Let’s talk – But do not stand in the way
Minister Chris Fearne’s contribution to your newspaper on the imminent changes to the law on IVF, with the title ‘Let’s Talk but respect our principles’, on 21 May, gives rise to further questions that have to be answered with a clear conscience before a final decision is taken by our parliamentarians and eventually by the Head of State.
As I stated elsewhere in one of my contributions on this matter, I am still in favour of a period of reflection long enough for the debate to mature at citizen level, and for expert opinion and advice to be put forward for consideration. Besides, I also believe that it would be useless going into such a period of reflection, with already formed opinions, and entrenched positions from which we know beforehand that whatever arguments are brought forward, we are not prepared to budge. This applies to either side of the debate.
For those who are putting forward the argument that they have a political mandate to fulfil, may I point out that the 2017 Labour Party electoral manifesto speaks only in the widest of terms on this matter, promising only to ‘widen’ and ‘extend’ this service (“inkomplu nwessgħu u nestendu dan is servizz”), without including any details whatsoever.
Dr Fearne says that patients speak on the subject with passion and urgency. I do understand and empathise, especially if they, or their near ones are involved. On the other hand, doctors, however sensitive to the issue, should keep their calm, reflect, weigh the pros and cons, and apply whatever medical knowledge and practice is available, always within specific ethical and moral consideration and parameters. Much as we may wish too, we cannot always meet the aspirations of our patients, for obvious reasons. As physicians, we always do our best to understand and empathise with people who are suffering, physically and emotionally.
There are limits to what we can do: limits imposed by nature itself, and limits imposed by morals and ethics, first among which is the principle enshrined in the Hippocratic Oath of ‘Primum non Nocere’ (First of all, do no harm). We cannot ignore moral issues, otherwise we would soon be cloning humans as we do with the clones of Dolly the sheep.
Dr Fearne writes that “our amendments will be increasing the likelihood of embryos reaching maturity than is the case with the current system.” What my esteemed colleague fails to point out is the increased number of discarded embryos that result from adopting this system.
He states correctly that “a facility like embryo freezing has been introduced in many European countries.” Not in all European countries, and for good reason. Many have been seriously debating the issue for years, and did not rush into certain decisions. But even so, since when have European standards in morality and ethics become our lodestar? Are we also aiming to meet EU standards on abortion, euthanasia, and drug liberalisation?
Much has been said about freezing of embryos, that I am sure the man in the street is justifiably confused. Freezing of an embryo in itself is not ethically, or medically wrong, if, and only if, resorted to only in particular emergency situations. Preferably, it should be avoided, but in certain circumstances (as provide by the present legislation) one will have to resort to it. The process itself is harmful to the embryo and should be avoided as much as possible. The exception in our present legislation does not justify this practice becoming the rule. Freezing as part of the normal process of IVF is objectionable.
It is to be noted that up to now no one has come out to state clearly and without equivocation what will be the eventual fate of those extra embryos that languish for years in deep freeze without being implanted.
I shudder to think of the concept to be introduced in the new law, with frozen embryos becoming the property of the state to be put up for adoption, after years not being used by their biological parents.
Inspired by the overarching concepts of ‘discrimination’ and ‘equality’ the honourable minister points out the inequality created by “those can afford treatment abroad do so and come back to Malta as happy parents. Those who cannot are denied that same right.” This argument, sadly, does not hold water. I have to ask: Will the same argument be brought forwards eventually in the future to justify the procurement of abortion, or legalisation of euthanasia, and consumption of drugs? This is a very slippery slope, down which one should rather avoid going.
We should all join forces in fighting discrimination, however we should first and foremost agree on what we mean when we speak about discrimination, and where we draw the lines.
I appreciate Dr Fearne declaring “we are open to any and all suggestions.” Fine, but how flexible is government going to be? On surrogacy, “we are open to the widest discussion possible,” he said. Does he envisage agreeing on not including surrogacy in the new law? Does he consider standing up to criticism from the LGBTIQ of denying ‘parenthood’ to male same-sex couples if surrogacy is not legalised?
Dr Fearne states: “I have dealt with my conscience.” In all sincerity, knowing Dr Fearne personally for many years, I am sure he has done his discernment. I might not agree with him, but I respect his decision.
My only concern here is whether enough space, time, respect and consideration, has been given to fellow legislators, who after dealing with their own consciences on the matter , may have come to different conclusions from those reached by Dr Fearne.
My able and esteemed colleague Dr Fearne ended his piece with a monitum to those who according to him stand in the way of infertile couples, advising them to deal with their consciences.
I am sure that anyone who has a defined stand on this issue has dealt with his or her conscience, and came to his or her own conclusions. My only concern is lest the rigid position taken on this matter by the honourable minister on behalf of government, has in any way ‘stood in the way’ of fellow members of parliament who have reached a different conscientious position on the matter.