have to swear in front of a judge to accept the resulting child and take care ofits upbringing. Professor Mattei says that the creation of supernumerary embryos cannot be avoided. should, however, be kept for only three ...... They BMJ: first published as 10.1136/bmj.307.6917.1445 on 4 December 1993. Downloaded from years. During that time an embryo could be used by the parents for another pregnancy, or, if the parents agreed, given to another couple. Parents could also ask for an embryo to be destroyed. Embryos should not be produced for experiments. Measures should be rapidly taken, says Professor Mattei, to control predictive genetic testing before it is used unethically. All genetic information gathered about a person should be used for medical purposes only and never be made available to insur- ...... ance companies or potential employers. Professor Mattei stands firm on the posi- tion adopted earlier by the Academy of Sciences regarding the patenting of genes. A patent on a gene or a genetic sequence should not be acceptable because genes

...... are part of the human heritage. But the

.... technique of using or isolating a gene is patentable. Legislation on the collection of organs and This Pakstinian is beinggiven the heart ofan Israeli soldier tissues from cadavers, he says, is urgently needed. Techniques have progressed rapidly, insist on only Jewish recipients," said Dr but tissues and organs are collected, con- signs for Barzilai. "We always refuse to take the served, and used under ill defined conditions. organs. But usually politics does not get in Because of the risk of contamination and the organs fom the way." possibility of using autografts, notably for An unusual agreement between the govern- Dr Barzilai will soon launch a major skin, he states that the risk of contamination ments of Israel and Cyprus means that educational and publicity campaign to is acceptable in the case of vital organs but Cyprus will send transplant organs to Israel increase Israelis' awareness of organ trans- not tisssues-except corneal tissue. (Some in exchange for Israeli doctors teaching plantation and help hospital staff get the surgeons have already protested that a ban on Cypriot doctors how to perform transplant message across to bereaved families. "Only the collection of bone and other tissues, surgery. The deal, signed by Manolis by depending on our own resources will we including skin, would be harmful and that Christofides, the Cypriot , ever be able to meet the demand," said Dr surgeons might be tempted to purchase and Haim Ramon, the Israeli health minister, Barzilai.-JuDY SIEGAL-ITZKOVICH, medical them abroad.) Professor Mattei also showed

is, however, unlikely to solve the chronic correspondent, Post concern about the use of placentas. The http://www.bmj.com/ organ shortage in Israel. Dr Ami Barzilai, 's largest processor of placentas is the head ofIsrael's National Organ Transplanta- French laboratory Pasteur-Merieux, which tion Centre, expects that Cyprus will send has a 20 year history ofcollecting placentas in just over 50 organs a year-mostly hearts and has another many countries and annually processes some livers because kidney transplant operations 4500 tonnes of placentas (corresponding to are done routinely in Cyprus. go at compiling an eight to nine million births) for the extraction "We do about 150 transplant operations of of various biological products. Although the all in a said Dr Barzilai. "There placenta is neither a human tissue nor an types year," ethics law on 23 September 2021 by guest. Protected copyright. are 700 Israelis waiting for a kidney, 70 for a organ, its collection poses ethical problems, heart, and 50 for a liver. Until recently most A French law to cover such bioethical issues says Professor Mattei. people on the waiting list would go abroad. as experiments on human embryos and the In preparing his report Professor Mattei Over 90% of all Israelis have supplementary use of organs and tissues from cadavers has talked to more than 160 philosophers, ethno- health insurance that covers transplant been proposed by Professor Jean-Francois logists, historians, doctors, and religious operations in a foreign centre if surgery is Mattei, a paediatrician and geneticist at the authorities to gauge the reasons why previous unavailable here. But the European Com- Hospital University Centre in Marseilles. His bills had not been adopted. His report is now munity is now closed and the US nearly shut proposal, which was put before the prime in the hands of Edouard Balladur, ready to to foreigners needing transplants." minister, Edouard Balladur, last week, could attempt the obstacle course where previous Although Israel's chief rabbinate has finally resolve 10 years of discussions, public bills have stumbled: the Council ofMinisters, authorised organ transplantation, some ultra- debates, and parliamentary voting on bio- the , and the senate. It is likely Orthodox rabbis do not accept brain stem ethics legislation. A bioethics bill was that any sweeping bioethics legislation, death as the end of life; thus they disapprove adopted by parliament in November last year which the French hoped would serve as of removing organs for transplantation while only to be rejected by the senate. an example to other countries, will have the person's heart is still beating. Previous attempts at bioethics laws have to wait at least another year.-ALEXANDER Forms for renewing drivers' licences stumbled over defining the legal status of an DOROZYNSKI, medical journalist, contain slips of paper for registration as a embryo. Professor Mattei avoids defining potential organ donor, but registration is this legal status, stating that an embryo is a voluntary. Legally organs may not be "temporary morphological expression" of a Correction removed unless the person who has died or life that starts at conception and continues his or her family has given written approval. until death. Female genital mutilaton condemned by WMA There are also prejudices and superstitions He proposes that in vitro fertilisation with An editorial error occurred in the article on female genital mutilation by Tessa Richards (16 October, about having to be buried whole. "We've had donor sperm and embryo transfer should be p 957). Professor Priscilla Kincaid Smith has seen a a few cases of Arab families who will donate available only for couples who are infertile. few cases offemale genital mutilation in , not only ifthe organs go to an Arab and Jews who Potential recipients of the treatment would many as the article stated.

BMJ VOLUME 307 4 DECEMBER 1993 1445