Tuesday, June 07, 2005

NIAS hospital- a proposal by Dr John Lee, AFCMA

Dear All,

FIAMC has developed a project with PERDHAKI to provide relief to Aceh and Nias. Nias in addition to being affected by the Tsunami was devastated by an earthquake on Easter Monday. During the course of discussion we have establish that there is a need to develop a hospital in Nias. We need to proceed on to the next level from here and there is a need to involve a few relevant parties in the discussions. This would include Prof Gian Luigi Gigli (President FIAMC) Dr Francois Blin (Hon Secretary FIAMC)Prof Kwang-ho Meng (President AFCMA) Dr Simon Castellvi (Spain) Dr Robert Walley (Matercare International) Dr Freddie Loh (Co-chair Missions AFCMA) Dr Kurniawan , Dr Albert Hendarta and Dr Widjo (Indonesian Catholic Doctors' Community) Dr Sally Ho and Dr Joseph Ong (Singapore) The people involved in this information group are concerned Catholic doctors who have indicated a desire to help in any project to relieve the sufferings of the vctims of Tsunami.

The proposal at the moment is to develop a hospital suitable for the needs of the people of NIAS. Dr Felix Kunawan will drive the project as he has been involved full time in the Tsunami relief and has the resources and local knowledge. We have negotiated with the diocese of Gunong Sitoli/Nias for the diocese to donate the land. This is important not only financially but because it signifies a commitment of the diocese to the project. Dr Felix has indentified a religious congregation FSGM Sister Congregation who will administer the hhospital and see to the recruitment of scarce medical personnel. FIAMC will help to coordinate the project and where necessary bring in foreign expertise. This is a massive project which will require the assistance of everyone.

As a necessary first step, Dr Felix will develop a project proposal which would include a simple need analysis (eg population served) and rough costing. He will also sign a MOU with the diocese of Gunong Sitoli/Nias agreeing to the donation of the land for a hospital. As we are all members of FIAMC I would suggest that the MOU be between FIAMC and diocese of Gunong Sitoli/Nias.

Rob, Felix has asked if you will agree to go to Nias and design the hospital layout which will include a maternity and children wing. (I am sorry that we have no funds for that at the moment. Can only promise free lodging in Singapore and maybe Indonesia if Felix can arrange it) We will also need some architectural and civil engineer input to ensure that the building is sound and able to withstand future earthquakes. If there is no suggestion of capable and willing individuals, I will source from Singapore. Experts from Indonesia will be better as they are more familiar with the culture and local conditions. I agree with Felix that the hospital should not be too big and sophisticated. However it must have the capability to perform surgery like Caesarean, appendisectomies, fracture reductions etc.

Any comments or suggestions from anybody?

Thank you for your interest in helping. God bless,
John Lee

The Vatican's View on CLONING

Vatican Official Urges Halt to Cloning TechniqueBishop Sgreccia Responds to Reports From England and Korea VATICAN CITY, MAY 24, 2005 ( Reports of "therapeutic" cloning of embryos in England and South Korea highlight the need for international organizations and political authorities to halt this practice, says a Vatican official.Bishop Elio Sgreccia, president of the Pontifical Academy for Life, sounded that warning Saturday on Vatican Radio.Echoing a report in The Times newspaper the day before, Vatican Radio explained that a team at Newcastle University, headed by Alison Murdoch and Miodrag Stojkovic, created three blastocysts, namely, the clones of human embryos in the first stage.Last year, the Human Fertilization and Embryology Authority of Great Britain authorized the university's team to work on "therapeutic" cloning.The British scientists worked on 36 ovules donated by 11 women who underwent treatment for in vitro fertilization. The nucleus of each ovule was replaced by a skin stem cell. The ovules were then subjected to an electric discharge to initiate the growth process."Custom-made"From 10 ovules, the researchers were able to create three blastocysts. The attempt to extract stem cells had not yet been successful as clones had not lived for more than five days. According to the researchers, the experiment was carried out to prove that ovules taken from women who have undergone treatment for in vitro fertilization are adequate to produce clones.The news from Newcastle paralleled that of another research group of the University of Seoul and the University of Pittsburgh, in Pennsylvania, directed by Woo Suk Hwang.The research was published online on "Science-Express." Adult skin stem cells were extracted from 11 individuals -- men and women -- affected by various illnesses. Eleven human embryos were obtained from this.At the blastocyst stage, the embryos were then destroyed to obtain "custom-made" stem cells. The objective is to transplant them to the 11 patients, theoretically to replace their sick cells, such as in the case of diabetes, reported the Italian episcopate's newspaper Avvenire.Compared to a previous experiment, in this test the technique continues to be "the nuclear transference of somatic cells." The 11 stem groups were obtained from transferring the genetic material of the patients' skin cells into the ovules of the donor women. The ovules are deprived of their original nucleus.The novelty this time is that, having obtained the human embryos, once their cells were extracted, the embryos were destroyed, noted Avvenire.5 days of lifeThe newspaper continued: "The procedure of cloning by transfer of the nucleus of a somatic cell into a little ovule deprived of its own nucleus is identical to that which could lead to the birth of a child if the embryo were transferred to the uterus of a woman capable of carrying the pregnancy to its term."Instead, the embryo generated by nuclear cloning is cultivated only up to 5 days of life. ... On this point, the one conceived artificially -- similar in everything to an embryo originated by fertilization, as studies on animals show -- is destroyed to extract a number of cells from its interior -- embryonic stem cells."Without these cells the embryo "cannot live and develop," the Italian newspaper said.For his part, Bishop Sgreccia observed: "What they have done is something that the U.N. declared illicit some time ago and with great firmness. … Sadly it is only a declaration of principle."Commenting on the cloning of human embryos in Great Britain and Korea, the prelate added: "It seems that from the scientific point of view it is but the repetition and multiplication of a type of cloning carried out on man, to which flippancy and indifference are added.""I read a headline that stated: 'Is It a Hope or an Exaggeration?'" he said. "There are those who say that financial incentives underpin it all. The laboratories that make the greatest impact probably attract more funding for research."ManipulationThe Vatican official emphasized that "from the moral point of view, we well know that so-called therapeutic cloning by nucleus transfer is but a procedure -- the most artificial one imaginable -- to give life to a human being without roots even in the paternal and maternal gametes."It is "agamic and asexual fertilization, 'driven' only by the pride of reproducing a being in order to manipulate it, because afterward it is killed and eliminated," he said."Therefore, there is not only the transgression of reproducing artificially, but also the suppression and manipulation, perhaps even the commercialization, of the product," noted Bishop Sgreccia."It must be emphasized that here we see transgressed the meaning of the rights of man," he said. "Hence, an ever more robust awareness is needed, on the part of both international organizations as well as political authorities, to put an end to this, which is a bad sign of moral decay in the scientific terrain" and thus "also offends science." ZE05052420

Wednesday, June 01, 2005

Beyond the Terri Schiavo Case

Following is an extract from Zenit on Vegetative states, hydration and nutrition:-

LONDON, MAY 28, 2005 ( During their visit to Rome last week Terri Schiavo's parents, Bob and Mary Schindler, thanked the Pope and Vatican officials for the Church's help in their attempts to keep their daughter from being starved to death.

The withdrawal of food and water that led to Schiavo's death in Florida last March 31 was condemned in a statement by Vatican spokesman Joaquín Navarro Valls. In a declaration issued the day of her death Navarro Valls described the event as "an arbitrary hastening of death." He also expressed the hope that the experience would lead public opinion to a greater awareness of human dignity and to improved legal protections for life.

The Schiavo case is by no means an isolated instance. Shortly afterward the Telegraph newspaper in British reported April 17 on an 81-year-old widow from the American state of Georgia, Mae Magouirk. In spite of having drawn up a living will she was deprived of food and water for 10 days after being admitted to hospital for heart problems, which, according to the Telegraph, were considered treatable by doctors.

The widow was not comatose or even in a so-called vegetative state. But a problem arose when her granddaughter, named in the living will as her guardian, decided that Magouirk was "ready to go home with Jesus." Her life was saved when other members of the family successfully took legal action to restore nourishment.

Last week the issue of withdrawal of food and water also came up in Britain, with what the Guardian newspaper described May 16 as "one of the most important right-to-life appeals to come before the English courts in recent years."

The case involves Leslie Burke, who suffers from a progressive degenerative disease. He fears that in the future, once his situation has deteriorated, doctors will decide to stop feeding him. Burke won a high court ruling last July, which declared the guidelines by the General Medical Council to doctors on the withholding of life-prolonging treatment were unlawful in some aspects.

Who decides?

The General Medical Council is now appealing the ruling and last week both sides presented their arguments before three appeals court judges. According to Burke's attorney, Richard Gordon, the issue was about "who decides," the BBC reported May 18. In the original case Burke argued that the General Medical Council advice, which gives doctors in cases such as his the final say on what treatment to give a patient in the final stages, was an infringement of his human rights.

In his ruling last year Justice James Lawrence Munby agreed with Burke, saying that if a patient is competent -- or, if incompetent, has made an advance request for treatment -- doctors have a duty to provide artificial nutrition or hydration.

A lawyer for Patricia Hewitt, the British health secretary, told the appeal court that the National Health Service should not have to give life-prolonging treatment to every patient who requests it "because that would mean a crippling waste of resources," reported the Times newspaper May 19. The Health Department is supporting the appeal against last year's ruling.

The government's position was criticized by Derrick Wilson, reported the Times. Wilson has a son who for the last eight years is in a "vegetative state" and he has refused to give doctors permission to end his life.

"I think this is the thin end of the wedge for euthanasia -- not only for people like Duncan but for people like me who are just getting old," he said. "It stinks of euthanasia, the government backing something like this. It's very distressing."

Last year's judgment does, however, have some defects, noted the Catholic bishops' conference of England and Wales. A note released May 17 by the Catholic Communications Network explained that the bishops are intervening in the appeal because they are concerned that by elevating the principle of patient autonomy to the level of an absolute, there could be "potentially dangerous implications for assisted suicide and euthanasia."

The declaration did stress, however, that the bishops are not opposed to Burke's attempts to ensure he will continue to receive nourishment.

Patients deprived of food and water die first of thirst, and this is not a pleasant experience, noted Dr. David Stevens, executive director of the Christian Medical Association in the United States.

On March 23, in the context of the Schiavo case, Stevens rejected claims made by some that dying in these circumstances is not painful. Based on his 13 years of work in Africa, where he saw many die of dehydration, Stevens criticized the "so-called experts" who have not seen someone die in this manner. "Contrary to those that try to paint a picture of a gentle process, death by dehydration is a cruel, inhumane and often agonizing death," he said.