international diary

1
532 recommedation 54)? Further, where the commissioning parents are rash enough to part with money and the carrying mother then insists on keeping the child, will the former be able to reclaim the cash by means of an action for money had and received, which is an action for breach of trust rather than of contract? Or are the courts to be invited to ride that dangerous horse, public policy? These seem to be matters which require further definition. Research on Embryos This is a subject of ethics and policy rather than of law, the principal legal questions being the problems of definition discussed above in relation to the licensing authority. All the proposals regarding research appear to assume that in this area research is synonymous with experimentation. Is this so? Might not mere observation, as distinct from a mechancial process applied to an embryo, rank as research? The answer to this may have some bearing on the 14 days’ limit from the date of fertilisation (recommendation 44). It may be added that the argument that this period should be extended to coincide with that during which, given certain conditions, a pregnancy may be terminated is fallacious. Experiments with an embryo may lead to an otherwise normal child being born with handicap or malformation. Rights of Parenthood and of Childhood Parenthood.-The main changes here are in relation to AID, where the donor of the semen is to have neither the rights nor the duties of the father of a child born out of wedlock and the consenting husband is to have the right to register the birth of the child as the father. These are doubtless in line with the gradual elimination of the distinction between births in and out of wedlock, though whether sufficient consideration has been given to the effects this may have on the concept of the family as the basic social unit is not altogether clear. Childhood.-The effect of the recommendation that on achieving majority the child is to be informed of the nature of his origin will not be known for eighteen years or so. In this sense all children born through artificial insemination or IVF are the subjects of experiment. W. T. WELLS, QC International Diary 1984 2nd international symposium on Fetal Liver Transplantation: Pesaro, Italy, Sept 29-Oct 1 (Dr L. Moretti, c/o Divisione di Ematologia-USL 3, Trebbiantico, 61100 Pesaro). International workshop on Down’s Syndrome-an Interdisciplinary Approach: Rimini, Italy, Oct 21-23 (Up Service srl, Via Matteotti 51, 60121 Ancona, Italy). 1985 8th annual Infectious Diseases in Clinical Practice: Steamboat Springs, Colorado, Jan 19-26 (Universal Travel-UC Desk, 140 Geary Street, Suite 404, San Francisco, CA 94108, USA). 2nd international symposium on Current Topics in Infectious Diseases: Grindelwald, Switzerland, Feb 9-16 (Travel Planners Inc, PO Box 32366, San Antonio, Texas 78216, USA). International symposium on The Impact of Biotechnology on Diagnostics: Rome, Italy, April 16-18 (Fondazione Giovanni Lorenzini, Via Monte Napoleone 23, 20121 Milano, Italy). 1st European symposium on Thyroid Cancer: Montpellier, France, June 6-7 (Societe Internationale de Congres et Services, 337 rue de la Combe Caude, 34100 Montpellier, Cedex). 3rd European conference on Clinical Oncology and Cancer Nursing: Stockholm, Sweden, June 16-20 (Mrs I. Thilen, Stockholm Convention Bureau, Jakobs Torg 3, S-111 52, Stockholm). International symposium on Hexachlorobenzene: Lyons, France, June 24-28 (Dr J. R. P. Cabral, IARG, 150 Cours Albert Thomas, 69372 Lyon, Cedex 08). 6th Asian colloquium in Nephrology: Kuala Lumpur, Malaysia, Nov 14-17 (The Sixth Asian Colloquium in Nephrology, 4th Floor MMA House, 124 Jalan Pahang, Kuala Lumpur). Obituary JULIUS HIRAM COMROE MD Pennsylvania Dr Comroe, an international authority on cardio- pulmonary physiology and disease who was director emeritus of the Cardiovascular Research Institute at the University of California San Francisco, died on July 31. He was 73. He was born in York, Pennsylvania, the son of a physician, and he graduated from the University of Pennsylvania, where he became first an intern and then a faculty member on the hospital’s pharmacology staff. At 35, he was appointed professor and chairman of the department of physiology and pharmacology in the Graduate School of Medicine. He held this post, interrupted onlyby employment in the Chemical Warfare Service during the 1939-45 war, until 1957, when he was recruited to UCSF to lead the fledgling Cardiovascular Research Institute. He is well known for his early work on lung physiology, especially the function of chemoreceptors. In the ’40s his studies broadened to include reflex regulation of the abnormal increase in ventilation accompanying exercise, the cardiovascular effect of drugs such as morphine, and the action of different oxygen mixtures on the cardiovascular system. His paper with Robert D. Dripps on the inefficiency of manual artificial respiration inspired the development of mouth-to- mouth resuscitation. Later he and his colleagues devised new methods and instruments for the study of pulmonary function in man. He was among the first to recognise the importance of the non- respiratory functions of the lungs. As CVRI director for 16 years, he recruited leading research workers in heart, lung, and kidney physiology. Advances which emerged from his Institute included the first progress in the treatment of respiratory distress syndrome and developments in neonatal intensive care. Under his guidance, the CVRI became a major centre for training in research and he has had a lasting effect on medical education. He was a popular and lucid lecturer; and he wrote TheLung(1955) and Physiology of Respiration (1965) and developed Physiology for Physicians, a series which he edited for three years (1963-66). From 1975 to 1983 he was also director of the National Pulmonary Faculty Training Center at UCSF. During these years, he had a great influence on biomedical research through his work on the National Advisory Heart Council. He was a member of the board of medicine of the National Academy of Sciences and of the executive committee of the Academy’s Institute of Medicine. He sat on the advisory committee to the director of the National Institutes of Health and on the National Academy of Science’s recombinant DNA advisory committee. After his retirement as director of the CVRI in 1973 he was appointed Morris Herzstein professor of biology at UCSF. After more than 40 years as medical educator and researcher, he then embarked on another career as medical historian. Stimulated by observations in the ’60s which appeared to show that goal- directed inquiry was the most productive type of research (a finding that shifted the Government’s funding emphasis towards contract- supported "payoff" research), he and his friend and colleague Dripps began to collect data on the development of life-saving advances in medicine. Confining themselves to progress since the ’40s, they examined advances in cardiovascular disease. Their findings, published in 1976 (Dripps died in 1973), showed that over 40% of all advances essential to later clinical benefits were the result of basic research-a percentage too large for the Government to ignore. His investigations continued in essays written for the American Review of Respiratory Disease, later collected into an impressive book, Retrospectroscope: Insight into Medical Discovery (1977) III which he points out the false starts, missed opportunities, chance discoveries, and success for the very few in medical research. His achievements were recognised by honorary degrees, including an MD from the Karolinska Institute, Stockholm, and other distinctions, such as election to the National Academy of

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Page 1: International Diary

532

recommedation 54)? Further, where the commissioning parents arerash enough to part with money and the carrying mother then insistson keeping the child, will the former be able to reclaim the cash bymeans of an action for money had and received, which is an actionfor breach of trust rather than of contract? Or are the courts to beinvited to ride that dangerous horse, public policy? These seem to bematters which require further definition.

Research on EmbryosThis is a subject of ethics and policy rather than of law, the

principal legal questions being the problems of definition discussedabove in relation to the licensing authority. All the proposalsregarding research appear to assume that in this area research issynonymous with experimentation. Is this so? Might not mereobservation, as distinct from a mechancial process applied to anembryo, rank as research? The answer to this may have somebearing on the 14 days’ limit from the date of fertilisation

(recommendation 44). It may be added that the argument that thisperiod should be extended to coincide with that during which, givencertain conditions, a pregnancy may be terminated is fallacious.Experiments with an embryo may lead to an otherwise normal childbeing born with handicap or malformation.

Rights of Parenthood and of ChildhoodParenthood.-The main changes here are in relation to AID,

where the donor of the semen is to have neither the rights nor theduties of the father of a child born out of wedlock and the consentinghusband is to have the right to register the birth of the child as thefather. These are doubtless in line with the gradual elimination ofthe distinction between births in and out of wedlock, thoughwhether sufficient consideration has been given to the effects thismay have on the concept of the family as the basic social unit is notaltogether clear.Childhood.-The effect of the recommendation that on achieving

majority the child is to be informed of the nature of his origin willnot be known for eighteen years or so. In this sense all children bornthrough artificial insemination or IVF are the subjects of

experiment.W. T. WELLS, QC

International Diary1984

2nd international symposium on Fetal Liver Transplantation: Pesaro,Italy, Sept 29-Oct 1 (Dr L. Moretti, c/o Divisione di Ematologia-USL 3,Trebbiantico, 61100 Pesaro).

International workshop on Down’s Syndrome-an InterdisciplinaryApproach: Rimini, Italy, Oct 21-23 (Up Service srl, Via Matteotti 51, 60121Ancona, Italy).

1985

8th annual Infectious Diseases in Clinical Practice: Steamboat Springs,Colorado, Jan 19-26 (Universal Travel-UC Desk, 140 Geary Street, Suite404, San Francisco, CA 94108, USA).

2nd international symposium on Current Topics in Infectious Diseases:Grindelwald, Switzerland, Feb 9-16 (Travel Planners Inc, PO Box 32366, SanAntonio, Texas 78216, USA).

International symposium on The Impact of Biotechnology on

Diagnostics: Rome, Italy, April 16-18 (Fondazione Giovanni Lorenzini, ViaMonte Napoleone 23, 20121 Milano, Italy).

1st European symposium on Thyroid Cancer: Montpellier, France, June6-7 (Societe Internationale de Congres et Services, 337 rue de la CombeCaude, 34100 Montpellier, Cedex).

3rd European conference on Clinical Oncology and Cancer Nursing:Stockholm, Sweden, June 16-20 (Mrs I. Thilen, Stockholm ConventionBureau, Jakobs Torg 3, S-111 52, Stockholm).

International symposium on Hexachlorobenzene: Lyons, France, June24-28 (Dr J. R. P. Cabral, IARG, 150 Cours Albert Thomas, 69372 Lyon,Cedex 08).

6th Asian colloquium in Nephrology: Kuala Lumpur, Malaysia, Nov14-17 (The Sixth Asian Colloquium in Nephrology, 4th Floor MMA House,124 Jalan Pahang, Kuala Lumpur).

Obituary

JULIUS HIRAM COMROEMD Pennsylvania

Dr Comroe, an international authority on cardio-

pulmonary physiology and disease who was director emeritusof the Cardiovascular Research Institute at the University ofCalifornia San Francisco, died on July 31. He was 73.He was born in York, Pennsylvania, the son of a physician, and he

graduated from the University of Pennsylvania, where he becamefirst an intern and then a faculty member on the hospital’spharmacology staff. At 35, he was appointed professor andchairman of the department of physiology and pharmacology in theGraduate School of Medicine. He held this post, interrupted onlybyemployment in the Chemical Warfare Service during the 1939-45war, until 1957, when he was recruited to UCSF to lead thefledgling Cardiovascular Research Institute. He is well known forhis early work on lung physiology, especially the function ofchemoreceptors. In the ’40s his studies broadened to include reflexregulation of the abnormal increase in ventilation accompanyingexercise, the cardiovascular effect of drugs such as morphine, andthe action of different oxygen mixtures on the cardiovascular

system. His paper with Robert D. Dripps on the inefficiency ofmanual artificial respiration inspired the development of mouth-to-mouth resuscitation. Later he and his colleagues devised newmethods and instruments for the study of pulmonary function inman. He was among the first to recognise the importance of the non-respiratory functions of the lungs.As CVRI director for 16 years, he recruited leading research

workers in heart, lung, and kidney physiology. Advances whichemerged from his Institute included the first progress in thetreatment of respiratory distress syndrome and developments inneonatal intensive care. Under his guidance, the CVRI became amajor centre for training in research and he has had a lasting effecton medical education.He was a popular and lucid lecturer; and he wrote TheLung(1955)

and Physiology of Respiration (1965) and developed Physiology forPhysicians, a series which he edited for three years (1963-66). From1975 to 1983 he was also director of the National PulmonaryFaculty Training Center at UCSF. During these years, he had agreat influence on biomedical research through his work on theNational Advisory Heart Council. He was a member of the board ofmedicine of the National Academy of Sciences and of the executivecommittee of the Academy’s Institute of Medicine. He sat on theadvisory committee to the director of the National Institutes ofHealth and on the National Academy of Science’s recombinantDNA advisory committee. After his retirement as director of theCVRI in 1973 he was appointed Morris Herzstein professor ofbiology at UCSF.

After more than 40 years as medical educator and researcher, hethen embarked on another career as medical historian. Stimulated

by observations in the ’60s which appeared to show that goal-directed inquiry was the most productive type of research (a findingthat shifted the Government’s funding emphasis towards contract-supported "payoff" research), he and his friend and colleagueDripps began to collect data on the development of life-savingadvances in medicine. Confining themselves to progress since the’40s, they examined advances in cardiovascular disease. Their

findings, published in 1976 (Dripps died in 1973), showed that over40% of all advances essential to later clinical benefits were the resultof basic research-a percentage too large for the Government toignore.His investigations continued in essays written for the American

Review of Respiratory Disease, later collected into an impressivebook, Retrospectroscope: Insight into Medical Discovery (1977) III

which he points out the false starts, missed opportunities, chancediscoveries, and success for the very few in medical research.His achievements were recognised by honorary degrees,

including an MD from the Karolinska Institute, Stockholm, andother distinctions, such as election to the National Academy of