Update on Life Issues - November 1996

If the days of last summer were not memorably long and hot, the ethical debates certainly were.  "Life issues" were again top of the media agenda and consent, in its various forms, was a major theme.

Caesarean sections without consent.  It all started during June, in two separate cases, when doctors were given permission to perform Caesarean sections on two women against their express wishes.  Almost unbelievably, the judgements were made while the women were in labour because the High Court judge thought that the pain and stress of labour would prevent them from making the right, informed choice.  However, there was no evidence from the medical staff accompanying either woman that they were anything other than mentally competent.  These, and other previous similar cases, do seem to contradict the well-established principle that informed and mentally competent patients should not be forced to undergo operations without their consent.  After all, we are told, “the patient does have the right to choose”.

 Orphaned embryos and the HFEA.  On Wednesday 31 July, the HFEA (Human Fertilisation and Embryology Authority) insisted that upto 4,000 human embryos must be destroyed because their 5-year storage period was up.  These embryos had been stored since 1991 and been abandoned by their parents.  At least, the HFEA and the IVF clinics could not trace the parents to gain their consent to store their embryos for a further 5 years.

It was indeed a macabre moment to witness the white-coated technicians on TV withdrawing the glass vials, containing the embryos, from the fuming, freezing liquid nitrogen, opening them and then allowing the embryos to warm up and perish so they could be discarded along with the hospital waste.  This ghastly activity was going on at IVF clinics up and down the UK for several days at the beginning of August.

The only sensible answer to this dilemma is quite simple.  Parliament must act immediately to halt the freezing of all human embryos.  However, even this solution will mean that many more embryos will have to be destroyed over the next five years because tens of thousands are already stockpiled, 'deserted' by their parents and awaiting the date of their 5-year storage period to run out.  But at least this solution would stop this awful practice continuing too far into the 21st century.

 Selective reduction and the 16-week twins.  Then in August there was the news of the 28-year-old mother, pregnant with 16-week-old twins, who wanted to abort one of them because she felt she was in “straitened circumstances” and could not cope with both.  In poured money, apparently about £50,000, as well as indignation from around the world that a so-called civilised society could allow the destruction of a perfectly healthy baby (not that the handicapped deserve to be aborted).  This so-called “selective reduction” of multiple unborn children is nothing new - it was practised on at least 74 occasions in the UK during 1994, mainly because of fetal handicap, or the presence of quads or quins resulting from IVF treatment.  What was “new” about this particular case was that selective reduction was, for the first time, being used for economic and social expediency.

A High Court injunction was obtained to stop the abortion, but it was later revealed that it had already occurred.  Indeed, it was later revealed that the mother was a married, wealthy career woman with no social problems.  Amid all the rumours, deceit and misleading of the media, politicians and the public there were some excellent articles in the press.  Some of these pieces were written by those who would normally support the idea that abortion is “a woman's right to choose” - even they had been shocked by this recent development.  Among them was Libby Purves, who, writing in The Times (6 August), traced the history of the last 50 years of medical ethics and demonstrated that, "Imperceptibly, disgracefully, we have lost our reverence for the unborn."

She finished her piece by lambasting the majority of churchmen, the moralists and the liberal and kindly people for saying little, and doing even less.  She concluded that, "Only a few organisations have taken the fully Christian route, welcoming the unwillingly pregnant, offering praise and sympathy when they decide to go through with the birth, looking after them in the months of helplessness, enabling them either to care for their babies or give them for adoption and to bear the resulting grief."  I think, without so much as a smidgen of triumphalism, that she was pointing, at least, to the wonderful, largely unsung, caring work of LIFE.

Mandy Allwood and her octuplets.  Perhaps the biggest ethical news of the summer was created early in August by Mandy Allwood, who managed to superovulate and conceive octuplets.  She went against medical advice and had sexual intercourse while being treated in a private clinic in Birmingham with fertility drugs.  Why a previously fertile woman (with a 5-year-old child, a previous abortion and a recent miscarriage) was recommended such treatment, especially in the absence of counselling with her partner, who apparently lives with another woman, is still a mystery.

However, what was clear was that by September she was pregnant and determined to go for a world record and carry all eight babies to term.  If sex and money make the biggest headlines then here was the near-perfect story, because Mandy Allwood had, to the annoyance of many, sold her account to The News of the World for an alleged six-figure sum.

What followed was most instructive.  Much of the medical profession, rather than rise to the challenge, spoke only in terms of gloom and doom.  The universally offered treatment was the barbaric selective reduction - “kill six to save two”. Mandy Allwood refused.  That is, she took advantage of that well-known liberal slogan, “a woman’s right to choose”.  And then what happened?  The pro-abortion press immediately rounded on her, often with near hysterical spite.

But late in September she started contractions and was moved to King’s College Hospital, London.  On Monday 30 September she lost three of her boys.  The very next day one girl was stillborn in the morning, and that afternoon the remaining three boys and one girl all died.

Much of the medical profession was aching to say, ”We told you so.  You should have aborted six.”  But the ends do not justify the means and it is simply wrong for doctors to kill their patients.  Poor Mandy Allwood - she was devastated  She was a mother, who wanted, but suddenly lost, eight of her children.  Undoubtedly she will grieve, but her one consolation is that she did her best for them all and did not consent to killing any of them - for that she need experience no guilt.

First legal euthanasia act.  On 22 September, Bob Dent, a 66-year-old carpenter with cancer, became the first person in the world to die under euthanasia law.  This occurred as a result of the Right of the Terminally Ill Act, which was recently passed in the Northern Territory of Australia.

The event caused an ethical storm across Australia and the law may soon be overturned by either a High Court challenge, or Parliamentary debate.  That notwithstanding, this incident does represent one more step down the slippery slope towards voluntary euthanasia.  Apparently, at least five other people in Australia are already queuing up for the same treatment.

Mr Dent used a computer-operated machine developed and supplied by a Dr Philip Nitschke.  The so-called “death machine” gives the patient control over the time of his death and means that a doctor does not need to be directly involved.  The patient’s consent is indicated by the answers he gives to three questions on a laptop computer.  If he answers ‘Yes’, ‘Yes’ and ‘Yes’ and then hits the spacebar, the machine delivers a lethal cocktail of drugs into his arm.

Dr Nitschke is reported to have said that, “It [voluntary euthanasia] is the greatest thing you can do for a person.  I felt at the end of it enhanced by the experience.”  All this writer can say is, “I am glad he is not my doctor.  And I am glad that I am computer-literate and can type ‘No’.”

US late-abortion vote.  President Clinton recently vetoed a bill to ban late abortions throughout the US.  But in September the Senate voted to override the President’s wishes.  However, although the vote for such a ban was 57 with 41 against, it was not the two-thirds majority needed to change the law.

Sperm donation and posthumous children.  Also in September the HFEA said that a 30-year-old widow from the Midlands must not be inseminated with her dead husband’s sperm.  The husband had contracted bacterial meningitis and while he lay in a coma, his wife asked for sperm samples to be removed from him.  But the HFEA insisted that the samples could not be used because her husband, who died four days later, did not give his written consent.  The HFEA does not require written consent when a couple are treated together.  Nor does it consider a marriage contract as sufficient evidence of consent.

Assisted conception clinics outside the UK agreed to inseminate the woman, who, for legal reasons, is known only as DB.  However, the HFEA has refused to allow the export of these gamete samples, though that may be in breach of EC law on “access to services”. 

This case is an ethical can of worms.  Apparently, according to DB, the couple had previously discussed and agreed upon this procedure if the husband was ever likely to die suddenly.  On the one hand, there is a general public sympathy for the woman - could not a child so conceived help her through the grieving process?  On the other hand, there is something distinctly eerie about taking gametes from a dying or dead patient and using them (not in the straightforward way that for example, corneas and kidneys are donated to support an already living person) to produce deliberately a posthumous child.  Can that ever be sensible?  Can that ever have in mind the best interests of the child?

Report on fetal pain.  Back in 1988, a survey asked paediatric anaesthetists if they thought newborn babies could experience pain.  Somewhat amazingly, about 33% answered “No” or “Don’t know”.  Now in 1996, 100% of such medical personnel believe that the newborn really can suffer pain.  The next question, can the unborn child suffer pain?, has become a hot topic.  It is also a controversial one, not least because there is currently no direct way of assessing fetal pain.  A proper doctor would say that because we do not know, it is better to err on the safe side.

A soon-to-be published Parliamentary report states that there is evidence to suggest that an unborn child, as young as 10 weeks, may experience pain.  From 14 weeks, most of the child’s body responds to touch by moving away.  Mr John Friend, senior vice-president of the Royal College of Obstetricians and Gynaecologists maintains that this is “unreasonable”.  He further states that, “We as doctors are not keen to do anything that causes suffering.”

And one final thought.  The above catalogue portrays a gloomy picture of the state of current medical practice.  It is beyond cavil that medicine has, within the last 50 years or so, drifted far from its high ethical moorings, derived from that robust combination of the pagan Hippocratic Oath and the doctrines of Scripture.  Human life was then seen as something special, to be protected and cherished.  The medical profession has, like most other aspects of 20th-century life, largely abandoned any moral absolutes and any such high ethical views.  But would it be any better if all our doctors were evangelical Christians?  Now, there’s a question!

During the summer the Christian Medical Fellowship (CMF) published the results of a survey entitled, Members’ Attitudes to Abortion.  A total of 2580 qualified doctors and 348 student doctors responded to the CMF’s questionnaire.
 
To the question, “When does human life have full value?”, about 70% of the students answered “at fertilisation”, whereas less that 40% of doctors gave that answer.  Concerning the acceptable reasons, or grounds, for abortion there was a wide range of views.  On the key question relating to the so-called “social clause” (that is, ground C; risk of injury to the physical or mental health of the woman (pregnancy has not exceeded its 24th week)), which accounts for about 90% of abortions in England and Wales, the responses were fairly liberal.  As many as 5%, 12% and 30% of qualified doctors would “always”, “often” and “sometimes” abort.  Put another way, about 50% of evangelical doctors could be, at least sometimes, persuaded to recommend abortion for social reasons.  Less than 20% would “never” abort.

One is left wondering if an entirely evangelical Christian medical profession would result in the practice of better medicine.  Or would human embryo destruction and abortion simply continue?  There is, however, a little hope.  The student doctors were invariably more conservative in their attitudes than their older mentors.  The world belongs to the next generation of men and women.  Let’s pray for them and encourage them to stand steadfast and to live by the non-negotiable truths of the Word.  Now, that is something worth giving our consent to.
When the foundations are being destroyed, what can the righteous do?  [Psalm 11:3]