Update on Life issues – Spring 1995

Lessons from the Holocaust
What will go down in history as the most cruel event of the twentieth century?  Probably, the Holocaust.  This year we especially remember that horror because 1995 is the 50th anniversary of the liberation of Auschwitz and some of the other Nazi death camps.  The systematic genocide of six million human beings is hard to comprehend.  Yet, it did happen, and it happened within living memory of many readers, and within a few hour’s travelling time from where we live today.  One of the most sobering events of my life was to stand, a few years ago, in the camp at Bergen-Belsen (which, by comparison, was a fairly mild regime because there were no gas chambers there) and to wander among the mass graves, where some 50,000 people were buried.  It was a bleak, bleak experience.

How and why did this unthinkable practice come about?  A ‘good’ read in this area is Michael Burleigh’s recent book, Death and Deliverance – Euthanasia in German 1900-1945, published by Cambridge University Press.  The seeds of such wickedness were sown well before the Nazis came to power.  At the turn of this century Mendel’s work on genetics was rediscovered and with it came the idea that a eugenic programme could gradually get rid of the so-called ‘inferior individuals’.  In 1920, a booklet by Binding and Hoche, The Sanctioning of the Destruction of Lives Unworthy to be Lived, was published.  Within two year Gerhard Hoffman was suggesting to the German government that mercy killing of the terminally-ill and ‘the exhausted’ should be widened to include crippled and incurably-ill children; after all, their care was costing the state a good deal of money.  At the time these proposals were regarded as outlandish; within a decade, they were official German policy!

In July 1933, six months after Hitler came to power, The Law for the Prevention of Hereditary Diseased Progeny was published and between 1934 and 1945 about 400,000 people (or 1% of the fertile population) were compulsorily sterilised.  In 1939 it became compulsory to register the births of all physically and mentally-handicapped babies.  Without examining such children, a committee of three decided their fate – those to be killed were taken to special clinics and either given an overdose of barbiturates or starved to death.  The killing of children, adolescents and young adults soon became routine and systematic.  In 1940, the euthanasia plan called Aktion T-4 was implemented and thousands of psychiatric patients were killed, mostly by gassing.  Once these atrocities were accepted, it was but a small step down the slippery slope to the mass extermination of the Jews and others in the death camps throughout Europe.

There are at least two alarming feature in all of this.  Firstly, the medical profession, the doctors, nurses and psychiatrists, were so easily persuaded to take in, indeed, to carry out, these horrors.  There is little doubt that without their collaboration the killings would never have occurred, or at least, not in such vast numbers.  Secondly, there were so few protesters; half of the victims in their early euthanasia programmes came from asylums run by churches.

If the Holocaust teaches Christians anything, then surely it is this: once a society has forgotten the biblical doctrine that men and women are special because we are ‘made in His image’, and has instead embraced the Helegian doctrine of ‘rational utility’, then there are no limits to human cruelty.  Could it be, in 50 years’ time, that our grandchildren will wonder how and why we allowed abortion, infanticide, euthanasia and destructive embryo experimentation to flourish in our land?

Results from the HFEA Consultation
Last year the Human Fertilisation & Embryology Authority produced a public consultation document entitled Donated Ovarian Tissue in Embryo Research & Assisted Conception.  Almost immediately after the July closing date for submissions had passed, the HFEA issues its analysis.  In all, there were 8,946 responses (including a joint one from the British Evangelical Council and the Evangelical Alliance).  One of the HFEA’s main recommendations was that the use of ova taken from aborted girl fetuses should not be used for infertility treatment.  Since most people consider such a procedure disgusting, or at least objectionable, it seemed as though common sense has prevailed.

However, all is not well.  The HFEA has decided to permit research on ovaries and ova taken from aborted foetuses, cadavers and live donors.  This is sinister for two reasons.  First, since only about 10% of respondents supported this type of research. We may well ask how the HFEA came to this decision.  Could it be that the HFEA had already made up its mind and the consultation exercise was a public relations’ stunt?  Second, for those at the forefront of medicine there is a very fine line between treatment and research – after all, every new treatment must first be researched.  This use of human gametes (whether donor ova or sperm) as mere biological material coupled with this blatant disregard of public opinion is a triumph for rational utility.  It will all end badly.

The House of Lords’ Report on Euthanasia
The House of Lords’ Select Committee on Medical Ethics has brought out a Report on euthanasia.  The Report was widely welcomed by many because it took a unanimous stand against euthanasia.  This was something of a surprise knowing the ethical perspectives of some of the Select Committee members.  However, such unanimity was possible because of some fudging of the issues.  For example, euthanasia was defined only as an intervention.  Thus, while the Report was against positive acts aimed at killing the patient, it says nothing about deliberate omissions aimed at killing the patient.  Furthermore, as the Report rightly states, it is the intention of the medical staff that is paramount.  However, if it is the doctor’s intention to shorten the patient’s life, there is no moral difference between killing by positive acts or killing by deliberate omissions.  This failure to recognise euthanasia by omission is lamentable, especially in view of the Law Lords’ poorly-reasoned judgement in the Tony Bland case the previous year.

Social Trends and Ethical Decisions
Some of the ethical seeds of an earlier generation are beginning to germinate.  The number of illegitimate babies is continuing to rise – 31% of births in the UK are now outside of marriage.  And nearly 6,000 babies are born in the UK to mothers aged 16 and under.  Meanwhile, the proportion of UK abortions performed through the NHS continues to rise, apparently because young, sexually-active hospital managers, raised in an ‘abortion-on-demand’ era, are happy to direct the needed cash towards providing such a service.  But the young are not the only ones to blame for sub-standard ethical practices.  A consultant obstetrician from St George’s Hospital, London and his boss, who also happened to be the president of the Royal College of Obstetricians and Gynaecologists – the sort of men we like to trust – have been caught cheating.  They recently published two research papers, one on a method for transferring a fetus which was growing outside the Fallopian tubes (a so-called ectopic pregnancy) to the womb.  Now they admit this work was a fake.  The consultant has been dismissed and his boss has resigned from the presidency of the RCOG.

Infertility and its Treatment
The drive for assisted conception continues to flourish.  A new variant of IVF is intra-cytoplasmic sperm injection (ICSI), which has recently produced its first live-birth in the UK.  This technique if especially aimed at infertile men with immotile sperm because it takes one sperm and injects it directly into one ovum; this is then followed by all the regular IVF procedures.  It has also been reported that sperm usually have a real struggle to reach and penetrate ova and that they need the help of the contractions produced by the muscles of the woman’s womb – lack of these is another probable cause of infertility.

And a group of chemicals called phthalates have now been linked to male infertility.  Phthalates are widely used in the packaging industry to keep plastics flexible, so even food wrappers may be a culprit.  Clearly, infertility has many causes – what we need is a decent study of its causes and some sensible preventative medicine, not all this high-tech IVF treatment with its attendant ethical problems.

Meanwhile, problems with surrogacy still rumble on.  In Italy a girl has been born from an ovum donated by a woman who died two years ago.  To increase the ethical problems the surrogate mother who carried her was her father’s sister, that is, the baby’s aunt!  And in America, where there are an estimated 1,500 surrogate births a year, a bachelor father has been charged with beating to death his five-week-old son before he was due to hand over $35,000 to the surrogate mother.  How can mere ‘breeding’ outside that relationship of marriage produce the profound loving environment we all yearn for?  Since when did surrogacy ever strengthen family relationships?

Human Embryo Experimentation in the USA
In the recent mid-term US elections the conservative-minded Republicans took control of the Congress and the House of Representatives from the libertarian Democrats.  Now, for example, the number of pro-life senators has risen to 19, an increase of five.  This has had some interesting effects on decision-making in some key ethical areas.  For example, in October 1994, President Clinton was about to give the go-ahead for public money to be used for human embryo research.  Such funding had previously been banned for nearly a decade because of the pro-life sympathies of Ronald Reagan and George Bush.  Then two months later, Mr Clinton was under pressure to appease the new Republican-dominated Congress and so he decided to change his mind and not fund such experimentation after all.  There can be little doubt that abortion and its associated issues will become hot items on the 1996 US election agenda.  US pro-lifers can take some heart.

Mother versus Baby and Abortion

In the closing months of 1994 there were two examples of that extremely rare ‘mother versus baby’ dilemma, where both patients cannot survive.  These are the really difficult cases where a heart-rending decision has to be made; they are a million miles away from the ‘social’ abortions that cost the lives of over 170,000 unborn children each year in England and Wales.  Both pregnant mothers had cancer and both knew that the required chemotherapy would harm their unborn children.  Both mothers therefore refused treatment and both died, but not before sharing several months with their newborn children.  These two women are the brave mothers, who thought carefully about the issues, took the awful decision and made the great sacrifice.