by NexDev | March 28, 2019 | News, Old age and Dependency
After consulting various social services for the past 5 months, the report “Advanced Age and Autonomy” was submitted to the French Health Minister, Agnès Buzyn, by the President of the High Council in charge of allocating funding for this sector, Dominique Libault, on March 28.
Today in France there are 1.5 million people aged over 85. By 2050, this age group will triple to 4.8 million. Consequently the percentage of dependent persons could increase by 50%. In the report’s preface Mr. Libault laments: “Time is of the essence. The entire report focuses on switching from caring for someone who is dependent, to implementing support systems to help the person remain autonomous. (…) Our society must include the elderly, and not isolate them, in their own homes or in institutions. We need to have a new outlook on how to treat advanced age”.
Since by 2030 there will be an additional 40,000 French seniors who will be dependent, the newly published report gives 175 measures. Ten of these are classified as priorities, aimed at meeting the 3 following objectives:
- promote home care (the solution preferred by most French people),
- improve residential care in nursing homes (French “EPHADs”) for the elderly, dependent individuals.
- address the personnel shortage for elderly care.
To enable dependent persons to remain at home, “their caregivers who are still in the work force, could be compensated for a leave of absence” for approximately 50 €/day, similar to that already allotted for parental presence and care of infants who are sick or handicapped.
Over the past 2 years, under-staffing in French nursing homes has been widely commented. Based on the 2015 statistics, the report recommends increasing the ratio of staff per elderly resident by 25% by 2024.
A national awareness campaign will be launched to attract candidates and address the shortage of caregivers in both individual homes and nursing facilities.
The caregivers who were consulted for the national report are disappointed; they believe that local efforts for solidarity should be more developed and receive more support.
The changes that can be done without legislative impact could be rapidly implemented, before summer. The French Health Minister, Mrs. Buzyn, announced that she intends to table a bill in the fall.
Advanced aging is an essential issue, not only for France, but throughout Europe. Alliance VITA underlines it as a major challenge for the candidates in the upcoming European elections, in order to build a coalition where the rights of the most vulnerable could be taken into account.
by NexDev | March 28, 2019 | Difficult pregnancy, Maternity, News
The smallest newborn in the world is headed home in good health after 5 months of hospitalization in Tokyo. This Japanese baby boy who weighed only 268 grams when he was born at 22 weeks gestation time (or 24 weeks amenorrhea) has set a new record in neonatal medicine.
In the past 30 years, neonatal medicine has made tremendous progress in managing the care of preterm babies. Edward Bell, Professor of Pediatrics, and Neonatologist at the University of Iowa (USA) states: “I’ve been in this business for 40 years, and I’ve seen the threshold of viability move back about one week every 10 years or so in my practice “.
A preterm birth occurs before the end of 41 weeks of pregnancy (counting from the first day of the last period). A baby is considered to be preterm when he is born prior to 8 ½ months of pregnancy (37 weeks of pregnancy).
Doctors have identified 3 levels of prematurity:
- moderate preterm babies born between 7 and 8 months of pregnancy (32- 36 weeks amenorrhea)
- very preterm babies born between 6 to 7 months of pregnancy (28 – 32 weeks amenorrhea)
- and extremely preterm babies born prior to 6 months of pregnancy (28 weeks amenorrhea).
Some factors contributing to enhanced neonatal medical progress include technological improvements in respirators and the invention of artificial surfactants which facilitate breathing in immature lungs. Whenever possible, prior to delivery, mothers can receive steroid injections to speed up the development of the baby’s lungs. Huge progress has also been made thanks to the attention given to the child’s relationship with his parents, especially the mother-child relationship.
The fact that hospital neonatal units encourage and support the parents’ presence to comfort babies physically and especially emotionally, contributes immensely to the baby’s development. Medical personnel encourages skin-to-skin contact between babies and their parents, and they assist mothers who wish to breastfeed their babies.
A newborn’s survival and development without sequelae is especially related to factors such as: gestational age, weight, birth conditions, gender, and the reasons for prematurity. Risk factors include overall immaturity, notably for the lungs, the digestive system, the brain and the heart. The growth and development conditions for a newborn baby are much more difficult than in utero.
Dr. Jean-Christophe Rozé, Professor of Pediatrics at the University of Nantes explains that “in France, the lower limit of viability is 24 weeks amenorrhea due to complications which are considered unacceptable, such as blindness.” As the vice-president of the French neonatal society he continues: “France is still struggling with its reluctance to make a place for disability. In the care and treatment of extremely preterm babies, the issue is to ensure the best possible overall development for the child, and not just the survival of a lung, a heart, two legs and two arms. In this outlook, the inherent consequences related to prematurity must also be taken into consideration.” But the pediatric professor reports that “recent progress has been made regarding the fear of disabilities and developmental difficulties.”
A national clinical trial conducted on preterm babies born in 2011, (known as “EPIPAGE”) shows that the situation is changing. Professor Rozé explains that “The initial results following hospital discharge showed that France was somewhat behind compared to other countries. Babies born between 24-25 weeks amenorrhea, either had minimum care or were not followed-up. Therefore, a vicious circle developed since the results were not encouraging, and the preterm babies were not actively cared for. This study helped us consider how to actively manage these babies born at 24 weeks, on a nationwide level. Since then the threshold of treatment and care has gradually been lowered”.
Recently, two studies also confirmed this remarkable progress.
The first one, published in JAMA (Journal of the American Medical Association) found that the survival rate of extremely preterm babies in Sweden had increased from 3.6 to 20% for those born at 22 weeks, and that 8 babies out of 10 survived at 26 weeks of age.
A second study in the United States included babies weighing less than 400 grams, and a gestational age of 22-26 weeks, from 21 hospitals from 2008 – 2016. The results found that 13% of these preterm babies survived; the smallest weighed only 330 grams.
Managing health care treatment for these babies represents a very important public health challenge.
Between 50,000 and 60,000 preterm babies are born each year in France (“INSERM” statistics). 85% of these are moderate preterm (32-37 GA), 10% very preterm (28-32 GA), and 5% extremely preterm, born prior to 28 GA. The preterm birth rate in numerous developed countries has risen in recent years. In France, preterm babies accounted for 5.9% of births in 1995, and increased to 7.4% by 2010.
To improve preterm babies healthcare, Professor Jean-Christophe Rozé specifies: “there is a major obstacle which is difficult for the health authorities to understand, that of aiming for an extremely high ratio of health care personnel for each patient. This would mean allotting almost one nurse for each baby, compared to the current ratio of approximately one nurse for every two infants. Thus the long-term survival for these preterm babies depends on closer follow-up and better monitoring.”
Professor Picaud, the Department Head for Neonates and Neonatal Resuscitation at the “Croix-Rousse” Hospital in Lyon, explains that the survival rates for extremely preterm babies vary greatly from one country to another. “In 2005, the estimated survival for extremely preterm babies born at 24 weeks of amenorrhea in Japan was 77% compared to 31% in France, and 55% in the USA. In Europe, Sweden has the best survival statistics at 67%. Japan is a very wealthy country thus allowing one-to-one care to be implemented: one caretaker (nurse or doctor) for each baby, accounting for their excellent results. Indeed, Japan’s expertise in this field is internationally renowned. In France, there is usually 1 nurse for every 2 babies in resuscitation units, 1 for 3 in intensive care units and only 1 for 6 babies in neonatal pediatric units”.
by NexDev | March 15, 2019 | News
Published on March 13, 2019 in the journal Nature, renowned scientists have called for a “global moratorium” on human germline editing for clinical purposes, that of changing heritable DNA in sperm, eggs or embryos to make genetically-modified babies. Among the scientists is Frenchwoman, Emmanuelle Charpentier, a co-discoverer of CRISPR-Cas9 technique.
After its catchy headline, the authors immediately state that their proposed moratorium does not apply to germline editing for research, provided the experiments do not involve implanting an embryo in a uterus, with the intention of giving birth to genetically-modified babies.
Although the signatories agree that modifying human DNA is neither safe nor effective, with a high risk of inducing unintended mutations, they are not at all calling for an international ban. They propose for each country to freely decide, and simply suggest not using this technique on embryos and gametes to give birth to GM babies “unless certain requirements are met”.
To define international guidelines, the authors recommend an initial moratorium of a fixed duration (they suggest a 5-year period) in order to evaluate the technical, scientific, medical, societal and moral implications. Thereafter, each nation could choose to maintain the status quo, to prohibit, or, on the contrary, to consider allowing these new practices for human procreation.
Prior to legalizing any new applications, the scientists suggest that multidisciplinary and public discussions be held in the country concerned, to carefully evaluate whether the application is appropriate and justified, and to inform its citizens if a broad societal consensus is determined for proceeding with human germline editing.
Blanche STREB, Alliance VITA’s Director of Training and Research, author of “Dystopia: the World of Designer Babies” declares:
“Moratorium is indeed the appropriate word… Moratorium originates from the Latin word, moratorius, which means “to postpone or delay”. What these leading scientists are clearly proposing is equivalent to gaining momentum on the runway for the long jump: “prepare to jump farther by taking a few steps backward”! This kind of half-hearted statement is not reassuring. And yet, the recent bombshell announcement of the first gene-edited babies in China, should strengthen political and scientific stances. Humanity must be protected against these temptations of tinkering with the human being at the beginning of life, jumping over precautionary principles for these babies who have become human guinea pigs “.
The authors suggest establishing an international “coordinating body”, in particular to provide the necessary information to any nation considering authorizing a particular gene-editing application. In their opinion, this global consortium could be organized under the World Health Organization (WHO) and could issue reports on a regular basis. They also recommend creating two separate subpanels: one composed of biomedical specialists for technical, scientific and medical considerations, and the other composed of specialists focusing on societal, ethical and moral issues.
Recently, the WHO has announced the creation of an “Expert Advisory Committee to Develop Global Standards for Governance and Oversight of Human Genome editing”. This Committee will first meet in Geneva on March 18-19, to agree on a working plan for the upcoming 12-18 months.
![[Press Release]: Alliance VITA Denounces Attempt to Abolish Conscience Clause in French Health Bill Reform](https://www.alliancevita.org/wp-content/uploads/2019/03/objectiondeconscience-1080x675-1.jpg)
by NexDev | March 13, 2019 | Abortion, News, Press Releases
Alliance VITA denounces an attempt to abolish the conscience clause for doctors and health professionals using amendments to article 17 in France’s Health Bill proposal, which is being discussed by the Social Affairs Committee.
Although the bill aims at reforming the Health System, some MP’s from Macron’s party LREM (La République en Marche) and from the left-wing, eco-socialist party “La France Insoumise” are attacking, against the government’s instruction, the freedom of conscience clause, stipulated by law for health professionals regarding abortion.
Article L2212-8 of the Public Health Code specifies that “a doctor is never required to perform an abortion but must immediately make his refusal known, and refer the person concerned to other practitioners likely to perform the abortion (…). No midwife, nurse, or medical assistant can be required to assist in performing an abortion.”
Tugdual Derville’s point of view, as Alliance VITA’s General Delegate:
“If the 1975 law on abortion includes an explicit conscience clause for health professionals, this is due to the very particular nature of an act that ends a human life. A professional cannot be forced to act in absolute contradiction to his conscience. The implication of this ideological maneuvering of some MP’s, is that today health professionals are nothing but service provider. However, the conscience clause legitimately recognized for abortion, out of respect for the caregivers’ personal convictions, is essential for protecting their freedom of conscience. If someone is forced to act in complete contradiction to his conscience, this fundamental democratic freedom is disregarded and trampled on. Many caregivers are likely to be very uncomfortable should this conscience clause be abolished, at a time when the health care system is supposedly being restructured. In addition, it could lead to discrimination, since some caregivers may be forced to abandon their profession.”
With more than 210,000 abortions performed annually, France has a high rate of abortion. Alliance VITA maintains that policy makers should be alarmed by the lack of a genuine abortion prevention policy, rather than concentrate on stigmatizing health professionals who act according to their conscience. While France is going through a serious social crisis, Alliance VITA solemnly asks the government to face its responsibilities and firmly reject this libertarian disposition.
by NexDev | March 8, 2019 | News
While the French government is deliberating on child welfare services, the National Assembly has appointed a task team to investigate on welfare and child support in charge of the follow up of children placed away from home.
This decision follows a controversial broadcast on French television (Channel “France 3”), which denounced several flaws in child protection programs. This included being bounced from one foster home to another, violence in the foster homes, lack of training for the educators, etc…Placed in protective custody as a child, the MP Perrine Goulet (“La République en Marche” party) enlisted several other deputies in January to create a committee to examine child welfare and support programs.
In France, action is taken to protect 341,000, and over half is placed in foster institution or families (statistics for 2017).
This investigative task force includes 23 deputies, who will evaluate the competences and appropriate role distribution of the responsibilities on both national and regional levels. Training for personnel, and ways to implement educational programs will also be studied. Until the end of the legislative period, this task team will carry out their functions, which will involve travel throughout France and abroad.
Simultaneously, at the end of January, the government launched a plan for social assistance for children, with provisions which should be confirmed this summer. The Secretary of State for Childhood Protection, Adrien Taquet, mentions that important subjects to be treated include the methods of recruiting and training professionals, and providing access to social assistance. In his opinion, this would help “implement judicial measures for placing children more rapidly“.
Another important challenge is to develop a program for these young people to help them after their 18th birthday. Indeed some of them end up homeless. According to a 2016 survey published by “INSEE” (National Institute for Statistics and Economics), 23% of the homeless adults in France had previously been placed in homes or institutions as children.
