MILE-HIGH DRUDGE
Thank you for writing "Is there a doctor on board?" (Sept 30, 2007, Vol 4, No 16) and bringing a not-so-uncommon occurrence to the attention of others. I commend Dr Coopersmith for his intended actions and wish to share my own experience on an Air Canada flight�from Toronto to Rome about two years ago.�

My wife and I were starting a holiday in Italy and had the pleasure of sitting in the front cabin of the airplane, intending fully to grab some sleep before arrival. About three hours into the flight, I was shaken awake by the purser and asked if I was a medical doctor and if I could help with a passenger who was feeling unwell and faint.

The middle-aged woman had apparently taken two sleeping pills, had more than two glasses of wine and two or three drinks of hard liquor. Her pulse was about 200/min and she had mild chest pain and was quite diaphoretic. I asked for some oxygen which I had to administer and also asked if the staff could get the medical kit. Fortunately for me and the patient, she stabilized on the oxygen. The purser told me that the key to the medical kit was not on board and that the only way he could get at the kit was to chop through the closet wall. This man didn't look like a handyman-type and I feared more for his ability (or inability) to use an axe than for the actual medical kit.

The patient settled down but did require oxygen for most of the remainder of the journey and of course I missed my dinner and sat next to her with the O2. So much for the luxury of a wide seat and much needed sleep. Rather, I felt like an employee for Air Canada, for which they gave me a lousy 10,000 Aeroplan points, as was given to Dr Coopersmith.

The lesson perhaps for all of us is that we should inform the airlines that they will be receiving an invoice for our services before we actually attend to the passenger. If they don't want to pay, they can make a decision to divert the aircraft to the nearest airport (which will cost them thousands of dollars).

Dr Robert J Schemmer, Victoria, BC

DESIGNER ETHICS
Your reporter John Stobo made a very serious error in "Reporter at large: Medical ethicists pilloried at IVF conference" (October 15, 2007, Vol 4, No 17) by stating that I "reached the conclusion that IVF, by its very nature, violates a child's fundamental rights." It's bad reporting such as this that leads to bad ethics.

The cases where I was arguing IVF is ethically unacceptable from the standpoint of respect for the fundamental human rights were not those when it is used to "repair nature when it fails," but rather those where the gametes have been genetically manipulated ("designer children"), or made from an adult stem cell, or an embryo is cloned or made from two ova or two sperm to enable same-sex couples to have their own shared genetic baby.

The basic principle I use to ethically assess these expanded IVF possibilities is that the most fundamental human right of all is every person's right to come into existence with natural, untampered-with human origins.

Margaret Somerville, McGill Centre for Medicine, Ethics and Law, Montreal, QC