The right to die: state courts lead where legislatures fear to tread.
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Certain kinds of medical treatment are often held to be morally unacceptable because they are an 'interference with nature'. I suggest a way in which we can make sense of such ideas. We can make significant choices only against a background of conditions which we regard as 'natural', and these will typically include such facts as those of birth and death, of youth and age, and of sexual relations. I argue, however, that such ideas, though intelligible, do not establish any valid moral objection to, for instance, the use of ovarian tissue for assisted conception.
Glutaraldehyde-cross-linked haemoglobin is potentially very attractive as a useful oxygen carrier for biomedical and technological purposes. However, its oxygen-binding ability is restricted by the autoxidation of the iron which is faster than for native haemoglobin. We have studied the stabilization effect of ethanol, butan-1-ol, ethylene glycol and glycerol on the autoxidation of glutaraldehyde-cross-linked oxyhaemoglobin. We have shown that, in the presence of water/alcohol mixtures, cross-linked haemoglobin became more stable towards autoxidation than native oxyhaemoglobin in an aqueous environment. From a structural point of view, an e.p.r. study showed that alcohols and cross-linking had opposite effects on the haem environment. In contrast with the cross-linking, alcohols stabilize oxyhaemoglobin by decreasing the charge transfer from the iron to the oxygen, decreasing the O-O length and increasing the total distance (F8 His)-N-F-O2.
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It is not easy to fit an introductory address to the topics of AIDS, transplantation, women's health, reproductive health, national health insurance and epidemiology and public health. I have been asked to speak on international challenges and opportunities in health care in the hope that the global context might frame your specific discussions in the broadest possible perspective. I will speak primarily about the widening gap in health status between rich and poor people and rich and poor nations -- a gap which poses great risks for the poor but increasing risks for all of us as well.
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