Rachel Attard speaks to Health Minister Chris Fearne about the new amendments to the IVF law, which have raised no small amount of controversy. Fearne was interviewed for The Malta Independent’s online interview programme INDEPTH
The original IVF law was passed by Parliament in 2012 and came into effect in 2013. Why did you feel the need to propose a set of amendments?
Before 2012, previous governments had not tackled the issue and what we had was non-regularised IVF. As a paediatric surgeon, I used to see cases where a mother gave birth to four children – to the detriment of both the mother’s and the children’s health. I still remember operating on IVF babies that had a lot of complications. When Lawrence Gonzi’s government decided to pass the first IVF law, it was a very important step and then, later, the Labour Government created the standards, the medical facilities and we started giving IVF treatment from Mater Dei and now we have more than 100 new lives. This law is six years old and medicine is constantly changing.
Do you have the backing of both the Cabinet and the Parliamentary Group?
Yes both of them. They are unanimously in favour of these changes.
Let us say that there is an unscrupulous doctor who decides to experiment on an embryo. How are you going to ensure that this does not happen?
The law was introduced in 2012 and with these amendments we are proposing this will still be against the law. Research on embryos was and will remain illegal. Also, harsh penalties will be given to any doctor caught experimenting on an embryo. We believe in life, and our main intention is to protect the embryo. Also the Embryo Protection Authority is there to make sure that the embryo – and the entire process – is monitored. Audits, and a number of protocols, are established and if these are not followed the doctor and the premises that facilitate the procedure will be penalised.
You said that with these amendments a single woman is eligible to make use of IVF procedure. What about single men?
Yes, single men also have the right. Single men looking to have a child will have two options: they could be given an ovum and use their own sperm and choice of a female relative to carry the baby; or, if sterile or if their sperm cannot be used for some other reason, he could adopt an embryo and chose a female relative to carry the baby for him.
One thing that we are proposing is the introduction of gametes. At present, if one of the people in that relationship is infertile, he or she has no option but to adopt a child. What we are proposing is that a sperm or an ovum can be donated in an anonymous way so that they will be implanted in the woman’s womb. We are also saying that women can continue to receive treatment up to the age of 48.
Up to now women who turned 44 have been refused treatment. This means that these women are eligible to eggs that belong to younger women. On the other hand, if a woman has medical problems in her womb, she has the right to choose a family member that is ready to carry that child for her. We are calling this ‘altruistic surrogacy’.
With these amendments, do you not think that the government is breaking down the concept of a family?
Nowadays, the concept of a family is not the traditional one of a mother, a father and children. Today, we have different forms of families; we have single mothers and single fathers who ended up in this way because of a particular situation in life but we have other women who are single by choice. Science and research show that kids raised by women who are single by choice are as good as that raised by the traditional form of a family.
Current legislation already allows the storage of sperm and ova from couples that are doing IVF. With these amendments will you be opening the sperm banks and ova banks for any donor to donate sperm and ova?
Yes. Till today you can save your sperm or ovum at the bank either because one is going through IVF treatment, or chemo therapy or other medical conditions. Now if this bill goes through an individual can come and donate and that donation will be registered. The donor is eligible to do this once and he will be financially compensated.
Can a couple or an individual decide to not freeze the third embryo?
The present law says that the doctor, in consultation with the parents, can implant a maximum of three embryos. Sometimes this situation resulted in a woman have multiple pregnancy, which means she would have twins or triplets. What we are proposing now is that the doctor will implant two and freeze the third embryo. The probability is that the third embryo will be used by the parents in the cycle. However, if the parents decide not to use the third embryo, they cannot keep it frozen forever because we believe that every embryo has the right to develop. So it will automatically go for adoption and will be under the protection of the Embryo Protection Authority. Another option that this bill is proposing is that the parents will tell the doctor that they only want to fertilise and subsequently implant two embryos. This means that the couple can decide not to have a third embryo frozen.
The bill is proposing that the embryo that will not be used by the biological parents, for various reasons, can be put up for adoption. Does this not mean that, in their quest to have children, prospective parents are allowed to create embryos and then divest themselves of all responsibility towards them?
From the moment that an embryo is given up for adoption, the biological parents will lose all rights and responsibilities for that embryo. They will also lose all rights once that embryo has been adopted by someone and become a child. The child will have all the rights that other children have.
But will that child have the right to know who his biological parents are?
Yes, when that child turns 16 he or she will have the right to access his or her medical file. If, during childhood, the child develops a medical condition, the adoptive parents (those who gave birth to that child) can access the medical file containing the history of the child’s biological parents.
Could we end up with a situation in which we will have a lot of embryos being frozen with no one making use of them?
No, because we are saying that we can only implant two and freeze the third one and, as things stand, the couple will always go for the next cycle so with this proposal we will give them the opportunity to use the frozen embryo. We are also saying that women aged between 43 and 48 can have embryos implanted but cannot use their own eggs. This will mean that the woman needs to adopt a frozen embryo. The bill is also saying that if the Embryo Protection Authority notices that there are more embryos than requests for adoption, it will be able to consider adoption from overseas.
The bill is saying that if an embryo developed a form of disability we still implant that embryo and let it develop. How will you make sure that the doctor does not discard that embryo?
If his happens it is illegal and there are harsh penalties, including prison. The IVF process is transparent and everything is recorded and filmed.
With these amendments, are we not opening the door for abortion?
Absolutely not. As a government, we made it clear that we are against abortion. We are also saying that all frozen embryos need to be developed. We are in favour of life and what we are doing is giving an opportunity for more children to be born. What we are doing is giving an opportunity to those who want to become parents. This is not a run-of-the-mill act. It concerns one of the most powerful forces in human nature, the will to procreate and have a family. If science can help these individuals, we should not stop them. Maltese doctors have told me that almost 20 per cent of Maltese couples have infertility problems.
Up to now, surrogacy has been illegal. With this new bill, you are saying that altruistic surrogacy is accepted and what will remain illegal is if that woman receives payment. You also said that you will open up the subject for public consultation. If your mind is already made up to introduce it, why are you having a consultation?
What we are saying is that, in the coming days we will publish a White Paper about altruistic surrogacy and all the stakeholders will give us their thoughts and feedback. My personal view is that surrogacy for commercial reasons should remain illegal but altruistic surrogacy by members of the family should not remain illegal. For me, an act of love should not be considered a crime any more.
If a woman wants to have the sperm of a particular man instead of an anonymous donor, does that man have any legal rights regarding the child?
No, because the woman is only using him as a donor and, before his sperm is taken, he will sign a contract saying that he will have no legal rights or responsibilities for that child. If the man wishes to have rights regarding the embryo, he should be in a relationship with the woman in question.