Update on Life Issues - February 2007

The Morning-After Pill
You must remember the hype.  The morning-after pill was going to reduce conception rates and therefore abortions, especially among teenagers.   The government certainly believed the propaganda.  It has banked on the MAP to help reach its target of halving teenage pregnancies by 2010.  The government believed that increased access and greater usage were the keys.  First, it allowed the MAP to be prescribed by doctors.  Second, to be sold over-the-counter.  Third, to be sold VAT-free.  Fourth, to be dished out for free at schools.

Two recent articles have seriously challenged this strategy.  The first came in the September 2006 issue of the British Medical Journal in an editorial entitled, ‘Emergency contraception: Is it worth all the fuss?’  Its author was Professor Anna Glasier, director of family planning at the Lothian Primary Care NHS Trust.  She concluded that making the MAP more readily available meant that, not surprisingly, more women have used it, but, perhaps surprisingly, that policy alone has had little overall effect –‘It [the MAP] is not a useful public health measure for reducing abortion rates.’  She contended that abortion rates are still rising, even though the MAP has been available from chemists for five years.  In 1984, 11 women per 1,000 aged 15 to 44 had abortions, compared with 17.8 in 2004.  The government responded by saying that the MAP was not targeted at cutting abortions. She retorted that it was.  Glasier further explained that the failure of the MAP strategy was because women did not always use it at the right time because they were unaware they had put themselves at risk of conceiving.  And as a result, the MAP has had no positive impact on either pregnancy or abortion rates.

The second article, entitled, ‘Population Effect of Increased Access to Emergency Contraceptive Pills: A Systematic Review’ appeared in the January 2007 issue of the Journal of Obstetrics & Gynecology.  The authors, Elizabeth Raymond and James Trussell, who have been keen advocates of the MAP, surveyed a series of studies from ten countries.  They concluded that the MAP, ‘… is unlikely to produce a major reduction in unintended pregnancy rates no matter how often women use it’ and that ‘… previous expectations that improved access could produce a direct, substantial impact on a population level may have been overly optimistic.’  Furthermore, Raymond and Trussell questioned the MAP’s effectiveness by stating that, ‘… the published efficacy figures calculated from currently available data on this regimen ... may overstate actual efficacy, possibly quite substantially.’  Oh dear – time for the government to think again.

Each month in the UK, more than 100 teenagers are having second abortions.  Could it be that the government’s policy to increase access to the MAP and to provide yet more sex education actually encourages teenagers to have sex?

Almost 28,000 girls under 18 had abortions last year.  A total of 1,316 girls under 18 had a second abortion, and 90 underwent a third.  And can you believe that at least one had six terminations?  Yes, think about the logistics of that.  In the 18-to-24 age group, out of a total of just over 74,000 aborted women, 16,674 had had a second abortion, and 3,060 were on their third.

Look – the media and the trendsetters have combined to debase sex.  Now sexual intercourse is typically regarded as merely a recreational activity – it has got precious little to do with deep human emotions within marriage.  Parents, whose traditional role has been to protect children from adversity and peer pressure, have been sidelined.  The government has relentlessly given greater access to contraceptives, the MAP and abortion, plus more and more explicit sex education.

So, did anyone ever think the outcome might be any different?  Girls are now entirely ‘available’.  Condoms, the MAP, abortions – what an impregnable array to reduce teenage pregnancy. Is it fiddle!

Assisted Reproductive Technologies (ARTs)
Yet another variant of IVF has been announced.  Originally developed by the IVF pioneers of the 1970s, Steptoe and Edwards, it has now been tested in Denmark and is called ‘in vitro maturation’ (IVM).  It involves collecting undeveloped ova and maturing them in the laboratory before fertilising them.  IVM is claimed to produce better success rates than standard IVF, and to be safer and cheaper because it uses less of those high-priced, dangerous ovarian hyperstimulating drugs.  IVF - low success, expensive, unsafe?  Surely not.

And there is now a new type of preimplantation genetic diagnosis (PGD) called preimplantation genetic haplotyping (PGH).  Come on, keep up!  Freddie and Thomas Greenstreet were born at Guy’s Hospital, London in October 2006 after their mother underwent IVF and PGH to screen out any embryos infected with a rare form of cystic fibrosis, from which their 5-year-old sister already suffers.  Their mother Catherine asserted, ‘They are designer babies, but they were designed for the good of mankind.’  PGH screens embryos for the presence of familial disease haplotypes, as opposed to specific mutations.  This means that while PGD identifies the presence or absence of a specific disease-associated mutation in an embryo, PGH can be used where the precise mutation is not known or cannot be identified.  So PGH can scan for the presence of a broader genetic ‘signature’, or haplotype, associated with the familial disease gene region.  For instance, PGD can detect the single most common causative mutation for cystic fibrosis, but PGH can detect many of the less common variants of the disease.

The most successful (and certainly the richest) IVF practitioner in Britain, Dr Mohamed Taranissi, has been in trouble.  He is accused of offering unnecessary treatments and unproven tests, operating a clinic without the required HFEA licence, encouraging multiple births and openly expressing contempt for the HFEA and its procedures.  The BBC’s Panorama programme, the police and the HFEA have all been chasing him.  The conclusion of these investigations is awaited.

Because ARTs are unnatural in both ethics and practice, the outcomes will sometimes be bizarre, even abnormal.  Here are just two.  These aberrations are worth noting because the unnatural has a habit of becoming accepted as natural, and therefore they may alert us to what may soon become more commonplace ethical dilemmas.

Yet another dubious world record has been broken.  Carmela Bousada, a 67-year-old Spaniard gave birth to twins in December 2006 and thereby became the world’s oldest mother.  OK, she had to lie about her age at the Pacific Fertility Centre in Los Angeles.  OK, the HFEA does not think it could happen in the UK.  OK, it involved buying sperm and ova.  OK she had to sell her house to pay for the treatment.  OK, it is unnatural – beyond the normal limits of childbearing.  OK, she is now looking for a younger husband.  OK, the episode will probably shorten her life expectancy.  OK, her family has since turned against her.  OK ….., but is it all OK?

And here is yet another case of posthumous fatherhood, though this time the man did not even have a wife.  This is the story of 20-year-old Keiven Cohn, who was killed by sniper fire in Gaza in 2002.  His distraught mother, Rachel Cohn, who probably hoped one day to be a grandmother, talked to her dead son’s photograph and heard him say, ‘Mum, it’s not too late. There is something you can take from me.’  Then it clicked with her, ‘Your sperm, that’s what you want me to take from you.’  So, for the last four years, she has been making the necessary arrangements – sperm frozen, court battles won, surrogate mother found, contract stating her only responsibility is to be a grandmother.  Is that weird, or what?

Stem Cell Therapies
The stem cell debate, adult versus embryonic, has a new component – amniotic fluid-derived stem cells (AFS cells).  In the January 2007 issue of Nature Biotechnology, researchers from the Wake Forest University School of Medicine at Winston-Salem, North Carolina, led by Dr Anthony Atala, claim that AFS cells, which are derived from amniotic fluid or placentas, possess all the advantages of embryonic stem cells (ESC), such as plasticity and self-replication, but not the propensity that ESC have to create tumours.  The team believes these newly-discovered stem cells may represent an intermediate developmental stage between embryonic and adult stem cells.

In laboratory experiments, Dr Atala and his research team have, ‘… shown the [AFS] cells can grow into nerve, blood vessels, liver cells, cartilage, bone and cardiac muscle.’  And, of course, the use of AFS cells does not require the destruction of human embryos.  This looks like good news.  And it could set off a boom in stem cell preservation facilities.  Certainly, that entrepreneurially-spirited Richard Branson is hoping so because he has just announced the opening of his Virgin Health Bank, a service for storing stem cells derived from umbilical cords.  Apparently, its storage costs will be about £1500.

Governments and scientists around the world continue to put their trust in the potential of embryo-destructive research, especially that related to stem cells.  Meanwhile, stem cells derived from adult sources, and now amniotic fluid, are moving closer and closer towards effective therapies.  The latest ‘score’ for stem cell research treatments, [from www.stemcellresearch.org], is Adult 72 : Embryonic 0.

Goodbye, President Bush?
Politicians come and go – well, some just hang around for too long.  Certainly, George Bush now appears to have lost his bioethical oomph.  The US Senate and the House have recently come under the control of pro-choice Democrats.  With that move, the opportunities to implement pro-life legislation have been greatly diminished.  Sure, Bush has accomplished some good on the pro-life front, in both appointments and legal implementation.  And he does still retain the presidential veto.  But he has also disappointed.  The high hopes of recent years have undoubtedly receded.  The lesson – ‘It is better to take refuge in the LORD than to trust in man [Psalm 118:8].

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