on Life Issues - February 2020
Decriminalisation in Northern Ireland –
the bioethical change
Is this not the worst bioethical news of the century?
Northern Ireland, that great bastion of pro-life sentiment and
deed, has had abortion-on-demand foisted on it by the government
in Westminster. The people of the Province did not request
it, nor did the Stormont government choose it. The sheer
audacity, the democratic disdain, the moral decay, the
destructive outcome, the inescapable sorrow – they all beggar
belief. What have we done?
Perhaps the raw truth is we have done nothing, or at least, not
enough. We have let a few stark, bigoted voices overrule
the truth. Did we object? Did we fight?
Everyone knows that the most enduring human right is the right
to life. It is written on paper for all to read – Article
2 of the European Convention on Human Rights declares,
'Everyone’s right to life shall be protected by law.'
Therefore abortion, the taking of human life, is always legally
and morally wrong, whatever the gestational age.
Now the people of Northern Ireland will suffer like those of us
in Great Britain with the long-term fallout of our wretched 1967
Abortion Act. Yet the law in the Province is set to be
worse because there will be no such restraining law there.
Abortion is to be decriminalised, which means no-one will be
prosecuted, no-one will be refused, abortion will be lawful for
any woman, anywhere, for any (and no) reason, at any gestational
age. Is this not the worst bioethical news of the
century? As we trample on the tiniest of those made in the
image of God, may God forgive us all. 'Righteousness
exalts a nation, but sin is a disgrace to any people' (Proverbs
Decriminalisation in Northern Ireland –
the political process
The abortion policy of the Province has long been a devolved
political issue. In January 2017, the Stormont Assembly
collapsed in a row between Sinn Féin and the Democratic Unionist
Party (DUP). In July 2019, a few extreme pro-abortion MPs
at Westminster seized on this impasse and succeeded in passing
the Northern Ireland (Executive Formation) Bill through its
final stages in the House of Lords and the Commons. That
Bill, which was primarily concerned with budgets and elections,
had been cunningly amended so that sections 58 and 59 of the
1861 Offences Against the Person Act would be repealed.
The ensuing Act set the decriminalisation enactment date for 21
October 2019. Stormont remained stubbornly non-operational
and so, on that day, abortion was automatically decriminalised
across Northern Ireland, that is, abortion was removed from the
criminal law and placed under mere medical regulations.
Furthermore, the 2019 Act necessitated access to abortion to
start by 31 March 2020.
The Act not only insisted that from 22 October abortion was
decriminalised in Northern Ireland, but it also placed a
moratorium on abortion-related criminal prosecutions. As a
bioethical crumb, since 22 October, the abortion of a child
‘capable of being born alive’ remains unlawful, except when the
purpose is to preserve the life of the mother.
In the meantime, on Monday 4 November 2019, the UK government
launched a public consultation on its proposed framework for
abortion in Northern Ireland. It closed on Monday 16
December. The government intends to publish its response
to this consultation and details of the action it will take
within 12 weeks after 16 December. That is, before early
These details of the proposed practice of abortion in Northern
Ireland are now awaited. Will it be unconditional up to 12
or 14 weeks? Or 22 or 24 weeks? Or later under some
circumstances? Will foetal abnormality and risk to the
life of the mother be up to birth? Will the ‘two-doctor
rule’ be abandoned? Will patient-doctor abortion
consultations be conducted over Skype? Will healthcare
workers other than medical practitioners be allowed to procure
abortions? What about protection of those who
conscientiously object to abortion? Whatever, the proposed
changes will certainly not be, as an editorial in the British
Medical Journal declared, ‘Toward healthier abortion …’
How can killing the unborn ever be described as health-giving?
And while the current focus is on Northern Ireland, the momentum
of decriminalisation is expected to spread across to England,
Wales and Scotland. And with such a pro-death ideology
taking hold across the UK, how long before those ugly sisters of
assisted suicide and euthanasia are legalised? Is this not
the worst bioethical news of the century?
It is now reckoned that 1 in 3 UK women will have had an
abortion by the time they are 45 years old. Many will have
found the experience traumatic and will not want to repeat
it. But many do. In fact, during 2018, as many as
172 women had their seventh abortion. This is according to
data obtained by Sky News from the Department of Health for
England and Wales and from NHS Scotland under the 2000 Freedom
of Information Act.
There is worse. Overall, 84,258 repeat abortions were
performed in Britain in 2018. And that included 3,332 on
teenagers. Shockingly, 5 teenagers had suffered their
sixth abortion in 2018. Why? Surely these girls and
women are crying out for help. Surely many of them are in
abusive situations and are coerced into abortion. Why is
no-one asking relevant questions whenever a teenager repeatedly
comes for an abortion? Where are the social workers and
medical staff? Are they deaf and blind? Are they
happy to repeatedly betray the vulnerable?
The Calthorpe Clinic in Edgbaston, Birmingham closed in December
2019. It was the oldest abortion clinic in the UK having
performed terminations for the last 50 years since it opened its
doors in 1969. By 2007 it was the largest single abortion
clinic in the UK performing about 10,000 abortions annually.
This abortion facility had a long history of unethical and
dangerous practices. For example, in November 2000, one of
the abortionists there, Dr Andrew Gbinigie caused horrific
injuries, on his first day at work, to a young woman seeking an
abortion. While performing the operation on the
21-year-old he tore a hole in her womb, removed an ovary, ripped
away part of a kidney and pulled down a piece of her bowel
before questions from the assisting theatre nurse eventually
caused him to realise his catalogue of mistakes. In 2012,
The Daily Telegraph caught one of Calthorpe’s
abortionists, Dr Palaniappan Rajmohan, agreeing to perform an
illegal sex-selection abortion on an unborn baby girl. And
Calthorpe doctors were also found to be illegally pre-signing
abortion consent forms. In the same year the Care Quality
Commission (CQC) inspection report found that the Clinic had not
met the required standard in both ‘staffing’ and ‘quality and
suitability of management’.
Also in 2012, the privately-owned Calthorpe was taken over by
the global abortion provider Marie Stopes International
(MSI). But the problems continued. For instance, in
2016, MSI Birmingham, as it was now known, along with other MSI
centres in the UK, had some of their ‘services’ suspended due to
concerns raised by the CQC. Between March 2018 and
February 2019 there were 18 ‘incidents’ when patients had to be
transferred to a nearby NHS hospital.
News of Calthorpe’s closure came to public attention on 12
December when its manageress came and spoke to one of the prayer
vigil volunteers outside. She handed him a doughnut and
told him that the centre was shutting at the end of the month
and that consequently staff would be looking for new jobs.
The backstory is that MSI Birmingham had had its NHS abortion
contract cancelled and that all three of its abortion facilities
in the Birmingham area had closed permanently. Sadly, that
local NHS contract has since been awarded to the British
Pregnancy Advisory Service (BPAS). The killing continues.
And talking of Marie Stopes International (MSI), its CEO has
been in the news again recently. In 2018, Simon Cooke’s
annual pay packet increased from £300,000 to £434,500. The
Charity Commission on 20 December delivered a severe rebuke to
MSI. The watchdog gave ‘formal advice’ to MSI to change
how it decides earnings of its senior employees. MSI has
39 staff on salaries of over £100,000. The Commission’s
warning was the first shot in a campaign to curb the pay
excesses of some charity bosses.
The MSI charity performs around 70,000 terminations a year in
its 60 or so clinics across the UK – almost all are funded by
the NHS, aka UK taxpayers. In 2018, MSI was awarded nearly
£50 million for its contraception and abortion work in the
developing world, funded from the UK’s foreign aid budget, aka
The world’s biggest killer
What was the cause of most deaths globally in 2019?
Cancer? HIV/AIDS, smoking, various diseases?
No, none of those. It was abortion with an estimated 42.3
million. Those other causes account for 8.2 million, 1.7
million, 5 million and 13 million respectively.
Worldometers (https://www.worldometers.info/) estimates that
there were 58.6 million deaths worldwide in 2019. But that
total does not include the 42.3 million aborted unborn because
Worldometers perversely fails to recognise their human being
If I Could Speak: Letters from the
This is the title of a 72-page booklet written by Mark Jones,
the minister of Faith Reformed Presbyterian Church (PCA) in
Vancouver, Canada. It was released in the UK on 10 January
2020 by Christian Focus and costs £9.99.
The publisher’s blurb commences, ‘Dear Mommy … So begins
the correspondence from an unborn baby to her mother.
Making an impassioned plea to her mother to not abort her, she
shares her hopes and fears with the woman who can control
whether she lives or dies. These letters are an appeal to
all who read them to choose life.
revisited and updated
As with all assisted reproductive technologies (ARTs), surrogacy
is weird and never a good idea. Not only is it unnatural,
it is also morally problematic and personally troublesome – a
can of bioethical worms. True, it is less commonly
practised than IVF, but there are moves afoot to make it more
readily-available and less bound by regulations.
The Warnock Report (1984, p. 42) gave this definition:
‘Surrogacy is the practice whereby one woman carries a child for
another with the intention that the child should be handed over
after birth.’ The main legislation concerning surrogacy is
the 1985 Surrogacy Arrangements Act and the 2008 Human
Fertilisation and Embryology Act.
There are several variations on this theme. First, there
is traditional, partial, or straight surrogacy. This is
the most common type when a husband is fertile, but his wife is
unable to sustain a pregnancy, possibly because of illness, or
because she has had a hysterectomy or maybe she is a ‘new’
career woman and just too busy to be pregnant. The hired
surrogate woman, a friend, a family member is then inseminated,
artificially or naturally, with the husband’s sperm.
Because she is using her own ova, she is the biological, genetic
and legal mother of the child.
Second, there is full, gestational, or 'host IVF'
surrogacy. Embryos are created by IVF using gametes either
from the commissioning/intended parents, or sperm and ova
donated by others. The resulting embryos are then
transferred to the surrogate and because she does not provide
any ova, she has no genetic relationship to the child, but she
is still the biological and, by birth, the legal mother.
Under current UK law, the surrogate woman who gives birth to a
child is automatically regarded as the child's legal
mother. A parental order obtained from a court is the
means by which legal parenthood is transferred from the
surrogate to the intended parent or parents. Applications
for parental orders must normally be made in the first six
months after birth. Commercial surrogacy is banned in the
UK so surrogates can be reimbursed only for ‘reasonable
expenses’, which typically range from £12,000 to £15,000.
And no surrogacy agreements are legally binding.
Surrogacy has already changed during the last decade. For
instance, the number of parental orders has tripled from 121 in
2011 to 368 in 2018. And there are increasing numbers of
gay men wanting children and inevitably having to hire a
surrogate woman. Since 2010, gay male couples have been
allowed to apply for parental orders. Since January 2019,
single persons can also become legal parents through
surrogacy. Since 2015, mitochondrial donation, commonly
known as 3-parent IVF (mother, father plus surrogate), has been
legal in the UK.
Perhaps not surprisingly, surrogacy is a practice ripe for
litigation. Here is the recent, strange and tangled case
of the Whittington Hospital NHS Trust. A 29-year-old
woman, known only as XX, developed cervical cancer which went
undetected for several year despite smear tests and
biopsies. The Trust admitted negligence. She and her
partner wanted children and she had delayed chemo-radiotherapy
to undergo procedures to collect 12 ova which were then
cryopreserved. The subsequent cancer treatment caused her
to become infertile and unable to sustain a pregnancy. XX
therefore hoped to use surrogacy in either America or the
UK. She preferred the former since commercial surrogacy is
illegal in the UK and pre-birth orders, giving her legal status
as the mother, are not available here. She took the Trust
to court to cover the costs for the Californian option. In
June 2017, the High Court awarded her £580,000 in negligence
damages, but denied her the cost of four surrogacies in the
USA. In December 2018, the Court of Appeal overturned the
High Court ruling and unanimously awarded her another £560,000
to cover the US surrogacy costs. On 16 December 2019, the
NHS Trust appealed that decision saying that paying for
commercial surrogacy would be ‘contrary to public policy’.
Five Supreme Court justices, in what was Lady Hale’s last
hearing, heard the case. Their judgement is awaited.
Surrogacy has even surfaced on that Radio 4’s guardian of
traditional countryfolk’s values, The Archers.
Aleksandra ‘Lexi’ Viktorova, a Bulgarian fruit picker on Home
Farm, became a surrogate for the ‘married’ gay couple, Adam Macy
and Ian Craig. The pregnancy was conceived by an ovum
donor and Adam’s sperm – Ian was discovered to be
infertile. Jennifer Aldridge, Adam’s mother, is convinced
that Lexi will flee with baby Alexander Macy-Craig (or Xander
for short) to Bulgaria. Well I never! Of course it
is fictional, but ….
These are some examples of changing attitudes towards
surrogacy. They have created a head of steam declaring
that the UK’s surrogacy laws are out of date and need amending.
The government has asked the Law Commission to review UK
surrogacy law. Its aim is to make surrogacy laws work for
the parents, the surrogate and, most importantly, the
child. A public consultation, contained in a 502-page
document, entitled Building families through surrogacy: a
new law, ran from 6 June to 11 October 2019. It is
expected that a final report with recommendations for reform of
the law, and a draft Bill, will be forthcoming in 2021.
The Law Commission has already proposed that parental rights
should commence at birth. However, it also wants the
surrogate mother to retain a right to object for a short
period. Furthermore, it calls for specific regulation of
surrogacy arrangements to include safeguards, such as
counselling and independent legal advice, to reduce the risk of
arrangements breaking down. And it proposes that all
advertising restrictions, including social media, should be
lifted. And it thinks that international surrogacy
arrangements should be recognised. Critics fear that these
proposals would target women as young as 18, who had not
previously had a baby, to become surrogates. Would
students use surrogacy to pay off their debts? Would
surrogacy become more commercialised? Would it become more
mainstream, more common?
Surrogacy UK, an organisation which represents about 150 active
surrogates and 500 intended parents, of which almost 50% are
same-sex couples, broadly agrees with the Law Commission's
proposals, but wants any surrogate’s objections to be tested in
court. It also wants the surrogate to lose all rights over
the child. This, it says, would protect surrogates from
the risk of intended parents abandoning a child with a
disability, or not paying the medical bills. Surrogacy UK
is also calling for safeguards so that payments cannot be
disguised as expenses. And intended parents should pay for
a surrogate’s life assurance, legal bills and IVF treatment,
often resulting in a total cost of between £30,000 and £40,000.
Sarah Jones, chairwoman of Surrogacy UK and four times a
surrogate, has said, ‘We are pleased to see that there has been
no movement towards permitting commercial profit-making
surrogacy organisations. We hope that the Law Commission
will resist any movement away from an expenses-only model.
Surrogacy should be about making families, not money.’
Surrogacy, whether it is traditional or gestational, is an
attack on the biblical pattern of family, where children are
conceived, born and nurtured within the family unit of mother
and father. Because surrogacy is fundamentally wrong,
tinkering with the concept and tweaking its legal status will
not make it right. It is best avoided.
Another IVF disaster
The Court of Protection in London is often required to decide
complex cases about people who are incapable of looking after
their own interests. Here is another such case curiously
coupled to IVF.
In 2012, a woman was hit by a bus while studying in
London. She suffered reduced mental capacity and other
health problems and was awarded £2.5 million in compensation
after suing the bus company.
In October 2019, she came to the Court of Protection with her
request. Mrs Justice Nathalie Lieven granted this severely
brain-damaged woman, now in her thirties, permission to pay for
IVF treatment, even though she is not married and lives in China
with her parents. Mrs Lieven noted that the unnamed woman,
‘feels that having a baby will give more meaning and purpose to
her life.’ The judge has never met or spoken to the woman,
but said, ‘It seems that she can communicate quite clearly,
including in English, and she can articulate her wishes and
Apparently no-one opposed the woman's request, but she needed a
judge's permission because she was deemed incapable of deciding
whether to spend the money on IVF by herself. The woman
now plans to have IVF treatment in the United States.
Is having a baby a justifiable action to give ‘meaning and
purpose’ to a potential mother? Can anyone assess the
capabilities of an unknown woman with serious disabilities,
without meeting her? IVF fails more than it
succeeds. This is a puzzling case of two-handed confusion
– a double whammy of legal pronouncement and bioethical choice.
Another IVF first - AneVivo
It just gets more bizarre. Jasmine and Donna Francis-Smith
are a lesbian couple. They have become the first in the
world to carry the same baby in both their wombs as part of a
novel process called ‘shared motherhood’.
The women used the AneVivo procedure, also called In Vivo
Natural Fertilisation, pioneered by the Swiss technology company
Anecova, and carried out at the London Women’s Clinic.
According to Martin Velasco, its founder and CEO, Anecova
‘enhances the emotional value for the couple.’
It involved collecting ova by IVF from the biological mother,
Donna. These were placed inside a miniature capsule with
donor sperm and inserted into her womb, where they were
incubated for 18 hours. Fertilisation and early embryo
development can thus occur in a more natural in vivo environment
rather than the artificial situation of an IVF laboratory.
A resulting embryo was then removed and transferred into the
womb of Jasmine, the gestational mother, who carried the baby to
term. As a result, baby Otis was born in September 2019.
Preimplantation genetic testing for
Fertility clinics have recently faced severe criticism for
offering numerous IVF treatment add-ons which can be ineffective
for the patient, but effective money-making schemes for the
Each year the HFEA conducts a review to assess the most commonly
used of these add-ons. One of them is preimplantation
genetic testing for aneuploidy (PGT-A, also known as
preimplantation genetic screening, PGS). It checks for
genetic abnormalities in the number of chromosomes of 5-day-old
embryos. Aneuploid embryos are less likely to develop to
term and more likely to suffer from various genetic
conditions. Embryologists remove a cell from the embryo
and analyse its chromosomal status before transferring it to the
woman. Embryos which exhibit aneuploidy are destroyed.
The HFEA has devised a traffic light rating system to allow
patients to assess the effectiveness of add-ons. In
December 2019, PGT-A was downgraded from amber to red, ‘meaning
that there is no evidence to show that the treatment is
effective and safe.’ PGT-A typically costs around £1,000.
and Assisted Suicide
Mr Newby is 49 years old, of French and English descent and, in
2014, was diagnosed with motor neurone disease (MND), an
incurable, progressive and life-shortening condition which will
eventually lead to his death. He is the latest in a
high-profile line, of mainly men, including Noel Conway, Paul
Lamb, ‘Martin’, Tony Nicklinson and Diane Pretty, who have
fought for the right to die.
Backed by Dignity in Dying, Mr Newby started a CrowdJustice
funding campaign to help pay for a legal challenge to the law
criminalising assisted dying. He raised over £44,000.
His challenge was considered to be different from previous cases
because in a new approach it would ask the courts to look at the
evidence on assisted suicide in more detail than the English
courts have ever done before. This would include detailed
cross-examination of expert witnesses and information from
countries where assisted suicide is legal, allowing judges to
test the strength of the evidence and whether the law is
incompatible with his human rights.
But on 19 November 2019, Lord Justice Irwin and Mrs Justice May,
sitting in the High Court, did not grant permission for the case
to be heard. They said, ‘It is impossible not to have very
great sympathy for the situation in which Mr Newby finds
himself. His clear and dignified statement compels
admiration and respect.’ However, both judges declared
that the Court is ‘not an appropriate forum for the discussion
of the sanctity of life.’
Lord Justice Irwin further explained, 'In the context of
repeated and recent parliamentary debate, where there is an
absence of significant change in societal attitude expressed
through Parliament, and where the courts lack legitimacy and
expertise on moral – as opposed to legal – questions, in our
judgment the courts are not the venue for arguments which have
failed to convince Parliament. Even if there was very
widespread examination of evidence in these proceedings, the
court process is in our view unlikely to provide reliable
answers so as to determine this issue.’
In a statement after the ruling, Mr Newby said, ‘The High
Court's decision not to hear my case, and not to test the
evidence for and against assisted dying, is disappointing to me
and the many hundreds of others who support my case. With
their support, I will be fighting on to bring attention to a law
that is widely thought to be cruel, so that it can be replaced
by something more humane and compassionate.’
Alistair Thomson from the Care Not Killing organisation
responded, ‘Parliaments across the UK have looked at this issue
more than a dozen times since 2003. And in both Scotland
and Westminster they have rejected any changes on grounds of
public safety. If you change the law, vulnerable people
will feel pressured into ending their lives.’
Mr Newby intends to contest the High Court’s ruling, though if
and when an appeal will be allowed in currently not known.
There is no prospect that Parliament will consider the
issues. In October 2019, the then Secretary of State for
Justice, Robert Buckland, stated that the Government ruled out a
public consultation on changing the law on assisted dying.
On 19 December 2019, Paul Lamb’s case came to an end. He
is the 63-year-old severely paralysed ex-builder from Leeds, who
has argued that the 1961 Suicide Act is discriminatory and
breaches his human rights. He lost his case at the Supreme
Court in 2014.
In 2019, he mounted another legal challenge maintaining that
public opinion had changed since then and so he asked the High
Court to allow a new hearing. But Lord Justice Dingemans
and Mrs Justice Elisabeth Laing said his case was ‘unarguable’
and should not proceed to a full hearing. Mrs Justice
Laing said that allowing exemptions to the law on assisted dying
would remove protection of ‘very vulnerable people’, some of
whom would not wish to take their own lives but may be subjected
to ‘pressure’ to do so.
World Medical Association declaration
You might think that the world is rushing headlong into
legalising euthanasia and assisted suicide. You would be
wrong. True, in June and December 2019 the Australian
states of Victoria and Western Australia respectively became the
latest jurisdictions to legalise assisted suicide, joining
Switzerland, Belgium, Canada, Colombia, Luxembourg, the
Netherlands and a handful of US states.
What about the UK? Are we inching towards
legalisation? Not so. Assisted suicide remains
illegal in the UK because of the robust 1961 Suicide Act.
Yet in March 2019, the Royal College of Physicians (RCP) rigged
a poll (which is currently being contested through the courts)
and moved its stance of opposition to one of neutrality.
In November, the Royal College of General Practitioners (RCGP)
similarly consulted its 53,000 members with a 13 December 2019
deadline. The results are awaited. And on 6 February
2020, the British Medical Association (BMA) started to survey
its 160,000 members on whether its official position should
change from opposition. The outcome will be announced in
advance of the BMA’s Annual Representative Meeting in June at
Let’s get some perspective. Apart from those jurisdictions
listed above, the practice of assisted suicide is repudiated
nearly everywhere else around the world. Resounding
evidence to support such a statement comes from the recent
meeting of the World Medical Association (WMA), which has had a
long-standing policy opposing euthanasia and assisted suicide.
During October 2019, at its 70th Annual General Assembly in
Tbilisi, Georgia, the WMA adopted a revised Declaration on
Euthanasia and Physician-Assisted Suicide. It
contains three bold statements. First, ‘The WMA reiterates
its strong commitment to the principles of medical ethics and
that utmost respect has to be maintained for human life.
Therefore, the WMA is firmly opposed to euthanasia and
Second, the WMA affirmed, ‘No physician should be forced to
participate in euthanasia or assisted suicide, nor should any
physician be obliged to make referral decisions to this end.’
And third, ‘Separately, the physician who respects the basic
right of the patient to decline medical treatment does not act
unethically in forgoing or withholding unwanted care, even if
respecting such a wish results in the death of the patient.’
Of course the WMA, with its membership of 114 national medical
associations and more than 10 million doctors, will now be under
pressure to change its policy. With that in mind, the WMA
issued this strong proclamation in May 2019, ‘Only a small
minority of physicians support E&PAS [euthanasia and
physician-assisted suicide]. The vast majority of doctors
around the world wish only to foster the will to live and to
cope with illness and suffering, not to facilitate acts of
suicide or to create ambiguity around what constitutes a medical
Assisted suicide on the Isle of Man
On 21 January, members of the House of Keys on the
Isle of Man debated the motion, 'That Tynwald is of the opinion
that legislation to allow for voluntary assisted dying should be
introduced.' It was proposed by Alex Allinson MHK and
debated for five hours. In the end,
an amendment 'to note the debate' received unanimous
support. If there had been sufficient backing
for his motion, Dr Allinson had planned to
bring forward a private member’s bill in March followed by a
public consultation in the summer. The issue was last debated on the Isle in
February 2015, when a similar bid was thrown out by members
of the House of Keys by a majority of 17 v. 5.
Assisted suicide in Westminster Hall
On the following Thursday, 23 January, in Westminster Hall, MPs
discussed the motion, 'That this House has considered the law on
assisted dying.' The 90-minute debate was secured by Christine
Jardine, the Liberal Democrat MP for Edinburgh West. She
said, 'It’s to spark discussion and public debate about where we
are and what we want to do, look at what other countries have
discussed and what they have done - with the aim of changing the
law eventually, but that’s a long way off.' There were no
firm proposals. The Government resisted a call to hold an
inquiry into the current law and its workings - as Chris Philp
(Parliamentary Under-Secretary for the Ministry of Justice)
announced, 'The Government do not have any plans at the moment
to initiate any review or call for evidence.' But just
three days later, on Sunday 26 January, it was reported that the Justice Secretary, Robert
Buckland, though personally against legalising assisted suicide,
has said he will, over the next few months, consider whether to
instruct the Ministry of Justice to review the evidence.
Then on 2 February, after pressure from pro-life opponents, Mr
Buckland rowed back, saying that the Government has 'no plans'
to hold a review of the law.
Dutch go even further
As if euthanasia in Holland is not bad enough in its extent and
numbers. Now there is pressure to go even further.
A recent report entitled, Medische beslissingen rond het
levenseinde bij kinderen (1-12) [Medical end-of-life
decisions in children (1-12)], from three Dutch teaching
hospitals claims that 84% of Dutch paediatricians who were
surveyed want euthanasia for children between 1 and 12 years
old. This proposal has been tabled in the lower house of
the Dutch parliament. Currently euthanasia is reserved for
Dutch newborns, up to 12 months old, and for children between 12
and 16 years old as long as they have the consent of their
And at the other end of the age spectrum, a recent survey shows,
for the first time, that a majority of Dutch citizens (55%)
support the idea that euthanasia is legitimate for those who say
they are healthy but ‘tired of life’. This year,
controversial new legislation is to be tabled in the Dutch
parliament by the centre-left party, known as D66. It
would make euthanasia available to citizens over 75 who believe
their lives are ‘complete’.
There were 6,126 deaths by euthanasia in 2018, amounting to 4%
of the people who died in the Netherlands last year.
Anyone like to wager this proportion will not increase this
New Zealand’s referendum on euthanasia
In mid-November, the New Zealand parliament, after eight debates
and a record 39,000 submissions from the public, passed its ‘End
of Life Choice’ euthanasia bill by 69 to 51 votes. But the
battle is not over. During the months of prior debate, in
October 2019, the New Zealand First political party inserted an
amendment into the bill requiring a national binding referendum
on the euthanasia bill, before it can become law. The date
of the euthanasia referendum, and the next general election, is
not yet determined, but it is likely to occur in the autumn of
Belgium's first euthanasia trial
On 12 January, the process of choosing a jury began for the
trial of three Belgian doctors - two GPs and a psychiatrist -
who stand accused of the unlawful killing of a patient in the
country's first long-awaited euthanasia criminal
prosecution. Drs Joris van Hove, Frank de Greef and
Godelieve Thienpont are charged after Tine Nys, 38, a patient
with a history of suicide attempts, was given a lethal injection
of barbiturates on 27 April 2010. The case has been
brought by Ms Nys’s sisters, Lotte and Sophie, and other family
members who say she was suffering from depression after a failed
relationship, not a 'serious and incurable disorder', as is
required by Belgian law. In addition, they maintained that
Tine's death was a botched affair.
More than 10,000 Belgians have been killed by doctors since the
country legalised euthanasia in 2002. According to public
data, during 2018, there were 2,357 such deaths. In only
one other case has a legal issue been raised concerning the
procedure, and this was summarily dismissed. The current
charge of unlawful killing by poisoning carries a possible life
sentence. This high-profile and controversial trial
continued for three weeks until Friday 31 January when, after
more than eight hours of deliberation, the jury in Ghent cleared
the accused doctors - and the courtroom burst into applause.
Mr. Van Steenbrugge, a lawyer for one of the doctors, said the
acquittal had sent a strong, reassuring message to
doctors. 'It was not manslaughter, it wasn’t a crime,' he
said. 'It was euthanasia.' Mr. Van Cauter, the
lawyer for the family, said of the decision, 'It’s a bit
disappointing', adding that the way Tine Nys was treated, 'was
Back in November 2018, the Chinese scientist He Jiankui shocked
the world by claiming to have created the first gene-edited
human babies using the germline altering techniques of
CRISPR-Cas9. Then mystery descended on the whole
affair. He disappeared with his two co-workers, his work
remained unpublished and the whereabouts and health of the twin
babies, Lulu and Nana, plus a previously unconfirmed third baby,
Then on 30 December 2019, the People’s Court of Nanshan District
of Shenzhen announced that He and his two colleagues had flouted
regulations as well as research and medical ethics by altering
genes in human embryos that were then transferred to two
women. According to the State news agency, Xinhua, the
Court declared that, ‘The three accused did not have the proper
certification to practise medicine, and, in seeking fame and
wealth, deliberately violated national regulations in scientific
research and medical treatment.’ All three pleaded
guilty. He was sentenced to three years imprisonment and
fined 3 million yuan (£300,000). His collaborators, Zhang
Renli was sentenced to two years in prison, while Qin Jinzhou
received an 18-month sentence, suspended for two years.
They were also fined 1 and 0.5 million yuan respectively.
In addition, they have all been banned for life from ever again
working in the field of human reproductive technologies and from
applying for research funding. That chilling news should
deter most other germline mavericks.
The Chinese Academy of Science released a statement, saying it
‘firmly opposed’ germline editing in humans. It added,
‘Under current circumstances, gene editing in human embryos
still involves various unresolved technical issues, might lead
to unforeseen risks, and violates the consensus of the
international scientific community.’
He’s unpublished manuscript
So where are the experimental details of He’s alleged
‘ground-breaking’ work? The 3 December edition of the
MIT Technology Review contained an article by Antonio
Regalado called, ‘China’s CRISPR babies: Read exclusive excerpts
from the unseen original research.’ It included extracts
from a previously unpublished manuscript entitled, ‘Birth of
Twins After Genome Editing for HIV Resistance.’ It was
4,699 words long and authored by He Jiankui and nine
others. This manuscript had previously been submitted to Nature
and The Journal of the American Medical Association, but both refused to publish it.
The draft text claims a medical breakthrough that ‘can control
the HIV epidemic’. It includes references to ‘success’ and
‘novel therapy’, but contains no convincing proof that the twins
really are resistant to the virus. Indeed, evidence from
the draft’s data which suggests that the gene-editing procedure
went wrong, is mostly ignored by the authors.
Experts who have assessed the manuscript have condemned the work
and its claims. For example, Rita Vassena, scientific
director of a fertility clinic in Barcelona, said, ‘Approaching
this document, I was hoping to see a reflective and mindful
approach to gene editing in human embryos. Unfortunately,
it reads more like an experiment in search of a purpose, an
attempt to find a defensible reason to use CRISPR/Cas9
technology in human embryos at all costs, rather than a
conscientious, carefully thought through, stepwise approach to
editing the human genome for generations to come.’
This Russian biologist, from the Pirogov Russian National
Research Medical University in Moscow, is bullish about ethical
guidelines. In June 2019, he informed Nature by
email that he intended to create gene-edited babies resistant to
HIV using CRISPR-Cas9, despite the global opposition to He’s
analogous work. Another email in October confirmed that
Rebrikov had started a second project, gene-editing ova donated
by a hearing women in order to understand how deaf couples might
be able to give birth to children without a genetic mutation
that impairs their hearing. Rebrikov is already in
discussion with several deaf couples. He insists that his
intention is not to create such a baby, yet.
Instead, Rebrikov expects to publish, in the near future, this
work which involves assessing the capability of CRISPR to repair
a gene linked to deafness called GJB2. People with
two mutated copies of GJB2 cannot hear well without
hearing aids or cochlear implants. Rebrikov says these
results will lay the groundwork for future clinical trials.
The benefits and ethics of this procedure have been called into
question because deafness is not a fatal condition. For
example, Jennifer Doudna, the pioneer of CRISPR gene-editing has
said, ‘The project is recklessly opportunistic, clearly
unethical and damages the credibility of a technology that is
intended to help, not harm.’
Though Rebrikov has insisted that he will follow all the Russian
regulators’ guidelines, his long-term plans appear to be
unchanged – he will create and transfer gene-edited human
embryos into women’s wombs.
The arguments are decades old – what is a designer baby, is it
ethical, when will one be born? The answer to the latter,
much simpler, question is probably 2020. But this baby
will not be stereotypically blonde, sporty, musical, beautiful
This first ‘designer baby’ has been conceived, the embryo
transferred to a surrogate mother (the ‘parents’ are a US male
couple) and the pregnancy confirmed. This is the result of
enhanced IVF conducted by the US firm Genomic Prediction, based
in New Jersey. The ‘designer’ label is because the embryo
has been selected after genomic analysis in order to decrease
the risk of contracting 11 diseases, including certain types of
cancer and diabetes.
Such screening techniques would be illegal in the UK. Here
preimplantation genetic diagnosis (PGD) screening of human
embryos is allowed only for specific diseases caused by a single
gene, such as cystic fibrosis. Genomic Prediction has
extended this procedure to test for diseases caused by multiple
genes and called it polygenetic preimplantation genetic testing,
or PGT-P. Genomic Prediction is understood to intend to
apply for a licence with the UK fertility watchdog, the Human
Fertilisation and Embryology Authority (HFEA).
Questions abound. Is this going to be a real designer, or
just a mildly genetically-tinkered, baby? We already have
PGD babies. Is this a case of stretching the legal
boundaries? Where will this sort of work lead? Will
such gene technologies eradicate genetic diseases? Or will
they eradicate human differences? Are we heading down the
road of ‘eugenics’ or ‘science fiction’?
Patients with sickle-cell disease (SCD) and beta-thalassemia are
the first beneficiaries of some innovative gene-editing
treatments. Victoria Gray, a SCD patient in the US, has
been pain free since July 2019. Using CRIPR-Cas9
techniques her bone marrow stem cells have been tweaked into
producing foetal haemoglobin, which effectively reverses her
symptoms. A similar process has been used on a thalassemia
patient in Germany, who has been symptom free since March 2019.
This is cutting-edge medicine. Whether the improvements
are permanent or temporary remains to be seen. But they
are both bioethical heralds of somatic cell gene therapy rather
than the unethical germline variety.
This a major upgrade for the CRISPR genome-editing
technique. It is touted as a better, more precise, more
predictable method of correcting disease-causing
mutations. Its novelty is primarily because it can add and
delete short DNA sequences. It can even change just one
DNA letter. And it gives rise to fewer unwanted side
effects. No wonder it has been described a ‘genetic word
processor’. Andrew Anzalone and his co-workers at the
Broad Institute, Massachusetts, headed by David Liu, have been
responsible for its discovery as described in
‘Search-and-replace genome editing without double-strand breaks
or donor DNA’ (Nature, 2019, 576: 149-157).
CRISPR is typically used in conjunction with Cas9. This
protein seeks out problem sequences of DNA. Cutting DNA is
one thing, repairing DNA is quite another. This has proved
to be not only an inefficient process, but sometimes the ‘novel’
DNA gets spliced into the wrong place so that uncontrolled
insertions and deletions occur, which can cause dangerous
Anzalone and his colleagues have altered Cas9 by fusing it with
an engineered reverse transcriptase enzyme to enable it to work
more accurately and more efficiently. ‘Old’ Cas9 cuts both
double strands of DNA, which can lead to those mistakes and
unwanted mutations. ‘New’ Cas9 allows a single strand to
be added and then cuts the opposite strand so the faulty DNA can
be repaired using the added strand as a template.
This new prime editing method has already been used to correct
mutations in human cells in the laboratory. It has
produced fewer off-target edits. However, it has, so far,
only allowed short sequences – only as large as 44 DNA letters –
to be changed. In other words, both ‘old’ and ‘new’ Cas9
techniques will currently be required, as well as any other
inevitable newcomers. Nevertheless, prime editing looks
like becoming a stimulus for the development of gene
therapies. Already it has been estimated that it could, in
principle, help tackle 89% of the 75,000 known human
disease-associated DNA variants.
The General Election – before and after
The UK held a general election on 12 December 2019. The
result provided the conservative Party with a landslide majority
of 80 seats. In contrast to the USA, bioethical issues
play very little part in UK elections. But the likelihood
is that two extreme matters, namely, the decriminalisation of
abortion and the legalisation of assisted suicide, will be
raised in the new Parliament.
How do the three major political parties view these two
issues? Prior to the election they revealed their stance
in their manifestos. They are worthy, as a matter of
historical record, to be retained (with thanks to CARE).
The manifesto contained no policy that specifically addressed
the issue of abortion.
Assisted suicide. ‘We will support our
precious hospices, developing the plans already announced by
Boris Johnson to secure their future, with a £25 million cash
injection in August to support 200,000 people at the end of
‘We will uphold women’s reproductive rights and decriminalise
abortions.’ And ‘Women in Northern Ireland should have
access to abortions in Northern Ireland.’
Assisted suicide. The manifesto contained no
specific policy with regard to assisted suicide or end of life
Liberal Democrat Party
‘We believe that everyone has a right to make independent
decisions over their reproductive health without interference by
the state, and that access to reproductive healthcare is a human
right. We will:
- Decriminalise abortion across the UK while retaining the
existing 24-week limit and legislate for access to abortion
facilities within Northern Ireland.
- Enforce safe zones around abortion clinics, make intimidation
or harassment of abortion service users and staff outside
clinics, or on common transport routes to these services,
- Fund abortion clinics to provide their services free of charge
to service users regardless of nationality or residency.’
Assisted suicide. ‘Provide more choice at
the end of life, and move towards free end-of-life social care,
whether people spend their last days at home or in a hospice.’
‘Regard every suicide as preventable. We will take an
evidence led approach to prevention, making it easier for people
at risk to get the help they need, and equipping more members of
the public with the skills and confidence to talk about
The bioethical shape of the new
Of course nobody yet knows if and when these issues will appear
on the Parliamentary order papers. But there is no doubt
they are already being discussed unofficially outside the
How might MPs vote? Again, nobody knows.
Interestingly, it is reckoned that no prominent pro-life MPs on
the mainland lost their seats. On the other hand,
pro-choice MPs, such as Anna Soubry, Paula Sherriff, Chuka Umuna
and Dennis Skinner did. The new intake of 140 MPs are
largely untried. However, James Grundy, Ruth Edwards,
Anthony Mangnall, Greg Smith and Carla Lockhart are among those
known to be pro-life. They will be tested soon.
New Year Honours
I always read through the list, just in case there is anyone I
know who is worthy of recognition beyond the call of duty.
I am never enamoured by awards for those merely doing their
duties, such as Inland Revenue workers and
ladies-in-waiting. And it is well-known that I would
accept nothing less than a knighthood.
However, this time there were three stand-outs that, IMHO, do
not deserve prizes. First, there was Alison Saunders DCB,
erstwhile Director of Public Prosecutions (DPP). She was
granted a damehood ‘for services to criminal justice.’ She
has been branded, by others, as ‘toxic’, ‘disastrous’ and ‘the
worst DPP in living memory’. Bioethically, she will be
remembered as the DPP who, in October 2014, controversially and
unilaterally amended the UK’s guidelines on assisted suicide so
that doctors and nurses would be less likely to be prosecuted
for assisting. Moreover, at that very time, the Supreme
Court had declared that Parliament was the place to debate this
issue, and indeed Parliament was doing just that. Which
made it even more worrying that the DPP had decided to step in
and relax the law. All this raised serious questions about
Alison Saunders’ motives, judgement and impartiality.
Vulnerable people in our society deserve the safeguards of the
1961 Suicide Act, a law against assisted suicide that offers
them strong and unambiguous protection. Mrs Saunders
clearly did not understand this.
Second, there was Professor Lesley Regan DBE, who in December
stepped down as president of the Royal College of Obstetricians
and Gynaecologist (RCOG). She was made a dame ‘for
services to women’s healthcare.’ And we all know what that
is a euphemism for. Indeed, she was a driving force behind
the move to decriminalise abortion in Northern Ireland and
beyond. She managed to persuade the RCOG’s council – but
not its membership – to back decriminalisation in a
ballot. And she is the one who famously argued that the
practice of abortion should be no more restricted by the law
than the practice of going to ‘get your bunions sorted’.
Third, there was Diana Johnson DBE, Labour MP for Hull
North. She too becomes a dame ‘for charitable and
political service.’ It was in March 2017 that her
ten-minute rule Abortion Bill 2017-19 was set to decriminalise
abortion in England and Wales and Northern Ireland.
Alarmingly, it passed its first reading on 23 October 2018 by
208 votes to 123. However, because Parliament was
dissolved, it made no further progress, but by then the damage
had been done, the direction of that rocky and dangerous road
had been set.
Maybe these women did some wonderful deeds deserving of such
high honours. But their bioethical breaches will not be
A short history of bioethics
Where was bioethics conceived? In the USA. When was
bioethics born? In the 1970s. Why was bioethics
born? Because of harmful treatment of humans. One
key example that generated widespread moral outrage occurred in
1972 when the topic of a US Public Health Service project at
Tuskegee University, Alabama came to light. It involved
more than 400 black US men, mostly poor share-croppers.
They were subjected to untreated syphilis between 1932 and
1972. As many as half of them died, and 60 of their wives
and children contracted the disease.
In response the US government passed the 1974 National Research
Act and established the National Commission for the Protection
of Human Subjects of Biomedical and Behavioral Research.
By 1976, the Commission had drafted a report outlining the
‘basic ethical principles and guidelines that should assist in
resolving the ethical problems that surround the conduct of
research with human subjects.’
In 1978, this draft was published as The Belmont Report
with its three abiding rules for undertaking future human
research, namely, respect, beneficence and justice. In
addition, informed consent and ethical oversight were
incorporated. Also in 1978, bioethics’ first hefty tome
was published as the Encyclopedia of Bioethics by the
theologian Warren T Reich. He was a founding member of the
Georgetown University’s Kennedy Institute of Ethics.
Furthermore, 1978 was the year in which Louise Brown was born in
the UK, the first baby conceived through IVF. Modern
bioethics was up and running.
The 1980s saw the subject blossom as it became central to
broader issues, such as public health and medicine, yet it
always remained sensitive to the protection and welfare of
vulnerable people. The HIV crisis of the mid-1980s also
allowed bioethics to develop a strategic role in governmental
and medical responses.
As bioethics grew it took on an even more important say about
the ethics and practices of ‘new’ biomedical procedures.
These novel technologies included organ transplantation and in
vitro fertilisation, but there were also the ‘old’ issues, like
abortion and euthanasia. Medicine was changing. The
ethical governing certainties of the Hippocratic Oath and the
Judeo-Christian doctrines with their ‘do no harm’ and ‘love your
enemy’ were under fire. Medicine was now being judged by a
new guideline, not just the preservation of human life, but the
quality of that life.
The 1990s brought a further challenge to bioethics – the Human
Genome Project (HGP), which sequenced the 3 billion letters of
the human genome. What might it lead to? Altering
the very genetic basis of man, gene therapies, designer babies,
scary sci-fi stuff? Would such enterprises be good,
indifferent, or bad? In the hope of answering such
questions, bioethicists were recruited into every university,
research centre and hospital.
These medico-legal-socio folk made little difference. That
longstanding, fundamental ethical basis of medicine had been
contested and downgraded. Human life had lost its
uniqueness and dignity. Medical tinkering was de
rigueur. Previously established boundaries and bans –
embryo experimentation, abortion limits, human cloning, assisted
suicides, germline editing – were ridden over roughshod, if not
immediately, then later as a consequence of scientific hype and
political lobbying. Bioethics was losing its utility.
Yet new techniques, especially those associated with human
reproductive and developmental biology, like 3-parent IVF,
stem-cell technologies and organoid production, require
arbitration and judgement. Who will assess what is right
and wrong? Who will bridle the scientific imperative and
the propaganda of researchers? There is undoubtedly still
a place for principled bioethicists. Who else will bridge
the bioethical ravine between science and society?
Principles of Biomedical Ethics
No self-respecting bioethicist has not owned, or at least not
read chunks of, Tom Beauchamp and James Childress’s 1979
masterpiece, Principles of Biomedical Ethics. It
must rank as the most influential bioethical textbook of the
twentieth century. It has given rise to the philosophical
school of principalism, a practical approach to ethical dilemmas
that is widely accepted, but which is also not without its
The book argues for a framework consisting of four major
principles that should universally govern medical ethics and
practice. They are autonomy, beneficence, non-maleficence
and justice. From these big four, several minor rules have
arisen to include veracity, confidentiality, privacy and
fidelity. Yet for some 40 years these major principles
have helped to stabilise the rush towards an unprincipled
medicine as well as engender a more thoughtful and practical
approach to the subject. We have all benefitted.
Beauchamp and Childress, or Tom and Jim, first met in the
mid-1960s at Yale University where their education in religious
studies overlapped for three years. After graduation both
started doctoral research – Tom in philosophy at Johns Hopkins
and Jim in religious studies at Yale. It was not until in
the mid-70s that they met again and cooperated as faculty
members at Georgetown University. It was then and there,
in the associated Kennedy Institute, that the world’s first
academic course in bioethics was started. They shared six
lectures. Tom favoured a consequentialist approach,
whereas Jim favoured deontology. Nevertheless, from these
two approaches the common idea of applying basic moral
principles to biomedical ethics was sown. Principles
of Biomedical Ethics was conceived – ethical theory and
practical problems were conjoined. Oxford University Press
excitedly guided its first bioethical project. The book is
now in its eighth edition (October 2019) of 512 pages at £56.23
paperback, or £226.19 hardback from Amazon.
In an editorial in the October edition of the American
Journal of Bioethics (2019, 19: 9-12) to mark the
book’s ruby anniversary, the authors describe how the concept of
a principles-based approach to bioethics came about. ‘We
appreciated the need for an approach that recognized the value
of ethical theory for practical judgments but that did not
fetishize a single type of theory or promote a single principle
over all others. We became convinced that several moral
principles provide significant common ground relevant to
judgments in the biomedical sciences, medicine, and health care
and that these principles could not be convincingly ranked a
priori in a hierarchical order.’ In other words, they
considered their four principles to be part of a ‘common
morality’, a mix of unphilosophical common sense and tradition.
Critics have variously argued that the four principles are too
vague, too narrow, or just downright simplistic. Beauchamp
and Childress have counter-argued, ‘We do not suppose that our
principles and rules exhaust the common morality; we argue only
that our framework captures major moral considerations that are
essential starting points for biomedical ethics. Some
critics contend that the principles in “principalism” are merely
clusters of moral concepts too abstract, general, and vague to
guide judgments about actions. In response, we show how
processes of specification and balancing link broad principles
and rules to the concrete moral judgments needed in practical
Furthermore, Beauchamp and Childress maintain that their
principalist approach is relevant, flexible and workable.
‘Because our principles are universally applicable, we defend a
global bioethics and not merely customary, regional, or cultural
rules. Our principles correlate with basic human rights
and establish what is ethically acceptable for all
societies. Nonetheless, the principles allow for justified
differences in the ethics of professional practice in societies
and cultures through processes of specification and balancing.’
There can be no doubt, Principles of Biomedical Ethics
is a great book, now in its eighth English edition and
translated into six languages. It is secular in nature yet
it jostles along with biblical ethics. Why? Because
biblical ethics are uniquely original, universally applicable,
ethically consistent and totally true. Principles
is, by contrast, derivative. So be warned, ‘These [rules]
are all destined to perish with use, because they are based on
human commands and teachings’ (Colossians 2: 22).
Traits of the religious
Scientific literature is not always a great place to understand
human thinking and actions. Yet, if science is true why
should it not chime with evidence from the Bible? What is
our true nature? Do we all have a religious streak?
And ‘religious’ is undefined here. There follows two
pieces of general interest – one metaphysical, one
biological. Can you spot yourself?
First, Jesse Bering is a psychologist now at the University of
Otago, New Zealand. He has told a particular story many
times. The audiences’ response is surprising.
Bering’s tale is about Richard Waverly, a 37-year-old history
teacher. Driving to work one day, tired and hungry and in
a bad mood, he loses control of his car, crashed into a
telegraph pole and is thrown through the windscreen. The
paramedics said he was dead before he hit the pavement.
The story is fictitious, but when asked questions, such as ‘do
you think Richard knows he is dead?’ and ‘do you think he wishes
he had told his wife he loved her before he died?’, large
numbers of volunteers answered, Yes. These are
unsurprising answers from those who had already professed a
belief in the afterlife. But, even people who totally
rejected the idea of life after death – so-called extinctivists
– also often answered, Yes. In other words, confronted
with the finality of death, the majority of people cling on to
the belief that it is not the end – most people believe in life
Second, what else do the religious have in common?
According to a recent study, they have more children.
Apparently it is because we have greater ‘fitness’ to reproduce
and pass on our genes. Or is it that we obey the commands
of Genesis 1:28 and 9:7, ‘Be fruitful and increase in number’?
Some scientists have argued that religious belief might help
people to cooperate, and so have helped to provide us with a
sense of common purpose. Others consider that it may help
the individual. In addition, most religions are ‘pro-life’
and therefore encourage family life. Some also discourage
the use of contraception.
Of course some want to explain it all in evolutionary
terms. For example, Janko Međedović, is from the
Department of Applied Psychology, Singidunum University,
Belgrade. Writing in the November 2019 issue of the Journal
of Biosocial Science, has states, ‘If individuals with
higher religiosity have elevated reproductive success, then
natural selection could actively propagate [genetic variations]
that contribute to the expression of religious
affiliation. In this case it could be reasonably assumed
that religiousness does have an adaptive function in
contemporary humans.’ Whatever that means.
Easier to understand is the key result of his study. He
asked 461 parents of psychology students at Singidunum
University how many children they had and also how many they had
planned to have when they were young adults. The more
religious the parents were, the more children they originally
desired and the more they ended up having – an effect
particularly marked among men.
Interestingly, Međedović’s results confirm the work of
others. In 2016, a review of census data, from almost 4
million women across 32 countries, found that those who were
religious were less likely to be childless.
Deaths over births
The UK’s industrious Office for National Statistics (ONS)
quietly hums away in the background. Its workers are busy
crunching the numbers about our lives – employment, internet
access, marriage, smoking, death, baby names (yes, it’s Oliver
and Olivia), travel and much more. Ultimately they produce
regular statistical reports. It’s all rather fascinating.
New ONS figures for 2018 point to a possible new trend for
England and Wales. The number of deaths of people, who
were born in the UK, was higher than the number of births to
UK-born mothers. The figures were 471,476 live births to
UK-born mothers and 487,618 deaths of UK-born persons.
This represents the first natural decrease of population, with
the exceptions of 1976 and 1977, since the publication of such
statistics began in 1838.
This 180-year demographic trend has been one of a natural
increase of births over deaths, apart from those 1970’s
blips. However, when the overall totals for all UK-born
and non-UK-born people are considered, they tell the customary
story. Non-UK born mothers are typically from countries
like Poland, Pakistan and Romania. 2018 saw an overall
total of 657,076 live births in England and Wales and 541,589
deaths. In other words, all births still outnumber all
Yet there is another unexpected statistic here. These data
demonstrate the lowest birth rate since records began 50 years
ago in 1938. It is also a 9.9% decrease from the recent
peak in 2012. The 2018 total fertility rate (TFR, the
number of children per woman, aged 14 to 44) decreased from 1.76
to 1.70. A TFR of 2.1 is regarded as the necessary
replacement rate for a stable population. Why the
decrease? People staying in education, fewer teenagers
having children and easier access to contraception are the
standard reasons given. Nobody seems to mention abortion,
which accounts for a loss of about 200,000 children each year.
Does it matter? Yes. A TFR below 2.1 means a country
has a skewed demographic pattern – lots of seniors and fewer
youngsters. If fewer workers are generating fewer taxes,
who will pay for the pensions and care of an aging
population? Some call this the ‘demographic cliff’.
Is 70 the new 65?
And the ONS has hit the headlines again recently. Its
November 2019 report entitled, Living longer: is age 70 the
new age 65? suggests that it may be time to rethink how we
measure and define old age in the UK. The reason?
Because more people are surviving and living more heathy lives
into their late 80s and beyond. This is the positive
outcome of improved medicine, public health, cleaner water and
air, the decline in heavy industry, campaigns against smoking,
and so on.
Traditionally, 65 has been taken as the entry point into ‘old
age’. For decades this has been the official retirement
age for men, when they can start drawing their state pension and
get free flu jabs. But working patterns are shifting and
the pension age is rising for both men and women – it will reach
66 in 2020 and 67 by 2028. Longevity patterns are also
shifting. Many who reach their 70th milestone birthday can
expect to live for another 15 years.
The ONS looked back at population data on health and life
expectancy to compare trends over time. If you take ‘15
years of remaining life’ as a marker, the average age when a
person will hit this point has changed over the last
century. In 1951, men and women around the age of 60 could
expect to live another 15 years. By the 1990s, it had
shifted to 65 and currently it is the 70-year-olds who can
expect another 15 years of life. In 2057, it is predicted
this average age will rise again to 75. So the ONS
proposes that ‘remaining life expectancy’ may be a better marker
of ‘old age’ than mere chronological age. That means we
should consider the years people have ahead of them, not just
their actual age when deciding to define what ‘old’ looks like.
If only we knew exactly how many years we had left. It
would probably spur us on. Yet we must be content with
this great unknowable. He is the Creator (Genesis 1:27),
the Sustainer (Psalm 54:4) and the Taker of human life (1 Samuel
The disgraced stem-cell maverick, Davide Vannoni, died on 10
December 2019 after a long illness. He was 53.
Vannoni had treated hundreds of people in Italy with his
unproven, unpublished remedies. Health authorities and
academic researchers fought to halt his work which they
considered to be pseudoscience and harmful.
Vannoni was born in Turin. He was neither a trained
scientist nor a doctor, but in 2007 he claimed to have invented
a stem-cell therapy that could cure neurological conditions,
such as Parkinson’s disease and muscular dystrophy. The
procedure, he said, converted stem cells taken from a person’s
bone marrow into neural stem cells, which were then infused back
into the patient. He marketed this therapy through his
organisation, the Stamina Foundation.
In 2012, the Italian Medicines Agency banned his therapy.
But Vannoni had a host of passionate celebrity, and often
desperately-ill, supporters, who repeatedly persuaded the courts
to permit the use of the ‘Stamina Method’. In May 2013,
the Italian health ministry even agreed to finance a €3 million
clinical trial to assess the Method. The contract was
quickly cancelled in October 2013.
In 2015, courts in Turin convicted Vannoni on conspiracy and
fraud charges. He was sentenced to 22 months in prison,
suspended on condition that he halted all further
treatments. Then in 2017 he was rearrested and charged
with offering the Stamina Method in other countries. He
was jailed, but released last year because of his ill health.
So ends a long saga, which made one man rich, but many patients
poor. It also highlighted the ease by which stem-cell
‘treatments’ can be hyped while damaging the reputation of
proper, proven stem-cell technologies.
Another one bites the dust
The controversial and shamed surgeon Paolo Macchiarini, who
faked research relating to dangerous and largely discredited
tracheal transplants, was, in November 2019, handed a 16-month
prison sentence. This was handed down by an Italian court in
Florence for his forging of documents and abuse of office while
he had worked at the Careggi University Hospital in that city
between 2009 and 2012.
From 2010, Macchiarini made headlines around the world after
claiming a major breakthrough for patients with failing
tracheas. He pioneered a novel procedure of regenerative
medicine by ‘seeding’ a prepared donated bio-scaffold with a
patient’s own stem cells, to generate a functioning trachea
which could be transplanted into the patient. Seven of the
eight patients who received one of his bioengineered tracheal
transplants have died.
Macchiarini’s subsequent time as a visiting researcher at the
prestigious Karolinska Institutet in Sweden was first greeted
with great excitement at the prospect of a genuine medical
advance. It then turned into an embarrassing scandal when
it emerged that Macchiarini had falsified some of his academic
credentials as well as his experimental results and knowingly
misled hospital authorities. The Karolinska was
dismayed. It conducted interminable enquiries, suffered
the resignation of senior staff, retracted several of
Macchiarini’s research papers and eventually dismissed the chief
troublemaker. He then went to work at the Kazan Federal
University in Russia until in 2017 it effectively fired him.
Stem-cell therapy for the heart
Stem-cell therapies are complex. Even when they seem to
work, their biological mechanisms remain largely unknown.
For example, when stem cells are infused into patients who have
suffered heart attacks, any improvements are thought to be
caused by the stem cells differentiating into beating
heart-muscle cells, called cardiomyocytes. This is now in
A team of researchers, led by Jeffery Molkentin, a
cardiovascular biology researcher working at the Cincinnati
Children’s Hospital Medical Center in Ohio, has demonstrated
that stem-cell benefits can occur without this
differentiation. Instead, the stem cells can trigger cells
of the immune system, known as CCR2+ and CX3CR1+
macrophages, which help to repair connective tissue in the
damaged area of the heart, which, in turn, improves the organ’s
function. In addition, they discovered that zymosan, a
chemical which is known to elicit an immune response, could
initiate the repair. This work was reported as ‘An acute
immune response underlies the benefit of cardiac stem-cell
therapy’ by Vagnozzi et al., in Nature (2020, 577:
The experimental results were quite unexpected. Two types
of stem cells were injected into artificially-damaged, so called
ischemia/reperfusion (I/R) injured, areas of mice hearts to
mimic the conditions of a heart attack. One type was
mononuclear cells taken from bone marrow, as commonly used in
human clinical trials, and the other was cardiac mesenchymal
cells. Both stem-cell types improved heart function of the
mice significantly better than when a placebo was
injected. And when macrophage activity was supressed no
repair occurred in the mice that received the stem cells or in
those that received zymosan. Yet even when the team
injected fragments of dead stem cells this too improved heart
So, could it be that local and acute inflammation, induced by
the immune system, is what drives the repair mechanism of
stem-cell therapies, rather than the regenerative capacity of
the stem cells themselves? And could this immune response
be the underlying mechanism that brings about health benefits
seen in successful stem-cell treatments for other diseases?
Stem-cell therapy for MS
From October 2019, a stem-cell therapy has, for the first time,
been recommended for use on the NHS for multiple sclerosis (MS)
sufferers in Scotland. This country has one of the highest
rates of MS in the world with an annual incidence rate of 8.64
cases per 100,000 people and with around 85% of patients having
the relapsing-remitting (RRMS) form of the disease.
Autologous haematopoietic stem-cell transplantation (AHSCT) has
been described as a ‘game-changer’ for MS after an international
clinical trial showed that it could reboot patients’ immune
systems and halt the progress of the disease.
The Scottish Health Technologies Group (SHTG) said there is now
sufficient evidence for it to recommend making AHSCT available
on the NHS in Scotland to MS patients who have highly active
relapsing-remitting (RRMS), rather than the progressive, form of
the disease, and who were not responding to drug
treatments. A number of high-efficacy drug treatments have
previously been approved but these therapies do not always
work. The theory is that the novel stem-cell treatment
works by enabling patients to 'reset' their immune system to
stop it attacking the central nervous system – as is the case in
However, the SHTG has warned that potential patients must be
made aware of the ‘demands, risks and uncertainties’ of the
treatment, which uses chemotherapy to wipe out a patient’s
faulty immune system before replenishing it with a transplant of
stem cells harvested from their own bone marrow. This
pre-treatment can put patients at high risk from infections,
which can be fatal. Nevertheless, some patients, who had
been in wheelchairs prior to undergoing the stem-cell treatment,
said their condition improved so dramatically it was like they
had never been diagnosed with MS. Everyone likes a good
story with a happy ending.
2020 is election year for US presidential candidates. At
the time of writing there is only one certain candidate – the
current and 45th President, Donald J Trump. Whatever the
personal, political and economic attributes of the man, one
thing is certain – Trump has so far been a seriously good ally
of the pro-life movement in America. On 22 January, the 47th anniversary of Roe v.
Wade, the 1974 landmark Supreme Court judgment that
legalised abortion in the USA, President Trump declared it to be
National Sanctity of Human Life Day. The associated
proclamation read, 'Every person - the born and unborn, the
poor, the downcast, the disabled, the infirm, and the elderly -
has inherent value ... As a Nation, we must remain steadfastly
dedicated to the profound truth that all life is a gift from
God, who endows every person with immeasurable worth and
potential.' By contrast, if a Democrat were to win the
election, he/she would undoubtedly be a poor ally, even an enemy
of the cause. Each of the six Democrats currently running
for nomination supports abortions up to birth.
March for Life 2020
On 24 January the US held its annual March for Life with its
main rally in Washington DC but with other gatherings in several
satellite cities across the country. It is the world’s
largest annual human rights demonstration. The theme for
the 2020 March for Life was ‘Life Empowers: Pro-Life is
Pro-Woman’. The main event began with a rally at noon in
downtown Washington, followed by a march to the US Supreme Court
The line-up of speakers included President Trump, the first
sitting US president ever to attend the March for Life. Mr
Trump declared to the crowds of tens of thousands, 'We're here
for a very simple reason: to defend the right of every child
born and unborn to fulfil their God-given potential.' The
annual event marks the anniversary of Roe v. Wade, the
1974 Supreme Court ruling that constitutionally allowed legal
abortion for basically any reason. Since then,
approximately 61 million unborn children have been legally
aborted in the US.
The Golden Globes
What? What’s this doing here? The Golden Globe
Awards are the annual bash for the Hollywood glitterati
honouring the best in film and American television. But
they also mirror the chattering of the liberal left, especially
in America. Michelle Williams (no, me neither) was
accepting an award in a Best Actress category and, though
pregnant, she turned her acceptance speech into a diatribe in
support of abortion.
Here are some extracts that were interspersed with the customary
inebriated cheers and applause. ‘I’m grateful for the
acknowledgement of the choices I’ve made and I’m also grateful
to have lived in a moment in our society where choice exists,
because as women and as girls, things can happen to our bodies
that are not our choice. I wouldn’t have been able to do
this without employing a woman’s right to choose. But
thank god or whomever you pray to that we live in a country
founded on the principle that I am free to live by my faith and
you are free to live by yours so, women, 18 to 118, when it is
time to vote please do so in your own self-interest it’s what
men have been doing for years.’ The luvvies loved it.
Christian pre-pregnancy centres
The choice for poor pregnant women in the US can be typically
stark. Abortion at a Planned Parenthood clinic, or
pregnancy at a Christian counselling centre. Now a third
option is opening. Get clients before they get pregnant.
Earlier this year, eight independent Texas-based pregnancy
crisis centres merged to form a chain called The Source.
Based in Houston, Dallas, San Antonio and Austin, this
non-profit organisation plans to offer a full array of medical
services, including testing for sexually-transmitted diseases,
first-trimester prenatal care and, most controversially,
contraception choices. Ironically, the business model they
are using is similar to that of hundreds of Planned Parenthood
The Source group, which will not refer patients for abortion,
will provide a range of contraception including pills,
injections, intrauterine devices (IUDs) and other contraceptive
methods. However, Plan B, the morning-after pill, will not
be offered. This venture represents a huge cultural shift
for Christian centres that normally do not offer
contraception. But it represents what some in the pro-life
movement say is a much-needed rebranding for pregnancy centres –
away from the emphasis of ending abortion and towards placing
women’s healthcare as the focus.
This new approach is not without risks. Many leading
pro-lifers are Roman Catholics and evangelical Christians,
who are either averse to contraception or at least think it
should be reserved for married couples. Others consider
that offering contraceptives will simply encourage
promiscuity. And some regard trying to compete with the
Planned Parenthood model to be a futile exercise. Will
such key supporters be lost? Will the scheme work?
Can providing abortion counselling and medical services be mixed
successfully? Yet there is a groundswell, particularly
among young pro-life supporters, that pregnancy centres should
concentrate on the needs of both babies AND their mothers rather
than just avoiding abortion.
Kentucky pro-life law stands
In 2017, the state of Kentucky passed a law, The Kentucky
Ultrasound Informed Consent Act, that requires doctors to
‘display and describe’ her foetus to a woman who wants an
abortion. In other words, she must undergo an ultrasound
scan and a description of what it depicts and hear the sound of
the unborn child’s heartbeat. However, women can avert
their eyes and cover their ears to avoid seeing the images or
hearing the foetal heartbeat. The State Governor, Matt
Bevin said, ‘We’re a pro-life state, we’re a pro-life
administration and I’m a pro-life governor, and we won.’
The American Civil Liberties Union (ACLU) challenged the law on
behalf of Kentucky’s only remaining abortion clinic. The
ACLU argued that ultrasound laws violate physicians’ speech
rights under the First Amendment. In June 2019, the
federal sixth circuit Court of Appeals in Cincinnati, Ohio,
upheld the Kentucky law and denied a review. That decision
was further challenged. Lawyers for Kentucky argued
against a review because, ‘Nothing can better inform a patient
of the nature and consequences of an abortion than actually
seeing an image of the fetus who will be aborted and receiving a
medically-accurate description of that image.’ On 9
December 2019, the US Supreme Court refused to review the
Appeals Court decision. The move is seen as a significant
victory for the pro-life movement.
Three other US states currently have similar ‘heartbeat
laws’. The Supreme Court will hear arguments in March in a
different abortion case. It concerns a Louisiana law that
requires abortion providers to have admitting privileges at a
nearby hospital. Pro-lifers are hopeful the Louisiana
case, June Medical Services LLC v. Gee, could be the
catalyst to overturn Roe v. Wade.
Slovakia almost followed suit
In late November, lawmakers in Slovakia debated a proposed law
that would compel women seeking an abortion to first have an
ultrasound and listen to the heartbeat of their foetus.
This is akin to the Kentuckian law.
Many will decry such a move. It’s cruel, it’s against
women’s rights, and so on. Those are logical responses if,
if, if the unborn child were not a real, live human being.
What is kind and gentle about abortion, where are the unborn
child’s rights? How conditioned we have become by the
encompassing attitude of progressive liberalism concerning the
whole abortion issue. Slovakian women will still be able
to go ahead and abort. All the proposed law would do is,
‘ensure that women are informed about the current stage of their
pregnancy.’ The authors of the bill have stated, ‘the
proposed draft law has positive impacts on marriage, parenthood
and family’ and that ‘society does not consider the induced
termination of pregnancy a good solution.’ See how easily
liberalism’s call for rights, privacy and autonomy can nowadays
transcend all other concerns. Christians and others can be
so confused, afraid and gullible.
The proposed bold bill narrowly failed on 5 December. A
total of 59 MPs voted in favour, which was just 4 short of the
simple majority of 62 MPs present. Only 24 MPs voted
against and 40 abstained. If passed, this law would have
been the first of its kind in the European Union. Across
Europe, 39 countries have legalised abortion on request, on an
industrial scale. Five countries – Andorra, Liechtenstein,
Malta, Poland and San Marino – allow abortion only in rare
instances, such as if the woman’s life is at risk.
Hungary’s push for babies
Like most European countries, Hungary’s birth rate is in
decline. Its population is shrinking by about 40,000
people a year. In an attempt to reverse the problem, prime
minister Viktor Orbán’s government is offering loans of £26,000
– roughly two years’ average salary – to any heterosexual,
newly-wed couple in which the woman is under 41. If they
have a child within five years, the interest is cancelled.
If they have three children, the loan is written off.
Perhaps not unsurprisingly, Hungary is currently experiencing a
wedding boom. The number of new marriages is the highest
since the fall of communism 30 years ago. The figure has
risen by 29% in the 12 months to last September. Bribery,
carrot, or social engineering, it will be fascinating to watch
China’s two-child policy
In 2016, China replaced its draconian one-child policy with a
two-child policy. If couples had more than two, they could
be punished by the loss of their jobs. Now that policy has
been relaxed. From January 2020, Chinese couples wishing
to have more than two children can now do so without the threat
of being sacked from state employment. Offenders may be
warned or demoted or fined, but no longer fired. Fines
have also been drastically cut.
Nearly 40 million Chinese people have state jobs, and another 40
million work for state-owned companies. Many people who
broke the law had previously lost their state jobs, while others
hid their children who had been born without authorisation for
fear of losing their employment. This new loosening of
birth restrictions is in response to China’s demographic
decline. Decades of its one-child policy have resulted not
only in slow population growth, but also in a rapidly ageing
sector. This is a potent recipe for creating and fuelling
a social and economic crisis. China, at last, has come to