Update on life issues

The latest issue of Affinity's Social Issues Bulletin is out now. It is free to download, as are all previous editions. One of the articles is a regular feature - an update on matters relating to bioethics and life issues in general, by Dr John Ling:

Update on Life Issues - November 2020

Abortion

BPAS and IVF
Here are two abbreviations nobody ever thought they would see juxtaposed. The British Pregnancy Advisory Service (BPAS) is the UK’s leading provider of abortions. According to its website, ‘We are the leading specialists of abortion advice and treatment in the UK, taking care of almost 80,000 women each year in over 70 reproductive healthcare clinics nationwide.’

BPAS is a not-for-profit charity, but its trade is abortion. Ann Furedi, its CEO, is an abortion zealot. She has said, ‘People talk about it as the lesser of two evils, and I think it’s important to recognise that what we do is actually a good thing; it’s good.’

BPAS makes its money by terminating the lives of the unborn. Therefore, who is not stunned to learn that BPAS is planning to open a clinic in London for fertility services, such as IVF – starting beautiful lives – in Spring 2021? BPAS and IVF are the oddest of bedfellows. Making unborn children and also killing unborn children is a bizarre industry. The parents of the very same IVF-aborted child could even be double-charged.

Furedi asks, ‘So how can a charity, known internationally for its advocacy and provision of abortion services, argue for, and offer, IVF?’ Unsurprisingly, in Furedi’s mind there is no conflict. She answers, ‘Everything is contingent, everything depends on context, and everything is personal. As an organisation, our core value is choice: the self-determination to decide if, when and with whom to have a child. We have helped women to exercise that choice to end pregnancy, now we will help women to achieve pregnancy.’

If you regard abortion services as an acceptable part of women’s reproductive healthcare, then maybe BPAS-IVF is not such a weird project. If you regard fertility care and abortion as antitheses, then BPAS-IVF will alarm you.

IVF and ARTs

Fertility treatments 2018
On 30 June, the HFEA published its annual Report entitled, Fertility treatment 2018: trends and figures. UK statistics for IVF and DI treatment, storage, and donation. The Report analysed data from all fertility treatments across the UK during 2018. Overall, it reported that during 2018 about 54,000 patients underwent 68,724 fresh and frozen in-vitro fertilisation (IVF) cycles and 5,651 donor insemination (DI) cycles at HFEA-licensed fertility clinics throughout the UK. Other headline findings included a surge in ova and embryo freezing, increasing IVF success rates for some, a decrease in multiple births and a decrease in NHS funding for fertility treatments.

Since 2013, the number of ova and embryo storage cycles have increased five-fold (523%) from 1,500 to just under 9,000 cycles in 2018 as freezing techniques improved and became more commonplace, and patients looked to future use as age, career and marriage prospects impacted on their options. Frozen embryo transfer is rapidly gaining on fresh as the favoured transfer protocol – fresh transfers decreased by 11% (48,391 to 42,835) between 2013 and 2018, while frozen transfers almost doubled (13,421 to 25,889) accounting for 38% of all IVF cycles in 2018. Vitrification is the new IVF snow queen.

The average birth rate per embryo transferred for all IVF patients was 23% – a stubbornly static statistic. Even so, rates have steadily increased for all patients aged under 43. Age is still a key factor in IVF outcomes, with younger patients reporting higher success rates. Birth rates for patients under 35 years old were 31% per embryo transferred, compared with below 5% for patients aged 43 and above when using their own ova.

The live birth rate per embryo transferred remains above 20% for each of the first three cycles of IVF treatment. Using donor ova increased considerably the chance of a live birth to above 25%, but only 18% of patients aged 40 and older used donor ova.

The multiple birth rate decreased to 8% in 2018 for the first time – a record low. Fertility clinics have been working towards a target of 10% of women who become pregnant with twins or triplets – multiple births are still the biggest health risk to IVF mothers and their babies. Transferring more than one embryo has no significant impact on the chance of a live birth but results in a 32% multiple birth rate for patients under 35.

The level of NHS funding for fertility treatment varies across the UK with 60% of cycles funded by the NHS in Scotland. This compares with 45% in Northern Ireland, 41% in Wales and 35% in England.

Euthanasia and Assisted Suicide

UK doctors vote for assisted suicide?
In 2006, members of the British Medical Association (BMA), the UK’s largest union, adopted a policy of opposition to assisted suicide. Now, after a February 2020 survey of its members, that opposition has declined. Of the nearly 29,000 responding doctors and medical students (19% of all BMA members), for the first time, 50% believe the law should be changed to allow them to prescribe life-ending drugs for patients to self-administer. That is an approval of assisted suicide rather than euthanasia. A further 39% opposed this and 11% were undecided.

Asked whether the BMA should campaign for a change in the law, 40% said it should, 33% said it should maintain its policy of opposing a law change, and 21% said the BMA should change to a neutral stance and 6% were undecided.

Asked whether they would personally support a law change to allow doctors to deliver the fatal doses, 46% opposed such a change, 37% supported it and 17% were undecided.

Asked whether they would be personally willing in any way to participate in the assisted suicide process, 54% were opposed, 26% were supportive and 20% were undecided. In other words, most of the doctors surveyed did not want to administer the life-ending drugs themselves, meaning they would be committing euthanasia. However, at least a quarter would be willing to presumably prescribe, obtain, prepare and hand over the lethal dose within the definition of assisted suicide.
 
BMA members from Northern Ireland, those registered with a licence to practise in the UK (rather than those unlicensed retired and medical students), GPs (as opposed to medical students), and those working in anaesthetics, obstetrics & gynaecology, emergency medicine, intensive care, oncology and palliative care were more opposed to assisted suicide. Significantly, these latter groups are those who work in branches of medicine involving frequent contact with, and experience of, terminally-ill patients.

The BMA emphasised that the poll was not a vote and did not commit the BMA to any change in its formal opposition to assisted dying, explaining, ‘These detailed findings will make for an in-depth, considered debate on the future of the BMA’s policy when our members meet at the association’s next annual meeting in the summer 2021. It is possible that doctors will then call for a formal change in the union’s stance on assisted suicide.

Unsurprisingly, the interpretation of the poll’s results have been varied. Humanists UK, which supports the legalisation of assisted dying, described the survey as a ‘landmark’ moment and said, ‘The BMA looks like it must end its policy of opposing assisted dying.’ Dignity in Dying responded, ‘This is a historic vote and shows the majority of doctors support greater choice at the end of life. The BMA’s official opposition to assisted dying is completely unrepresentative of its members.’ On the other hand, the Care Not Killing group said, ‘We are seeing strongest opposition to changing the law from those medics actually working most closely with terminally ill, elderly and disabled patients, compared to those who work in other non-related fields.’ And Baroness Finlay, professor of palliative care, has written, ‘Whatever view as a society we may take on this complex subject, one thing is clear: assisting people to take their own lives is not a role for doctors. Decisions that involve balancing rights for some against protection for others are for the courts, not the consulting room.’

Last year, the Royal College of Physicians (RCP) faced criticism and a legal challenge from its members after it moved from a stance of opposition to one of neutrality based on the results of an online survey. Its poll found that 43.4% of respondents said it should oppose the legalisation of assisted suicide, 31.6% said it should support legalisation, and 25% said it should be neutral. Robert Buckland, the justice secretary, told the House of Commons last year that, ‘A change to the law in this sensitive area is a matter of conscience and a matter for Parliament rather than one of Government policy.’

Genetic Technologies

CRISPR babies still too risky
Editing genes in human embryos could one day prevent some serious genetic disorders from being passed down to future generations. Maybe. But for now, the technique is too risky to be used in embryos destined for reproductive purposes. So concludes the Report of a high-profile international body, The International Commission on the Clinical Use of Human Germline Genome Editing.

The Commission was formed after the Chinese biophysicist Dr He Jiankui shocked the world in 2018 by announcing that he had edited human embryos that were then reproductively implanted in an effort to make the resulting children resistant to HIV infection. That work, which led to the birth of twin girls, was widely condemned by the scientific community and resulted in prison sentences for He and his two colleagues.

On 3 September, the Commission published Heritable Human Genome Editing, a hefty 212-page document containing 11 Recommendations. It is the result of discussions by experts from 10 countries convened by the US National Academy of Medicine, the US National Academy of Sciences and the UK Royal Society. Overall, it agrees with other recent reports that have argued against deploying gene editing in the clinical setting until researchers are able to address safety worries, and also when the public has had a chance to comment on bioethical and societal concerns.

The Associated Press release stated, ‘Human embryos whose genomes have been edited should not be used to create a pregnancy until it is established that precise genomic changes can be made reliably without introducing undesired changes – a criterion that has not yet been met by any genome editing technology. Heritable genome edits can be passed down to future generations, raising not only scientific and medical considerations but also a host of ethical, moral, and societal issues. Extensive societal dialogue is needed before any country decides whether to permit clinical use of heritable human genome editing – making alterations to genetic material of human eggs, sperm, or any cells that lead to their development, including the cells of early embryos – with the intention of establishing a pregnancy.’

It continues, ‘If a nation decides that heritable human genome editing (HHGE) is permissible, initial uses should be limited to the prevention of serious monogenic diseases, which result from the mutation of one or both copies of a single gene – for example, cystic fibrosis, thalassemia, sickle cell anemia, and Tay-Sachs disease’, the Report says. For these cases, HHGE should only be considered when prospective parents who are at known risk of transmitting a serious monogenic disease have no option or extremely poor options for having a biologically related child who is not genetically-affected without the editing procedure, due to genetic circumstances or the combination of genetic circumstances and fertility issues.’

In other words, the CRISPR-Cas9, and similar technologies, is not presently ready for clinical application. Though such techniques offer a fairly precise way to edit the genome, they have been shown to generate some unwanted, off-site changes to genes as well as a range of different outcomes even within cells of the same embryo. Furthermore, the Report – which reviewed the scientific and technical state of heritable gene editing, rather than strictly bioethical questions – advocates the formation of an international committee that evaluates developments in the technology and advises political leaders and regulators on its safety and utility.

Heritable Human Genome Editing is a scholarly approach to a complex issue. It is readable, international in content and conservative in tone. It is to be cautiously welcomed. However, its great lacunae is any in-depth discussion of the bioethical aspects of heritable genome editing – they are numerous, complex and essential. If, and when, the scientific and technical aspects are sorted out, the human editing project must not be allowed simply to go ahead without vigorous discussion of its ethics. Another report, anticipated by the end of 2020 and coordinated by the World Health Organization, is expected to deal more fully with the issues of ethics and governance.

 

Stem-cell Technologies

3D printing cardiac organoids
Here is a fascinating incongruence – the physicality of 3D printing and the corporeality of a beating human heart. After years of trying, a research group at the University of Minnesota has finally achieved the implausible.

Previously the scientists had followed a sensible protocol. They used human induced pluripotent stem cells (iPSCs) and differentiated them into cardiac cells. They then used 3D printing technology to graft them onto an extracellular matrix to give them structure. Sensible, but ineffective. The cells never reached a critical density to allow for the formation of beating organoids.

The research team was ready to abandon the project. Then, according to Professor Brenda Ogle, the lead researcher at the Department of Biomedical Engineering in the University of Minnesota College of Science and Engineering, the unexpected occurred. Two of her biomedical engineering PhD students, Molly Kupfer and Wei-Han Lin, suggested trying printing the stem cells first. Eureka!

By 3D printing the stem cells and allowing them to reach a critical density before they were differentiated into heart cells, the team was able to demonstrate that it is possible to grow 1.5cm beating-heart organoids in less than a month. Professor Ogle declared, 'I couldn't believe it when we looked at the dish in the lab and saw the whole thing contracting spontaneously and synchronously and able to move fluid.' Some call it scientific serendipity.

Of course, these lab-grown, mini, beating, heart organoids are nowhere near as complex as a fully developed human heart, but this work should advance cardiac research and treatments. Moreover, as Ogle has said, 'We can introduce disease and damage to the model and then study the effects of medicines and other therapeutics.'

Details of this ground-breaking discovery were published as ‘In Situ Expansion, Differentiation, and Electromechanical Coupling of Human Cardiac Muscle in a 3D Bioprinted, Chambered Organoid’ by M Kupfer et al., in Circulation Research (2020, 127: 207–224).

 

Miscellaneous

Ruth Bader Ginsburg (1933 - 2020)
Ruth Bader Ginsburg was a pioneering lawyer, a libertarian advocate for equality, especially for women’s rights, and a pro-abortionist. She was only the second woman ever to serve on the Supreme Court of the United States (SCOTUS) and for several years she was its only woman member – imagine, eight burly men and little her. On 18 September, she died at her home in Washington from complications of metastatic pancreatic cancer. She was 87.

Though barely five feet tall and weighing about 45 kg, she was a toughie, legally and medically. She beat colon cancer in 1999 and early-stage pancreatic cancer in 2009. In 2014, she had a stent fitted to clear a blocked artery. In December 2018, two small tumours were found on one of her lungs. A medical scan in February 2020 revealed growths in her liver. In July 2020, she released a statement saying that her liver cancer had returned and she was undergoing chemotherapy. Would she retire early? No way! She planned to stay ‘as long as I can do the job full steam’.

She was as precise in her appearance as in her approach to her work. She wore her dark hair pulled back and wore tailored suits by Giorgio Armani. On the court bench she was an active and persistent questioner, but in social settings she tended to say little letting her more outgoing husband speak for her. Yet, into her ninth decade she remained a most unlikely cultural icon. She became known as the Notorious R.B.G., a play on the name of the Notorious B.I.G., a famous Brooklyn-born rapper. The name caught on, as did her image – her serene yet severe expression, that frilly lace collar over her black judicial robe and her eyes framed by those oversized glasses. Young women had her image tattooed on their arms and ‘You Can’t Spell Truth Without Ruth’ appeared on bumper stickers and T-shirts. Biographies of her became bestsellers, documentary films were box office hits. She was an internet sensation. Hers was a late-life rock stardom.

Joan Ruth Bader was the Brooklyn-born daughter of Ukrainian Jews. Her father, Nathan Bader, immigrated to New York with his family when he was 13. The family owned small retail stores, including a fur store and a hat shop – money was never plentiful. Her mother, Celia (née Amster), was born four months after her family’s own arrival. Ruth, as she was formally known, though nicknamed Kiki, was born on 15 March 1933. She grew up in Flatbush, a low-income district of New York. She was essentially an only child – an older sister, Marilyn, died of meningitis at the age of 6 when Ruth was 14 months old. Her mother died of cancer, aged 47, on the day before Ruth’s graduation from James Madison High School.

In 1950, Ruth Bader arrived at Cornell University on a scholarship. During her first year, she met a second-year student, Martin (aka Marty) Ginsburg. For the 17-year-old Ruth it was love at first sight. ‘He was the only boy I ever met who cared that I had a brain’, she frequently recalled in later years. By her third year, they were engaged, and they were married after her graduation in 1954. Theirs was a lifelong romantic and intellectual partnership of opposites – she was reserved, choosing her words carefully, he was an ebullient raconteur.

Following their marriage, they moved to Oklahoma where Marty Ginsburg served for two years as an Army officer. Ruth applied for a government job at the local Social Security office. She was offered a position as a claims examiner, but when she informed the personnel office that she was pregnant with her first child, the offer was withdrawn. Instead she accepted a lower-paid clerk-typist job. Years later, such adverse employment incidents and ingrained assumptions that limited women’s opportunities were to become the focus of Ginsburg’s life work.

Meanwhile, law studies took her to Harvard University. When her husband found work in New York City, she transferred to Columbia Law School. Despite coming top of her class, she struggled to find employment there. ‘I was Jewish, a woman and a mother’, she explained. Eventually she found work as secretary to a federal judge in New York, but only by reassuring him that she would never wear trousers to work.

By 1963, she was a professor at Rutgers Law School. While undertaking a study of Swedish civil law at Lund University she was impressed by Scandinavian thinking on gender equality. Feminism was flourishing in Sweden, and it was commonplace for women to combine work and family obligations.

In addition to teaching, she began volunteering to handle discrimination cases for the New Jersey affiliate of the radical American Civil Liberties Union (ACLU). These cases included complaints by school teachers who had lost their jobs when they became pregnant. In 1972, the ACLU created a Women’s Rights Project and hired Mrs Ginsburg as its first director. It was under the auspices of this ACLU project that she developed her strategy to persuade the courts that official discrimination on the basis of sex was a harm of Constitutional dimensions. It was a daunting uphill task. Yet between 1973 and 1978, Ginsburg presented six sex discrimination cases before the SCOTUS, and won five.

Though ardently in favour of a woman’s right to choose, she was a critic of Roe v. Wade, the Supreme Court’s 1973 decision establishing a constitutional right to abortion. In a speech at New York University Law School in 1993, several months before her nomination to the Supreme Court, she criticised the ruling as having ‘halted a political process that was moving in a reform direction and thereby, I believe, prolonged divisiveness and deferred stable settlement of the issue.’ She maintained that the SCOTUS should have issued a narrow rather than a sweeping ruling, one that left States with some ability to regulate abortions without prohibiting them. Nevertheless, on abortion she stubbornly declared that ‘the Government has no business making that choice for a woman’.

In 1993, President Clinton had a seat to fill on the SCOTUS. It was his first nomination to the Court and he carefully searched for the right candidate – some turned him down. Then there was Ruth Bader Ginsburg. After a 90-minute meeting with her on 13 June, the President has made up his mind. He phoned her with the news later that night. The next day, at the announcement ceremony in the Rose Garden of the White House, Clinton said, ‘I believe that in the years ahead she will be able to be a force for consensus-building on the Supreme Court, just as she has been on the Court of Appeals.’ Judge Ginsburg replied with a tribute to her mother. She declared, ‘I pray that I may be all that she would have been had she lived in an age when women could aspire and achieve and daughters are cherished as much as sons.’ It brought tears to Clinton’s eyes.

During her SCOTUS nomination hearings, addressing the Senate Judiciary Committee, Ginsburg said her approach to judging was neither ‘liberal’ nor ‘conservative’. She did, however, make clear that her support for the right to abortion, despite her criticism of Roe v. Wade, was unequivocal. Her subsequent appointment was confirmed on 3 August 1993.

Again, on abortion, Justice Ginsburg invariably displayed her true colours. In 2020, in June Medical Services v. Russo, she voted to strike down a Louisiana pro-life law that would save the unborn from abortion and protect women’s health by requiring abortionists to have hospital admitting privileges for patient emergencies. She questioned the necessity of the law, arguing that most women who get abortions do not require medical treatment afterwards. On 29 June, the SCOTUS announced, in a 5 v. 4 decision, that the 2014 Louisiana law was unlawful.

In 2016, she joined the majority for Whole Woman's Health v. Hellerstedt, a case which struck down parts of a 2013 Texas law regulating abortion providers. She claimed the law in question was not aimed at protecting women's health, but rather to impede women's access to abortion. In 2007, she was in the minority of a 5 to 4 decision in Gonzales v. Carhart which upheld a federal law restricting partial-birth abortions – she considered that the procedure was not safe for women. In 2000, in Stenberg v. Carhart, she joined in the Court's majority opinion striking down Nebraska’s partial-birth abortion law. Ginsburg’s unbounded pro-abortion ideology paraded itself finally in 2020, when she voted to force the Little Sisters of the Poor to pay for abortion drugs within their healthcare insurance plan.

Her husband, Martin, became a highly-successful tax lawyer yet he happily gave up his lucrative New York law practice to move with her to Washington DC in 1980 when she was appointed to the United States Court of Appeals for the District of Columbia Circuit. He taught tax law at Georgetown University’s law school. He was also a talented cook compared with his wife who was, by her own admission, terrible – apparently her children forbade her from entering the kitchen.

The Ginsburgs lived next to the John F Kennedy Center for the Performing Arts, where they frequently attended the opera and ballet. Their 56-year marriage ended with his death from testicular cancer in 2010 at the age of 78. In his final days, he left a note, handwritten on a yellow pad, for his wife to find by his bedside. It began, ‘My dearest Ruth. You are the only person I have loved in my life, setting aside, a bit, parents and kids and their kids, and I have admired and loved you almost since the day we first met at Cornell. What a treat it has been to watch you progress to the very top of the legal world!!’ Their two children, Jane, a professor at Columbia Law School, and James, a record producer of classical music and the founder of Cedille Records in Chicago, survive their parents, along with four grandchildren.

Ruth Ginsburg was a non-observant Jew. After the two days in repose at the Supreme Court building, she lay in state at the Capitol. She was the first woman and first Jew to lie in state there. On 29 September, she was buried beside her husband at the Arlington National Cemetery. What a gifted and strong-minded woman she was. Yet one thing she lacked ... (Mark 10:21).

Suicide numbers
Numbers of deaths by suicide are increasing in England and Wales – and probably elsewhere too. The Royal College of Psychiatrists has recently called for more research to understand the reasons why.

Figures published in September by the Office for National Statistics refer to deaths in 2019. Overall 5,691 suicides (4,303 in men and boys) were registered in England and Wales during 2019. That is up from a total of 5,420 in 2018. And that means there was 1 suicide every 90 minutes, with an estimate of 1 attempted every 5 minutes. And these figures are probably underestimates.

The figures also show that the suicide rate among men and boys was 16.9 deaths per 100 000, the highest since 2000 and slightly above the 2018 rate of 16.2 per 100 000. The suicide rate among women and girls was 5.3 deaths per 100 000 in 2019, up from 5.0 per 100 000 in 2018 and the highest since 2004.

This is just about the grimmest and saddest issue to review. We are all affected. The suicidal and the para-suicidal are nearby. As mental health is becoming a more widely discussed topic, how much do we understand? Why, for example, is the highest suicide rate among middle-aged men? Surely they are now established in their careers, families and communities. Surely they are now relatively healthy and wealthy. If so, such factors are not the key drivers of suicide. Indeed, suicides are more frequently linked to isolation after divorce, or separation from a spouse, or partner and their children, as well as alcoholism, and lost employment. Men in this group are also often less willing, or too proud, to seek help.

But all of us, including switched-on bioethicists cannot afford to ignore the topic. It can cause untold grief for those ‘left behind’, but it can also inform our thinking about assisted suicide. Why, for instance, do those doctors who campaign for the legalisation of assisted suicide also run campaigns in their GP practices to help their suicidal patients avoid it?

And figures are expected to be even higher in the coming months and years. Think for example of those with increasingly fragile mental health caused by the negative effects of the Covid-19 pandemic. The take-home message? Watch out for those middle-aged men especially and other suicidal people in your family, church, workplace and community. It’s a Mark 12:30-31 affair.

 

USA and Elsewhere

Amy Coney Barrett
With the recent death of Supreme Court judge Ruth Bader Ginsburg, the opportunity for President Trump to nominate a new member of the 9-person Supreme Court of the United States (SCOTUS) occurred. The rush was on – the uncertain presidential election was on 3 November. Would his candidate be approved in time?

The President went for it. On Saturday 26 September he nominated Amy Coney Barrett. This was bold on several levels. Whereas Ginsburg was a radical abortion activist, Barrett was known to be radically pro-life. If appointed, Barrett would tilt the SCOTUS towards a conservative balance of 6 to 3. Potential challenges to Roe v. Wade were openly discussed, with dread by some, but with joy by others.

Who is she? Born in New Orleans, Louisiana, into a family of devout Roman Catholics, she studied English at Rhodes College, Tennessee and then law at Notre Dame Law School, Indiana. She is the 48-year-old wife of Jesse Barrett, mother of seven children, including two adopted from Haiti, and her youngest biological child has Down’s syndrome. She tested positive for Covid-19 this summer, but has since recovered. She is a law professor at the University of Notre Dame Law School, where she has taught civil procedure, constitutional law, and statutory interpretation. And she is a judge on the Seventh Circuit Court of Appeals.

She is a staunch Roman Catholic and member of the parachurch charismatic renewal organisation People of Praise, which holds, for example, that sexual relationships should occur only between married, heterosexual couples. She believes life begins at conception and has noted how both pro-life and pro-abortion legal experts have criticised Roe v. Wade as a bad decision. She also has made several statements about the value of babies in the womb, signed a public letter in 2015 that emphasised ‘the value of human life from conception to natural death’ and has called abortion ‘immoral’.

In a 2006 speech to graduates at Notre Dame Law School, she previously declared, ‘...if you can keep in mind that your fundamental purpose in life is not to be a lawyer, but to know, love, and serve God, you truly will be a different kind of lawyer’.

On 12 October, she began her Senate Judiciary Committee nomination hearings. Before, during and after those hearings she has been aggressively attacked by Democrats, mainstream media, abortion activists, humanists, Planned Parenthood, LGBT activists and many more for her conservative personal and political views and her faith. She would make a great member of the SCOTUS!

And indeed, she will. On 26 October, the US Senate voted 52 v. 48 to confirm Judge Amy Coney Barrett to be the next Associate Justice on the Supreme Court. She took the oath of office later that night. A conservative, constitutionalist, pro-life woman at the Supreme Court. Whatever next? We wait expectantly.

 

France goes bioethically mad
At 04:00 in the morning on the first Saturday in August, members of the National Assembly of France voted on a number of radical amendments to its bioethical laws. The vote in favour was only 60 v. 37 with 4 abstentions out of a total of 577 Assembly members. In particular, the Assembly approved liberal abortion laws, the creation of genetically-modified embryos, chimeras (animal-human hybrids), saviour siblings, plus state-funded assisted reproductive technologies for lesbian couples and single women as well as ‘shared motherhood’, meaning the donation of ova or embryos between lesbian partners.

This bill, first adopted in October 2019, was a flagship commitment by President Emmanuel Macron at his 2017 election. His position is unequivocal – earlier this month he declared, ‘Everywhere, women’s rights are under attack, starting with the freedom for women to control their own bodies, and in particular the right to abortion.’

This latest political episode has not been an example of sensible democracy. For instance, the debate was held in the middle of summer, discussion time was reduced, and a last-minute, extreme pro-abortion legislative rider was added, which would permit abortion up to birth for the so-called unverifiable criterion of ‘psychosocial distress’ of the mother.

Currently in France, around 220,000 legal abortions are performed every year, though in 2019 the figure rose to a record number of 232,000 abortions, 8,000 more than the previous year. Most of these are performed as medical abortions. Late-term abortions (after 12 weeks of gestation) require medical approval that is legally limited to cases of severe malformation, or supposed unviability outside the womb, or when a mother’s life is endangered. In effect, the proposed legal changes would introduce a ‘right’ to abortion, for any reason, fully funded by the French Social Security.

These revised bioethical regulations will now be returned to the Senate for a second reading, where they will probably be heavily amended, perhaps before the end of this year. The modified law will then be voted on by a joint committee of the two houses. If a consensus cannot be reached, the National Assembly’s decision will be final.

But that is not all. On 8 October, a bill extending the abortion time limit from 12 to 14 weeks without conditions, some to be performed by midwives, and the restriction of conscientious objection, passed its first reading in the French Assembly. A sparsely attended lower house backed the proposed law change by 102 votes to 65. The following weekend, on 10 October, saw thousands join 61 nationwide demonstrations against this draft ‘Law Concerning Bioethics’. ‘Marchons Enfants!’ was their cry.

John Ling

(A fuller version of John’s regular update of bioethical news and views can be found at www.johnling.co.uk)

(This article was originally published in the Affinity Social Issues Bulletin for November 2020. The whole edition can be found at www.affinity.org.uk)


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