In Canada, there are currently no guidelines at either the federal or provincial level regarding the provision of kidney transplantation services to foreign nationals (FN). Renal transplant centres have, in the past, agreed to put refugee claimants and other FNs on the renal transplant waiting list, in part, because these patients (refugee claimants) had health insurance through the Interim Federal Health Programme to cover the costs of medication and hospital care. However, severe cuts recently made to this (...) programme have forced clinicians to question whether they should continue with transplants for FNs, for financial and ethical reasons. This paper first examines different national policies (eg, in Canada, USA, France and the UK) to map the diversity of approaches regarding transplantation for FNs, and then works through different considerations commonly used to support or oppose the provision of organs to these patients: (1) the organ shortage; (2) the free-rider problem; (3) the risk of becoming a transplant destination; (4) the impact on organ donation rates; (5) physicians’ duties; (6) economic concerns; (7) vulnerability. Using a Canadian case as a focus, and generalising through a review of various national policies, we analyse the arguments for and against transplantation for FNs with a view to bringing clarity to what is a sensitive political and clinical management issue. Our aim is to help transplant centres, clinicians and ethicists reflect on the merits of possible options, and the rationales behind them. (shrink)

Janet Radcliffe Richards’ The Ethics of Transplants outlines a novel framework for moral inquiry in practical contexts and applies it to the topic of paid living kidney donation. In doing so, Radcliffe Richards makes two key claims: that opponents of organ markets bear the burden of proof, and that this burden has not yet been satisfied. This paper raises four related objections to Radcliffe Richards’ methodological framework, focusing largely on how Radcliffe Richards uses this framework in her discussion of (...) kidney sales. We conclude that Radcliffe Richards’ method of inquiry hinders our ability to answer the very question that it ought to help us resolve: What is there best reason to do, all things considered? (shrink)

There is a global shortage of organs for transplantation and despite many governments making significant changes to their organ donation systems, there are not enough kidneys available to meet the demand. This has led scientists and clinicians to explore alternative means of meeting this organ shortfall. One of the alternatives to human organ transplantation is xenotransplantation, which is the transplantation of organs, tissues, or cells between different species. The resurgence of interest in xenotransplantation and recent scientific breakthroughs suggest that genetically-engineered (...) pigs may soon present a realistic alternative as sources of kidneys for clinical transplantation. It is therefore important for nurses and allied health professionals to understand what is involved in xenotransplantation and its future implications for their clinical practices. First, we explore the insufficiency of different organ donation systems to meet the kidney shortage. Second, we provide a background and a summary of the progress made so far in xenotransplantation research. Third, we discuss some of the scientific, technological, ethical, and economic issues associated with xenotransplantation. Finally, we summarise the literature on the attitudes of healthcare professionals toward xenotransplantation. (shrink)

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there (...) is only one ‘buyer’—in this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)

Worldwide 1.2 million people are dying from kidney failure each year, and in the USA alone, approximately 100 000 people are currently on the waiting list for a kidney transplant. One possible solution to the kidney shortage is for governments to pay donors for one of their healthy kidneys and distribute these kidneys according to need. There are, however, compelling objections to this government-monopsony model. To avoid these objections, I propose a small adjustment to the model. (...) I suggest we reward kidney sellers with both money and a ceremony that celebrates their noble act. They should, in other words, receive a prize rather than a price. (shrink)

Chronic Kidney Disease (CKD) is a significant global health issue, often leading to kidney failure and requiring costly medical treatments such as dialysis or transplants. Early detection of CKD is essential for timely intervention and improved patient outcomes. This project aims to develop a machine learning-based predictive model for diagnosing CKD at an early stage. By utilizing a range of clinical features such as age, blood pressure, blood sugar, and other relevant biomarkers, we employ machine learning algorithms, including (...) Decision Trees, Random Forests, and Support Vector Machines (SVM), to predict the likelihood of a patient developing CKD. The dataset used in this study includes medical records of patients with various kidney conditions, and preprocessing techniques such as normalization and missing data handling are applied to ensure the model’s robustness. The performance of the model is evaluated using metrics such as accuracy, precision, recall, and F1-score to ensure reliable predictions. This approach not only aims to improve diagnostic accuracy but also provides a data-driven solution to assist healthcare professionals in making informed decisions. The outcome of this project can contribute to better management of CKD, ultimately helping to reduce the burden on healthcare systems and improving patient care. (shrink)

Chronic Kidney Disease (CKD) is a significant global health issue, often leading to kidney failure and requiring costly medical treatments such as dialysis or transplants. Early detection of CKD is essential for timely intervention and improved patient outcomes. This project aims to develop a machine learning-based predictive model for diagnosing CKD at an early stage. By utilizing a range of clinical features such as age, blood pressure, blood sugar, and other relevant biomarkers, we employ machine learning algorithms, including (...) Decision Trees, Random Forests, and Support Vector Machines (SVM), to predict the likelihood of a patient developing CKD. The dataset used in this study includes medical records of patients with various kidney conditions, and preprocessing techniques such as normalization and missing data handling are applied to ensure the model’s robustness. The performance of the model is evaluated using metrics such as accuracy, precision, recall, and F1-score to ensure reliable predictions. (shrink)

Chronic Kidney Disease (CKD) is a significant global health issue, often leading to kidney failure and requiring costly medical treatments such as dialysis or transplants. Early detection of CKD is essential for timely intervention and improved patient outcomes. This project aims to develop a machine learning-based predictive model for diagnosing CKD at an early stage. By utilizing a range of clinical features such as age, blood pressure, blood sugar, and other relevant biomarkers, we employ machine learning algorithms, including (...) Decision Trees, Random Forests, and Support Vector Machines (SVM), to predict the likelihood of a patient developing CKD. (shrink)

Chronic Kidney Disease (CKD) is a significant global health issue, often leading to kidney failure and requiring costly medical treatments such as dialysis or transplants. Early detection of CKD is essential for timely intervention and improved patient outcomes. This project aims to develop a machine learning-based predictive model for diagnosing CKD at an early stage. By utilizing a range of clinical features such as age, blood pressure, blood sugar, and other relevant biomarkers, we employ machine learning algorithms, including (...) Decision Trees, Random Forests, and Support Vector Machines (SVM), to predict the likelihood of a patient developing CKD. The dataset used in this study includes medical records of patients with various kidney conditions, and preprocessing techniques such as normalization and missing data handling are applied to ensure the model’s robustness. The performance of the model is evaluated using metrics such as accuracy, precision, recall, and F1-score to ensure reliable predictions. This approach not only aims to improve diagnostic accuracy but also provides a data-driven solution to assist healthcare professionals in making informed decisions. The outcome of this project can contribute to better management of CKD, ultimately helping to reduce the burden on healthcare systems and improving patient care. (shrink)

Obituary of an American philosopher born in Latvia. Family fled Russians, migrated to Milwaukee. John became first non-identical twin to receive a kidney transplant, wrote about new technology.

For a long time, discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. This narrow focus on medical resource prevents us from seeing that there are many cases-- perhaps even the majority--in which time is the real scarce resource, particularly nurse time. What ethical principles should apply to nurse time as a scarce health care resource?

For a long time discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. However, a narrow focus on medical resources prevents us from seeing that there are many cases-- perhaps the majority-- in which less dramatic but equally important issues of rationing occur. The allocation of nurses' time is one such issue.

This paper explores some ways in which artificial intelligence (AI) could be used to improve human moral judgments in bioethics by avoiding some of the most common sources of error in moral judgment, including ignorance, confusion, and bias. It surveys three existing proposals for building human morality into AI: Top-down, bottom-up, and hybrid approaches. Then it proposes a multi-step, hybrid method, using the example of kidney allocations for transplants as a test case. The paper concludes with brief remarks about (...) how to handle several complications, respond to some objections, and extend this novel method to other important moral issues in bioethics and beyond. (shrink)

After a long search, Jonathan has finally found someone willing to donate a kidney to him and thereby free him from dialysis. Meredith is Jonathan's second cousin, and she considers herself a generous person, so although she barely knows Jonathan, she is willing to help. However, as Meredith learns more about the donation process, she begins to ask questions about Jonathan: “Is he HIV positive? I heard he got it using drugs. Has he been in jail? He's already had (...) one live donor, so what happened to the first kidney? Did he forget to take his drugs or something?” The transplant center must, then, decide if Meredith is, in fact, entitled to answers to these kinds of questions. According to the Consensus Statement on the Live Organ Donor, “It is incumbent on the transplant center to provide full and accurate disclosure to potential donors of all pertinent information regarding risk and benefit to the donor and recipient.” But whether answers to the Meredith's questions count as “pertinent information regarding the risk and benefit” is the issue at hand. (shrink)

-/- Extending Human Lifespan: Scientific and Technological Possibilities -/- The quest for extending human lifespan has fascinated humanity for centuries. Advances in genetics, medicine, artificial intelligence, and bioengineering are bringing us closer to significantly prolonging life, potentially even achieving biological immortality. This essay explores various scientific and technological approaches to extending human life, from genetic modifications to mind uploading. -/- 1. Genetic Engineering & Cellular Reprogramming -/- One of the most promising fields in lifespan extension is genetic engineering. Our DNA (...) holds the key to aging, and modifying it could slow or even reverse the aging process. -/- Gene Therapy: Scientists are exploring ways to edit genes associated with aging and longevity, such as the FOXO3 and SIRT genes. CRISPR gene-editing technology allows precise modifications to enhance DNA repair mechanisms and eliminate age-related mutations. -/- Telomere Extension: Telomeres, the protective caps at the ends of chromosomes, shorten with age. Techniques like telomerase activation could extend telomeres, effectively delaying cellular aging. -/- Epigenetic Reprogramming: Aging is influenced by chemical changes in DNA called epigenetic markers. Scientists like Dr. David Sinclair are working on methods to reset these markers, restoring youthful function in cells. -/- 2. Anti-Aging Drugs & Therapies -/- Medical research is identifying compounds that slow aging and enhance longevity. Some of the most promising drugs and therapies include: -/- Senolytics: These drugs target and remove senescent cells, which accumulate with age and contribute to inflammation and tissue damage. Removing them has been shown to extend lifespan in mice. -/- Metformin & Rapamycin: Metformin, a common diabetes drug, has shown promise in reducing cellular stress and extending lifespan. Rapamycin, originally used for transplant patients, has been found to mimic calorie restriction, enhancing longevity in animals. -/- NAD+ Boosters: Nicotinamide adenine dinucleotide (NAD+) is a molecule essential for cellular energy production. As we age, NAD+ levels decline, leading to cellular dysfunction. Boosters like NMN and NR are being tested to restore energy metabolism and promote longer lifespans. -/- 3. Regenerative Medicine & Organ Replacement -/- Aging is often associated with organ failure, but regenerative medicine could help replace worn-out body parts. -/- Stem Cell Therapy: Stem cells have the potential to repair or replace damaged tissues, offering a biological rejuvenation strategy. Scientists are investigating methods to grow new skin, bones, and even organs using stem cells. -/- 3D Bioprinting & Artificial Organs: Advances in 3D printing allow researchers to create lab-grown organs, such as artificial hearts, kidneys, and livers, which could replace failing ones without the need for donors. -/- Cloning & Tissue Engineering: Personalized tissue regeneration using a patient’s own cells could eliminate transplant rejection risks. Scientists are also exploring ways to clone healthy organs for transplantation. -/- 4. Enhancing Brain & Cognitive Function -/- Longevity is meaningless without maintaining cognitive function. Neurodegenerative diseases like Alzheimer’s pose a significant threat to longevity, but new technologies are emerging to counteract cognitive decline. -/- Neural Implants & Brain-Computer Interfaces (BCIs): Companies like Neuralink are developing brain implants that could enhance memory, prevent neurological diseases, and even allow direct communication with AI. -/- Cryopreservation: Some futurists believe in cryonics, the process of freezing the brain (or entire body) after death in the hope of future revival using advanced medical technology. -/- AI Integration: Artificial intelligence could assist in decision-making, memory enhancement, and mental health support, preserving cognitive abilities well into old age. -/- 5. Lifestyle & Environmental Optimization -/- While high-tech solutions are promising, natural lifestyle changes have been shown to promote longevity. -/- Diet & Caloric Restriction: Studies indicate that intermittent fasting and calorie restriction can extend lifespan by reducing oxidative stress and inflammation. -/- Exercise & Hormesis: Regular physical activity helps maintain muscle mass, cardiovascular health, and brain function. Hormesis—exposing the body to mild stress, like cold showers or sauna therapy—has also been linked to longevity. -/- Microbiome Optimization: A healthy gut microbiome influences the immune system, metabolism, and overall health. Prebiotics, probiotics, and personalized microbiome therapies could extend lifespan by reducing chronic diseases. -/- 6. Nanotechnology & Molecular Repair -/- Future breakthroughs in nanotechnology may allow precise control over aging processes at the molecular level. -/- Nanomedicine: Tiny robots (nanobots) could patrol the bloodstream, repairing cellular damage, removing toxins, and targeting diseases at the microscopic level. -/- Artificial Blood Cells: Scientists are developing synthetic blood that can enhance oxygen delivery and immune function, potentially extending life. -/- Targeted Drug Delivery: Advanced drug delivery systems using nanoparticles can deliver medication exactly where needed, reducing side effects and increasing effectiveness. -/- 7. Mind Uploading & Post-Biological Life -/- The most radical vision for immortality involves leaving behind the biological body altogether. -/- Whole Brain Emulation: Researchers are exploring the idea of scanning and copying a human brain into a digital system. If successful, this would allow a person’s consciousness to continue in a virtual or robotic form. -/- Consciousness Transfer: Some futurists speculate that advanced AI or quantum computing might enable transferring human consciousness into an artificial body, bypassing biological aging altogether. -/- Conclusion: The Future of Human Longevity -/- While full immortality remains theoretical, science is making rapid progress in extending human life and improving quality of life. A combination of genetic engineering, regenerative medicine, AI integration, nanotechnology, and lifestyle optimization may push human lifespan beyond 120 years, potentially even eliminating aging as a cause of death. -/- However, ethical, social, and economic challenges must also be addressed. Who will have access to these life-extending technologies? How will society handle overpopulation and resource distribution? These are critical questions as humanity moves toward a longer and healthier future. -/- . 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There is a widely acknowledged shortage of and an increasing demand for transplantable human organs and tissues (e.g., kidney, heart, lung, liver, cornea) in developed and developing countries around the world. In response to this need, Lott and Savulescu (2007) propose the creation of a human embryonic stem (hESC) bank to facilitate the equitable and efficient dissemination of human leukocyte anti- gen (HLA) matched tissues and organs to patients in need of replacement. Although not an unreasonable proposal, the authors (...) go on to make a much stronger claim. They argue that hESCs are such important tools for addressing the massive unmet global need for organs that it is ethically justified to require mandatory banking of spare embryos, and they argue for the use of financial (or other) inducements to procure embryos for the derivation of hESCs. (shrink)

Kidney stones pose a significant health concern, and early detection can lead to timely intervention and improved patient outcomes. This research endeavours to predict the presence of kidney stones based on urine analysis, utilizing a neural network model. A dataset of 552 urine specimens, comprising six essential physical characteristics (specific gravity, pH, osmolarity, conductivity, urea concentration, and calcium concentration), was collected and prepared. Our proposed neural network architecture, featuring three layers (input, hidden, output), was trained and validated, achieving (...) an impressive accuracy of 98.67% and an average error of 0.012. In addition to model performance, feature importance analysis was conducted to determine the most influential factors in predicting kidney stone presence. The findings underscore the significance of urea concentration, specific gravity, calcium concentration, conductivity, osmolarity, and pH as key indicators. This research contributes to the early diagnosis of kidney stones and demonstrates the potential of neural networks in medical diagnostics. The clinical implications of these findings are discussed, emphasizing the importance of timely intervention in managing kidney stone-related health issues. (shrink)

‘Transplant’ thought-experiments, in which the cerebrum is moved from one body to another, have featured in a number of recent discussions in the personal identity literature. Once taken as offering confirmation of some form of psychological continuity theory of identity, arguments from Marya Schechtman and Kathleen Wilkes have contended that this is not the case. Any such apparent support is due to a lack of detail in their description or a reliance on predictions that we are in no position (...) to make. I argue that the case against them rests on two serious misunderstandings of the operation of thought-experiments, and that even if they do not ultimately support a psychological continuity theory, they do major damage to that theory’s opponents. (shrink)

A dissociated area of medical research warrants bioethical consideration: a proposed transplantation of a donor’s entire body, except head, to a patient with a fatal degenerative disease. The seeming improbability of such an operation can only underscore the need for thorough bioethical assessment: Not assessing a case of such potential ethical import, by showing neglect instead of facing the issue, can only compound the ethical predicament, perhaps eroding public trust in ethical medicine. This article discusses the historical background of full-body (...) transplantation, documents the seriousness of its current pursuit, and builds an argument for why prima facie this type of transplant is bioethically distinct. Certainly, this examination can only be preliminary, indicating what should be a wide and vigorous discussion among practitioners and ethicists. It concludes with practical suggestions for how the medical and bioethics community may proceed with ethical assessment. (shrink)

This research paper presents the development and evaluation of an expert system for diagnosing kidney diseases. The expert system utilizes a decision-making tree approach and is implemented using the CLIPS and Delphi frameworks. The system's accuracy in diagnosing kidney diseases and user satisfaction were evaluated. The results demonstrate the effectiveness of the expert system in providing accurate diagnoses and high user satisfaction.

The dataset used in this study includes medical records of patients with various kidney conditions, and preprocessing techniques such as normalization and missing data handling are applied to ensure the model’s robustness. The performance of the model is evaluated using metrics such as accuracy, precision, recall, and F1-score to ensure reliable predictions. This approach not only aims to improve diagnostic accuracy but also provides a data-driven solution to assist healthcare professionals in making informed decisions. The outcome of this project (...) can contribute to better management of CKD, ultimately helping to reduce the burden on healthcare systems and improving patient care. (shrink)

An analysis of the identity issues involved in facial allograft transplantation is provided in this paper. The identity issues involved in organ transplantation in general, under both theoretical accounts of personal identity and subjective accounts provided by organ recipients, are examined. It is argued that the identity issues involved in facial allograft transplantation are similar to those involved in organ transplantation in general, but much stronger because the face is so closely linked with personal identity. Recipients of facial allograft transplantation (...) have the potential to feel that their identity is a mix between their own and the donor’s, and the donor’s family is potentially likely to feel that their loved one ‘‘lives on’’. It is also argued that facial allograft transplantation allows the recipients to regain an identity, because they can now be seen in the social world. Moreover, they may regain expressivity, allowing for them to be seen even more by others, and to regain an identity to an even greater extent. Informing both recipients and donors about the role that identity plays in facial allograft transplantation could enhance the consent process for facial allograft transplantation and donation. (shrink)

An important argument against prohibiting organ sales is that it removes the best option available to individuals in dire circumstances. However, this line of reasoning fails to recognise that selling a kidney on a regulated market is only the best option in a very narrow comparison, where a regulated organ market is compared with banning organ sales. Once we acknowledge this narrowness, selling a kidney is not the best option. This paves the way for a distributive justice-based critique (...) of the ‘best option’ argument for organ markets, which illuminates that organ markets should be compared with a broader set of alternatives. If providing the option of selling a kidney is not the best option, but rather the best option we are willing to provide, and one which means that many people will remain in poverty and unjust circumstances, then this reflects poorly on those societies willing to offer only this option and not a better one. (shrink)

People tend to be repulsed by the idea of cash markets in kidneys, but support the trading of kidneys through paired exchanges or chains. We reject anti-commodification accounts of this reaction and offer an egalitarian one. We argue that the morally significant difference between cash markets and kidney chains is that the former allow the wealthy greater access to kidneys, while the latter do not. The only problem with kidney chains is that they do not go far enough (...) in addressing equality concerns, and we show how the introduction of cash payments by the state could remedy this. (shrink)

The growing demand for uterus transplantation (UTx) invites continued philosophical evaluation of the function of UTx (and what constitutes its ‘success’), as well as the recipient eligibility for UTx. Currently, UTx caters to partnered, cisgender women of childbearing age looking to get pregnant and give birth to a biogenetically related child. The medical justification for this—the treatment of uterine infertility—explains the primacy of this practice. However, this dominant conceptualization of UTx does not necessarily capture the diverse needs for which both (...) cis‐ and transgender women might take interest in UTx that are not strictly procreative, such as bodily integrity and gender identity reasons. In this paper, I argue that non‐procreative motivations for uterus acquisition ought to be taken seriously as a matter of non‐discrimination and consistency. (shrink)

Introduction: The having extremely detailed macroscopic anatomy knowledge of the present medicine literature has been result of the information accumulation throughout the hundreds years. The numerous science hero have contributed for this purpose. The scientists being ahead of his time by their knowledge and scientific perspective have contributed worthy to development process of medicine. -/- Materials and Methods: The chapters related to the kidney anatomy in El-Kânûn Fi’t-Tıbb was written by İbn-i Sînâ in the 11th century, Kitab-ı Teşrihü’l-Ebdan Min (...) e’t-Tıb is one of the first illustrated anatomy books that was written by Mansur b. Muhammed b. Ahmed in 14th century, Teşrih-ülEbdan ve Tercümânı Kıbale-i Feylesûfan is the first illustrated Turkish anatomy book that was written by Şemseddîn-i İtâkî in 17th century were evaluated. -/- Results: The informations were compared in three books and were interpreted by the present informations. These books have contributed to development of anatomy although some of the informations in them are faulted. -/- Conclusion: All three books are valuable in point of showing the development of medicine. The extensive evaluation of books which have important place in history of medicine will give valuable information about development process of medicine. (shrink)

Bioethical discourse on organ donation covers a wide range of topics, from informed consent procedures and scarcity issues up to ‘transplant tourism’ and ‘organ trade’. This paper presents a ‘depth ethics’ approach, notably focussing on the tensions, conflicts and ambiguities concerning the status of the human body. These will be addressed from a psychoanalytical angle. First, I will outline Lacan’s view on embodiment as such. Subsequently, I will argue that, for organ recipients, the donor organ becomes what Lacan refers (...) to as an object a, the ‘partial object’ of desire, the elusive thing we are deprived of, apparently beyond our grasp. Within the recipient’s body an empty space emerges, a kind of ‘vacuole’, once occupied by a faltering organ. This space can only be filled by a ‘gift’ from the other, by an object a. Once implanted, however, this implant becomes an ‘extimate’ object: something both ‘external’ and ‘intimate’, both ‘embedded’ and ‘foreign’, and which is bound to remain an object of concern for quite some time, if not for life. A Lacanian analysis allows us, first of all, to address the question what organ transplantation has in common with other bodily practices involving bodily parts procured from others, such as cannibalism. But it also reveals the basic difference between the two, as well as the distance between the ‘fragmented body’ of Frankenstein’s ‘monster’—as an aggregate of replaceable parts—and the multiple organ recipients of today. (shrink)

This paper deals with the core version of the Trolley Problem. In one case many people favor an act which will bring about the death of one person but save five other persons. In another case most people would refuse to “sacrifice” one person in order to save five other lives. Since the two cases seem similar in all relevant respects, we have to explain and justify the diverging verdicts. Since I don’t find current proposals of a solution convincing, I (...) propose an alternative one according to which —but not —violates two forms of equality. I also test the underlying egalitarian principle against other cases. I argue that it offers a good explanation and also a normative justification of our intuitive verdicts about the cases. (shrink)

Nils-Frederic Wagner takes issue with my argument that influential critics of “transplant” thought experiments make two cardinal mistakes. He responds that the mistakes I identify are not mistakes at all. The mistakes are rather on my part, in that I have not taken into account the conceptual genesis of personhood, that my view of thought experiments is idiosyncratic and possibly self-defeating, and in that I have ignored important empirical evidence about the relationship between brains and minds. I argue that (...) my case still stands and that transplant thought experiments can do damage to rivals of a psychological continuity theory of personal identity like Marya Schechtman’s Person Life View. (shrink)

Philosophers have given sustained attention to the controversial possibility of (legal) markets in transplantable human organs. Most of this discussion has focused on whether such markets would enhance or diminish autonomy, understood in either the personal sense or the Kantian moral sense. What this discussion has lacked is any consideration of the relationship between self-ownership and such markets. This paper examines the implications of the most prominent and defensible conception of self-ownership--control self-ownership (CSO)--for both market and nonmarket organ-allocation mechanisms. The (...) paper contends that CSO rules out a large set of nonmarket mechanisms, including escheatage ("presumed consent"), compensated takings of organs, and restricted gifting. It also argues that CSO, if accompanied by an economistic concern for welfare, can underwrite varying types of markets in human organs, ranging from mutual-insurance pools to inter vivos (i.e., live donor) organ sales. (shrink)

Liver transplantation (LT) activities during the COVID-19 pandemic have been curtailed in many countries. The impact of various policies restricting LT on outcomes of potential LT candidates is unclear. We studied all patients on the nationwide LT waitlists in Hong Kong and Singapore between January 2016 and May 2020. We used continuous time Markov chains to model the effects of different scenarios and varying durations of disruption on LT candidates.

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in (...) distributive justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

In the absence of kidney markets, alternative institutions for exchanging kidneys have arisen to give donors incentives to donate. I examine thirteen such institutions, and ask whether moral arguments against markets, such as commodification, apply to them or not. I find that most arguments against kidney arguments also argue against these alternative institutions, meaning those arguments are not strong enough to prevent society from using institutions to exchange kidneys. Two arguments that do explain which kidney exchange institutions (...) are socially accepted and which are not are that institutions should not be want-regarding and should not be exploitative.Screening donors to eliminate those with socially unacceptable motives for donation and those who are in a position of being exploited could make kidney markets acceptable, since they would then only be vulnerable to arguments which have not prevented alternative exchange institutions from functioning. (shrink)

Organ transplantation centers set criteria for candidate qualification, which has led to disparate healthcare resource allocation practices affecting those with a substance use history. These individuals are denied organ transplants by committees and healthcare providers who assign them lower priority status. The lower priority argument claims that healthcare resources should not be provided equally to individuals who fail to share responsibility for not doing enough to address the diseases associated with substance use. The purpose of this paper is to explore (...) the interrelatedness between the ethics of a merit-based system of moral responsibility and the lower priority setting involved in healthcare resource allocation pertaining to those with substance use histories. An interdisciplinaryapproach to the argument against the lower prioritists is taken with a focus on the relationship between different organ allocation practices affecting substance users and the justification for resource allocation practices of healthcare and transplant committees. Lower priority setting is challenged, and an argument is offered in which substance users are assigned higher priority when relying on "doing enough" in a merit-based system of moral responsibility. It is determined that one cannot substantiate assigning a lower priority status since a lack of success in rehab does not imply a lack of effort. Additionally, neither to confirmatory behavior nor to non-conforming behavior may freedom be justifiably ascribed in a merit-based system of responsibility because freedom to choose can neither be established a priori nor a posteriori concerning meritorious behavior. (shrink)

Bioethical discourse on organ donation and transplantation medicine covers a wide range of topics, from informed consent procedures and scarcity issues up to transplant tourism and organ trade. Over the past decades, this discourse evolved into a stream of documents of bewildering proportions, encompassing thousands of books, papers, conferences, blogs, consensus meetings, policy reports, media debates and other outlets. Beneath the manifest level of discourse, however, a more latent dimension can be discerned, revolving around issues of embodiment, the moral (...) status of the human body and the concept of bodily integrity. This publication aims to bring these “deeper” questions to the fore. What is envisioned is a “depth” ethics (the moral equivalent of a depth psychology) focussing on the tensions, conflicts and ambiguities at work in bioethical deliberations on organ transplantation, fuelling the viewpoints articulated on the more manifest levels of discourse. Organ donation reopens the question of the status of the body as something which we have, but at the same time are, and as something which constitutes a whole, while at the same time being a set of replaceable elements or parts. (shrink)

Julian Koplin, drawing extensively on empirical data, has argued that vendors, even in well-regulated kidney markets, are likely to be significantly harmed. I contend that his reasoning to this conclusion is dangerously mistaken. I highlight two failures. First, Koplin is insufficiently attentive to the differences between existing markets and the regulated markets proposed by advocates. On the basis of this error, he wrongly concludes that many harms will persist even in a well-regulated system. Second, Koplin misunderstands the utilitarian assessment (...) of the market. He focuses on the costs and benefits of the transaction for the vendor. But, the relevant comparison is between an individual’s welfare across different courses of action, namely, vending and the nonvending alternative. Although Koplin’s empirically informed contribution is a welcome addition to this literature, the mistakes that pervade his interpretation of the data demand correction. (shrink)

The application of this system can lead to higher crop yields, sustainable farming practices, and reduced risks associated with poor crop choices. Through rigorous evaluation using standard classification metrics, the model's performance demonstrates its potential to revolutionize farming practices by aiding farmers in making informed decisions. The system has the potential to be an invaluable tool for agricultural consultants, farmers, and policymakers, ensuring long-term sustainability and improved productivity.

Entre as alternativas investigadas para suprir o déficit de órgãos disponíveis para transplante está o uso de animais não-humanos como fornecedores de órgãos, técnica conhecida como xenotransplante. Embora os primeiros experimentos desse tipo remontem a mais de um século, e as pesquisas tenham progredido nas últimas décadas impulsionadas pelos avanços em manipulação genética, o procedimento ainda permanece desconhecido para grande parte da população, com escassa discussão acerca de seus desafios e implicações éticas. Desta forma, este estudo tem uma dupla finalidade: (...) (a) consolidar dados relevantes que evidenciam a complexidade que transcende a execução clínica do procedimento, proporcionando elementos para uma análise ética da xenotransplantação, e (b) fomentar a reflexão crítica e encorajar outras pessoas a se engajarem em uma discussão rigorosa e detalhada sobre o assunto. Refletindo esta preocupação, o trabalho foi estruturado em duas seções. A primeira seção, de caráter descritivo, reúne informações técnico-científicas. O Capítulo 1 debruça-se sobre as complexidades, desafios e limitações do sistema tradicional de transplantes. Já no Capítulo 2 é traçado um panorama histórico da xenotransplantação, priorizando o xenotransplante de órgãos. A segunda seção apresenta os dilemas éticos advindos da xenotransplantação. No Capítulo 3 abordo o equilíbrio entre os (possíveis) direitos individuais dos pacientes a receberem órgãos de origem animal e os riscos coletivos associados às xenozoonoses; preocupações relativas ao monitoramento e potencial invasão de privacidade dos pacientes xenotransplantados e seus entes próximos; desafios e limitações no processo de consentimento livre e informado dos pacientes; a postura do sistema de saúde face aos pacientes que declinarem de órgãos de origem animal ou que optarem pelo xenotransplante; os recentes casos de uso de pacientes com morte encefálica em experimentos de xenotransplantação de órgãos e suas possíveis repercussões; e, por fim, nos dedicamos à reflexão sobre a utilização de animais não-humanos, com foco nas justificativas que buscam legitimar este uso. Os capítulos foram estruturados de modo que, juntos, estabeleçam uma narrativa contínua, em que a análise de conceitos, argumentos e preocupações em um capítulo conduzem ao tema subsequente. Ao término, espero que delineiem um panorama abrangente das questões envolvidas, e forneçam uma argumentação fundamentada e coerente que respalde a conclusão de que a prática de xenotransplantação de órgãos deve ser abandonada e avaliada como moralmente errada. (shrink)

Background: While the solid organ transplant evaluation process is designed to function equitably, discriminatory practices remain, resulting in disparities in access for persons with disabilities. Physical function and frailty status are often-cited factors in establishing transplant, despite limited consensus on their assessment and impact. Objective: The purpose of this study was to describe how transplant healthcare professionals conceptualize the relationship between physical disability and transplant candidacy. Methods: A convenience sample of multidisciplinary transplant was solicited to (...) respond to an electronic survey between February and March 2024. Results: Of the 126 professionals contacted, 43 participants responded, yielding a response rate of 34 %. The majority of participants (88 %) held contradictory views of physical disability as it relates to transplant candidacy (p = 0.049). Men were more likely to endorse awareness of bias when evaluating transplant candidates (p = 0.008). Professional discipline was significantly associated with perception of transplant process fairness, impact of bias, and interpretation of quality of life. Iterative thematic analysis revealed a propensity to conflate frailty with physical disability. Conclusions: Multidisciplinary transplant professionals rarely endorsed overtly ableist sentiments. However, responses highlighted inconsistent, unclear, and at times contradictory conceptions of physical function and physical disability, which may contribute to disparate access to solid organ transplant for individuals with physical disability. (shrink)

This project aims to develop a machine learning-based predictive model for diagnosing CKD at an early stage. By utilizing a range of clinical features such as age, blood pressure, blood sugar, and other relevant biomarkers, we employ machine learning algorithms, including Decision Trees, Random Forests, and Support Vector Machines (SVM), to predict the likelihood of a patient developing CKD. The dataset used in this study includes medical records of patients with various kidney conditions, and preprocessing techniques such as normalization (...) and missing data handling are applied to ensure the model’s robustness. The performance of the model is evaluated using metrics such as accuracy, precision, recall, and F1-score to ensure reliable predictions. (shrink)

Chronic kidney disease (CKD) is a global health problem with high morbidity and mortality rate, and it induces other diseases. There are no obvious incidental effects during the starting periods of CKD, patients routinely disregard to see the sickness. Early disclosure of CKD enables patients to seek helpful treatment to improve the development of this disease. AI models can effectively assist clinical with achieving this objective on account of their fast and exact affirmation execution. In this appraisal, proposed a (...) Logistic relapse framework for diagnosing CKD. Proposed calculation like NAIVE BAYES , DECISION TREE , KSTAR , LOGISITIC , AND SVM and look at these calculation and get the most noteworthy precision .AI store, which has an enormous number of missing qualities. Missing characteristics are for the most part found, taking everything into account, clinical conditions since patients might miss a couple of assessments for various reasons. By separating the misjudgements delivered by the set up models and proposed a fused model that unites determined backslide and sporadic woods by using perceptron. (shrink)

The human soul has been believed to be immaterial and immortal element which exclusively inheres in the human body. Ukpugho ukpong (soul transplant) is an ancient meta-medical science of the Annang and Ibibio people, which is hinged on the belief that the human soul is transcendent and it exclusively inheres in proxy animal; that the soul is mortal, and can be surgically transplanted in the likeness of somatic tissue transplant. This study aimed at carrying out a philosophical critique (...) of this belief in order to determine its significance as a metaphysical concept. It also aimed at critically examining the philosophical as well as sociological discussions on the subject of ukpuho ukpong. The study was discussed on the framework of African concept of mind which holds that the soul has dual nature, namely – the Active Principle and the Quiescent Counterpart. The paper debunks the doctrines of metempsychosis and transmigration as alien to African metaphysics. The method of ordinary language analysis was employed to analyze the concepts ukpong and mbukpong. In conclusion, the paper made the following observations that: the soul is transcendent but perishable substance, the mind has dual nature, the soul does not transmigrate and the science of ukpuho ukpong is not a pseudo-metaphysical concept but was founded on African logic of dualistic mind. The paper notes that the science of ukpuho ukpong is bugged with a number of unresolved philosophical problems. Despite that the paper discovered that the science of ukpuho ukpong can contribute significantly to meta-medicine and sustainable environmental values. (shrink)

By utilizing a range of clinical features such as age, blood pressure, blood sugar, and other relevant biomarkers, we employ machine learning algorithms, including Decision Trees, Random Forests, and Support Vector Machines (SVM), to predict the likelihood of a patient developing CKD. The dataset used in this study includes medical records of patients with various kidney conditions, and preprocessing techniques such as normalization and missing data handling are applied to ensure the model’s robustness. T.

The dataset used in this study includes medical records of patients with various kidney conditions, and preprocessing techniques such as normalization and missing data handling are applied to ensure the model’s robustness. The performance of the model is evaluated using metrics such as accuracy, precision, recall, and F1-score to ensure reliable predictions. This approach not only aims to improve diagnostic accuracy but also provides a data-driven solution to assist healthcare professionals in making informed decisions. The outcome of this project (...) can contribute to better management of CKD, ultimately helping to reduce the burden on healthcare systems and improving patient care. (shrink)

Early detection of CKD is essential for timely intervention and improved patient outcomes. This project aims to develop a machine learning-based predictive model for diagnosing CKD at an early stage. By utilizing a range of clinical features such as age, blood pressure, blood sugar, and other relevant biomarkers, we employ machine learning algorithms, including Decision Trees, Random Forests, and Support Vector Machines (SVM), to predict the likelihood of a patient developing CKD.

In this article I attempt to show conclusively that the apparent intrinsic difference between causing collateral damage and directly attacking innocents is an illusion. I show how eleven morally irrelevant alterations can transform an apparently permissible case of harming as a side-effect into an apparently impermissible case of harming as a means. The alterations are as obviously irrelevant as the victims’ skin colour, and consistently treating them as relevant would have unacceptable implications for choices between more and less harmful ways (...) of securing greater goods. This shows not only how the principles philosophers have proposed for distinguishing between these cases cannot withstand scrutiny, but how we can be sure that there are no relevant differences yet to be discovered. I conclude by considering reasons to think that there are deontological constraints against harming, but that they apply just as forcefully against collateral harms as they do against intended harms. (shrink)

The performance of the model is evaluated using metrics such as accuracy, precision, recall, and F1-score to ensure reliable predictions. This approach not only aims to improve diagnostic accuracy but also provides a data-driven solution to assist healthcare professionals in making informed decisions. The outcome of this project can contribute to better management of CKD, ultimately helping to reduce the burden on healthcare systems and improving patient care.

Joshua Mezrich is a practicing transplant surgeon who draws on his experiences, and those of his patients, to provide a "here's where we're at" moment in the story of transplant medicine. In so doing, he explains what it is like to practice while telling the stories of his patients, donors, and the pioneering surgeons who persisted in the face of failure to make what Mezrich does a work of healing. Written for a popular audience, When Death Becomes Life (...) is perhaps the most accessible work yet on the modern history of organ transplantation and what the current "standard of care" actually looks like. Indeed, it rounds out a "trinity" of quality books about the transplant experience, this one from the surgeon's... (shrink)