebumples all the best with their repeal attempt.

Hey, now, Elias - we all have our own neuroses. Yours just happen to involve the Security Council.

Anyhow, my thanks for your support!
Nikolas Eberhart
Ambassador from the Doctoral Monkey Feet of Mousebumples
WA Delegate for Monkey Island

[Charlotte Ryberg]

Ms. Harper hurriedly writes a note announcing her support:

Instant Approval. I invite others to do the same. I've just arrived but I must vote for tihs as qwuick as posisble ot ensure it passes.

[Alcatrazin]

This perpeal must not go through! We have to keep it in place! I am sure some more resolutions to fix the so called problems can be passed, through these so called loopholes. This repeal has no need to be on the voting ballot.

[Flibbleites]

This perpeal must not go through! We have to keep it in place! I am sure some more resolutions to fix the so called problems can be passed, through these so called loopholes. This repeal has no need to be on the voting ballot.

Really, would you care to explain exactly how one would go about doing that without running afoul of either the rule prohibiting amendments or the rule prohibiting Duplicating an existing resolution?

Bob Flibble
WA Representative