Need of compassion and understanding

Comments made some time ago by the Commissioner for Children on in vitro fertilisation sparked off a controversy. I, too, would like to add my voice to the debate that ensued.

If you belong to that category of families who after years of desperately trying to get pregnant, and after having tried everything under the sun to achieve this, yet fail, what are you to do? Use "natural methods", says Sonia Camilleri, Commissioner for Children. Just as if you wish to be tall and slim, but were not, you had to accept that fact. This sort of trivial argumentation characterises her responses on being questioned on the issue of IVF.

She seems to think of abortion and IVF in the same framework. She is amazed that the Maltese public is overwhelmingly against the former but in favour of the latter. How can one seriously compare a crime like abortion with a therapeutic procedure aimed at procuring life?

Obviously, she is worried by the number of frozen embryos which do indeed create an ethical issue. But this is not an insuperable problem. Where freezing of embryos are allowed by law, and where, as in the UK, the law stipulates that frozen embryos must be discarded after a period of time (say, five years) there is the inevitable outcome of having embryos to be discarded.

However, this is not an inevitable outcome of IVF. Fertilisation of a smaller number of ova in vitro, while more burdensome on the mother, would obviate such a problem. One need not risk the death of embryos in order to have children, as she seems to think.

The commissioner is not impressed, it seems, with the 68,000 children born world-wide resulting from this technique over the past 24 years, bringing joy to as many families who would otherwise remain barren. She concentrates on the problems associated with the procedure, including the fact that only one in 25 embryos transplanted will survive till birth. Instead of interpreting this fact as an indication for further research, she seems to think that the solution is to outlaw the procedure.

There is also no doubt that IVF children may suffer complications, including visual and aural problems, low birth weight, cerebral palsy and so on. But does this burden out-balances the positive results obtained in the vast majority of infants who achieve a satisfactory life?

Would we outlaw pregnancy in all those couples who may be carrying a genetic disorder, including thalassaemia, haemophilia, breast cancer or a tendency to diabetes or high blood pressure with their dependence on medication throughout a significant stretch of adult life and where, indeed, the chances of an abnormal outcome is actually higher than in the case of IVF?

If Mrs Camilleri would agree with IVF techniques only "if the whole process was healthy and no child was lost" then she would have to ban all pregnancies because such a guarantee cannot be given even in the best of circumstances. A significant number of pregnancies conceived in the "normal" way end up in miscarriage. A not insignificant number of newborn babies have congenital abnormalities, including heart problems.

The infertility problem will indeed stay with us and will, no doubt, become even more significant for a number of reasons, many of them societal in origin. It is also true that IVF does not "cure" infertility and would be required again and again for the production of a successful pregnancy, thus necessitating "resorting to science" to achieve more children.

According to Mrs Camilleri, a woman should just accept the fact that she could not have children and not strive to get pregnant through IVF. How one could prescribe such hard medicine is beyond the capacity of most people to understand. One might as well say that hip-replacement should be banned because it is not a "natural" thing to do.

What "natural methods" or "natural technologies" is she speaking about? She seems to conflate this issue with that of contraception, where again she speaks of "natural methods", which worked for her, she says, and presumably should work for every one else!

The commissioner is reported as saying: "Just as nobody has the right to kill a child, nobody has the right to have a baby at all costs". She should make a distinction between positive and negative rights (following Isaiah Berlin): Negative rights imply that the average citizen expects to live a life without any undue interference from the state. Legislation against IVF would be a glaring example of interference with negative rights of an individual. Comparing the "right" of having a baby with the right to kill is not only confounding but foolish in the extreme.

It is distressing to witness such an exhibition of extreme views, unmodified by any sense of compassion towards those who are desperate to fulfil the basic biological imperative involved in having a family and children.

It is short-sightedness on her part to believe that there are alternative forms of therapy, which she calls "natural methods", that can be used in situations where there is no other acceptable way of achieving a pregnancy. It is above all misleading to indicate that IVF can be achieved only through destruction of frozen embryos: embryos are frozen as a matter of convenience rather than absolute necessity.

I believe it is the function of the state to interfere as little as possible with the life of the average citizen and not promulgate normative legislation affecting the most private aspects of life.

While there is no doubt that the embryo should be protected, one should approach serious problems with a degree of compassion and understanding.

Extreme points of view are often one-sided, poorly thought out and incompatible with a philosophy of life applicable to the majority of citizenry.

Editor's note: This contribution was submitted some time ago but inadvertently was not published earlier. Any inconvenience is regretted.