The Ad Hoc Committee on Human Fertilisation has, after rather long and deliberate considerations, come out in favour of the freezing of human embryos during the process of in vitro fertilisation (IVF). It is good that they finally came to a conclusion, which conclusion is never easy to reach. It is bad that they unfortunately came to the wrong conclusion. The previous 2005 Parliamentary Commission on IVF had reached a different conclusion, as did the Bioethics Consultative Committee. In fact, out of all the people interviewed or written to by the present Parliamentary Committee, the majority are against the freezing of embryos. IVF is fraught with hazards to human life whichever way one looks at it, but considering that in Malta we are told that about 150 couples have recourse to IVF every year, and given that it is an available process for couples who cannot have children and knowing clinically how difficult it is for couples not to have children when they want them, it is only natural that the state should regulate this process in such a way that the best outcome for human life is preserved. IVF in Malta has been carried out unregulated for about 20 years. Of course we can always opt to look the other way or allow couples to travel abroad for the procedure!
A human one-cell zygote is very much a human being like any child or adult human being is. No matter what anybody says, biologically it has the same intrinsic self-moving properties that any human organism has, with a full complement of DNA that remains the same throughout life except for varying epigenetic expression. It is not a living cell of the human organism like a skin or liver cell is, but a single living human organism capable of its own self-development. Therefore, once such a cell or ball of cells exists, natural law teaches us to respect it, as we would have liked others to respect us when we were at that stage of our own physical development. One cannot say that a two-day-old embryo, a 26-week old child in the womb, a 40-year-old woman or an 80-year-old man, are to be treated any differently as regards respect for human life. The dignity that must be shown to a human being is an absolute fundamental right and being absolute cannot be denied under any circumstance and surely not those of any medical efficiency that freezing is supposed to provide to the process of IVF. One cannot hope to produce human life in a laboratory and then go on to treat it like a disposable item! The European Court of Human Rights of Strasbourg has argued in a judgement that the protection of unborn human life need not be given the same type of protection as born human life by European States. However this does not mean that it cannot be extended by any European State that wishes to offer it. Malta offers equal and unarbitrary protection under law to any human life at whatever stage of development and that’s the way it should stay.
This is essentially the wrong turn that the Committee has taken. It has argued that in order to prevent the unlikely but possible occurrence of twins and triplets during the IVF process, embryo transfer should be restricted to one or two embryos at the most so as not to increase perinatal mortality in case there are multiple pregnancies, and to make the IVF process more efficient. The problem is that they have stopped there and not considered the selection of embryos and the high attendant mortality of embryos that goes with the process of freezing. One doctor friend of mine has even reasoned that surely the life of a 26-week-old foetus, which has the faculty of sensation, is worth more than that of a three-day-embryo with no such faculties! This reducing our humanity to a functional rather than ontological personalism and can just as easily be applied to demented old people as much as to human beings who simply happen to be asleep.
The whole issue emanates from the quandary that if human embryo transfer into the womb fails, as it often does, and there are no previously frozen embryos available, then the mother needs to undergo hyperstimulation of the ovaries again to obtain more eggs, which has its attendant woes. However I think the only humane way forward is to allow not more than three embryos to be inserted into the womb (parents may choose to insert less than three following appropriate counselling and more weight needs to be given to information availability and the choices they make) which has a success rate of about 40 to 50 per cent and is the method currently being practised at a fertility clinic here, which to its credit has opted not to freeze. There should be no recourse to embryo freezing as a necessary means of doing IVF if we want to respect human life. There is also a minor problem of who would shoulder the expense of freezing!
Another possible way forward that has now started to be practised in some countries is to allow the freezing of female ova. In this latter case, only one or two fertilised embryos need be transferred into the womb and if this procedure fails, then more ova can be defrosted, fertilised and inserted into the womb. Unfortunately, the success rate with defrosting frozen ova is not yet very good, but it is improving significantly with time.
The freezing of embryos will result not only in a eugenic selection of human beings and a large scale destruction thereof, as has happened in other countries where extranumerary frozen embryos are either poured down a lab sink or given for scientific research. Adoption of embryos is a non-starter and, if opted for, will never compensate for the large numbers of embryos that would eventually accumulate. Unfortunately these embryos/human beings all have one big disability in a modern democracy. They are unable to speak up and they certainly cannot vote. These days those who are disenfranchised have a growing tendency to become increasingly worthless in the eyes of society!
Michael Asciak MD
BIRKIRKARA