Doctor can I buy a new kidney? I've heard it isn't forbidden: what is the role of the nephrologist when dealing with a patient who wants to buy a kidney?

Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments. In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient (and, with several caveats, of the donor) may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles (beneficence, non-maleficence, justice and autonomy) to the donor and recipient parties

EFFECTIVENESS OF TREATMENT FOR QUITTING SMOKING AND MARAS POWDER USE IN

Introduction: The aim of this study was to investigate the effectiveness of treatment for quitting smoking and Maras powder use in patients aged 60 years or older, and to examine factors likely to be effective in stopping tobacco use.Materials and Method: Out of 178 patients aged 60 years or older, who presented to our outpatient clinic for quitting smoking and Maras powder use, 115 for whom there were no missing data were enrolled in this study.Results: Out of 100 patients who presenting to quit smoking, 76 (76.0%) were male and 24 (24.0%) were female. Fifteen patients who presenting to quit Maras powder use were all male. The mean age of the participants was 62.98 +/- 4.30 years (min=60, max=81) and did not differ between the female and male participants (p=0.351). Forty-eight smokers (48.0%) gave up smoking during treatment, but 52 smokers (52.0%) were still smoking during treatment. Eight Maras powder users stopped using the powder after treatment, but seven Maras powder users continued using Maras powder despite treatment.Conclusion: We found that a high proportion of patients aged 60 years or older stopped using tobacco after treatment. Determination to stop tobacco use, appropriate treatment and regular follow-up play an important part in quitting tobacco use