CDC appoints ethicists to study flu vaccine shortfall

For the first time in its history, the Centers for Disease Control and Prevention (CDC) has created a permanent panel of ethicists to help the agency navigate the life-and-death questions of who should get flu vaccines in the current crisis and how the agency should cope with any future epidemics.

John Arras, a professor of bioethics at the University of Virginia and a member of the panel, said that the panel, which began deliberating in mid-October, might have to decide whether crucial professions — perhaps even undertakers — should receive priority. Such questions, he said, are explosive.

The CDC already has decided that, in broad terms, only the very young, the very old, and the chronically ill should receive the limited supply of flu vaccines. State and local health officials complain that their shortages are so dire that they do not have enough vaccines to inoculate everyone covered under these guidelines and have been making decisions themselves about who should receive priority, but say they want better guidance from the CDC about who is the highest of the high risk.

Internet-brokered kidney transplant raises questions

A Colorado man who had waited for a new kidney for five years underwent surgery in late October at a Denver hospital to receive the kidney of a Tennessee man who responded to an ad posted on a commercial web site, marking what is believed to be the first transplant brokered through a commercial web site.

Bob Hickey had needed a transplant since 1999 because of kidney disease, and joined the commercial Internet service MatchingDonors.com; he paid the service more than $200 per month for several months, and through the service met Rob Smitty, who was cleared by physicians to donate a kidney to the Colorado man.

The transplant, originally scheduled for mid-October, was temporarily delayed after the transplant surgeon slated to perform the surgery at Presbyterian/St. Luke’s Medical Center in Denver learned of the means by which the two men had been matched. The hospital’s ethics committee was convened, and after both men signed statements that neither was profiting from the transplant, the hospital granted a "compassionate exception" and the surgery was performed without complication.

The United Network for Organ Sharing, the nonprofit, government contractor that allocates organs donated from deceased donors, has been critical of for-profit groups such as MatchingDonors.com, saying they prey on a vulnerable population and may put less affluent patients at a disadvantage to patients who can afford to solicit for organs. Both Hickey and Smitty have denied that any money exchanged hands in the match, and Presbyterian/ St. Luke’s says it will critically examine any future transplants to ensure the organs are procured ethically.

New stiff penalties for violating HIPAA rules

In sentencing the first person convicted of violating the privacy portions of the Health Insurance Portability and Accountability Act (HIPAA), a federal judge has delivered a message that violations of the privacy rules will be met with severe penalties. In sentencing former cancer treatment center technician Richard W. Gibson, of SeaTac, WA, U.S. District Judge Ricardo Martinez added four months to the 12-month plea-bargained sentence agreed to by prosecutors. Martinez sentenced Gibson to 16 months in prison and charged him with at least $15,000 in restitution.

Gibson’s conviction was the first in the country involving a breach of the privacy portion of the HIPAA act, which went into effect in April 2003. Gibson admitted that, while he worked at Seattle Cancer Care Alliance, he used a patient’s personal information to get four credit cards on which he charged more than $9,000. Penalties for violating the HIPAA privacy rule range from up to $50,000 and a year in prison for wrongful disclosure of private information, to up to $250,000 and 10 years in prison for selling or trying to sell private health information.