Men and women who have undergone sex change operations may be allowed to marry legally and adopt children under new proposals drawn up by Home Office Ministers. It is currently illegal for Britain’s 5,000 transsexuals to have their original sex altered on their birth certificate. However, last year they won the right under the Sex Discrimination Act to have their new gender recorded on passports and driving licences. Civil liberties groups claim that Britain is out of step with the rest of Europe where, with the exception of Andorra, Albania and Ireland, transsexuals are not prevented from marrying. (Weekly Telegraph 2000 [Australasian Edition];470:5, 26 July-1 August)

The first working draft of the human genome has been completed ahead of schedule, the result of an international collaboration between eight publicly funded university centres that started in 1990. The draft has sparked widespread concern about the potential misuse of the information and the British Prime Minister, Tony Blair, has said that the information must be used to transform medicine, not abused to make man his own creator or enable him to invade an individual’s privacy. The Human Genetics Committee has been set up to act as an advisory committee to the British Government and to protect society from the misuse of the information revealed in the genome. It will address issues such as patenting, genetic testing and insurance, and genetic testing and employment (BMJ 2000; 321:7, 1 July).

A meeting of the Northern Ireland Assembly expressed a rare consensus on a motion opposing the extension of the Abortion Act (1967) to Northern Ireland. The motion was proposed by Rev Ian Paisley’s Democratic Unionist Party and supported by the SDLP, Sinn Fein, the Ulster Unionist Party and the Alliance. Only one member from the Progressive Unionist Party opposed it on the grounds that it violated a woman’s right to control her body. Female members also challenged the male consensus, arguing that it would make no difference to the 2,000 women who travel to Great Britain from Ireland every year for abortions. The Women’s Coalition proposed that the issue be referred to the Assembly’s health committee in order to obtain evidence from doctors and other experts, but this was defeated by 43 votes to 15.

The current abortion laws in Northern Ireland are highly ambiguous and there have been many calls for the government to provide clarification. However, as a result of devolution, the laws are now the responsibility of the Assembly. Unlike the Irish Republic, abortion is permitted in cases where a substantial threat to the mother’s health can be proved, in the case of severe abnormality, or when the pregnancy is the result of rape or incest.

Recent figures released jointly by the Irish Family Planning Association (IFPA) and the British Pregnancy Advisory Service show that 2,460 Irish women travelled to Great Britain for abortions in 1999. Twelve of these were girls less than 16 years old whilst the majority (933) were between 20 and 24. However, the IFPA claim that, in reality, the figures are actually much higher as many women provide false British addresses in order to protect their identities (Guardian 2000; 25 June), (Times 2000; 10 June).

The Family Planning Association have unveiled a new leaflet, Abortion - Just so you know, which aims to reassure 14 to 18 year olds that abortion is free, legal, confidential and common amongst teenagers. It states that ‘a girl under 16 can give consent to an abortion without telling her parents if doctors believe she fully understands what is involved’. It also cites several reasons for having an abortion, including that the child would stop the woman ‘having her own life and going to the pub’. The publication has been attacked by the Society for the Protection of Unborn Children as it presents no alternative options. Britain currently has the highest number of teenage pregnancies in Europe and teenagers account for one fifth of all abortions performed in this country (Times 2000; 10 June), (Telegraph 2000; 10 June).

The world’s first abortion ship is about to set sail, travelling around the world performing abortions off the coasts of countries where the practice is currently outlawed. The scheme is the brainchild of Dutch doctor Rebecca Gomperts and has angered authorities in many of the targeted countries.

The ship, Sea Change, will visit South America, most of Africa, much of Asia, Poland, Malta and Ireland. It will drop anchor twelve miles offshore in international waters and therefore under Dutch law. Women will be ferried out to the vessel by boat. It is expected that 5,000 women per year will make use of the service, which will be free to most women. The ship will stay in one place for six months and arrive unannounced so as to reduce the risk of attacks by anti-abortionists. It will also be equipped with state of the art security equipment and will have 24 hour security patrols. Dr Gomperts plans to sail the world ‘until abortion is legalised everywhere’. A two month pilot programme is likely to get underway later this year (Guardian 2000; 26 June).

The House of Lords has once again comprehensively rejected the Government’s latest attempt to scrap Section 28 of the Local Government Act, which bans local authorities from promoting homosexuality. As a result, it is likely to remain in place until after the next General Election. For the second time this year, the peers voted overwhelmingly to keep Section 28 after it was removed by the Commons. The Government was defeated by 270 votes to 228 - roughly the same figure as last time, despite the recent increase in the number of both Labour and Liberal Democrat peers.

However, Section 28 (or Section 2A as it is now known) has been repealed in Scotland after a failed campaign by millionaire business tycoon Brian Souter to stop its abolition. He is believed to have spent around £2 million on the ‘Keep the Clause’ campaign and a Scotland-wide referendum also revealed that 87% of the population wanted to retain Section 28. However, the Scottish Parliament voted 99 to 17 to remove what the Labour Party describes as a standing rebuke to the gay community. Supporters claimed that it will provide more scope for the discussion of alternative sexual lifestyles in schools in the next academic year (Times 2000; 22 June), (Times 2000; 25 July).

The Home Office has unveiled proposals for drastic alterations to the current sex laws in which rape suspects would be unable to claim consent if they were drunk or the victim was asleep or intoxicated. The term ‘rape’ would also be expanded to encompass both anal and oral sex. Gay sex crimes - gross indecency and buggery - would also be abolished. Incest would be replaced by a new offence of family sexual abuse to cover blood relatives, foster and adoptive parents and partners. Voyeurism and necrophilia would also become crimes for the first time and tougher sentences would be put in place for indecent exposure. Consent would be defined as ‘free agreement’ in an attempt to increase the current number of rape convictions. The most comprehensive review for over 100 years also rejected the lesser offence of date or acquaintance rape (Times 2000; 27 July).

The homosexual couple who fathered twins by a surrogate mother have confirmed reports that they are expecting an addition to their family. In response to reports that they are expecting triplets, Barrie Drewitt, partner of Tony Barlow, said, ‘We are pregnant with more than one child, but I cannot say any more at the moment’. The wealthy couple have been told by the Home Office that there is no guarantee that any more children born outside the UK would be allowed to join their family (Times 2000; 25 July).

Millennium pledges by G8 leaders to write off £65 billion of debt owed by the world’s poorest countries have been labelled ‘a sham’ by pressure groups. By the year’s end Britain will have reduced $2.5 billion outstanding loans by only $26 million, according to a report by the Jubilee 2000 group. On a world scale, no timetable has been set for implementing these pledges.

The row focussed on Japan, which has spent £500 million on preparations for the recent G8 summit to discuss world debt. If this money had been directed into third world schools, it could have paid for the education of about one tenth of the 125 million children who do not go to school. Instead the bill includes some touches of sheer extravagance- all the bushes around the conference centre have been replaced with varieties primed to bloom during the three days of the summit. For President Clinton, a £4 million replica of his home in Arkansas has been built near the conference centre.

Mr Blair told his fellow heads of government that the scale of lobbying reflected ‘real interest in this around the world and a desire to focus on it’. He also acknowledged that there has been progress since the last G8 summit in Cologne. He praised moves by the World Bank and multinational development banks to begin implementing debt relief and the anti-poverty strategies (Telegraph 2000; 22 July), (Times 2000; 3 July), (BMJ 2000;321:320, 5 August).

The 13th International AIDS conference in Durban, South Africa was overshadowed by dispute about the true aetiology of AIDS. Thabo Mbeki, South Africa’s current president has already publicly voiced his doubt over traditional theories of the origins of HIV. Most of the conference was devoted to the rising problem of HIV in sub-Saharan Africa, and the inability to pay for effective treatments. Figures recently published by UNAIDS predict that AIDS will cause the early death of as many as half of the teenagers living in the hardest hit countries of southern Africa, causing population imbalances nearly without precedent. The report says that the AIDS epidemic is already measurably eroding economic development, educational attainment and child survival - all key measures of a nation’s health - in much of sub-Saharan Africa. The manufacturers of Nevirapine, a drug shown to reduce the vertical transmission of HIV during birth, used the conference to announce their willingness to donate the drug free to countries in the developing world.

The US has also offered sub-Saharan Africa a $1billion loan programme to buy anti-AIDS drugs. The offer has been condemned by Oxfam as ‘a debt that tomorrow’s AIDS orphans will be forced to pay’. The US offer requires countries to buy drugs manufactured in the United States. Oxfam accused the United States of setting up a deal to help the drug companies to fight off competition from generic drugs that can be manufactured locally at a fraction of the cost (BMJ 2000; 321:72,8 July), (BMJ 2000; 321:193, 22 July), (BMJ 2000; 321:262, 29 July).

The BMA has urged the NHS to make acupuncture more widely available, saying that the vast majority of doctors believe that it works. The BMA is recommending that training is made more widely available. It has also called upon the National Institute for Clinical Excellence to issue guidelines on the use of acupuncture in the health service. Family doctors traditionally have regarded alternative medicine and therapies with scepticism but a BMA survey found that 58% had arranged some sort of complementary or alternative treatment. Of these, acupuncture was the most popular (Telegraph 2000; 26 June).

A recent MORI poll has discovered that three-quarters of the population would be happy to see lottery money spent on the NHS. The poll was commissioned by the BMA as part of its own detailed study of options for long-term sustainable funding of the NHS. Other popular options for increased funding included taking money away from other departments of state. An increase in taxes was only favoured among those in the highest social classes (Telegraph 2000; 7 August).

The first Chinese nurses recruited to ease shortages in the NHS could be at work by the end of the year. The Department of Health has confirmed that worsening shortages have prompted it to turn to China. Four NHS trusts in London, Birmingham and Coventry are involved in negotiations. This move is part of a short-term solution to fill the estimated 15,000 nursing vacancies until enough nurses can be trained in the UK to meet needs (Telegraph 2000; 7 August).

The row sparked when Jill Baker, a 67-year-old patient with stomach cancer discovered a do-not-resuscitate (DNR) order on her notes without having been consulted by doctors, has lead to an investigation by the BMA ethics committee. It will look at how some form of compulsory written consent could be obtained in the future before any DNR orders are made. Many of the speakers at the BMA national conference in June told of how junior doctors, only months out of training were being ‘cajoled and coerced’ into making DNR orders for hospital patients contrary to national guidelines.

In a separate study performed at the Imperial College School of Medicine, it was found that although at first many elderly did not know about the existence of living wills, once made aware, seven out of ten elderly people wanted to let doctors know their wishes in the event of a terminal illness. The first study of its kind in Britain found that most patients over 66 want to relieve doctors and families of the burden of having to decide whether to prolong their life. Most would refuse life prolonging treatment once they were bedridden and suffering advanced dementia (Telegraph 2000; 16 June), (Telegraph 2000; 28 June), (BMJ 2000; 320:1618-1619, 17 June).

A preliminary murder investigation has been opened into the deaths of more than 20 elderly patients in a clinic in Saclay, south-west of Paris, after staff complained that they had been forced to carry out euthanasia. Police raided the clinic to investigate suspicious deaths of patients in the past five years (Times 2000; 10 July).

The execution of Gary Graham in Texas, who went to his death calling on American blacks to avenge his ‘lynching’ by any means possible, has placed the death penalty on the political agenda at a crucial moment in American politics. The timing of this death in the run up to the US presidential elections in November, has allowed opponents of capital punishment to have their voices heard. Support for it in public opinion polls has fallen in the past six years. Opponents of the death penalty say that it is ‘collapsing under the weight of its own mistakes’, with two-thirds of those sentenced to execution winning reprieves because of legal errors (Telegraph 2000; 13 June), (Telegraph 2000; 25 June).

If you have ever been told that you will only ever get anywhere with hard work and determination, smile politely and ignore whoever told you. A Jobcentre manager deemed the words ‘hardworking and enthusiastic’ too discriminatory for a recruitment advertisement. They were included in an advert for a trainee manager submitted to a Jobcentre office in Aldridge, Staffordshire. The Jobcentre manager said such words were forbidden from any advertised position, as they were ‘too subjective’ and breached the Disability Discrimination Act, 1999. He was unavailable for comment, as he was on holiday (Telegraph 2000; 7 June).