Hysteria is no basis for law

Ongoing assisted fertility debate is ignoring need for IVF law that reflects standards of modern science

The ongoing debate on assisted fertility has been upstaged by emotive displays of public concern – mostly genuine, but in some cases clearly politically motivated – and is therefore increasingly ignoring the main objectives of this bill: i.e., the need for an IVF law that reflects the standards of modern science.

This is not something that can be decided by mass hysteria, or on the basis of unrelated issues such as abortion. Still less can it be subject to convictions, to be enforced by some kind of ‘morality’ police.

It fell to a noted obstetrician to make the argument in a newspaper article: but infertility is a health issue, not a popular front for social conservatism. It should be regulated in the same way as other health issues:  where ethical questions arise, these should be addressed through legislation... but the primary objective should always be the provision of treatment for patients, and for the improvement of public health as a whole.

From this perspective, opponents to the bill in Parliament would be advised to tread with caution. One can understand the widespread social concern regarding embryo-freezing and especially surrogacy – which, by definition, would require substantive changes to our understanding of the broader term, ‘family’. But to extend such concerns to opposition of IVF in its totality, is to (almost literally) throw the baby out with the bathwater.

It is all too easy to overlook the very real tribulations of couples requiring this technology, in our haste to make moral political capital out of every new development. Campaigners in general – but politicians in particular – should also be mindful that we are talking about a very sensitive topic which has serious ramifications for people’s personal lives.

It is also an important piece of legislation in its own right. For the first time in Maltese history, a government seems prepared to take the bull by the horns, and instead of resting on the facile conservatism of the moral majority, is proposing a normal IVF process for childless couples, along the same lines as offered in many European health services.

Let us not forget, too, the long and often tortuous road that led us to this debate. Back in 2009, a select committee of MPs had debated medically assisted procreation: the MPs included doctors from both sides of the House, who spoke to various experts in the field. Their final recommendation in 2010, to allow a limited form of embryo freezing, was not taken on board by the health minister. Instead, the egg vitrification system was introduced in 2012; but this system has not been delivering the efficient results yielded by embryo freezing.

Latest statistics show that the current pregnancy rate is low – 20.33% from fresh oocytes cycles: that is, where the freshly-harvested egg was successfully fertilised; and only 12.33% where cryopreserved oocytes are used. The take-home baby rate for Malta in 2017 was just 17%.

Science has an answer to these problems, though it may not be to everyone’s satisfaction. Here, it must be stressed that the emotive language used in this debate has distorted the playing field beyond recognition. Using words like ‘baby’ and ‘child’ to describe a newly-conceived human embryo is not only scientifically inaccurate; it also drags in a host of other issues that have no real place in this debate.

Nonetheless, ethical issues do arise from embryo-freezing: and it is up to the couples who want to benefit of this system to bear any such moral responsibility for the embryos that are generated. But on this front, this newspaper notes that the government is now proposing a procedural band-aid by creating an adoption process for unwanted embryos... because the practice of disposing frozen embryos is, for obvious reasons, off the cards.

One can understand the intention, but the approach is flawed on two counts. First, the ultimate aim of this legislation is to create a functional framework for the provision of IVF treatment... not to placate popular concerns with a sop to the moral majority.

Secondly, it transfers the onus of responsibility from the parents to the State. Ultimately, parents should be made to pay for the prolonged cryopreservation of embryos beyond a stage where their thawing would not even allow these embryos to be successfully implanted. At least, this would create a relationship between the biological production of the embryos and their continued existence... instead of carelessly delegating that responsibility to the State as curator.

Separately, it is regrettable that the full gamut of judicious pre-genetic diagnosis (PGD) science, to be applied on a case-by-case basis with regards to inherited neurodegenerative diseases, has not been introduced in the new bill. Sold carelessly as an abusive ‘baby shopping’ science, PGD testing could have further alleviated the silent suffering of countless families dealing with the stigma of rare diseases which they don’t want passed on to new generations.

Applied to any other sphere, the reasoning becomes instantly illogical. Cars kill people on the road; but that is not a reason to ban motorised traffic. It is, in fact, to limit this possibility that we draw up traffic regulations. The same principle applies (or should apply) to IVF.

Such illogicality is however to be expected, if we base our approach to science on mass hysteria.