Human cerebral organoids (HCOs) are miniature brains cultivated in a dish using pluripotent human cells that, thanks to advanced technologies, tend to reproduce the development path of the brain of an embryo in the mother’s uterus. Recent data from studies carried out in different laboratories have indicated that HCOs show complex electrical activity, are receptive to light stimuli, and can command a muscle connected to them. The presence of the main neuronal structures in them suggests that, despite currently lacking vascularization and sensory exchanges with the outside world, more developed HCOs could exhibit some rudimentary form of consciousness, specifically a minimal sentience with respect to the basic experiences of pain and pleasure. Faced with this possibility, which for many scientists is still a long way off, we have begun to reflect on how we could empirically investigate the presence of consciousness. If we were certain or had a reasonable belief that some types of HCOs are sentient, what kind of entity would we judge them to be? Would they have specific legal protection? Should they be attributed to a moral status? This article tries to give an initial answer to these two questions. On the one side, it seems that no special rights can be claimed for HCOs other than those relating to human biological material. On the other side, instead, a sentient HCO could aspire to having its moral status recognized. If this were the case, the law may have to adapt to this unprecedented situation.
Laparotomy with splenectomy and multiple tissue biopsies was performed in 106 adult patients with non‐Hodgkin's lymphoma (histiocytic—76, lymphocytic—25, and mixed type—5). The histologic pattern at initial biopsy showed nodular lymphoma in 33% and diffuse lymphoma in 67%. Diffuse histiocytic was the most frequently observed histologic type in this series (54%). Before laparotomy, 92% of patients had primary lymphatic and 8% primary extralymphatic involvement. Waldeyer's ring involvement accounted for 27% of all patients. Systemic symptoms were present in 7%. Clinical stage (Ann Arbor Classification as proposed for Hodgkin's disease) was as follows: I—29%, II—32%, IIs— 2%, III—24%, IIIs—8%, and IV—5%. After staging laparotomy these figures were 25%, 29%, 1%, 20,% 8%, and 17%, respectively (down stage 23%, up stage 4%). Spleen was involved in 23%, liver in 12%, gastrointestinal tract in 5%, and bone marrow in 12%. In 27%, lesions were occult to conventional diagnostic methods. Although not sampled in all patients, splenic hilar, celiac, and mesenteric nodes were the most frequent occult sites of intra‐abdominal lymphoma. With clinical methods, false negative findings for spleen involvement were 12% and for liver 11%. Spleen involvement occurred more often in nodular (29%) than in diffuse lymphoma (19%). There was no appreciable difference in the splenic infiltration among histiocytic (22%), lymphocytic (24%), and mixed (20%) types. With the exception of one case, there were no patients with hepatic involvement without concomitant splenic involvement. Lymphography yielded a 96% accuracy proving once more to be a sufficiently reliable diagnostic method. Two patients died after laparotomy because of acute peritonitis and acute pancreatic necrosis, respectively. Otherwise, the incidence and type of complications were found acceptable. Collectively, our findings indicate that staging laparotomy is a useful procedure in non‐Hodgkin's lymphomas to identify occult lesions before planning treatment and to gain more information on the natural history of these diseases.
Politically strident debates surrounding end-of-life decisionmaking have surfaced once again, this time across the Atlantic in Italy. Eluana Englaro died in 2009 after a prolonged court fight, causing the international press to compare her case to that of Theresa Marie Schiavo, who passed away in 2005 in Florida after nearly This Article's analysis of proposed Italian legislation was current as of August, 2010. Political debate has, however, continued in Italy, so that any legislation eventually passed may differ in important ways from that discussed here. * Kathy L. Cerminara, Professor of Law at the Nova Southeastern University Shepard Broad Law Center, is co-author of the nationally known treatise on end-of-life law, The Right to Die: The Law of End-of-Life Decisionmaking (3d ed. Aspen 2004 & annual supps.). She received her J.D. from the University of Pittsburgh School of Law and her LL.M. and J.S.D. from Columbia University School of Law. She would like to thank Christopher Brown, Christopher Davis-Traina and Maria Albanese for their excellent assistance on this piece.
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