The reproductive system of both males and females are specialized in function and that they only work with the specific gender they are given to. While the female reproductive system is more complex as it houses the environment a fertilized egg will grow into, the male reproductive system is in no way a simple one as well. Perhaps, the most visible difference of the male reproductive system to that of the females is that the male have an external protruding structure. This external structure is situated outside of the body and consists of the penis, the testicles, and the scrotum. Read more…
Canada goes too far in excluding gay men from blood donation
It was fairly predictable that Canadian Blood Services would win their negligence suit against Kyle Freeman, the gay Ontario man who introduced syphilis into the blood supply after lying about his sexual history in a donor screening interview.
Mr Freeman lied, he gambled on the safety of his blood, and he lost. He must now repay the $10,000 that CBS spent tracking down and destroying his blood. Public sympathy is most unlikely to be on his side.
But things might have been very different if a more honest gay man had forthrightly challenged, in the courts, a policy that many consider discriminatory. Several such cases are now in the works, and here, the CBS is on much shakier ground.
The current policy demands that would-be male donors reveal, in a private interview, whether they have had sex with another man at any time since 1977. If the answer is yes, they can’t donate.
Obviously, Canada’s strict donor regulations – which prohibit plenty of other groups from donating – were born of the ghastly tainted blood scandal. Overreaction is natural after such an event. Few doubt that there was heavy pressure from Ottawa to err on the side of caution. That has certainly been the case in organ donation, where many specialists say retrictions imposed by Ottawa are far too tight.
In fact, Canadian Blood Services was set up with a mandate not just to be safe, but to be seen to be safe, to “(re)gain the trust, commitment and confidence of Canadians, particularly patients”. That may necessitate going beyond what the evidence justifies.
But with changing technology, the gap between the current policy and what the evidence justifies is growing every year. Until quite recently, there was a longish latent period during which HIV infection in blood could not be detected prior to seroconversion. But with nucleic acid testing, that window of danger has been reduced to about 12 days.
So why does CBS have a deferral period after sex between men of 33 years (and getting longer all the time)? One year would surely be enough, and indeed, that’s the period in numerous countries, including Japan, Australia, and Sweden. Already Héma-Québec, responsible for collection in that province, has said it wants to move to a 5-year deferral.
Nowadays, every single bag of blood is being rigorously tested before it reaches the patient. Mr Freeman’s syphilis infected no-one; the system worked.
The job of Canadian Blood Services is to keep the blood supply safe and visibly so. It has no mandate to make gay people happy. It isn’t required to treat everyone equally, but is free to differentiate between groups based on legitimate safety concerns. I myself am disqualified from giving blood, because I’ve spent too much time in Britain and am judged at risk of variant Creutzfeldt-Jacob disease.
That said, CBS does clearly want to accommodate the concerns of gay people. In fact, it’s had grant money on offer for years to study whether the rules can be safely relaxed. No qualified researchers have taken up the offer. That puts CBS in a weak position in any dispute with Health Canada, who will always be driven by the overriding political need to avoid new tainted blood scandals.
But, as a CMAJ article pointed out earlier this year, the policy may be costing Canada needed blood. Not only are we losing donations from gay men, there are also numerous blood drive boycotts by organizations who once helped, but who now opt out because they find this rule discriminatory. University blood drives have particularly suffered.
So much has changed since this rule was laid down. It’s time to change the rule. It would be nice if any new dispensation could be based on solid research. Because if scientists don’t step up and address this issue, lawyers may do it for them.
Posted by David Elkins and others at 4:43 PM
Labels: Canadian Blood Services, HIV, Kyle Freeman, tainted
A shift to splints?
September is here – a month when kids tend to break their wrists more than most others. A trip to the ER usually ends up with the unfortunate child garnering a heavy, new accoutrement – a cast. After 6 weeks of itchy discomfort and the sight of a scary saw used to take off the cast, said child’s almost good as new.
A new study done at the Hospital for Sick Children in Toronto has shown there may be a better way ( http://www.cmaj.ca/cgi/content/abstract/cmaj.100119v1 ). For kids with minimally angulated fractures of the distal radius, using a splint instead of a short arm cast was equally effective. The 96 5- to 12-year olds had similar range of motion, grip strength, degree of improvement, and complications at the end of therapy. However, the splint group could also remove the pre-fab splints to take a bath.
A previous study on 113 6- to 15-year olds with uncomplicated ulna buckle and/or distal radius fractures also concluded that splints were preferable for these types of fractures in children ( http://pediatrics.aappublications.org/cgi/content/full/117/3/691 ).
Right now, the Ontario healthcare system doesn’t cover the cost of prefabricated splints, but they’re cheaper than fiberglass casts and can be made out of plaster of Paris. “You can make them any size you want,” says Dr. Joe Hyndman of Halifax’s IWK Health Centre, a long-time veteran of treating kids’ fractures.
And, Dr. Kathy Boutis, an ER doc at SickKids and the study’s co-author, is confident that staff members will adopt this treatment quickly, considering her study’s results.
Most of the injured kids -- and their parents -- preferred the ease and versatility of the splints. Considering the comparable physical function the children enjoyed, which was measured by the Activities Scale for Kids (ASK) ( http://www.activitiesscaleforkids.com/ ) after their splints were removed, this shift in treatment seems like a no-brainer.
Posted by David Elkins and others at 4:28 PM
Labels: cast, Dr. Kathy Boutis, Hospital for Sick Children, splint, wrist fractures