Forty-nine years of abortion
Thursday 14 July 2016 marked
the forty-ninth anniversary of the passage of the
Medical Termination of Pregnancy Bill following
its third reading in the House of Commons.
The voting was a massive 262 for and only 181
against. The Bill received the Royal Assent
on 27 October 1967.
Under the aegis of what was to become known as the
1967 Abortion Act, the killing started six months
later on Saturday 27 April 1968. It is
estimated that some 8.6 million abortions in
England, Scotland and Wales have since been
performed. Next year is the Golden
Anniversary of the Act – how should that be
marked?
Marie Stopes and the CQC As I wrote
in my book, Bioethical Issues (2014, p.
68), ‘Evidence suggests that the Abortion Act 1967
is not being correctly enforced or adequately
monitored. Moreover, the Care Quality
Commission (CQC), the NHS watchdog in England,
which oversees the legal compliance of abortion
services, patently has work to do.’
Well, surprise, surprise! The CQC has done
some work. In August, CQC inspectors raised
concerns about abortions being carried out at
Marie Stopes clinics in England. In
particular, it uncovered poor governance
arrangements and ‘specific immediate concerns’
about patient safety with respect to consent and
safeguarding. In addition, the CQC was not
satisfied with training and competence for
terminations that took place under general
anaesthetic or conscious sedation.
Marie Stopes International’s response was to
suspend abortions for under-18s and vulnerable
groups of women, suspend abortions under general
anaesthetic or conscious sedation and suspend
abortions at its Norwich centre. It
estimated that about 250 women a week would be
affected and it confirmed that they would be
diverted to other abortion clinics.
The CQC has promised to publish its findings once
its inspection reports are completed, sometime in
the autumn. This affair should send a shock
wave throughout the abortion industry – abortion
is a heinous business, but if it must persist,
then it must be done within the law, ‘correctly
enforced [and] adequately monitored.’
However, by
early October, Marie Stopes had resumed performing
abortions at several of its suspended clinics,
with the expectation that all of them would be
operational by the end of October. Should
Marie Stopes be allowed to restart before the
CQC's official report into these serious failings
has been published? Apparently, yes.
The CQC has stated, 'Detailed reports will be
published in due course and will be made available
on our website.' We shall be watching.
A Report into Freedom of
Conscience in Abortion Provision Back in 1966, when
the Medical Termination of Pregnancy Bill was being
debated in Parliament, abortion was still
controversial, still divisive, still contested.
In an attempt partly to satisfy the many opponents of
the Bill, a conscience clause was included as Section
4 (1) of the 1967 Abortion Act. It reads, ‘… no
person shall be under any duty … to participate in any
treatment authorised by this Act to which he has a
conscientious objection …’ In other words,
doctors and nurses can opt out of involvement in
abortions.
In recent years, discussions in medical ethics have
been dominated by two topics – patient autonomy and
patient consent. A third emerging subject is
that of conscientious objection (CO). And the
area in which CO has become most discussed is that of
abortion. How can freedom of conscience be
balanced with the professional duty of healthcare
bodies to provide access to abortion services under
the 1967 Act? More pointedly, how can those
healthcare professionals with a moral objection to
abortion exist and thrive in a workplace where
abortion is legally provided?
The Report makes 9 important and sensible
Recommendations. For instance, Number 3,
states, ‘The General Medical Council should maintain
their current guidelines regarding referrals, thereby
ensuring that no doctor who has a conscientious
objection to abortion should be required to refer a
patient to another practitioner.’ Number 9
states, ‘That consideration be given to the
introduction of the principle of ‘Reasonable
Accommodation’ into legislation in this country, in
the form of an amendment to the Equality Act 2010.’
The response from bpas (the British Pregnancy Advisory
Service) included, ‘…we would ask the MPs behind this
‘inquiry’ to extend the same respect to the many
doctors, nurses and midwives who have a conscientious
commitment to providing abortion services, and the
women who decide abortion is the right decision for
them. They have a conscience too.
These issues of conscientious objection and freedom of
conscience will not go away. In fact, they will
intensify. Not only doctors and nurses, but also
teachers, magistrates, cake makers and all
‘morally-sensitive’ people in the public square are
set increasingly to become targets to conform under
the heavy hand of equality, diversity and the
State. From that perspective, this Inquiry
Report is an additionally welcome and timely piece of
work.
Abortion for disability Discrimination
on the grounds of disability was made illegal 20
years ago when Parliament passed the 1995
Disability Discrimination Act. Yet it
persists as a reason, known as ground E, for
abortion. It starts with prenatal
screening. If the test results suggest the
unborn has a disability, such as Down’s syndrome,
then abortion is the common response. About
90% of all such unborn children are aborted.
And abortion on the grounds of disability can
occur right up to birth. Yes, up to 40
weeks. Disability is portrayed as a
tragedy. How can that be in the afterglow of
the 2016 Paralympics? Yet thankfully, people
are beginning to respond positively.
First, there was the Don’t Screen Us Out
campaign, which was initiated in response to UK
National Screening Committee’s proposal to
introduce NIPT – non-invasive prenatal testing –
into the UK’s Fetal Anomaly Screening
Programme. The new technique is known as
cell-free DNA (cfDNA) testing and is regarded as
non-invasive because it relies on a blood test
rather than the invasive nature of chorion villus
screening and amniocentesis. The maternal
blood is then examined for abnormal foetal DNA.
While this new method is acknowledged to be safer,
resulting in a projected 25 fewer miscarriages
caused by the old invasive methods, it is also
more accurate, resulting in a projected 92 more
unborn children with Down’s syndrome being aborted
each year. This will have a profound and
discriminatory effect upon the Down’s syndrome and
other disability communities, their families,
carers and pro-life supporters. Less haste
in implementation and more support for the
disabled are the duties of a decent society.
Read more here, http://dontscreenusout.org/
Second, there is now the We're All Equal
campaign. This is run by people with
disabilities, their families and supporters and
has been introduced in response to Lord Shinkwin's
Abortion (Disability Equality) Bill in the House
of Lords. The Bill proposes to remove
s(1)(1)(d) from the 1967 Abortion Act, which
allows abortion on the grounds of disability,
right up to birth.
Also the moving and thought-provoking BBC2
documentary, A World Without Down’s Syndrome?
by Sally Phillips was broadcast on 5
October. It can be viewed on the BBC iPlayer
at
http://www.bbc.co.uk/programmes/b07ycbj5 Phillips
opens the programme by saying, 'It’s a film that
asks the question – what kind of society do we
want to live in, and who do we think should be
allowed to live in it?' She continues, 'Of
course, I have a biased opinion because I have a
child with Down’s syndrome who I love more than
life. And, 'My big question to the world is
what is so very dreadful about Down’s
syndrome? It’s not a catastrophe. Why
is everyone behaving like it’s a
catastrophe?' Her 11-year-old son, Olly, was
diagnosed with Down's 10 days after he was
born. She recalls that she was expecting
tragedy. Instead, she got comedy.
Watch this documentary – it is both compelling and
revealing.
Abortion
for cleft palate
It seems
that abortions for cleft palate – an easily-fixed
facial deformity – are rising. According to
figures from the Office for National Statistics,
there were 4 such abortions in the UK to
during 2012. The figure in 2015 was 11.
Fiona Bruce MP commented, ‘It is deeply disturbing
if these figures reflect a worrying trend in
society to disproportionately value the physically
perfect and beautiful.’ And Lord Alton
declared, ‘Aborting a baby with a cleft palate
should be unconscionable. For the law to
allow this up to birth should be unthinkable.’
Unborn human rights in
Ireland
On 4 August, a significant statement was handed
down from the High Court in Dublin. Mr
Justice Richard Humphreys made the ruling when
granting leave to a Nigerian man, his Irish
partner and their now almost one-year-old child
for a judicial review over the man’s intended
deportation.
The judge referred to the Eighth Amendment of the
Irish Constitution, which was approved by
referendum on 7 September 1983. It asserts,
‘The State acknowledges the right to life of the
unborn and, with due regard to the equal right to
life of the mother, guarantees in its laws to
respect, and, as far as practicable, by its laws
to defend and vindicate that right. In
effect, it introduced a constitutional ban on
abortion by recognising a right to life of an
unborn child. Mr Justice Humphreys ruled
that the word ‘unborn’ in the Eighth Amendment
means that an unborn child enjoys significant
rights and legal position at common law, by
statute and under the Constitution, which go well
beyond the right to life alone, which must be
taken seriously by the State. He further
added that Article 42a of the Constitution,
inserted as a result of a 2012 referendum, obliges
the State to protect all children and that because
an unborn is clearly a child, Article 42a applies
to all children, both before and after birth.
Furthermore, the judge held that when the Minister
of Justice comes to resolve this case, he must
consider the constitutional, statutory, EU and
European Convention on Human Rights (ECHR) rights
of the man, his partner and the child, including
their family rights under Article 8 of the
ECHR. Mr Justice Humphreys dismissed the
State’s arguments that the couple have no family
rights under the Constitution because they are not
married, no rights under Article 8 because their
situation is ‘precarious’ and the only right their
unborn child had was to life.
In other words, an unborn child is deserving of
all the rights and protections to which every
other person is entitled. This judgement
runs counter to the notion of those who seek to
discriminate against children before birth and who
argue that the pre-born child is not fully human,
or entitled to human rights. It was indeed a
landmark ruling.
Abortion in Ireland
If ordinary politics can be
opaque, Irish politics can be obscure. The
United Nations Human Rights Council has recently
criticised Irish abortion law saying that the
country needs to comply with international
standards on abortion by making it available to
women in cases of rape, incest and fatal foetal
abnormalities. Yet in early July, a bill to
allow for abortions in cases of fatal foetal
abnormality was defeated in the Dáil by 95 votes
to 45.
In addition, there has been internal and external
pressure to repeal the Eighth Amendment of the
Irish Constitution (see above). This has led
the government to create a Citizen’s Convention to
examine the controversial 2013 Protection of Life
during Pregnancy Act, which has permitted abortion
to save the life of the mother, but which also
includes the risk of suicide as a threat to her
life. In late July, Supreme Court judge,
Mary Laffoy, was appointed to chair this
100-member Citizens’ Convention tasked with
examining the Eighth Amendment. The
Convention is to be established by October and the
Eighth Amendment is the first issue it will
examine.
Pro-life campaigners in Ireland hope that the
crucial Humphreys’ ruling will cause the
government to repeal the pro-abortion 2013
Protection of Life during Pregnancy Act and to
oppose any moves to repeal the Eighth
Amendment. Irish politics can indeed be
obscure. Some commentators expect that yet
another Irish referendum on abortion is inevitable
and maybe imminent.
Gene editing
Beyond CRISPR Most of us
have only just got used to hearing about
CRISPR–Cas9, the gene-editing tool, which enables
scientists to alter genomes of bacteria, plants
and animals, practically at will. It was
first mentioned in these Updates only in October
2015. Well, it is already becoming a
somewhat dated technology.
Now there is NgAgo. It is an acronym for Natronobacterium
gregoryi Argonaute – don’t blame me!
Basically, it is an enzyme that can break DNA at
specific, gDNA, sites. It was first reported
as a possible gene-editing tool by Han Chunyu and
his team from the Hebei University of Science and
Technology in Shijiazhuang, China. The
report was published as Goa et al. in May
2016 in the journal Nature Biotechnology34:
768–773. They used NgAgo to edit eight
different genes in human cells and to insert genes
at particular points on chromosomes.
One disadvantage of the CRISPR-Cas9 system is that
the enzyme Cas9 is too large to package into any
of the viruses that are commonly used as vectors
in gene therapy. Enter an alternative,
mini-Cas9, a smaller version derived from the
bacterium Staphylococcus aureus.
Mini-Cas9 has already been used to correct the
gene responsible for Duchenne muscular dystrophy
in mice.
Cas9 has other limitations. It will not cut
everywhere because it requires a certain DNA
sequence for that to occur. Enter an
enzyme called Cpf1 which is smaller than Cas9,
with a different sequence requirement for
cutting. And there is yet other enzyme,
called C2c2, which targets RNA rather than
DNA. This is just the very beginning of
discovering and applying gene-editing tools –
there is now talk about adding other types of
enzymes, such integrases and recombinases, to the
gene editor’s toolbox.
Does NgAgo actually work?
Oh no, is this another case of fraud at the
forefront of hot science? Han Chunyu, the
senior author on the Nature Biotechnology
paper, cited above, has been accused by several
scientists because they cannot replicate his
results with NgAgo. An informal online
survey found that 9 scientists said that NgAgo
works, while 97 said it does not.
Han is convinced that his technique is sound and
on 8 August, he submitted his protocol in detail
to Addgene, an online genetic information
repository, for all to see. The stakes are
high. Time will tell. Meanwhile, Nature
Biotechnology has launched its own
investigation.
The first human CRISPR
trials
Chinese scientists are on the verge of being first
in the world to inject people with cells modified
using the CRISPR–Cas9 gene-editing technique. A
team led by Lu You, an oncologist at Sichuan
University’s West China Hospital in Chengdu, plans
to start testing such cells in people with lung
cancer now that the trial has been approved.
Lu’s team will enrol patients who have metastatic
non-small cell lung cancer and for whom
conventional treatments, like chemotherapy,
radiotherapy and so on, have failed. They
will extract T-cells from the blood of the
patients, and then use CRISPR–Cas9 technology to
knock out a specific gene in those cells.
The gene encodes a protein called PD-1 which
normally acts as a check on the cell’s capacity to
launch an immune response, to prevent it from
attacking healthy cells. The gene-edited
cells will then be multiplied in the laboratory
and re-introduced into the patient’s
bloodstream. The engineered T-cells will,
the team hopes, home in on the cancer cells and
destroy them.
Meanwhile, Carl June, a clinical researcher in
immunotherapy at the University of Pennsylvania in
Philadelphia, has been granted approval for a
similar human trial using CRISPR-Cas9 modified
cells to treat cancer patients, which should also
start before the end of 2016. The US team’s
protocol will similarly knock out the PD-1 gene,
but also add NY-ESO-1, a tumour antigen, and
disrupt TRAC and TRBC genes in order to enhance
the proliferation and immune response of the
T-cells before they are infused into the
patients. The 2-year trial will treat 18
people with myeloma, sarcoma or melanoma, who have
stopped responding to existing treatments.
These phase I trials will seek to establish the
safety and effectiveness of these proposed
treatments, but because they are entirely novel,
they are also inherently hazardous. ‘Proceed
with caution’ is the maxim. Catastrophe
could hinder human gene-editing technologies for
decades.
Assisted
Reproductive Technologies
The saga
of A and Mr & Mrs M
If you want a good reason to reject IVF, here it is.
IVF turns natural procreation on its head and often
creates huge bioethical dilemmas. Consider this
case.
A young, single woman, known as A, suffered from bowel
cancer. During a period of remission, she underwent
treatment to collect three ova, which were frozen and
which she later referred to as ‘my babies on ice’.
Prior to storing the ova, A completed a form which asked
what she wanted to happen in the event of her death.
She wrote YES to the ova being stored ‘for later use’, and
NO to the ova ‘being allowed to perish’. However,
she did not give specific written consent about how she
wanted the ova to be used after her death.
In June 2011, A died at the age of 28. Her parents,
Mr M and Mrs M, then sought to give effect to their
daughter’s wishes by trying to conceive a child, with
anonymous donor sperm, who Mrs M, now aged 60, would carry
and who they would raise as their grandchild.
The UK clinic, IVF Hammersmith, where the ova were stored
declined to offer them assistance, citing a lack of
written consent to the treatment proposed by A’s
parents. Mr and Mrs M then sought to export the ova
to the USA where a clinic, New York Fertility Services,
was identified that was prepared to help. The Human
Fertilisation and Embryology Authority (HFEA) refused the
UK clinic’s application to export the ova. Mr and
Mrs M sought a judicial review of that decision. On
15 June 2015, Mr Justice Ouseley in the High Court said
the HFEA was right to conclude that there was insufficient
evidence of A’s wishes and was therefore entitled to
refuse consent to export.
However, the Court of Appeal disagreed. On 30 June
2016, Lady Justice Arden stated that the HFEA and Mr
Justice Ouseley had erred. Although A had not
completed additional written consent forms explaining the
terms of her initial consent, all available evidence
indicated that A wanted the ova to be used by her mother
after her death, and there was no evidence that A wanted
the ova to be allowed to perish.
The ruling meant that the HFEA needed to reconsider
whether to exercise its discretion to permit the export of
the ova. It did just that. On 9 September
2016, the Statutory Approvals Committee of the HFEA
reconsidered this case in the light of the Court of Appeal
judgement. It agreed, ‘in the exceptional and unique
circumstances of this case, to grant special directions to
export A’s eggs to the USA.’
Legal permission is one thing – biological reality is
another. A’s so-called ‘babies’ are ova, not even
embryos, the three ova are frozen, they are 5 years old,
Mrs M is post-menopausal and quite unlikely to become
pregnant, if she does conceive any complications could be
life-threatening, and there is, as yet, no identified
sperm donor. The entire proposal seems more like a
grandparent’s emotional dream rather than a rational
reproductive strategy. Such is the disconcerting and
dishonest power of IVF.
And another IVF tangle
Samantha Jefferies, aged 42 from East Sussex, is the widow
of a Falklands war veteran. She and her husband
Clive had previously gone through two unsuccessful cycles
of IVF funded by the NHS. They were about to undergo
their third when Mr Jefferies died suddenly of a brain
haemorrhage in 2014, aged 51.
The couple had signed consent forms for 10 years' storage
and posthumous use of their embryos. But, in early
2015, Mrs Jefferies was told by the Sussex Downs Fertility
Centre that the embryos must be destroyed because the 2
years of her NHS treatment would expire in that
August. Yet in 2012, the HFEA had urged all IVF
clinics in the UK not to restrict storage times to less
than 10 years. And neither she nor her husband had
signed any consent amendments.
Mrs Jefferies went to law and on 27 September, Sir James
Munby, president of the family division of the High Court,
stated, ‘I am just so sorry that people like you should
have no idea that this can end up in court because of
mistakes made by other people who should have known
better.’ And, it is ‘obviously right’ that the
embryos be stored for 10 years. Mrs Jefferies
revealed that she did not have any plans to use the
embryos soon but added, ‘I would love to be a mum.’
Thus IVF has crafted itself yet another problem, a
bureaucratic one. IVF clinics are typically driven
by financial considerations and if funding is not
forthcoming, as in the Jefferies’ case, then they will
override consent, as in the Jefferies’ case. It is a
shabby practice.
World’s first ‘three-parent’ IVF
baby born
In February 2015, the UK government became the only
country in the world to sanction the controversial
technique known as mitochondrial replacement therapy
(MRT), or ‘three-parent’ IVF. Now American doctors
have reportedly beaten the British in the race to use the
technique. The HFEA has still not given permission
for any such usage in the UK.
The unnamed baby boy, with genes from two women, was
conceived in a Mexican clinic last summer and was born on
6 April 2016. The ‘primary’ mother, who is Jordanian
and in her 30s, contacted the New Hope Fertility Centre in
New York after learning that she carried the mitochondrial
disease, Leigh syndrome. She had already lost two
young children to the disease and had suffered several
miscarriages.
Because the couple are devout Muslims, they were opposed
to the destruction of two embryos, as occurs in pronuclear
nuclear transfer, the MRT protocol approved in the
UK. Instead the US-led team used spindle nuclear
transfer, which involves cutting and pasting before
fertilisation occurs. The scientists removed the
nuclei from several of the ‘primary’ mother’s ova and used
them to replace the nuclei in ova obtained from a
‘secondary’ or donor mother. These ‘new’ ova were
activated and then fertilised with the father’s
sperm. Five embryos were created, but only one
developed sufficiently to be transferred to the ‘primary’
mother. The baby’s nuclear DNA is 99.8% from his
parents with 0.2% of his mitochondrial DNA from his
‘secondary’ mother. Less than 1% of the boy’s
mitochondria carry the genetic mutation.
The procedure was carried out in a branch of the NY clinic
in Guadalajara, Mexico because there are no fertility
regulations there. It is all a little
Machiavellian. The whole episode has again raised
the many questions about the ethics and safety of the
technique. Dr John Zhang, who led the work, has no
such qualms, he said, ‘To save lives is the ethical thing
to do.’ Yet an additional fear is that doctors using
such unregulated treatments will now exploit desperate
couples. One thing is sure – this will not be the
last we hear of ‘three-parent’ IVF.
Babies without mothers?
Those UK tabloids of spin have overstepped the mark
again. The headline in the Daily Mirror was,
‘Fertility breakthrough means babies could be conceived
from skin cells.’ Whereas the Daily Mail led
with, ‘The babies with no mothers’ and ‘We can create
babies without men, claim scientists.’
The science in question appeared in Nature
Communications (2016, doi:10.1038/ncomms12676) by
Suzuki et al. under the title, ‘Mice produced by
mitotic reprogramming of sperm injected into haploid
parthenogenotes.’ And the truth is that it was a
small study, with no skin cells involved, and it was done
in mice, not humans.
This is what Dr Perry and his colleagues at the University
of Bath did. They took unfertilised mouse ova,
treated them chemically to trick them into dividing, and
thus created so-called parthenogenotes. In other
circumstances these usually die within a few days.
These entities are haploid, that is, they contain only one
set of chromosomes. The Bath team then injected them
with mouse sperm and transferred them to mouse
uteruses. About a quarter of them developed into
newborn mouse pups. These appeared healthy and were
subsequently able to produce two or more generations of
their own offspring.
These results challenge our previously-held understanding
that mammalian embryo development requires the fusion of
ova and sperm. Furthermore, the authors suggest that
their work, ‘calls into question the argument that
parthenogenotes do not have the potential for full-term
development and are accordingly a more acceptable source
of human embryonic stem cells.’ But what next?
Could all this lead to future fertility treatments?
This is where Dr Perry went into hype mode, ‘It might one
day mean that we could generate embryos from other cell
types – perhaps even somatic cells, perhaps skin cells,
for example’, he said. At that, the tabloid press
woke up and loved it, embroidered it and printed it.
Dr Paul Colville-Nash of the Medical Research Council was
a little more understated. He said, ‘This is an
exciting piece of research … It may one day even have
implications for how we treat infertility, though that's
probably still a long way off.'
Dial a sperm donor
Ah, the wonders of online shopping! London Sperm
Bank Donors has just launched a phone app that allows
women to choose sperm donors by race, education, height,
weight, education, even eye colour. Furthermore,
users can sign up for alerts and ‘new arrivals’.
The service has been called, ‘digital dads’ as well as
‘the denigration of fatherhood’. It is understood
that around half of Britain's IVF clinics registered to
use the service. Once a woman has chosen her
preferred sperm donor, she makes a payment of £950 via the
app and the sample is delivered to the HFEA-approved
clinic where the woman is being treated.
Sally Cheshire reappointed as
head of the HFEA
The HFEA has announced that Sally Cheshire has been
reappointed as its Chair for a further three years from 1
April 2017. Commenting on her reappointment, Mrs
Cheshire said, ‘We have a lot to be proud of, from
licensing world firsts like mitochondrial donation and
ground-breaking gene editing research, to regulating the
day-to-day clinical and emotional journey our patients
face as they try to have a much wanted family.’
She continued, ‘Our refreshed strategy for 2017-2020 will
build on our success and will significantly raise the bar
on providing high quality care. We will do that by
being clearer with patients about evidence-based
treatment, being more transparent about the cost of that
treatment, making better use of research and treatment
data to improve patient care, and working to improve the
quality of commissioning of IVF treatment. We can
only do this by continuing to place patients at the centre
of what we do.’
This is neither the time nor place to rehearse the
historic failings of the HFEA – scientific, ethical and
bureaucratic – this website has traced and reported on
those deficiencies for many years. However, it is
notable that in October, the HFEA published its latest
report on adverse incidents in UK fertility clinics for
2015. The total number of such events, 517, were up
on the previous year. While no Grade A incidents,
the most serious, were reported, the number of Grade B was
200 compared with 165 in 2014. Grade B incidents can
include, somewhat understatedly, 'loss of embryos' and
'breaches of confidentiality'. We wish Mrs Cheshire
well and hope that she can both instil a better sense of
responsibility as well as inject a dose of bioethical
backbone into her charge.
Human-admixed embryos back on the
agenda
After a decade of hype and failure it seemed that the
story of human-admixed embryos had closed, but now they
are back on the agenda. Since September 2015, US
scientists have been banned from receiving federal funding
for adding human stem cells to animal embryos in order to
create chimaeras, or human-admixed embryos. Yet, in
August, the US National Institutes of Health (NIH), after
a public consultation, proposed lifting that funding
moratorium.
Some say such research is essential. It will lead to
our greater understanding of human development and
disease. It could even lead to the production of
transplantable human organs in livestock, such as human
kidneys in pigs.
Others say it is a step too far. Some US states may
yet ban such research, review committees may block such
projects, and public opinion may revive protests against
such work. These protesters say that these studies
could result in chimaeric animals with human cellular and
functional modifications to the central nervous
system. This, in turn, could elevate chimaeras to
something approaching, or equalling, human moral
status. Proponents retort that this conflation of
the biological humanisation of chimaeric animals with
their moral humanisation is a fallacious argument.
They maintain that the moral status of humans – though
they do define that – is not automatically granted by
genetic composition or physical arrangement of our cells,
but rather by a complex of mental traits. In other
words, we are back to the old wranglings over personhood
designations, plus legal and moral definitions of the
status of human beings. Rather than seeking answers
to these hot issues, the NIH’s new rules would merely set
up review panels which would concentrate on animal welfare
issues. They might also prohibit extreme protocols,
such as limiting the number of human cells in a chimera’s
brain, or the birth of an animal more humanised than its
parents.
Currently, all research subjects fall into two classes –
human or non-human. There are strict and different
research guidelines for each. Chimeric research
introduces a third category for which there are no
research guidelines. Without the construction of a
robust bioethical framework, this research will proceed on
a ragbag basis with the currently unthinkable eventually
becoming the acceptable norm.
For those, Christians and the ‘morally sensitive’, who
draw a bright line between animals and human beings, these
arguments are fundamental. We have been here
before. If animal cells contain 0.1% of human DNA,
are they animal or human? What about 10%? What
about 50%? Destruction of human embryos, creatures
that are part human-part pig – do these constitute a
bioethically-acceptable research pathway?
Dolly’s siblings are well
When Dolly was born on 5 July 1996, she was the first
mammal to be cloned from an adult cell using a cloning
technique known as somatic-cell nuclear transfer
(SCNT). She died at the relatively young age of 6.5
years raising the fear that cloned mammals may suffer from
serious degenerative conditions
In July, Nottingham University announced that four of
Dolly’s siblings, Debbie, Denise, Dianna and Daisy, which
had been cloned from the same ewe as Dolly, had reached
their eighth birthdays apparently in good health and
ageing normally.
Now this cheery news raises at least two serious
questions. First, if human reproductive cloning is
banned until it is safe, does this healthy animal report
move us nearer its approval? Second, if animal
cloning is to be perfected, what will stop the demand for
human cloning?
Trending in fertility
For the first time in England and Wales for nearly 70
years, women over 40 are having more babies than those
under 20. In 2015, there were 697,852 live births
with 15.2 births per 1,000 women aged over 40, compared
with just 14.5 per 1,000 women in their teens. The
last time the over-40s had the higher fertility rate was
in 1947, in the wake of World War II – the very year I was
born!
The current trend is two-fold. The teenage pregnancy
rate has more than halved from the 33 births per 1,000
teenagers in 1990. And pregnancies in the older age
group have rocketed from 5.3 per 1,000 in 1990. The
average age of having a child is now 30.3 – a figure that
has been increasing since 1975. And the cause of
these trends? Fertility treatment, women in higher
education and careers, and the rising costs of housing and
childbearing – these factors delay motherhood.
Female fertility starts to decline from the late 20s and
especially from the mid-30s, so reproductive outcomes are
poorer in older women. Take note and beware you
young married couples!
How to increase your fertility
First, get your appendix removed. A 15-year study
from the University of Dundee analysed the medical records
of more than half a million British women. The
researchers found that women who have had their appendix
or tonsils removed seem to be more fertile as shown by
increased subsequent pregnancy rates. That is, for
every 100 pregnancies in women who had had no surgical
procedures, there were 134 pregnancies in those who had
had their appendix removed, 149 in those who had had their
tonsils removed and 143 pregnancies in women who had had
both removed. In addition, surgery was associated
with shorter times to pregnancy. It is uncertain if
the apparent increases in fertility were directly caused
by the surgery, or if there is a ‘behavioural’ explanation
to these numbers.
Second, get your endometrium scratched. It will cost
about £300, but a study of 1,180 women from New Zealand
reported that women who used the technique had on average
a 122% better chance of conceiving. The theory
behind the operation, which involves making four
moderately-painful cuts to the inside of the womb, is that
it prompts a repair reaction, which in turn gives the
embryo a better chance of implanting.
Third, abandon any involvement with these and dozens of
other (expensive) fertility add-ons. Instead, eat a
balanced diet, exercise frequently, sleep well, de-stress,
recognise self-inflicted factors, such as alcohol and
other drug abuse, STIs and smoking, to name but a
few. And remember 84% of couples who have regular
sexual intercourse, say two or three times a week, without
contraception, will achieve a pregnancy within a
year. And about 92% of such couples will conceive
within two years.
Fourth, if all that fails, contact the Life FertilityCare
Centre at http://lifefertilitycare.co.uk/
There you will find a pro-life, pro-woman, pro-child,
alternative to IVF. And the number of babies born
there is steadily increasing.
Is IVF changing the human
population?
Nowadays as many as 1 in 25 children born is an
IVF-baby. Is all this artificial procreation having
an effect upon the wider population? Certainly, IVF
enables many people to reproduce who would not naturally
be able to do so.
By definition, IVF-couples come from a distinct subgroup,
typically sub-fertile and often relatively rich.
And, for example, IVF-ova are different from normal ova,
even biologically inferior. Similarly, IVF-sperm are
distinct, selected for their ability to swim short
distances, whereas in a natural environment, successful
sperm are long-distance swimmers. Again, IVF-embryos
have to endure unnatural freezing as well as the
environment and culture media in laboratory Petri
dishes. And there may be differences in how
IVF-embryos survive implantation and miscarriage.
And there is also a generational perspective - boys
conceived by ICSI (intra-cytoplasmic sperm injection), the
most common type of IVF, apparently inherit their fathers'
infertility problems. In adulthood, they have half
the normal sperm count and half the number of good
'swimmers'. This, according to
research by André
Steirteghem and his team and published in Human
Reproduction http://humrep.oxfordjournals.org/content/early/2016/10/05/humrep.dew245.abstract
is the upshot, 'In this cohort of 54 young adult ICSI
men, median sperm concentration, total sperm count and
total motile sperm count were significantly lower than
in spontaneously conceived peers.'
So,
because IVF supports the propagation of these sub-fertile
couples, is that a disadvantageous development for the
whole human population? If the sub-fertile give
birth to sub-fertile offspring and the sub-fertile pool
increases, will we become more and more dependent on
assisted reproductive technologies? In other words,
is IVF a retrograde step? It is certainly not a
cure, but merely a way of bypassing a problem.
Stem-cell Technologies
Where are the embryonic stem-cell treatments?
Bioethicists and others are, at last, beginning to realise
that no field of biotechnology has promised more and
delivered less than the overhyped and long-promised
treatments from embryonic stem-cells. A few human
studies have been conducted with mostly unclear or
insignificant results. We were told that these
embryonic stem cells were the gold standard of stem-cell
technologies, capable of differentiating into any of the
adult human tissues and organs and therefore able to
regenerate and replace our ageing and diseased bodily
parts.
The enterprise has been a flop. Bioethically, it has
failed because the harvesting of embryonic stem cells
demands the destruction of human embryos. Medically,
it has failed because there are no forthcoming wonderful
treatments. Will the stubborn researchers now give
up on their pet projects and move onto adult stem-cell
technologies? Probably not.
Yet, just in the USA, adult stem cells are currently being
used in several thousand FDA-approved human clinical
trials, involving tens of thousands of patients every
year. An estimated 1.5 million people have been
treated to date. Why have we not heard about
these? Why the information blackout? The
stem-cell science deniers, continue to disparage adult
stem cells. But for patients, adult stem cells are
the true gold standard of stem-cell technologies.
And yet, caveat emptor
And now a word of caution. Stem cells are
increasingly being used in unproven therapies in clinics
across the world. Such activities are being reported
in the USA, Australia, Japan, India, China and
elsewhere. The problem is two-fold. First,
there is an assumption that all stem-cell treatments
work. Yet, many are unproven, ineffective and maybe
even dangerous. Second, government regulations,
including those issued by the FDA, are insufficient to
sift the good from the bad. The regulators cannot
keep up and the sham clinics are exploiting loopholes.
The answer is the establishment of stringent assessments
based on rigorous, double-blind, human clinical trials –
the sort that are required before the marketing of new
drugs. An example of the problem is that numerous
stem-cell treatments are currently being marketed for
neuro-degenerative diseases, but no stem-cell treatment
has ever been proved to be effective for these conditions.
Yet, counter-intuitively, some want a relaxation of
regulations. For instance, in the USA, the REGROW
Act has been proposed. It stands for the Reliable
and Effective Growth for Regenerative Health Options that
Improve Wellness Act. Its supporters want less, not
more, government oversight. They say FDA regulations
hamper the introduction of novel stem-cell treatments,
patients deserve more rapid access to potential cures, and
the USA is slipping behind other less-regulated countries
in the stem-cell race. Those lobbying for the REGROW
Act seem to come from the more dubious sector of stem-cell
clinicians. Bioethically and medically, their agenda
would be dangerous, if not lethal. While it is
beyond cavil that stem-cell treatments can be effective,
we need to know which ones work. Stem-cell
technologies belong in mainstream medicine, not
charlatanism.
Is Paolo Macchiarini a fraud?
Oh dear, we’ve been here before with Woo Suk Hwang, the
South Korean stem-cell researcher, who, in 2004, claimed
to have created stem cells from cloned human
embryos. He was later exposed to be a charlatan.
Paolo Macchiarini was a stem-cell researcher at Sweden’s
world-famous Karolinska Institutet, just outside
Stockholm. In 2011, he announced that he had created
an artificial windpipe by seeding a plastic tube with stem
cells taken from a patient’s bone marrow. The
patient was 36-year-old Andemariam Beyene. Five
years later, Beyene was dead and Macchiarini has been
charged with gross negligent manslaughter and grievous
bodily harm – he denies all charges. Macchiarini’s
research has now been called corrupt and unethical, the
reputation of the Karolinska Institutet has plummeted, its
head has been sacked, its governing board has been asked
to resign and a cloud hangs over the forthcoming Nobel
Prize for Medicine or Physiology. The whole affair
has become the biggest scandal ever in Swedish medicine.
What has gone wrong? Apparently, though a gifted
surgeon, Dr Macchiarini managed to fool top people in the
Swedish medical establishment. Investigative
journalism has begun to expose the truth. Between
2011 and 2013, a series of three transplant operations
using his artificial polymer trachea method ended in
failure. Two of the patients died and a third was
keep alive only by extraordinary hospital care in the USA.
Reviews of Macchiarini’s published work have revealed
errors and doubts as well as an embellished CV. And
the Karolinska has handled the crisis, which included
allegations of scientific misconduct, badly – the medical
establishment was blind or naïve. All in all, this
predicament created a ‘culture of silence’ in which the
important questions were never asked. Karolinska
bosses also thought that the Nobel Prize for Medicine or
Physiology was within Macchiarini’s grasp - it was not,
because Yoshinori Ohsumi of Japan won it. It is not
incidental that a committee of 50 Karolinska professors is
responsible for choosing the winners of this particular
Nobel Prize. An investigative report by the Swedish
Council on Medical Ethics has been fiercely critical of
the Karolinska. The report’s chairman said that,
‘Macchiarini should not even have been employed at the
hospital. There was never a job interview.’ On
23 March 2016, the Karolinska Institutet fired
Macchiarini.
During late October, BBC4 broadcast a three-part series on
Paolo Macchiarini, who has been accused of using
terminally-ill patients as human guinea pigs and
falsifying his science. The programmes are entitled
The Fatal Experiments: The Downfall of a Supersurgeon.
Part 1 can be seen at http://www.bbc.co.uk/programmes/b080k2z4
The other two parts follow on.
N. B. None of the above is to be confused with the
hugely successful pioneering work of Macchiarini and his
University of Bristol colleague, Martin Birchall, and
their team at the Hospital Clínic of Barcelona as reported
in The Lancet (2008) 372: 2023 -
2030. That work involved the use of a human donated
trachea, rather than a polymer version, and the patient,
Claudia Castillo, was reported five years later, in 2013,
to be in good health.
Stem cells and 3D-printers
Here comes the combination of two recent and fascinating
technologies – stem cells and 3D-printers. Together
they can produce artificial bone, called ‘hyperelastic
bone’, to overcome skeletal defects and fractures.
As reported in the journal, Science Translational
Medicine (2016, 358: RA127), a team of
scientists, headed by Ramille Shah, at Northwestern
University, Illinois have already used the twin
technologies to repair bone in mice, rats and a
monkey. Testing the protocol in humans is expected
within the next five years. If successful, the
printers could be installed in hospitals to produce
patient-specific bones within 24 hours. The ‘bones’
could even be impregnated with drugs and antibiotics to
enhance recovery and reduce infection.
The scheme involves constructing a flexible scaffold
consisting of hydroxyapatite, the major component of bone,
and some added polymers. The microscopic lattice of
these scaffolds encourages the body’s stem cells to morph
into bone cells and allow blood vessels to proliferate
within weeks. Eventually, when transplanted, this
artificial bone is degraded and replaced by robust,
natural bone. Remarkable, or what?
Euthanasia and Assisted
Suicide
Euthanasia in Belgium
Since legalising euthanasia in 2001, it seems as though
Belgium cannot get enough of it. The mentally
disturbed, twins, the anorexic and even children are all
willing, if not pressed, candidates.
Now, bizarrely, a Roman Catholic nursing home has fallen
foul of the apparently all-embracing law. The
incident occurred at the Huize Sint-Augustinus home in
Diest, in the northeast of Belgium. According to its
website, it is, ‘a dynamic elderly facility with 150
residents, located on the outskirts of the city in a quiet
residential area.’
The occasion was in 2011. The patient was Mariette
Buntjens, a 74-year old, who was suffering from terminal
metastatic lung cancer. She and her family had made
prior arrangements for her euthanasia to be performed by a
doctor not connected to the home. When he came,
apparently, to give her a lethal injection, the directors
of the home refused him access.
In June 2016, a civil court in Louvain ruled that ‘the
nursing home did not have the right to refuse euthanasia
on the grounds of conscientious objection.’ The
three judges awarded €3,000 in damages to Mrs Buntjens on
the grounds of the increased suffering she experienced, to
be shared among her three children, as well as an
additional €1,000 for each of them.
This case is important. First, it extends the reach
of Belgian euthanasia practice. Second, it does not
allow an institution, albeit a religious home doctrinally
opposed to euthanasia, to refuse euthanasia. Third,
a nursing home, with a remit to provide care for its
residents, cannot come between them and their doctors. Marieke Vervoort – Belgian gold medallist
The end-of-life wishes of a Paralympic medallist have
again raised the question of what constitutes eligibility
of a Belgian citizen for euthanasia. Almost
anything, it seems.
Marieke Vervoort won a silver in the 200-metre wheelchair
sprint and a gold in the 100-metre event in the London
2012 Paralympic Games. But she told the media that
she may request euthanasia after competing at Rio.
She signed her euthanasia papers in 2008. She has
said, ‘Rio is my last wish, hopefully I can finish my
career on the podium.’ She had her wish – she won a
silver in the T52 400-metre wheelchair race.
She suffers from an incurable degenerative disease which
causes her such great and constant pain that she barely
sleeps, though she can still compete at a high level in a
range of sports, including basketball, swimming and
triathlons. Yet also says, ‘Sport is my only reason
for living. But after Rio I will have nothing to
live for.’ At a news conference after her victory
she rejected media speculation saying that the time to be
euthanized was not yet. First Belgian child euthanasia
In Belgium in mid-September, a terminally-ill child became
the first minor to be helped to die since the country
voted to allow voluntary euthanasia for children, without
any age limit, in 2014. Parental consent is
required.
The head of Belgium’s Federal Control and Evaluation
Committee on Euthanasia, Wim Distelmans, gave no details,
such as name, age, ailment or location, other than to say
it was an exceptional case of a child with a terminal
illness. Subsequent reports suggest that the child
was 17-years-old and from the Flemish-speaking area of
Belgium. Assisted suicide challenges in Canada
On 17 June 2016, the Canadian Parliament passed a bill to
legalise and regulate ‘medical assistance in dying’
throughout Canada. It did not take long before
challenges were raised to extend the eligibility of the
new law. It is always the case – proponents always
want more and more.
On 27 June, Julia Lamb, aged 25, became one of the first
challengers. She has a progressive neurodegenerative
disease and is currently ineligible for medical assistance
because she is not terminally ill – the Canadian law
states that in order to qualify for death by lethal
injection, a person's ‘natural death must be reasonably
foreseeable’. Ms Lamb was diagnosed with spinal
muscular atrophy when she was 16 months old and she may
live for many more years, even decades. She has
filed her constitutional challenge in the British Columbia
Supreme Court with the backing of the British Columbia
Civil Liberties Association.
Similarly, Quebec’s Health Minister, Gaétan Barrette,
wants more. A palliative care unit at the McGill
University Health Center did not permit euthanasia on its
premises. Patients who want to be killed could
simply be moved out of the palliative unit and into the
adjoining hospital. Yet the palliative care unit was
reluctantly forced to change its policy. Minister
Barrette was ‘shocked’ by the unit’s apparent
intransigence.
The Euthanasia Prevention Coalition believes that the
Canadian euthanasia lobby is wanting to extend euthanasia
to ‘mature’ minors, to people with dementia and for people
with psychiatric conditions alone. Where will it
end? Should someone who is blind be eligible?
Should someone who has autism be entitled? Will
Canada outdo the Netherlands, or even Belgium, in
extending the qualifying boundaries? How many Canadians have been euthanized?
In early September, the Canadian Broadcasting Corporation
(CBC) reported that more than 120 Canadians have already
died as a result of the new assisted suicide law enacted
in June. Official numbers are unavailable because
the government has yet to implement a protocol to collect
the required data.
The actual number of deaths is probably significantly
higher than 120 because several provinces, when asked by
the CBC, could not, or would not, provide figures.
For example, Québec provided no official data whatsoever,
but the disability rights group Toujours Vivant - Not
Dead Yet, has reported that from December 2015 to
June 2016, there were 166 euthanasia deaths in
Québec. Where numbers were returned they amounted to
49 assisted deaths in Ontario, 46 in British Columbia, 15
in Alberta, 8 in Manitoba and with fewer in other
provinces.
The truth is that, like everywhere else where euthanasia
and assisted suicide has been legalised, official figures
are hard to come by, and when they are published, nobody
believes that they are accurate – they are always
underestimates.
My Death, My Decision
(MDMD)
This is yet another right-to-die campaigning group
attempting to legalise assisted dying in the
UK. In truth, it is not a new organisation,
but a rebranding and relaunching of the old Society for
Old Age Rational Suicide (SOARS), which was established in
the UK in 2009, by Michael Irwin, a former chairman of the
Voluntary Euthanasia Society. The latter was founded
in 1935 as the Voluntary Euthanasia Legalisation Society,
then it became the Voluntary Euthanasia Society in 1969,
Exit in 1979, before reverting to the Voluntary Euthanasia
Society in 1982 and eventually, in 2006, it renamed itself
Dignity in Dying – come on, keep up! Unlike the
latter, MDMD thinks that assisted dying should not be
restricted to those who are terminally ill with a
prognosis of 6 months or less.
The MDMD website states that it, '... wants to see a more
compassionate approach to dying in the UK, including
giving people the legal right to a medically assisted
death if that is their persistent wish.' In other
words, it wants assisted suicide legalised for the
non-terminally ill. As such it has a focus on, '...
in particular those suffering from long term degenerative
diseases such as MS, MND and dementia.' Of course,
MDMD wants 'safeguards' and 'personal autonomy'. It
wants, '... to agree a workable set of safeguards which
will protect vulnerable people' and, of course, it wants
to accomplish this '... while allowing personal autonomy
to those who feel their life is complete and no longer
wish to endure their worsening conditions, prefering [sic]
the option of assisted dying.' We have heard these
seemingly laudable aspirations before – many times
before. They are both dangerous and unachievable.
USA and Elsewhere
The USA Presidential election
The run-up to the November election always has its own
momentum and drama. But what could the future
incumbent mean for bioethical issues, particularly
abortion, in America? Of course, nobody knows –
politicians have a habit of promising lots and delivering
little.
But what have the candidates said so far?
Hillary Clinton, best friend of Planned Parenthood, the
largest abortion agency in the US, has promised to ‘put
Christianity at the heart of her presidency if she is
elected.’ She has said she had a ‘deep and abiding
Christian faith and practice’ and her aim is ‘to reflect
the love of God and follow the example of Jesus Christ to
the greater good of God's beloved community.’ Those
are nice words, but with little bioethical content.
Her running mate is Tim Kaine, a senator from
Virginia. He is also a Roman Catholic, but also
pro-choice. Previously he has admitted to having ‘a
faith-based opposition to abortion’ but he also has said
that, ‘Roe vs. Wade is ultimately about saying that there
is a realm of personal liberty for people to make this
decision’ and ‘I don’t think ultimately we ought to be
criminalizing abortion.’ The Clinton-Kaine ticket is
bioethically vague, but undoubtedly pro-choice.
On the other hand, Donald Trump has been more
explicit. He has attacked, ‘Hillary Clinton’s
unwavering commitment to advancing taxpayer-funded
abortion on-demand.’ Furthermore, he has pledged to
nominate pro-life justices to the US Supreme Court, sign
into law the Pain-Capable Unborn Child Protection Act,
which would end painful late-term abortions nationwide,
reallocate funding to community health centres that
provide comprehensive health care for women, and make the
Hyde Amendment permanent law to protect taxpayers from
having to pay for abortions.’ They too may be just
pretty words, but they are also pretty specific.
Meanwhile, Trump’s running mate, Mike Pence, governor of
Indiana, has repeatedly declared, ‘Well, I'm
pro-life. I don't apologize for it. I’d like
to see Roe vs. Wade overturned and consigned to the ash
heap of history.’
In late September, Trump announced a team of pro-life
heavyweights to act as his brains trust on life issues,
the Pro-Life Coalition. There are 32 national
co-chairs of the group, including several evangelicals,
whose remit is to speak in support of the Trump-Pence
ticket and drive the campaign’s pro-life message to
individual voters. The other side is not sitting on
its hands. Planned Parenthood has committed at least
$18 million to the 2016 election. And NARAL
Pro-Choice America recently announced a $300,000 digital
advertising campaign to target Trump and some Republican
senators on the issue of abortion.
Come Tuesday 8 November, the votes will be cast.
What then will the 45th President of the United States do,
as opposed to merely say, about bioethical issues?
Only time will tell.
Watch out, here comes China
China has already become a great manufacturing hub – we
all have Chinese products in our homes. The country
is also determined to become a biological
superpower. For instance, it was in April 2015 that
Chinese scientists accomplished a world first by
successfully using gene-editing techniques with human
embryos.
As a step towards its desired goal, China is now preparing
to become the world’s largest biological information
centre. BGI, formerly known as the Beijing Genomics
Institute, had developed the China National Genebank,
located in the south of the country. It hopes to
identify genes linked to diseases and thereby increase the
average human lifespan by five years.
The facility already had 10 million samples. And it
is already storing, sequencing and handling data to boost
its own genetics industry. Nevertheless, doubts have
been raised about the ethical nature of some of the
centre’s activities – they would not be sanctioned in
other parts of the world. Bioethical sensitivity is
not one of China’s strong suits. Be that as it may,
watch out, China is planning to be a big player in the
world of genetic research.
Abortion in France
Laurence Rossignol, the French minister for Families,
Childhood and Women’s Rights celebrated the Global Day
of Action for Access to Safe and Legal Abortion on
28 September by announcing plans to suppress websites that
‘mislead’ women about the methods and outcomes of
abortion.
She plans to criminalise those sites that aim to dissuade
women from obtaining a ‘voluntary interruption of
pregnancy’, a procedure that is state-funded in France
during the first 12 weeks of gestation. Offenders
will incur sentences of up to two years imprisonment and
fines up to 30,000 euros (about £26,000). Rossignol
has announced that the government will propose a legal
amendment to be presented to the French Senate on 4
October. Nobody supports the dissemination of
misinformation, but there are those who deny that abortion
takes the life of an unborn child and that it can
physically and psychologically damage women. M.
Rossignol must be careful to separate fact from fiction
and reality from ideology.
Abortion in Poland
On 23 September, the Lower House of the Polish parliament
voted to reject a ‘Save Women, Not a Step Further’ bill,
which proposed legalising abortion-on-demand. At the
same time it voted to continue the legislative process on
a ‘Stop Abortion’ measure, which could result in a
near-total ban on abortion in Poland.
The ‘Save Women’ proposal, presented by abortion advocates
and which sought inclusions for the health of the mother
and foetal deformity up to 24 weeks, was defeated by 230
votes to 173. Meanwhile, the ‘Stop Abortion’ bill
passed by a majority of 267 votes to 154. Backed by
the governing conservative Law and Justice Party, the bill
now moves to the Committee stage for final drafting before
returning to the House for approval. The wide voting
margin is seen as a sign that the final bill will
pass. Could Poland design the blueprint for other
European countries? Apparently not - on 6 October,
Poland’s Sejm, the lower house of Parliament, surprisingly
voted 352-58 to reject the abortion ban proposed by the
'Stop Abortion' Committee. Who can understand
politics, especially abortion politics?
Abortion in Russia
Abortion has long been a recognised social practice in
Russia. In 2015, there were, according to official
figures, 930,000 abortions performed in that country –
some say the real figure is perhaps twice that. At
the end of September, Russia reopened its abortion
debate. Significantly, the head of the Russian
Orthodox Church, Patriarch Kirill, endorsed an
anti-abortion petition.
The petition calls for a ban on any surgical or
therapeutic interruption of pregnancy, as well as the use
of contraceptives with abortion-inducing effects
throughout the country. In addition, it requests
that the moment of conception be recognised as the
beginning of human life and stresses that the human embryo
should be legally protected.
The goal of the petition organisers is a million
signatures, which will allow them access to President
Putin. More than 300,000 people have already signed
it. While the Kremlin generally supports the social
conservatism propagated by the church, officials have
largely ignored its previous calls to reduce access to
abortion.