Those who argue against the use of IVF are seen, at times naively and at others disingenuously, as being against the creation of children where none could otherwise be created. That is why the Commissioner for Children drew such opprobrium with her remarks on the matter. Yet it is a lot more complicated than this, and instead of dismissing her as a fundamentalist who wants to prevent the childless from having children, we should push her less worthy remarks aside and look at her arguments properly. The fact that somebody may have been clumsy or tactless in making a case does not invalidate the case itself. Only the lack of soundness of the argument itself can do that.

So what was it that Sonia Camilleri said? She said that fertilization outside the womb should be prevented, because there is evidence that babies conceived this way are less healthy than those conceived through straightforward sex, and that there is a higher mortality rate among them. This is where I disagree with her, but it is not because I think that she ‘wants to stop people having children’ or because she is ‘fundamentalist’, which are the irate comments I have heard ad nauseam at virtually every social gathering I have been to since her comments were reported. I disagree with her because her logic is flawed, and consequently, her argument does not withstand close examination. This is how she worked it out. Babies conceived through IVF are likely to be unhealthy; the deliberate conception of high-risk babies is wrong; ergo, we should prevent conception through IVF. Where it all comes undone is here: that the deliberate conception of high-risk babies is wrong. That doesn’t form the basis of an argument against IVF; it forms the basis of an argument for a eugenics programme, as it has in fact done during less enlightened periods of recent history.

* * * * *

The Commissioner for Children is entirely genuine. Of that, I have no doubt. She would not have made the link between the case that she put forward, and the case put forward by past promulgators of eugenics, who claimed that the mentally and physically deficient should be prevented from reproducing because they would only bring other mentally and physically deficient people into the world. She would be horrified at the suggestion that there is any commonality between her arguments and theirs, because her motives are so different. But motives are by the by if the results are the same. You cannot prevent people from conceiving children on the grounds that the children may have serious mental or physical deficiencies. The fact that conception is through IVF rather than through straightforward sex does not affect this established principle of human rights.

* * * * *

The Commissioner for Children is certainly more genuine and honest in her opinions that many of the others who have held forth about this subject – including one or two whose business revenue forecasts are dependent on a scenario in which IVF continues apace and with absolutely no regulation, as has been happening for the past two decades or so in Malta. I qualify the arguments of these individuals, and their demands for Sonia Camilleri’s resignation, with their need to keep well-plumped-up the bottom-line on their balance sheet. When these people are interviewed about IVF, it should be about the business angle, and not about the moral aspects. You cannot speak about the morality of something from which you are deriving a great deal of revenue. You are obviously going to say that it is a good thing, and that it shouldn’t even be regulated (so that you can carry on doing what you like), let alone banned (which would stem your revenue flow).

* * * * *

IVF cannot be considered, as the Commissioner for Children appears to have done, in the same way as a drug like Thalidomide, the pregnancy morning-sickness medicinal that caused many babies of my generation to be born with physical deformities like missing limbs. It was banned soon after. IVF is not an agent that disturbs the development of an extant foetus in the womb. It is a method of conception. We can no more argue for the prevention of this kind of conception, on the grounds that children may be born ill or deformed, than we can argue against conception through straightforward sex in a woman who is a carrier for haemophilia, on the grounds that there is a high risk that she might have a son and not a daughter, and that son will be a haemophiliac.

The same applies to her argument that conception through IVF should be prevented because babies born this way are probably at a higher risk of cancer than babies conceived through sexual intercourse. Given that there

are near-conclusive indications for a genetic predisposition to cancer (the absence of a gene that guards against cancer, rather

than the presence of a gene that causes it) – particularly breast cancer – if we accept Mrs

Camilleri’s argument, than we must also extend it to cover the prevention of conception by whatever means among those with a family history of cancer, on the grounds that their children are at considerable risk of developing the disease.

* * * * *

Human rights considerations do not allow the state to prevent or ban conception on the grounds that the resulting children may be somehow deficient. They do not allow the banning or prevention of conception on any grounds at all, which is why totalitarian China’s ‘one child per family’ policy is unacceptable to Western democracies. The State cannot even prevent paedophiles, mad people, drunks, violent psychopaths, murderers, drug traffickers and heroin-addicted women from conceiving, despite the obviously high physical, mental and moral risks to the child. That is now established beyond argument after doubtful periods in the last century when it was up for debate. If you start laying down the law as to who is allowed and who is not allowed to have a baby, on the basis of risks posed to that baby, you are on the slippery slope to hell.

After conception, the legal situation changes, and not only is the State allowed to get involved, in highly developed societies it is actually obliged to do so. The State can decide whether or not the foetus may be killed in the womb (abortion), and whether or not to institute penalties for women who harm the foetus through heavy drinking, smoking, or drug-taking. The situation changes once more after the baby is born. The State then has the power to remove the child from the custody of its parents if it deems that child to be at risk. The State also lays down parental obligations, and castigates the parents who fail to adhere to them.

* * * * *

This does not mean that the IVF clinics in Malta should carry on with what they are doing now, in a completely unregulated environment. As one man pointed out on Bondiplus, there are licences and controls for take-away pizza places in Malta, but not for clinics where embryos are started off. The head doctor of the Special Care Baby Unit at Karin Grech Hospital described, on that same television show, an appalling scenario which his team recently had to handle. His unit went on red alert when a woman was brought in suddenly to deliver severely premature quadruplets. As they were coping with the quads, each of whom weighed 800g, another woman was brought in, also with quads, and just as premature. All hell broke loose. His points were: IVF doctors should not implant more than two embryos in a woman (two is the maximum allowed in Britain), and given that these babies usually end up in the Special Care Baby Unit, the IVF clinics’ ‘clients’ should be staggered so as not to cause the kind of pandemonium that breaks out when the SCBU finds itself with several stricken babies admitted concurrently. He also remarked that the IVF doctors should behave responsibly, and consult with the SCBU, besides alerting them to the possibility that some time in the next month there might be two lots of 800g quads to cope with.

* * * * *

It is true that there is a higher incidence of general health shortcomings in babies born through IVF, but as Dr Donald Felice pointed out on television and in print, this is in all probability not due to IVF at all, but to genetic deficiency. Those who have trouble conceiving (laying aside the obvious factors of age, a low sperm count, or damage to the reproductive system of the woman) usually cannot do so because of these ‘weak genes’. In other words, the chances are that even if they were to conceive their children through straightforward sex, the child would have health problems. Making conception difficult or impossible in carriers of such genes is nature’s way of controlling their proliferation. Even if there is conception, the deficient foetus usually aborts naturally – what we call a miscarriage. But nature doesn’t always work. Deficient foetuses are not always aborted naturally; conception is not always prevented in those with ‘weaker genes’, and sometimes, those with the weaker genes that nature doesn’t want reproduced can have children who are healthy.

* * * * *

The fact remains that it is not

up to the authorities to decide whether or not individuals should take the risk of bringing an unhealthy child into the world. That decision rests solely with

the individuals themselves. Plenty of people who are actual or potential carriers of congenital disease or disorders, or who come from families with a genetic predisposition to mental unsoundness, decide not to take the risk of having a child. Sometimes it is because they think it would be unfair to the child; sometimes it is because they feel they would not be able to cope; usually it is a mixture of both sentiments. But if people with deficient genes want to reproduce themselves, if people want to cheat nature by using IVF and risk having a child who dies in the womb or soon after birth, if women over 40 want to have a child despite the sky-

high risk to the baby and the mother, if those with congenital deformities want to have a child, then no one can prevent them from doing so. That has been established. We may disapprove of how people set about having a child, we may frown upon their readiness to take the risk of passing on congenital problems, but that does not mean that we can prevent them from having children.

* * * * *

The state cannot take upon itself the responsibility of preventing genetically weak babies from being brought into the world. It can – and should – only ensure that those babies are properly cared for.