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With regard to medicolegal problems, semantics are of considerable importance: indeed, depending on whether we call grafting or transplantation of an organ the operation that takes a living organ to reimplant it in the same person or the operation that takes a living organ from a donor to reimplant it in a recipient, the issues raised are completely different. The transposition of a dental organ does not raise any particular problems apart from the technical requirements to be met; there is no special problem of prevention or ethics to be taken into consideration. The problem is a completely different one when it means taking a living organ from a living or dead subject and reimplanting it in another subject. All measures decreed from the point of view of law and regulations that are dictated by considerations of prevention and ethics must then be strictly applied.

The authors treat questions involving post-mortem examinations and autopsies, as regulated in the "Order Pertaining to Post-mortem Medical Examinations" in the former GDR. The administrative autopsy is of special importance in this respect. This regulation, which has been demanded by German physicians for more than a century and has existed for a long time in Austria (1857), should finally be introduced in the Federal Republic of Germany as well. It should at least be retained in the new Federal States. In the field of alcohol-related traffic law, the authors advocate a reduction of the blood-alcohol limit throughout Germany, even if the zero limit in the former GDR does not appear to be implementable. The time-tested regulations applying to organ graftings are presented as the third topic. In the GDR there was a uniform order based on the right to object.

France was in tenth position in the field of kidney transplant in Europe in 1982, and is currently at the top of western countries for all transplant activities (per million inhabitants). Cyclosporin A was certainly a favourable factor for liver, heart and lung transplantations. Nevertheless the transplantation activity in France is twice than of Great Britain or Germany for those transplant specialties and the percentage of renal transplantations from living related donors is very low in France: 2.7% versus 30% in others. These data depend on a specific French organization which involves: a presume consent law; an emergency policy with mobile medical rescue teams and polyvalent intensive care units; a three level France Transplant organization: national, regional and local; hospital physicians as regional transplant coordinators who are independent from transplant teams; waiting list telematic computer system which promotes priorities: high emergencies, high-sensitized and pediatric recipients.

Critically examining what most people take for granted is central to philosophical inquiry. Philosophers who accept positions on policy making commissions, tasks forces, or committees cannot, however, play the same uncompromisingly critical role in this capacity as they do in the classroom or in their personal research or writing. Still, philosophers have much to contribute to such bodies, and they can do so without compromising their integrity or betraying themselves as philosophers.

Philosophers may play the role of insider, e.g., serving as advisor to government commissions, or of outsider, commenting on the work of such commissions. Each role may raise dilemmas. It is argued that as insider the philosopher's primary duties should be to clarify and inform, as well as philosophize with the commissioners, and help them stay on a course in which moral considerations are given their proper weight. Fulfilling these duties means that the philosopher will sometimes have to help produce a weaker intellectual document than he would prefer, or lose a chance to directly promote the public good. The insider philosopher will also have to consider whether it is appropriate for a policy proposal from a commission to differ from much current government policy, and how morally appropriate compromise can be reached among commissioners. Given his understanding of how an insider philosopher should function and how commission reports are constructed, the outsider philosopher can comment both on how close a report comes to being perfect of its type, and how far short of an ideal philosophical analysis even a perfect government report is. It may be appropriate for him to give greater weight to the public good, if his comments are very likely to affect it, than the insider philosopher. Examples for discussion are drawn from government reports on organ transplantation, embryo research, terminating care, and compensation for research subjects.

As medical barriers to human organ transplants have fallen, serious legal and ethical obstacles have emerged. This article provides an overview of those obstacles, taking into account the relevant legislation in force in 16 Latin American countries in 1989. The author proceeds by considering postmortem and inter-vivos organ donations separately and examining the principal ethical and legal issues relating to each kind. In the case of postmortem donation these deal mainly with donor consent, recipient selection, funding of transplant costs, and possible conflict of interest. In the case of inter-vivos donation they relate again to donor consent and funding as well as to certain other matters-notably donor compensation, commerce in organs, and international sharing of organs. On the whole it is concluded that the countries of Latin America, together with the nations of the world in general, urgently need to develop more comprehensive legislation on organ procurement and transplantation.

In Mexico, as in many other countries, there are numerous situations involving bioethics that are not necessarily covered by officially sanctioned policies or guidelines. In such cases, it is reasonable to describe commonly accepted rules, opinions, and practices in a general way so as to illustrate how bioethical questions are being managed. This article describes certain goals and practices relating to education in bioethics in Mexico. It then outlines Mexican laws and procedures governing research on human subjects, cites certain official rules and activities relating to regulation of human reproduction, quotes literature dealing with intervention in human procreation, discusses artificial prolongation of life, describes laws and practices governing organ transplants, considers ethical issues relating to such transplants, reviews the AIDS situation, and describes how the need for confidentiality is dealt with in managing AIDS cases and related data. In this manner it indicates how bioethical questions in these various areas are being handled and points out certain priority areas needing work.

Canadian bioethicists have long enjoyed access to bioethics programs in the United States and have collaborated with U.S. organizations working in this field. Nevertheless, special features of Canada's multicultural society and public health services are increasingly seen as raising distinctive issues requiring special attention. The purpose of this article is to provide an overview of current Canadian bioethics trends in various areas--including those of training, research on human subjects, human reproduction, termination of life, biotechnology, organ transplants, and AIDS. Comparison of this work with other articles in this issue will show that while some of the trends involved have paralleled similar ones in the United States, some trends (such as that regarding confidentiality and the reporting of HIV infection) have been quite different.

Colombia in recent decades has been exposed first-hand to a broad spectrum of important medical advances ranging from organ transplants to techniques for assisting human reproduction. It has also confronted an array of modern problems--including the abortion issue and the AIDS epidemic. Many of these matters have bioethical implications. This article describes the more important measures that have been and are being taken in Colombia to deal with those implications.