Prisoners of conscience

Last week Justice Minister Chris Said presented an eagerly anticipated bill for a law to regulate assisted fertility therapy, including the 'in vitro fertilisation' technique (IVF), under the revealing title: 'Protection of Embryos Bill'.

On Saturday the Prime Minister described this initiative as "one of the most important bills discussed and tabled in this legislature": a rather strange thing for him to say, considering that the same law has been in the pipeline since his first term in office... and yet unaccountably took almost 10 years to see the light of day.

Since then, the parliamentary discussion on the subject has been consistently sidetracked and derailed: with no fewer than three parliamentary groups set up to discuss the issue (one in particular to fill in the gaps after preceding efforts failed to reach agreements on a number of cardinal points).

From this perspective the government's timing appears questionable. If Gonzi himself feels this bill is the 'most important' of his legislature - why take so long to draw it up? Could it be that the law suddenly became a priority only after the Opposition leader Joseph Muscat declared last month that "a law to regulate IVF" would be the first bill presented under a new Labour government... thus providing government with an opportunity to sweep the carpet from under his feet, and rob the Opposition of an electoral platform?

Either way, now that the bill is finally on the table, it may be worth remembering the cause of so many delays in the first place. Initially the discussion was aborted (so to speak) after objections by then President Eddie Fenech Adami, who reportedly voiced concerns in private about a 'crisis of conscience' - thereby de facto postponing matters until after his Presidency.

It is not altogether surprising that Fenech Adami, and others within the establishment, would be reluctant to approve a law which runs directly counter to Catholic teaching on the subject of human life.

The Church has in fact denounced IVF on moral grounds for decades. And as if on cue, the local Bishops issued a pastoral letter last Wednesday - the day before the bill was presented - in which they described IVF as a 'threat to life', and urged Catholic politicians to plumb their conscience before legislating on the issue.

Given that the committees and sub-committees discussing the matter have traditionally been very close to the Church (one was even chaired by a member of Opus Dei), and that the public hearings were heavily weighted in favour of theological arguments throughout, it is hardly surprising that Parliament would approach the issue with extreme caution bordering on paranoia.

Ten years after the first indication of a law to regulate IVF, we finally have a bill before Parliament - and it is clear from even a cursory glance that much of the thinking that went into it was infinitely more concerned with assuaging the troubled conscience of certain politicians, than with addressing the medical concerns of persons suffering from infertility.

In its present form, the law to regulate IVF would preclude the freezing of embryos in all but emergency scenarios, and instead promulgate the prototypical technique of oocyte (egg) freezing. Furthermore the treatment would be offered only to married couple, or couples in 'stable relationships' - and the law envisages an Authority for the Protection of the Embryo to determine precisely who is and is not eligible for the service.

Already the embryonic law has been pilloried by (among others) the Malta Gay Rights Movement for being discriminatory towards gay couples. But the most revealing criticism came from Dr Josie Muscat, who is to date the only medical professional to have provided the service for the past 25 years.

According to Muscat, setting an implantation limit of only two fertilised embryos, in conjunction with a blanket ban on embryo freezing, will render the therapy ineffective to the point that couples will have to go abroad to seek treatment elsewhere.

In the absence of embryo freezing, success in IVF depends largely on multiple implantations. Standard practice in countries where freezing is permitted is to implant fewer embryos than are actually fertilised, and freeze the surplus for future use if the implanted embryos fail to gestate. Remove freezing from the equation, and one is faced either with the prospect of implanting numerous fertilised embryos in the hope that at least one will be successful - a process which incurs the dangerous possibility of multiple births - or else resign oneself to greatly lowered success rates, which would drive patients to seek treatment in countries with more liberal IVF laws.

Oocyte freezing admittedly sidesteps the moral issue, but is in turn characterised by considerably lower success rates, at much higher cost - estimated at as much as 10 times the cost of ordinary IVF.

At this point, it may be worth asking ourselves a vey simple question. How much more public funds are we willing to spend, and how much more procrastination are we willing to endure, to ensure that the conscience of some of our MPs is assuaged?