Update on Life Issues – June 2007
This year is the ruby anniversary of our dreadful 1967 Abortion Act – there is nothing to celebrate. This is the legislation that has sanctioned the death of some 7 million unborn children throughout England, Scotland and Wales. Abortion is a gruesome practice, unworthy of any civilised society. We should all be ashamed that we ever allowed it to occur – and then to let it continue for so long. The latest figures show that there were 201,173 abortions in England and Wales during 2006 – these were performed on 193,737 resident women plus 7,436 non-residents. This was a record total and the first time the 200,000 barrier has been breached. While there can be no redeeming features from the grim facts, there are some recent crumbs of consolation that may, just may, point to a change of heart among some.
In April, the Royal College of Obstetricians and Gynaecologists (RCOG) warned that Britain could be facing an abortion crisis because an increasing number of doctors and nurses are refusing to get involved. The staid RCOG reported that it was aware of, ‘the slow but growing problem of trainees opting out of training in the termination of pregnancy and [that it] is therefore concerned about the abortion service of the future.’
The very same RCOG owns its own journal – the British Journal of Obstetrics and Gynaecology. In its May 2007 issue it reported a 10-year analysis of abortions performed in the West Midlands on the grounds of fetal abnormality. It revealed that 102 (3.2%) babies from the total of 3,189 abortions were actually born alive – and survived for an average of 80 minutes, but also as long as 6 hours. Such live births occurred in 18 out of 20 maternity units throughout the West Midlands. Now is that any way for the RCOG to attract trainees into the abortion industry?
Also in May, in an issue of the GPs' magazine Pulse were the results of a survey. It seems that a quarter of UK doctors are refusing to refer women for terminations and more than half said that the current 24-week abortion limit should be reduced because medical advances mean that babies born before that cut-off time are capable of survival.
Earlier in the year, the Howard de Walden estate, owner of many of the properties on the UK’s most famous medical district, Harley Street, where more than 3,000 medical practitioners work, banned its tenant-doctors from performing ‘lifestyle’, abortions on its premises. It is these ‘lifestyle’, or ‘social clause’, abortions which account for more than 90% of the total currently carried out in the UK. Harley Street is the area where many of the pre-1967 abortions took place – where having a 100 guineas and knowing the ‘right’ person were the entrées to a termination. Now it seems that some of the well-to-do are beginning to abhor abortion.
Apparently, this change of heart is all to do with ethical distaste and growing religious convictions. Among healthcare workers it has led to an increase in ‘conscientious objectors’ who request exemption from the ghastly task. In addition, there is the so-called ‘dinner party test’ – whereas gynaecologists who deliver babies are revered, no one boasts about being an abortionist. Although public opinion still remains largely in favour of abortion provision, and though repeated political attempts to tighten the law have failed, if there are insufficient abortionists, the practice may begin to shrink. No practitioners – no practise.
Predictably, the British Pregnancy Advisory Service, which carries out a quarter of all UK abortions, believes the Government should do more to, ‘motivate doctors to train in abortion.’ But instead of treating these ‘rebel’ doctors as a problem, should we not be listening to them? Abortionism is a low-grade, undemanding profession, it heals nothing, and frankly it stinks. It does seem that the younger generation of doctors and nurses (and others) are beginning to understand and reject the abortion trade. That is a sizeable crumb of good news.
Meanwhile in the USA, abortion rights have already been restricted for the first time since the 1973 Roe v Wade legislation. In April 2007, the US Supreme Court voted 5-4 to uphold a nationwide ban on ‘partial birth abortions’. These are a particularly grisly type of late-term abortion, where the unborn child is pulled out feet first, the head is then crushed and the brain sucked out to ease the extraction of the rest of the body. It is the first time that the Supreme Court has intervened in the doctor’s choice of abortion methods. Most commentators agree that this landmark ruling, which has been fought over in the lower courts since 2003, could provide the impetus to tackle the colossus of Roe v Wade.
This happy crumb of news comes after a series of minor victories against abortion since President Bush came to power. For example, South Dakota has already passed a law banning most types of abortion. Other states have started to outlaw it too. Procuring an abortion is becoming increasingly difficult in most states. For instance, in the whole state of Mississippi, with a population of about 3 million, there is now just one abortion clinic remaining, incongruously called the Jackson Women's Health Organization. Many doctors and nurses in the US, as well as swathes of ordinary citizens, have long abhorred the practice of abortion, mainly on religious grounds. After all, some 120 million US citizens say they attend a place of Christian worship every Sunday. And 22% of Americans regard abortion as a key issue in the upcoming 2008 presidential elections. And more than 60% of the US electorate want either stricter limits or a complete ban. Contrast those figures with the UK!
Preimplantation Genetic Diagnosis (PGD)
The HFEA is about to do it again. A few years ago the HFEA banned the screening of human embryos by PGD, it then permitted a few cases to create lifesaving ‘saviour siblings’, then for some ‘serious diseases’. Now it is about to sanction PGD for diseases which may, or may not, even occur in the future. This is a classic bioethical slippery slope – each extension of the PGD procedure justifies the next even greater step. The day is approaching when all IVF embryos will be PGD-screened for hundreds of defects and unwanted characteristics and those found to contain any such genetic features will be simply squashed – that will be the day of the fully-fledged designer baby.
This latest bioethical blunder by the HFEA concerns a type of breast cancer caused by a fault in the gene known as BRCA1. Researchers at London’s University College Hospital have applied for a licence to screen embryos for this particular gene because two young couples, with family histories of breast cancer, are hoping to use PGD and IVF to select unaffected embryos.
Breast cancer is a nasty disease. After lung cancer, it is the most common cause of cancer death – in 2004, it was responsible for 12,347 deaths of UK women. Currently, there are around 42,000 new cases of breast cancer among women and 300 among men diagnosed each year in the UK. Most breast cancers occur randomly, though 5% are caused by inherited genes, one of which is BRCA1. Women with this defective gene will not definitely contract breast cancer, but 80% will. Even then, the onset of the cancer is likely to be 20 or more years away.
Some women who have had BRCA1-type cancer in the family refuse to be tested as adults, primarily because of the psychological effects of the uncertainty surrounding a positive test. Others, upon discovering that they are carriers, have undergone double mastectomies. The proposed PGD screening will eliminate BRCA1 carriers, although, of course, the non-carriers may still contract other more common types of breast cancer.
The above procedures seem all the more crude and unnecessary because in late May it was reported that, ‘New research into breast cancer genetics opens a fresh chapter in medicine’ and, ‘A revolution in cancer screening and treatment within 15 years is heralded’ and, ‘The biggest advance in the field for more than a decade.’ The new techniques, developed at Cambridge University, can examine 200,000 pieces of DNA simultaneously and are analogous to ‘trawling’ for rogue cancer-causing genes rather than the previous ‘rod and line’ approach. Already four commonly-occurring such genes have been identified – rapid screening, accurate diagnosis, effective treatment, even prevention are in the pipeline not only for breast cancers but for other types of cancer too.
Meanwhile, where will all this PGD screening and destruction of embryos lead? It is a crude, modern-day Herodian tactic – wipe out the perceived enemy. Such an approach obviates any effective search for proper treatments and cures – from that standpoint it is simply old-fashioned eugenic medicine. Yet there is something additionally sinister here. Medical geneticists and others repeatedly tell us that they expect cures to be discovered for BRCA1 and similar late-onset diseases within the next decade, but their current screening and destruction activities do not support their own words. Moreover, the HFEA talks about PGD only for ‘serious medical conditions’, yet PGD is now being permitted for conditions such as congenital fibrosis of the extraocular muscles (CFEM), where there is no impact on life expectancy and for which effective treatments already exist. ‘Serious’ can be a hollow word. Could it be that these technologies are for the long-term prevention of disabled people being born? Well, there’s a disturbing thought!
Hybrids, Chimeras and Cybrids
Mixing genetic material from different animal species is nothing new. It can occur naturally – a mule is the offspring of a male donkey and a female horse. Or it can occur deliberately – in 1984, a sheep embryo and a goat embryo were artificially fused to create a chimera named the ‘geep’. Such creatures are somewhat strange but not particularly sinister. However, when inter-species fertilisation involves those made in the image of God, we all need to wake up.
Back in the 1970s, male subfertility was assessed by the ‘hamster test’ – if human sperm could not penetrate a specially-treated hamster ovum then the man was probably infertile. It was a queasy artifice that has since been superseded by other methods.
Even in 1984, the Warnock Report recognised that, ‘There are a number of specific techniques and procedures involving the use of human embryos which have caused much public anxiety.’ The Report went on to recommend that, ‘… where trans-species fertilisation is used … for diagnosis of subfertility it should be subject to licence and … the development of any resultant hybrid should be terminated at the two cell stage.’ Who would have thought that the infamous Warnock Report would one day be regarded as prohibitive? But that is what twenty years of slippery slopes can accomplish.
Now comes something much more alarming and sinister. In December 2006, the Government, in a White Paper, announced its intention to outlaw the creation of animal-human hybrids. Furthermore, in January 2007, the HFEA decided to postpone a decision on two licence applications from research teams that wanted to produce such hybrids. That was a welcome stance, and one which was in line with most other European countries.
But in April 2007, the House of Commons Science and Technology Committee published its report, which, after heavy lobbying from scientists and the biotechnology industry, recommended the creation and use of nonhuman-human hybrids, chimeras and cybrids. Why? Because, according to that tired old mantra, embryonic stem cells are necessary for research into serious and debilitating human diseases. The so-called ‘necessity’ for such hybrids is due to a dearth of human ova. Human sperm is easy to obtain – human ova are not. There are some left over from IVF treatments, but there are not enough to use for therapeutic cloning and the subsequent embryonic destruction and harvesting of their stem cells. Scientists have therefore turned their thinking to, for example, using ova from cows – there is a glut of these in every slaughterhouse across the land. So, why not use them to generate human (well, 99.9% human) stem cells using these human-nonhuman gamete combinations? After all, these creations are only for research purposes and they must be destroyed after 14 days.
Then in May came the publication of the Human Tissue and Embryos (Draft) Bill [www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegislation/DH_074718] by which time the Government had completely dropped its previous opposition to the creation of animal-human hybrids and chimeras. This is a most unwelcome shift. The draft Bill now goes for pre-legislative scrutiny by a Parliamentary Select Committee before being debated in both Houses at Westminster later this year. Then we will all have the opportunity to meet with and write to our MPs and peers to express our objections to all this wrong-doing – the finalised Bill will include other unpalatable features relating to IVF, surrogacy and probably abortion too.
This is a hugely complex area of science. There is, for instance, disagreement even over the precise definition of some of the terms. Nevertheless, the Bill identifies five types of inter-species embryos as:
1] Human-animal hybrid embryos: These are embryos created by the fertilisation of a human egg by the sperm of an animal, or fertilisation of an animal egg by a human sperm.
2] Cytoplasmic hybrids (cybrids): These are embryos created by techniques used in cloning, using human cells and animal eggs. The embryos would be mostly human except for the presence of animal mitochondria.
3] Human transgenic embryos: These are embryos created by the genetic modification of a human embryo, specifically by the addition of animal DNA to the nucleus of any cell of the embryo.
4] Human-animal chimeras: These are human embryos altered by the addition of one or more cells from an animal or animal embryo.
5] Embryos created using the DNA from a human gamete or gamete like cell, where that embryo also contains animal DNA.
Of course, creating such inter-species embryos is entirely unnecessary – the use of adult stem cells is the bioethically prudent and practical alternative. And their creation is also unethical – it diminishes human dignity, it blurs moral boundaries, and it crosses that fundamental frontier which separates humans from animals. Is this the beginning of making animals with human traits, or of humans with animal characteristics? It certainly is not science conducted within a robust ethical framework.
Assisted Reproductive Techniques
One case has dominated the ART news recently, that of Natallie Evans. This is the background. In 1999, Miss Evans met Howard Johnston and they began living together. In October 2000, she was diagnosed with ovarian tumours. The required removal of her ovaries would render her unable to conceive naturally, though she would still be able to carry a normal pregnancy. In order that she might one day have children she agreed to have some ova harvested and for these to be fertilised by sperm from her partner Howard Johnston. In November 2001, the couple underwent IVF at the Bath Assisted Conception Clinic and six of their IVF embryos were frozen and stored for future use. Both Miss Evans and Mr Johnston gave the required written consent for the creation, use and storage of these embryos. Later that month, Miss Evans had an operation to remove both of her ovaries. But by May 2002 their relationship had ended, and in July of that year, Mr Johnston wrote to their fertility clinic requesting that their embryos be destroyed.
Miss Evans went to law requesting the use of the stored embryos. Her action failed in both the High Court and the Court of Appeal. Leave to appeal to the House of Lords was denied. The Human Fertilisation and Embryology Act (1990) makes it plain that both gamete donors have a clear and unambiguous right to withdraw consent to the use and storage of IVF embryos. On 14 February 2005, Miss Evans applied to the European Court of Human Rights on the grounds that the UK law, which required the destruction of her six stored embryos, was a breach of her human rights. In March 2006, that Court decided 5-2 against her. An appeal was lodged. On 22 November 2006, Miss Evans made her final appeal before the seventeen judges of The Grand Chamber of the European Court of Human Rights, but on 10 April 2007, they unanimously ruled against her – her right to become a mother did not outweigh Mr Johnston's right not to become the father of their children. The embryos were ordered to be destroyed.
This prolonged case raises all sorts of tangled issues – consider just seven. First, we ask and expect mothers to defend and nurture their children, whether born or unborn, and we commend them when they do just that. Natallie Evans tried to do just that, but the system was against her.
Second, one cannot but feel sympathy for Natallie Evans. She wanted children and so, at one time, did Howard Johnston. Moreover, they both signed a contract stating that wish. What is more, they actually became a mother and a father as soon as those embryos were ‘made’. It is obvious that they ‘belonged’ to somebody – call them the gamete donors, the couple, mum and dad, whatever, parenthood was inescapably chosen by Miss Evans and Mr Johnston.
Third, when one party breaks the IVF contract, the law cannot dissolve that bond of parenthood, instead the law rigidly and cruelly, even absurdly, insists that human life must be destroyed. Human embryos thus become the bargaining chips, mere commodities, the pawns in a broken relationship – they are provided with zero protection.
Fourth, if Mr Johnston had died before withdrawing his consent, the transfer of the embryos to Miss Evans’ womb could have proceeded. The fact that a living ex-boyfriend can deny a mother the opportunity to gestate her children is bizarre – it is truly, an extraordinary state of affairs.
Fifth, was Mr Johnston’s action so very different from thousands of other men/fathers, who get their girlfriends naturally pregnant and then decide to scarper? However sad and cowardly a deed that is, at least no embryos die as a direct result. It may be an easy way out for the father, but not so for the expectant mother. The obligations of parenthood are clearly not equal.
Sixth, does anyone, or even everyone, have a right to children, a right to become a parent? ‘No’ must be the common and commonsense answer. But is there a right not to be a parent? Abortion is generally considered as a woman’s right not to be a parent. But a man who cannot face parenthood is not allowed to force a woman to undergo an abortion. Nor, on the other hand, can his desire for fatherhood prevent a woman from aborting. Moreover, a mother can give her child up for adoption, but the father can have no say in the matter. So why is the choice to have, or not to have, children so arbitrary? In one case the father is the arbiter, in another it is the mother – the unborn child of course never has a say. The secular humanist’s beloved concept of maintaining autonomy over one's body and reproductive rights begins to crumble in the real world of broken relationships and careless reproduction. No legal tinkering is going to iron out these genuine predicaments.
Seventh, because of the very nature of IVF, with all its artificiality and irregularity, such bioethical dilemmas will inevitably occur again. Some sort of solution would be to allow only ova, rather than embryos, to be frozen and stored for women about to undergo operations that will result in their infertility. Such freezing and storage is already available for men, but the required technology for ova lags behind that for sperm.
What then is the real answer? Three things are required. First, we must uphold and promote the model of Christian marriage – that lifelong, exclusive covenant between one man and one woman. When such wholesome marriages become the rule the majority of relationship problems will disappear. When chastity before marriage and fidelity within marriage become the norm, promiscuous sex, unwanted pregnancies, lies and cover-ups will fade away.
Second, we must maintain that sexual intercourse, pregnancy and parenthood are designed for, and appropriate only within, the marriage covenant.
Third, we must recognise that the use of assisted reproductive technologies encourages bioethical disasters – these procedures are to be avoided.
Of course, critics will sneer that ideals such as these are unattainable – but why should we be constantly striving for second or third best? Such defeatism is egregious. As cheerless as the Evans’ case has been we must acknowledge that if it were not for cohabiting, promiscuous sex and IVF it would never have come about. What a trio of problem-causing catastrophes they are.
On the other hand, the application of biblical Christianity is
always entirely practical and beneficial. Its wisdom shines through – how
marvellous that you can be ‘transformed by the renewing of your mind’ (Romans
12:2). Moreover, the end of abortion, infanticide, euthanasia, embryo
destruction and so on, depend ultimately upon a return to the Book. Easy to say,
harder to do. Yet the application of biblical ethics is for the good of all men
and women and children. Yes, the entire answer has been carefully written out
for all to read, understand and obey – it is ‘through our knowledge of Him’ that
‘has given us everything for life and godliness’ (2 Peter 1:3).