Update on Life Issues - June 2009

Abortion and Related Issues

Abortion Statistics.  In May 2009, the latest abortion statistics for England and Wales were released by the Department of Health – they refer to 2008.  They show that there were 3,440 fewer abortions (a drop of 1.7%) compared with the previous year.  Of course, any decline is good news, but a total of 202,158 abortions is still a huge, huge number.  And these annual abortion totals have remained stubbornly set at over 200,000 for the last three years.

Teenage abortions, for residents in England and Wales, also fell slightly.  Nevertheless, there were still 41,593 girls in the 15 to 19-year-old range, who had terminations, and there were still 4,113 under-16 year olds who went for an abortion.  These small, but nevertheless welcome, decreases occurred across nearly every recorded age group – are they just statistical blips, or could it be that more and more girls and women are recognising the value of their unborn child and seeking other ways to cope with their crisis pregnancies?

Two other, somewhat miscellaneous yet startling, figures stand out. Forty-six women, who had abortions during 2008, had had seven or more previous abortions.  And twenty-one women aged 50 and over terminated their pregnancies in 2008.

These data are contained in a 38-page Bulletin, which can be viewed at www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_099285.  They are complex, but they do show what is happening nationally, as well as in our local, primary care organisations.  They are well worth a quick look to remind us, if nothing else, of the magnitude and extent of abortion.

Abortion Advertising.  Meanwhile, plans are being hatched by the Broadcasting Committee of Advertising Practice to allow advertisements for condoms and abortion services on prime-time TV and radio.  The Government’s Independent Advisory Group on Sexual Health and HIV says this will help lower teenage pregnancy rates.  But surely, the primary purpose of all service and product advertising is to increase sales and usage.

Perhaps not surprisingly, members of this Group include representatives from the fpa (Family Planning Association), Brook and the British Pregnancy Advisory Service.  These are the very organisations promoting value-free sexual activity for all, and who also dish out contraception to all (including to under-age children, without parental knowledge) and provide the full range of abortion services (excluding, of course, proper counselling) to all.  The phrases, ‘poachers turned gamekeepers’, ‘biased advice’ and ‘vested interest’, come to mind.

The Government’s Teenage Pregnancy Strategy.  This has so far cost taxpayers more than £300 million and was meant to halve the rate of conceptions among under 18-year-old girls in England between 1998 and 2010.  It will undoubtedly miss that target.

Nevertheless, health minister Dawn Primarolo, stated recently that improved access to contraception has played ‘a vital role’ in preventing teenage pregnancy.  She continued, ‘Last year we invested £26.8m and have made a further £20.5m available this year to improve women's access to contraception, and help reduce the number of abortions and teenage pregnancies.’

So there seems to be plenty of money out there for sex education – so why not splash the cash and try something bizarre?  Why not?  Dutifully, the Government recently launched a so-called safer-sex campaign aimed at teenagers, called, Want Respect? Use a Condom.  It targeted young people via mobile phones and social networking websites.  But only 5,576 mobile phone users signed up for the videos, which cost £250,000 to make – that is, a cost of about £45 per user.  The Government said the campaign had been a success and the number of subscribers had exceeded its own targets.  Really?

Now try and think of something even more wacky.  What about this?  Give boys, as young as 12 years old, C-cards, condom ‘credit cards’, which entitle them to pick up free contraception at football grounds, barber’s shops, scout huts and the like.  That will spare them the embarrassment of visiting sexual health clinics, or facing that awkward assistant in the local chemist shop.

And guess who is drawing up this strategy for the Department for Children, Schools and Families?  Brook – who else?

Of course, the boys will have to earn their C-cards.  They must first attend a lesson to learn how to use the condoms.  Then, if they go to an additional class on sexually-transmitted infections, they get a special stamp on their C-card.  The organisers hope this extra insignia will become a real status symbol.  Oh, you mean like bragging about how many girls they’ve had sexual intercourse with?

One man who has a clear overview of the Government’s Teenage Pregnancy Strategy is David Paton, professor of industrial economics at Nottingham University Business School.  Earlier this year, he told politicians, regulators and policy advisors at a Westminster meeting, that the Teenage Pregnancy Strategy has been ‘absolutely disastrous’.  True, we all knew that, but when will the Government listen?

And to cap it all, UNICEF now says that UK teenagers are the unhappiest in Europe.  We have the highest level of sexually-transmitted infections in Europe.  We have the highest level of teenager pregnancies in Europe.  Yet we still persist with policies that deliberately sexualise our young people.  At times, more really can mean less.  Dare we now even mention the A-word?  Abstinence does work (of course it does), but who in schools, Government, even churches, is brave enough to talk about it, let alone, recommend it?

A Postscript On Dr George Tiller.  George Tiller ran an abortion clinic – Women's Health Care Services – in Wichita, Kansas.  It was one of only three in America that specialised in performing late-term abortions, that is, after 21 weeks of pregnancy.  Dr Tiller was shot and killed at around 10.00 am on Sunday 31 May as he attended a worship service at the Reformation Lutheran Church in Wichita.  A 51-year-old, Scott Roeder, who police believe pulled the trigger, was arrested – he was later charged with first-degree premeditated murder and aggravated assault.

We have been here before.  Here is the Christian stance.  Murder is wrong – it breaks the Sixth Commandment.  And while we abhor the practice of abortionists, we never adopt their strategy of deliberately robbing others of life.  The Bible, in passages such as Romans 13:1-7 and 1 Peter 2:13-17, allows us to resist civil government only a] when it commands something forbidden by God (such as, idol worship) and b] when it forbids something commanded by God (such as, preaching and praying).  Acts of violence will never bring an end to abortion, only changed hearts and minds can do that.  The killing of George Tiller is indefensible.  But it should not cower us, rather it should galvanize us to defend and protect the unborn.


Assisted Reproductive Technologies (ARTs)

The Global Overview.  ARTs (predominantly as IVF or ICSI) are becoming more and more popular and more widespread.  The May edition of the journal Human Reproduction contained the results of the Eighth World Report on ART, which refers to 2002 data derived from 1,563 fertility clinics in 53 countries.  Compared with figures for 2000, the number of ART cycles worldwide increased by about 25%, while the numbers of ART babies born in 2002 was 246,000, an increase of about 12% over that two-year period.

Some of this increase in ARTs is because more career women are delaying starting a family only to find that getting pregnant is no longer straightforward.  In the mid-1980s, about 8% of women who got pregnant were over 40, whereas now that figure is 19%. Many have turned to ARTs.  Yet no panacea exists here.  For a woman over the age of 42, the success rate, in terms of a ‘take home baby’ for each IVF cycle is just 5%, whereas for a woman under 35, it is 31%.

And more and more of these older UK women are travelling abroad for treatment.  Apparently lack of access to ARTs and NHS funding are big issues for UK women over 39 years old.  And in addition there is a shortage of donated ova within the UK.  So, Spain and the Czech Republic have become the most popular destinations for fertility tourism.

While in many countries, such as the UK, the number of embryos transferred per IVF cycle has decreased, in others, such as South Korea, Latin America, India, and the United Arab Emirates, multiple transfers and thus multiple pregnancies, are still commonplace with the inevitable higher rates of prenatal deaths, premature births, low birth weights and poor cognitive development.  This global trend is demonstrated by the fact that in 1997, twins, triplets and quadruplets accounted for 29.5 percent of all assisted reproduction births, whereas in 2006, only 19.9 percent were twins, 0.9 percent were triplets and, for the first time, there were no quadruplets.

Problems and More Problems.  Yet another recent study reported that IVF twins are more likely to be admitted to neonatal intensive care and to be hospitalised in their first three years of life than naturally-conceived twins.  Why IVF twins are at additional risk in unknown, but the underlying causes of parental infertility and the physical manipulation techniques of ARTs may be factors.

Then there are IVF ‘mix-ups’.  Admittedly, these are rare, but there were more than 60 so-called minor ‘mishaps’ last year in UK fertility clinics.  The latest ‘mix-up’ occurred in December 2007 at Cardiff's University Hospital of Wales but was only confirmed in June 2009.  A couple from Bridgend had the last of their nine frozen embryos wrongly transferred to another patient, who, upon hearing of the blunder, took the morning-after pill to end any possibility of a continued pregnancy.  The couple, who were described as in ‘shock and anger’ and ‘absolutely devastated’, won a reported £25,000 in damages from Cardiff and Vale NHS Trust.

This is a poignant and sad story – it includes human embryo death by either freezing or abortion, a broken-hearted couple and a runaway technology.  But it raises two questions.  First, over the years just a handful of such serious IVF ‘mix-ups’ has been reported – is the real total much higher?  Second, if a human embryo is just a collection of cells, which can be as easily destroyed as it can be transferred, why is anyone upset by such a gaffe?

The Way Around ARTs.  All of this is unsettling.  Of course, ART babies are still a small percentage of any country’s total births – less than 2% in the UK.  Yet, there is an undeniable train of thought here, namely, that science, in this instance, fertility medicine, will answer society’s problems, self-inflected or otherwise.  Sadly, more and more evangelical Christians are resorting to ARTs, apparently disregarding both the medical, and especially the bioethical, issues.

The pastoral call is this.  Statistically, there are infertile couples in every evangelical church.  What do we do?  Counsel the couple to accept childlessness?  Yes, many do.  Investigate the cause(s) of their infertility?  Yes, many do.  Support them in some low-grade assistance, such as a less stressful lifestyle, or some hormonal stimulation of the ovaries?  Yes, some do.  Or turn to Natural Procreative (NaPro) technology, which offers a decent pro-life solution to many couples’ infertility?  Sadly, too few do.  The details are available at www.lifecharity.org.uk/fertilitycare


The Obama Months

The Good and the Bad.  Barak Hussein Obama was sworn in as the 44th President of the United States on 20 January 2009 – he has now been in office for about six months.  Like all new heads of state, he will inevitably disappoint – the hype and hope that surround elections can never be sustained (remember that of Tony Blair in 1997?).

Yet Obama seems such a nice guy – sharp dresser, warm smile, GSH, pleasant voice, good rhetorician with a sweet family, but already he is proving to be a bioethical disaster.

On the third day of his presidency, he rescinded the so-called Mexico City Policy, which barred US aid to foreign organisations that perform or promote abortion.  Then he reversed Bush’s restrictive policy on destructive human embryonic stem cell research.

Responses From Pro-lifers.  The honeymoon is apparently not quite over, though a rocky road inevitably lies ahead.  For example, at the annual Southern Baptist Convention held during June at Louisville, Kentucky, some 8,600 delegates commended Obama for ‘his evident love for his family’.  However, they also expressed strong disagreement with the President on some of his policies, including his decisions to expand federal funding for human embryo research, increase funding for pro-abortion groups, and reduce funding for abstinence education.  Yet rightly, they also urged Christians to pray for Obama that he will promote liberty and justice for all people, including the unborn.

He has also upset the Roman Catholics.  In May, one of the USA’s leading Catholic centres of learning, Notre Dame University, invited President Obama to receive an honorary degree and address the student body.  It was a controversial move.  There were vigils and protests (and arrests) by those opposed both to the President’s pro-choice stance on abortion and embryos as well as to the University authorities betrayal of Catholic principles.  During his speech, the President made this plea, ‘Let's work together to reduce the number of women seeking abortions by reducing unintended pregnancies, and making adoption more available, and providing care and support for women who do carry their child to term.’  Fine words indeed, but already he is aggressively promoting policies that deny the basic equality and dignity of every human being – that should upset evangelicals as well as Roman Catholics.

More Bad Decisions.  Then again he has nominated Sonia Sotomayor to serve on the country's Supreme Court to replace Justice David Souter, who recently announced his retirement from the top US court. Souter has been no great friend of the pro-life cause, and the liberal Sotomayer (who, at just 54, will serve on the Court for many, many years) already has a record of abortion activism.  Of the present nine incumbents, four are regarded as liberals, four as conservatives and one as unaligned. Disappointingly, she will maintain the status quo in this finely-balanced Court, which on bioethical issues has often voted 5-4.

And in yet another early and unprecedented move, President Obama has promptly dismissed all the current members of the President’s Council on Bioethics.  This grouping was inherited from the Bush years and typically held a strong conservative line on matters of bioethics.  According to Reid Cherlin, a White House press officer, the Council was designed by the Bush administration to be, ‘a philosophically-leaning advisory group’ that favoured discussion rather than the development of a shared consensus.  Apparently, President Obama will appoint a new bioethics commission with a new mandate and, in the words of Mr Cherlin, one that ‘offers practical policy options.’  Hmmm, that sound ominous!

Finally, in yet another reversal of George W Bush’s policies, 30 June 2009 marked the end of most federal funding for abstinence-only sex education.  The new President has instead called for at least $164 million to fund contraceptive-only education in schools, which will be organised by pro-abortion groups like Planned Parenthood.  It is often said that Britain follows America – this looks like a bit of role reversal.


Epigenetics and Karyotyping

By and large they speak a different language in Genetics City.  It is beyond the comprehension of most of us, but now and again a little Genetish can be useful.  These two terms are currently just about the hottest buzzwords in Genetics City, so we should try to master them.

Epigenetics Is Not A New WordConrad Waddington is generally credited with coining it as long ago as 1942.  Now it has taken on a new lease of life.  It refers to the study of interactions that bring about changes to an organism by mechanisms other than via its DNA sequence (from the Greek, epi-, in addition to).

In other words, what we are, physically, is not entirely determined just by our basic DNA code – that is last-century biological dogma.  The latest thinking suggests there is a host of other subtle triggers and products that can turn our genes on and off, sometimes at inappropriate times.  We know virtually nothing about these epigenetic modifiers and the ways in which they operate, but they do seem to be important in making us unique individuals.  It may be that these tiny epigenetic changes account for say, the onset of a particular cancer.  So, the hope is that epigenetic knowledge will lead to significant improvements in both disease diagnosis and therapy.  Hot stuff indeed.

Karyotyping Is Not A New Word Either.  It is a technique that involves examination of the chromosomes in the nucleus (from the Greek, karyo, nucleus) in order to identify the presence of chromosomal abnormalities.  It has been used for many years in prenatal screening, for example, for detecting Down’s syndrome or spina bifida in fetuses, or in the preimplantation genetic diagnosis (PGD) of embryos in conjunction with IVF.

Karyotyping has surfaced in the news because it is just about to become very, very sophisticated. Instead of screening for just one or two genetic disabilities, scientists can now screen for thousands, perhaps as many as 15,000 inherited diseases and other characteristics, simultaneously and rapidly.  Known as karyomapping, it is likely to become generally available within the year at a cost of around £2500.

How sophisticated we will then become in weeding out those with disabilities and displeasing characteristics, however minor. Researchers have already attempted to allay our future fears by reassuring us that there will be strict limits on what the tests can be used for.  Embryos will only be tested (and discarded) for conditions that are serious or life-threatening.  We need have no fears about designer babies.  And with the HFEA overseeing and issuing the required licences, we can all rest assured.  Oh yes?  I smell eugenics.


Spain And Its Bioethics

Well, Spain is apparently the favourite foreign holiday destination for Brits.  It may beat us on sunshine, but bioethically it is becoming just as bad as Blighty.

In June, the Spanish government announced it was to be the latest European country to allow over-the-counter sales of the morning-after pill (MAP, or la pildora del dia despues).  The government also approved sales of the MAP with no age restrictions, so teenage girls can purchase the drug with neither a consultation with a doctor nor parental input.

The health minister, Trinidad Jimenez, justified the move by saying that the morning-after pill has reduced the number of abortions in countries where it is widely accessible.  That is certainly not the case within the UK. Here the MAP became available as a prescription-only drug in February 2000 as Levonelle-2, and then in over-the-counter formats, as Levonelle in January 2001 and as Levonelle One-Step from November 2004.  Yet our abortion figures have risen from 185,375 in 2000 to 202,158 in 2008.  Señora Jimenez, you are wrong.

Furthermore, the Spanish government has also recently approved plans to relax its abortion law (ley del aborto) and allow the procedure, without restrictions, up to 14 weeks of pregnancy.  In other words, it will be abortion on demand. Under the current law, abortions are only allowed under restricted circumstances and rarely in a public hospital.  In future, abortion will also be available up to 22 weeks of pregnancy, as long as two doctors certify that there is a serious threat to the health of the mother, or fetal malformation.

The deputy prime minister, Maria Teresa Fernandez de la Vega, stated that the new law would be, ‘in line with today's Spanish reality’ and necessary, ‘to preserve the dignity of women.’

Think about that as you bask under the Iberian sun – it’s just like home.

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