This, for clear moral reasons. Sometimes, as with the sale of organs, the consequential issues outweigh the moral issues – it is always the worse off and poor countries which will resort to such sales. In the case of IVF there are clear consequential issues but the main objection has been a clear moral imperative put down by the Catholic Church that IVF introduces third parties in the creation of an embryo in the lab. However, for a secular government there have been other consequential moral issues to reckon with which, if not resolved, can in themselves outweigh the good IVF is seen to bring to many couples.

Many of the consequential issues – such as the use for gay couples, single parents etc. – although having a claim by the respected parties, seem to go against the normative values which parliament upholds. Others, such as the moderate freezing of embryos and the burden which multiple pregnancies put on our services are still at large.

Although in principle I am against the freezing of embryos as I see it as an insult to the developing embryo, and have joined the pressure group against embryo freezing, I had offered a compromise that the government should, if it contemplated freezing, guarantee a limited time and number, after which it would take custody. This was the lesser of evils, as it were, at the time. We have to remember that although many see the early embryo as merely a clump of cells, we were all an early clump of cells and if we have moral value now, we had it then too.

The developments which saw the Health Minister pronouncing himself against freezing will clearly put a stop to the contemplation which had been put forward by the parliamentary committee. Moreover the freezing of ova is clearly a mechanism which offers a reasonable possibility and is bound to develop even further, putting a stop once and for all to any contemplation of freezing a developing embryo.

But we also witnessed another issue which people seem to ignore, but which can cost lives notwithstanding. It calls into question many of our practices and any law should contemplate this. The Special Care Baby Unit (SCBU) – the children’s ITU – was overwhelmed with several couples giving birth to triplets and quadruplets at the same time. This is not a quirk, as it has happened before and has caused its chief, Dr Paul Soler, to speak several times.

Now ironically multiple births can be regulated if one puts a limit on how many fertilised eggs one puts into the womb of the mother during an IVF process. It does not limit multiple births in that procedure which does not involve IVF, and which therefore is not seen to provide any moral issues and indeed which the Catholic Church sees as licit, as it does not interfere with the conjugal act. It is that process where the ovaries of infertile women are stimulated with a drug and which cause her to release several eggs at once. It often happens that with millions of sperm in her tube, all of these can get fertilised. When conditions are good, they will all implant. We have seen the televised series of one woman having six children at one go. But triplets and quadruplets are very common indeed.

When these turn in at an emergency unit at once, lives are put into danger. Even though one can make an approximate prediction, and perhaps be prepared with more equipment and staff, it still causes extra expense. The question raised is who should pay for this service. If this were a treatment being given at hospital then one can reasonably say that the hospital should be prepared for the eventualities. But is it right that when these services are offered privately, costing the couple a considerable amount of money, and of course producing considerable profits as well, the tax payer should shoulder this expense? Perhaps should couples incur this cost? Perhaps the private sector should provide the service as well? Perhaps they can pay the hospital?

One can argue that if this be the case then anyone seeing an obstetrician privately does not have a right to free hospital delivery. But these are the packages which the government offers. In fact the private obstetricians and GPs relieve the government services. Not so with IVF where the stakes are higher. It is true that this would increase even further the expense for couples; but the question remains whether it is fair that the extraordinary nature of having an emergency service put into another state of adventure which it is not meant to cater for, puts other babies into danger.

The private sector does indeed relieve the services of the government, as private schools relieve the education sector. But there is a limit to this relationship and clearly a symbiotic relationship has here turned into a rather parasitic one.

Pierre Mallia is Associate Professor in Family Medicine, Patients’ Rights and Bioethics at the University of Malta; he is also Ethics Advisor to the Medical Council of Malta. He is also former president of the Malta College of Family Doctors.