My way or the highway!

This is the attitude of our Prime Minister, who is being pig-headed and seems to have decided a long time ago to introduce certain changes to the IVF law, even though this involved the sacrifice of innocent human lives in the process. We have seen that we can have IVF with fresh and frozen oocytes (eggs), which has given us an ethical edge and success too. Our pregnancy rate per embryo transfer is 30 per cent, similar to the European average, and our take-home baby rate is 21 per cent, slightly below the 25 per cent European average, with about 250 babies born through IVF in six years. Not bad considering that our IVF centre and expertise is 6 years old, that we carry out IVF ethically and preserve human dignity, that we do not do Pre-implantation Genetic Diagnosis and discard disabled embryos like those with Down’s syndrome and that we protect human life completely.

However the Prime Minister is determined to introduce IVF with embryo freezing in order to have a batch of frozen embryos available for surrogacy, and according to his ill-given advice, to maybe raise the IVF take home baby rate by about two per cent by transferring embryos to a women’s womb at five days of development rather than at three days of development, at the so called blastocyst stage rather than the morula stage. To do this after five days, weaker or non-viable embryos would have likely died, and the new legal amendments will allow for the fertilisation of five oocytes rather than the previous two. The result is that one could possibly end up with more than two embryos at the five-day transfer stage, which means that the best two have to be chosen for transfer to the womb (a eugenic practice) and the others frozen (to be later donated to people who will take them). The resulting cost comes as a gross travesty of human dignity.

To be able to bring in surrogacy and carry out the above-mentioned blastocyst stage transfer, the government is prepared to do away with the life of several (10 to 30 per cent) human beings at an early stage of development both because they die in the thawing or freezing process and because they will inevitably accumulate as they do in other countries, which then presents a problem with what to do with them other than donate them to surrogate mothers as baby commodities. This is unacceptable ethically and unlike the way the government thinks, the end does not justify the means, meaning it is not acceptable to do something wrong to achieve something right (if one can ever call surrogacy right). Not that this principle bothers it or any of the Labour MPs it seems.

In its rush to appear progressive and modern and to have its way, the government and its cronies are saying and doing a lot of silly things such as stating that the early stage embryo is not a baby or a child because it has only eight cells while big daddy has about a trillion cells. What difference may I ask is there whether I sweep away the life of a human being at the eight-cell stage and that at the trillion cell stage or any cell stage in between? The reality is that science shows us clearly that at the stage of fertilisation there is an actively developing human being with its own DNA and active potency to develop till birth and adulthood. These are called the Carnegie stages of embryological development which start at the single cell zygote stage after fertilisation is ended. Anything else is not scientific! Cells at the eight-cell stage are said to be totipotent because they develop into an adult human being if given half the chance, that is, unlike skin or liver cells said to be mature cells or pluripotent stem cells which can never do so. This can only happen after fertilisation when the establishment of the cell with the new singular embryonic DNA has taken place and new original epigenetic patterns start to be laid down. Not only is it a human being, a new unique member of our species, but it is also a human person because it is an individuated, developing human being, after Boethius’ definition of personhood that being an individuated human being of a rational nature. It is the rational nature or essence of the human being that defines him as such rather than the exhibited particulars such as moving, walking or exhibiting self-consciousness as we all exhibit these traits at certain times of our life and not at others.

The fact is Joseph Muscat must be seen to have his way, he has to have freezing and surrogacy brought in to accommodate lobbies, even though strictly speaking there is no need for embryo freezing to be allowed in order to bring about surrogacy, as this can still happen with frozen eggs! All this is done in the name of progress, without any respect for nascent human life. Some progress! I would say a retrograde travesty of human dignity.

I personally would find difficulty reconciling this position with natural law, which commands us to respect and protect other human lives as members of our own species, especially if they are innocent and powerless and endowed with an absolute right to life. I find it difficult to reconcile it with virtue ethics and particularly justice, justice asking us to give everyone his equal share. I find it difficult to reconcile it with the ethics of duty. I find it difficult to reconcile this position with Maltese law which is clear about purposeful killing of innocent life. I find it impossible to reconcile this position with Christian doctrine because of the Divine order not to kill (Do not kill – other human beings), especially St Paul’s clear position in Romans where he states clearly that it is not morally acceptable to do something bad to ever achieve something good. Neither does it tally with any commandment to love one another. Therefore, I leave it to the dictates of these individuals to justify their consciences and think about what to say when they ultimately need to give an account of their actions. I hope they can convince God that the eight-cell embryo is not a human being, but respectfully to them and to God, they sure do not convince me!

michael.asciak@parlament.mt

Dr Asciak is a Senior Lecturer II in Applied Science at MCAST.

Option for the strong – Fr Robert Soler

The Bill amending the Embryo Protection Act 2012 embodies a philosophy of law that is completely distinct from the philosophy of the original 2012 law. Misleadingly clothed as ‘amendments’ to the 2012 law, the Bill embodies a totally new philosophy.    

An initial observation is necessary. Sometimes, one may feel in conscience impelled to speak out when an important issue is eminently ethical. When on a given ethical issue a stand is taken, it cannot in fairness be called “meddling in politics”.

I now take up three specific issues.

Firstly, if the proposed Bill is passed, Maltese law would recognise an unrestricted right to adults who desire it to have a child within our national health system. Now if the embryo’s mother will not be carrying the child herself, then another woman must stand in for her. Thus surrogate motherhood “has” to be introduced.

At a forum organised by the Christian Life Communities (CLC) at the University Chaplaincy, moral theologian Nadia Delicata emotionally but most correctly blasted surrogacy as “double objectification”: both the embryo and the surrogate mother are there reduced to objects (Times of Malta, April 24).

Sweden’s Social-Democratic government, “the first feminist government in the world”, in 2016 totally banned surrogacy in Sweden.  So ‘liberal’ Sweden has banned surrogacy as offending the dignity of woman. 

At a conference on women’s rights in 2017, feminists and Catholics joined forces to condemn surrogacy as totally “incompatible with the human rights and the dignity of women”.

Secondly, the present Bill, were it to become law, would guarantee the total anonymity of all adults involved in an IVF process through gamete-donation: a child born out of the said process can never discover who her/his biological parents are. This gives 100 per cent protection to the adults involved, while giving zero importance to the legitimate interests of the child.

We can easily end up with half-brothers and half-sisters marrying, which in the small genetic pool of our Maltese community, could have significant long-term genetic consequences.

Thirdly, since life begins at conception, freezing an embryo is tantamount to freezing a human being. When embryos are later thawed, statistically anything up to 25 per cent of them die a natural death.  In other words, setting up an embryo-freezing facility implies that one in four of those human beings with immense potential would be condemned to die before they have even opened their eyes. 

 

Read in depth, the new Bill would bring about a total change in perspective as regards IVF.  The 2012 Maltese law was carefully modelled on its Italian counterpart law, the 2004 law regarding Fecondazione Assistita.

The Italian law and hence our 2012 law placed the embryo/foetus/baby at the centre of legislative attention, thereby also sending a subliminal message to the public that, even prescinding from religion, it is eminently human and ethically absolutely correct to put the vulnerable little person at the very centre of IVF legislation. 

This did not mean that the desires of adults were/are not important, and insofar as such concerns were, at least in secular (non-religious) ethics, acceptable, they were in fact met by the 2012 Act.  That law however stopped short of giving the adults all they wanted, particularly if this could only come about at the expense of the little vulnerable human being.

What we could call the fundamental philosophy of the 2012 Malta law concerning IVF was that the interests of the embryo/foetus/child were paramount.

In sharp contrast to the 2012 Malta law, the fundamental philosophy of the present Bill is consciously to favour, not the embryo/foetus/child, but the adults involved.  The Prime Minister was keen that this legislation would be rushed through Parliament. This had happened at least once before – after the 2013 election, when, as promised in the electoral manifesto, same-sex marriage was approved, but with an added element not to be found in the manifesto – the possibility of adoption by same-sex couples.  

It will escape nobody that this is exactly the same philosophy of law that animates the present ‘amendments’: please the adults, don’t ask what might or might not be in the best interests of the children.

It is sad that some, who are intellectually gifted, have attempted to present this as an issue mostly concerning the interests of adult minorities. In the light of the multi-faceted ethical concerns presented above (and expressed better elsewhere by others), these persons have completely missed the point.

The Prime Minister (April 23) acknowledged that some ‘genuine’ criticism against the amendments was offered.  Besides former Labour Cabinet members George Vella and Deborah Schembri, serious concerns about the ‘amendments’ were also expressed by the Maltese bishops, the Malta Paediatric Society and doctors and scientists, raising various scientific points, including possible incest and the gradual degeneration of the genetic pool, lawyers viewing the matter from a human rights perspective, philosophers writing about the violation of the dignity of the human embryo… indeed citizens from all walks of life have criticised the ‘amendments’.

All finally finding powerful expression in the presence of the many thousands of people who thronged Valletta on April 22 to protest against the ‘amendments’.

Dr Muscat argues that the 2017 electoral manifesto and his success at the polls give him a strong mandate to ‘improve’ the 2012 IVF law. Improve yes, radically change no! The ‘amendments’, far from being an “improvement” on the 2012 Embryo Protection Act, would de facto lead to the “complete travesty” that George Vella spoke of.

The 2012 law would be shamelessly deformed, its noble original purposes totally debased. 

Together against discrimination – Tonio Fenech

The statement issued by the Malta Gay Rights Movement (MGRM) supporting the proposed changes to the Embryo Protection Act shed light on some misconceived ideas.

Every human being has the right to live the lifestyle he chooses, to be esteemed, and not to be discriminated. This is a basic value that we all cherish, at least those who believe in freedom and equality.

However, equality is not one sided. Equality is about giving respect, dignity and the right to freedom to everyone, even the embryo who is a human being that deserves his or her freedom, to be also esteemed and not discriminated against.

This is not about the rights of a minority group against the will of the majority, this is about the protection and respect we give to the vulnerable. In pursuit of our rights we cannot trample on others; this too is a basic value. The fish in an overcrowded aquarium kill the weaker and smaller fish to have more space and survive. But we are not fish, we are humans.

There is no discrimination in a single woman not having a child. We already have single mothers; they never needed IVF.  There is neither any discrimination against same-sex couples in sexual reproduction or health services. A same-sex couple cannot blame the rest of society for discrimination because it cannot have children when the limitation is biological, created by nature and beyond anyone’s control.  

I would like to assert a very important principle: having children does not make one more human, or more dignified, as much as not having children does not in any way make you inferior. Children are a gift from nature and despite all the technological advances not even IVF can guarantee a couple a child.

Not to have their own children is the choice of same-sex couples, who take that decision knowingly when they enter into such a relationship. Therefore, playing the discrimination card is most unfair, as it is not society that has imposed this limitation. It is a simple fact of life. 

When we talk of children we cannot reason as though we are talking of a soft toy you pick from a store. Children have rights, the right to know their natural parents, to be cared, nourished, educated and loved by them. 

It is even most unfair that in its statement MGRM “uses” the legitimate pains of childless natural parents to further its claims. IVF is important to support childless couples and the focus of the debate should not be detracted from the President’s message, i.e. to find the balance between the heartache that childless couples face and the ethical, moral and scientific considerations connected with right of embryos that are human beings.  

 

Now let me be very clear. I am in no way saying that same-sex couples cannot love children, but this is not what these amendments are about. The State has already granted the right to adoption to same-sex couples, and despite the claims made by MGRM, the jury is still out on the welfare of the children.  

If the issue is discrimination, then we should be all against these amendments, even the MGRM. The law will allow only two embryos to be implanted in every cycle, the “extra” embryos will be frozen. Can you imagine what MGRM will say if somebody claims that gay people are “extra” and therefore should be discarded?  Rightfully, that person would be accused of spreading hate. But what makes it so different when we talk of an embryo, which is the first step of our human existence?  Being eight or a million cells makes no difference.

Is it fair that these humans may never see the light of day, dying in the defrosting process, or forever forgotten as frozen orphans? Is it not discrimination that those implanted in their mother will know their parents but those that are frozen/donated will not have this opportunity?  

How can those fighting discrimination accept the concept of creating children in undesirable situations as frozen orphans and say that they are equal? This is discrimination and not arguments that ignore the laws of nature.

As parents our concern is the child’s best interest. That is why this value is so close to us. If we keep the value of the “best interest of the child” first in our discussion, these amendments need some considerate rethinking.

Adoptions are a remedy for an undesired outcome. In such situations adoption is a noble act. It does not follow that creating orphans is a good thing.  Unfortunately adopted children pass through difficulties many of us cannot understand. The yearning to know from where they come, and to which there will not be an answer; if they trace their biological parents they struggle to understand why they have been rejected, thinking that it was for something wrong that they did, creating anxieties, inferiority complexes and other psychological difficulties. There are ample studies and real-life stories of these situations, why do we chose to simply ignore?   

Sperm and egg donation and surrogacy create even more of such confusion in the child. A child can have three mothers and two fathers, the biological parents, the surrogate mother and the adoptive parents, or other combinations like four mothers and a father or two mothers and three fathers. Is this confusion for the best interest of the child?

Surrogacy is a practice that is totally banned even in very liberal countries. In 2016, feminists and human-rights activists from all over the world met in Paris to sign the charter against surrogacy with the European Parliament calling on states for its total ban.

Surrogacy is exploitation, goes against the dignity of the woman and the child she carries. It renders the woman no more than an object. Endless stories of surrogate mothers refusing to give the child they bore and bonded with for nine months for the obvious natural reason that they feel the child is theirs. Prolonged court disputes, separation from the mother, are not the best interest of the child. 

Who will defend the child against discrimination, forced abduction and separation from the mother that gave the child flesh? I hope MGRM are genuine in their fight against discrimination. If so let them become LGBTIQE, with “E” for embryo.

Having or not having children makes you no more and no less human. There is no discrimination in not having children. These amendments create real discrimination, discrimination against the embryo/child.

Proposed changes ‘seriously dilute the focus on the dignity and protection of the human embryo’

The Dean of the Faculty for Social Wellbeing, Andrew Azzopardi has called for reflection on this delicate matter by first and foremost advising for a non-partisan approach to such an important national debate.

This Press Release he issued, he said, is intended to lay out the matters on the table and commend legislators, policy makers, experts, stakeholders and the general public to take in cognizance the following as we reflect on the proposed changes to the ACT to amend the Embryo Protection Act, Cap. 524.  In this Press Release I will list the pros and cons to avoid simplistic entrenching and turf defending.  Above all our discourse needs to be informed by rational, ethical and considerate argumentation.

His initial reactions are the following:

–          that the proposed changes seriously dilute the focus on the dignity and protection of the human embryo;

–          that the consultation period has been too brief and that the matter is being rushed through prematurely. 

The three major bones of contention are; the ‘freezing of embryos’; ‘anonymous donation’; and ‘surrogacy’. 

Freezing of embryos

Arguments have been made to the effect that the proposal to allow the ‘freezing’ of embryos will inevitably result in a surplus of embryos.  While some will not survive the thawing process, others will simply continue to ‘exist’ as they may not necessarily get adopted or donated as indicated in the revisions. I think that the proposed Act does not cater for these surplus embryos, and fears have been expressed by various parties that these might simply be thrown away or given for experimental research (even though according to the current law and the amendments proposed, research on embryos is and will remain illegal).  Furthermore, the very fact of selecting which embryos are to be implanted and which not also poses an ethical and social justice dilemma.  I do not think that the number of fertilised cells should be used as a defining argument.  

On the other hand, it has been argued by Deputy Prime Minister and Minister of Health Hon. Chris Fearne, that “the rate of success of embryos from the freezer have doubled the success rate [to current procedures where embryos are planted in the womb]” and that “none will be left in the freezer forever“.  Dr Miriam Sciberras from Life Network Foundation Malta, states that “With the current law, we can do away with embryo freezing. The ova can be cultivated and only the ones that will be implanted will be fertilised. The remaining ova can then be frozen. During subsequent cycles, the ova can be thawed and then fertilised to be implanted. The national health system only gives you three cycles. If we really want to help these women, we should not introduce embryo freezing but more IVF cycles.”  The Commissioner for Children, Pauline Miceli, said that “Cryo-preservation or freezing of human embryos has become a medically viable practice by virtue of the high rate of survival of cryo-preserved or frozen human embryos. The Bill provides a framework for the cryo-preservation of embryos to be conducted in a way that maximises the chances of the individual human embryo to survive throughout the freezing and thawing process and thus to eventually develop healthily.”

Anonymous donation

Another concern has been expressed about the anonymous donation of gametes, both in terms of a child’s right to know his/her biological parents, and also in view of the possibility of close relatives (unaware of being so) eventually entering into an intimate relationship with all that this implies medically for the health of the ensuing offspring.

Dr Mark Sant, Consultant Obstetrician and Gynaecologist, has stated that “research had extensively assessed the psychological adaptation of donor children, and found it to be comparable to that of children born naturally or through IVF…. He warned that banning anonymous donation would destroy any donation programme, as it meant that prospective donors would have to reconcile themselves to the possibility of being sought out by their biological children against their own wishes.”

The counter-arguments are the following;

As to potential relationships between relatives, Minister Fearne said that “all individuals born through IVF procedures will have access from the authorities so people will know that they are not from the same donor” and Commissioner Miceli states that “the Bill safeguards the right of a child conceived through such means to his or her individual identity by giving children, when they turn sixteen, the right to know the identity of the donor through whose gamete they were conceived. The fact that the Bill proposes that gamete donation by the same donor can happen once only preserves the uniqueness of the child’s biological identity.”

Surrogacy

A third issue that is being discussed is that of Surrogacy.  Commercial surrogacy remains a criminal act in the proposed revisions, in recognition, perhaps, of the commodification of women and the maternal bond and responsibilities that surrogacy implies.  However, it is proposed that it will be at the Minister’s discretion to regulate ‘altruistic surrogacy’ through a legal notice.  Opening up the door to surrogacy, and the difficulties in ascertaining where this is truly altruistic, is a very big step and insufficient thought and debate appear to have gone into this proposal. Issues around psychological ramifications of such a procedure are to be placed on the agenda rather than choosing to view the ‘surrogate’ as being void of personhood or feeling. 

Dr Miriam Sciberras says that the law states that “surrogacy, also known as altruistic surrogacy, between friends could be anyone. This law gives all the options of surrogacy even to two gay men. Both the donors of the sperm and ovum can be donated to be carried by someone else. This leads to an identity crisis for the child.”

The TMI Editorial on the other hand notes that, “There are arguments both for and against surrogacy. In some of the cited examples it might make sense, especially in cases where a woman might not be able to carry a child in her own womb.  But some other examples are so highly convoluted that one might ask why these prospective parents do not opt to adopt a child instead. Which also begs the question: should the state not make it easier and more affordable to adopt? “

Where does all of this leave us?

He believes that there are ten points for reflection on this proposed Bill – a Bill that expedites the creation of a surplus of embryos, that facilitates the freezing of embryos, that enables IVF through donor gametes and that enables the de-criminalization of noncommercial surrogacy.

Reflection 1:

All human life, presently alive, or who ever lived, started life as an embryo.  Science confirms, as a fact, that at fertilisation a new life genetically distinct from the ovum (the mother) and the sperm (the father) that created it begins. This life is referred to by different terms through its different stages of development, from zygote to embryo to foetus to baby to child to youth to adult to older person. The genetically distinct new organism formed at fertilisation is the same human life until death.

Reflection 2:

The human natural desire to propagate and to have children can be a cause of immense pain for couples who cannot have children. If we can do something to alleviate this pain and longing, we should.  The advancement of science that supports the creation of life is an amazing source of hope for many such couples and merits full support through legislation and resources.  However, all such support for the creation of life cannot be done at the expense of dispensing some other life.

Reflection 3:

While recognising the deep human and natural desire for children, this desire does not constitute a right to have children. 

Reflection 4:

All children have a right to know their full genetic identity and their genetic history.  It is not enough for a child to know his or her inherited medical conditions through a file.  One’s genetic identity includes the full knowledge and access to one’s roots.  Professionally, we know the importance that human beings give to their roots. We all know stories of children, youth and adults who do not manage to come to terms with their past and find peace because of gaps in their roots which they never manage to fill.  Children born through IVF should also have their genetic identity rights safeguarded.  Parliament should safeguard and protect the biological heritage of all citizens rather than facilitate the process for the creation of a generation of citizens deprived of their biological heritage.

Reflection 5:

Gestational surrogacy is effectively the legalisation of a new market of human beings, with the possibility of creating another entry point to human trafficking.  What also concerns me is the fact that whoever opts for surrogacy to carry the child of others without having been pregnant before will suffer immense psychological harm. A surrogate mother who already has her own children already knows what pregnancy and bonding are like. 

Reflection 6:

Gestational surrogacy places the creation of life in the realm of commerce and law.  It may involve up to 5 separate individuals: egg donor, sperm donor, gestational carrier and one or more “commissioning parents.” (Theoretically, it can actually involve even more than 5 people in situations when an embryo is created from more than one egg donor because of possible “defects”.)  As a consequence, the law decides who the legal parents of the child will be, highlighting the artificial nature of the whole process.  The woman who carries the child for nine months and the egg and sperm donors (when none of these are the “commissioning parents”) are simple components in the commodification of the creation of a human being.

Reflection 7:

Another argument that has been made in regards to surrogacy is that it is known to be potentially economically exploitive, manipulating poor women for the benefits of the reproductive goals of the rich. 

Reflection 8:

It is common practice in IVF for the doctor to implant multiple eggs with the hope that some of them will survive.  It is common for surrogacy agreements to bind the surrogate to undertake a process of “selective reduction” (abortion) if more than the required number survive or if the foetus does not meet the specifications of the “commissioning parents”.

Reflection 9:

Surrogacy commodifies and objectifies the maternal identity of women.  It uses a woman’s womb for gestation with no consideration for the post pregnancy period. Basically, the gestational mother has no right whatsoever to express any feelings or attachment to the child she would have carried for nine months.  Once the baby is born, the gestational mother’s bond to the child is discarded. Naturally this might not be the case if the surrogate is a member of the same family.

Reflection 10:

Ultimately, we have no idea on the possible psychological impact of severing the infant’s attachment to the gestational mother.  Yet, surrogacy assumes that the infant’s attachment to the surrogate is dispensable.  So asking the question: “Is surrogacy in the child’s best interest?” is essential if the law is to be guided by the paramountcy principle. This question becomes even more pertinent in situations of legal limbo following the rejection of a commissioned child by the commissioning parents due to the child not meeting the expectations of the commissioning parents (for instance when child has birth “defects”).

His appeal is once again that we should safeguard the best interests of children at all times.  Whilst a point has been made about an increase in the number of people with infertility problems this does not preclude us from being cautious on decisions that will have a long-term impact.  More time is required to discuss the implications of such a delicate piece of legislation.

Ref: http://www.independent.com.mt/articles/2018-05-01/local-news/Proposed-changes-seriously-dilute-the-focus-on-the-dignity-and-protection-of-the-human-embryo-6736189072

Down the slippery slope – Mario Stellini

It is not like me to voice a strong opinion about anything. I believe that most issues can be examined from different perspectives and no opinion can be absolute and exclusive.

The recent debate on IVF, however, has brought me to tears, anger and yes, fear. Why fear? Maybe I should explain.

What are the main issues behind the IVF debate, if we can leave the political obfuscation aside? I think the first issue is whether an embryo is a human being or not and whether we have a right to do whatever we please with that embryo.

The other issue is whether we have a right to meddle in other people’s lives and their right to have children. These people have been discriminated against by nature and deserve our empathy and all manner of support. “Discrimination” seems to be a strong key word in this second debate.

Let’s start with the first issue. It is useless quoting very learned and sometimes very ignorant professors and authorities on the subject. We all know that an embryo is alive and has the potential to become a full human being.

The real point is, do we have a right to kill it, freeze it or put it in indefinite storage in order to make IVF easier and more successful? When does “it” become a he or a she? Is this when “it” can move or think or protest? A comatose person or an anaesthetised person is also incapable of moving or thinking or protesting. They may not even have a functional brain. Should we also kill these people? 

Or is it the form that makes us human? Is an embryo only human when it has formed limbs, a face, a fully formed brain? What about those people who are deformed in some manner with no limbs, a scarred face and a shrunken brain? Should they not be condemned to die as well? Should one’s past shape and form determine one’s fate or is maybe one’s potential development more important for the future?

Maybe it is size that determines humanity. After all an embryo is just a small bunch of cells, hardly visible with the naked eye. Does that make my obese, tall, multicellular, neighbour more human than me?

If we can agree that these embryos are human beings, then we must agree that we have no right to objectify these people. We cannot put them in a freezer indefinitely, until somebody decides to implant them, possibly into a surrogate mother. We cannot deliberately turn them into orphans, with unknown biological parents. We simply cannot play around with these people’s lives. They too have rights.

Which brings us to the second issue, the right of people to have babies without discrimination. What is a “right” anyway? Is it the possibility to do whatever I wish, no matter what? In other words, does the end, no matter how wonderful, justify the means? Do I have the right to take my neighbour’s car because I also have the right to luxury transport?

Why should I be discriminated against just because I was born into a poorer family? Or for that matter, do we have a right to kill all handicapped and senile people because they are weighing the nation down? Most of them will not protest or defend their rights, just as embryos cannot defend their rights. Do I have the right to eliminate my boss because he is blocking my career progress? After all, I am being discriminated against and I do have a right to better future prospects.

Where do we draw the line? Is the fact that we cannot see this “embryo”, and maybe think of it as something “theoretical” and not yet human, make it so much easier to kill and manipulate at will?

Sending a missile to the other side of the world and killing anonymous persons and maybe creating new orphans, is also quite painless for the perpetrator. Does that absolve him from his guilt? Stalin once said that a single death is a tragedy; a million deaths is a statistic. Is this the way we wish to treat embryos?

That is why this debate makes me fearful. It should also make you fearful. At some stage in your life, you may be deemed not worthy of living, an anchor to the progress of society. Or else your death or removal from society may help someone who has a “right” to something or other. Where will it end?

A very slippery slope indeed.

Mario Stellini is a physician and gastroenterologist.

In the child’s best interests – Ramon Bonett Sladden

Over two decades ago, Malta signed and ratified the UN Convention on the Rights of the Child. This lays down that the family, with particular reference to children, “should be afforded the necessary protection and assistance”.

The Convention also refers to the antecedent declarations of 1924 and 1959, which recall the need to extend particular care to the child. Crucially, the Convention states that “the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth”. This shows that the Convention’s recognition of the fact that the rights of the child begin not at birth, but at conception. It cannot be clearer.

The Convention demands that the safeguarding of the best interests of the child is given the highest priority.

In 2003, Malta enacted the Commissioner for Children Act, and the Commissioner for Children became the local guardian of the Convention. The law lists the functions of the commissioner, including the duty to promote and advocate for the rights and interests of children, as well as the protection of children from physical and mental harm, including exploitation.

The Commissioner for Children, for reasons incomprehensible and contrary to good sense, has chosen to support the Bill proposing to introduce embryo freezing, gamete donation and surrogacy. The statement issued by the commissioner’s office erroneously states that, at 16 years of age, minors born from donation will be allowed to know the identity of the donor, hence the identity of one of their biological parents.

This is unquestionably wrong. Article 7 of the Bill (which amends Article 9 of the Embryo Protection Act) states very plainly that only the donor’s anonymous medical records shall be accessible to the child upon the latter reaching 16.

The commissioner’s statement is further misinformed of the proposals she is bound to monitor in view of the Bill’s clarity on the severing of all bonds of filiation between donor and offspring.

Clearly, the commissioner has either not read the Bill or has not read it properly.

The commissioner, whose duty it is to be the guardian of children’s rights in Malta, has come out in support of a Bill that turns children into commodities and which should, to any sane public servant, be anathema to children’s rights.

Now, the commissioner is surely placed in the uncomfortable position of explaining to an awaiting public how she has managed to conclude that the freezing of embryos is conducive to fulfilling her mission to promote children’s rights and ensure all children are treated with dignity, respect and fairness. As those who have read the Bill know, it is neither dignified nor respectful nor fair to implant the best embryos in the mother and leave their siblings, deemed of lesser quality, in a freezer.

The Commissioner for Children Act empowers the commissioner to carry out investigations connected with her duties either following an individual’s complaint or from her own motion. However, it is pertinent to ask who has the power to investigate how and why the Commissioner for Children has chosen to endorse a Bill that clearly does not have the protection of children as its primary object.

The law also empowers the commissioner to issue a child impact statement relating to any decision or proposal on any policy that affects children. In a situation in which the commissioner has come out in favour of a Bill that harms children, to whom does the sad duty to issue a child impact statement fall?

What is the impact on children when the Commissioner for Children decides not to be on the side of children?

The Malta Paediatric Association and the Maltese Association of Social Workers have both encouraged the government to protect the embryo and to focus on the best interests of the child.

However, this advice from competent and dedicated professionals seems not to have been heeded by the commissioner.

I distinctly remember previous commissioners for children organising short summer courses to educate children on their rights under the Convention. In fact, I myself attended such a course in 2004.

All participants agreed that the first among rights had to be the right to life, without which all rights are useless.

I am genuinely curious what children will be taught at the next such course. When a brave young child asks the commissioner why she has come out in favour of freezing the youngest of children, how will the commissioner respond?

Personally, I hope the commissioner comes to her senses long before she has to disappoint a hopeful child.

Ramon Bonett Sladden is a lawyer.

IVF law: woman born of anonymous donor conception views concession on medical history as ‘token’

 
Helena Grech Sunday, 29 April 2018
 
 

A woman born by anonymous donor conception, Dr Joanna Rose, views the Maltese government’s offer to allow those born through the same practice to have access to their genetic parent’s medical history as more of a “token”.

Rose is an activist who works to highlight the plight of those born by anonymous donor conception, resulting in identity issues and medical issues as a result of having incomplete access to the genetic family’s medical history.

Born in the UK, Rose went to university and after she graduated, she was awarded a scholarship to get her PhD on the subject.

Anonymous donor conception is when sperm and/or eggs are donated to an infertile woman seeking to become pregnant through IVF. Parliament is set to discuss amendments to the 2012 Embryo Protection Act which would introduce embryo freezing and tie it to anonymous embryo adoption.

Currently, Malta’s IVF laws allow a heterosexual couple to have up to two eggs fertilized with both embryos implanted in the womb. The government is seeking to allow three eggs to be fertilized with one being frozen. Should the woman not use the third embryo, she is obliged to allow that embryo to be adopted by a third party. Nobody is permitted to avail him or herself of the third egg being fertilized and frozen without consenting to adoption in the case that the embryo is not used under the current amendments.

In addition, IVF would be open to homosexual couples as well as single people, therefore necessitating the introduction of sperm and egg banks. The government is also seeking to decriminalise altruistic surrogacy with a consultation period expected to be launched on the issue.

Rose’s particular concerns, having first-hand experience, is the aspect surrounding anonymity of the genetic parents in the entire process.

“One of the reasons why I am involved is because this is a huge social experiment that has been taking place for over 100 years in different countries.

“There are all sorts of people who have spoken out about various aspects. What is super clear is that donor offspring have raised awareness about the anguish and pain it has caused them.”

Rose spoke of a previous occasion when she was in Malta speaking about this issue. She was invited to speak at a Parliamentary committee in November 2017. Rose described her feelings of frustration and how she had been insulted by the implication that her concerns were only limited to her.

She said that the government’s medical adviser, Dr Mark Sant, had implied that this was just her personal issue and “everyone else was fine”. He had insisted there was no empirical evidence to back the statements she was making about the negative fallout of anonymous donor conception.

“One of my best friends Narelle Grech died and had become public about the fact that she was donor conceived and did not know her medical history. She was diagnosed with stage 4 cancer, she had eight siblings in various families and could not legally inform them that they were predisposed to the same cancer.”

Rose was speaking about her close friend from Australia who got to know who her genetic father was, who happened to be Maltese, eight weeks before she passed away. What happened to Narelle Grech resulted in a law being passed in Victoria, Australia – the name and birthdate of donors will be released to biological children, regardless of donor consent. The law was also enacted retrospectively.

“I cannot believe or stand the fact that Malta could introduce anonymous donation after such a beautiful woman, who is Maltese, has a law against that practice.”

Having access to the medical history

One of the strongest arguments against anonymous donor conception is the lack of access to a child/adult’s genetic medical history. Many illnesses have genetic components and it is imperative for an individual to know what to look out for, what they are vulnerable to and what the risk factors are.

Asked about this when unveiling the government proposals, Health Minister Chris Fearne had said that in the case of a child born by anonymous donor conception is sick, the adoptive parents would have access to the genetic parents’ medical record, and when that child turns 16, it would also have access.

When addressing this with Rose, and asking if it appeases many of the concerns she has, she remarked that this is a kind of “token”.

“It does not appease my concerns. This is what they were saying in Parliament. The only aspect of the best interest of the child they were prepared to engage with was the medical history. It looked floppy to me and more of a token.

“What I have seen throughout the world when my friends uncovered who their fathers are the lies. Friends found it was the gynaecologist themselves who donated, or their husband or sons were the donors. A friend discovered his father lied because he suffered from schizophrenia and did not include it in his medical history.

“It is the tip of the iceberg. It simply does not register when you think about the best interest of the child on the one hand and on the other having this legislative wall of secrecy, where apparently the figures of righteousness and greatness are going to pass on information when you need it.

“When you see this information in the hands of doctors, it is not squeaky clean. This industry has a lot of money involved all over the world.

“Why would somebody who is an anonymous person update their medical history? What is their incentive for doing that if they are told they have no emotional or personal responsibility for their own genetic children. Why would they have that little responsibility there? It is a strange notion about how the genetic parent will respond to their responsibilities to their own genetic offspring in this one instance.

“Looking at this industry and what happens across the world, it does not appease my fears at all. It is common for donors from abroad to be used. Truly, how well are people screened? The screeners are the clinics themselves who have a financial interest in collecting gametes. There have been people who have died and their sperm was used regardless.

“We cannot trust a system that is secretive and be placated by notions that everything will be handled well.”

Rose then described how elsewhere, what she has seen are industry players in the infertility industry actually enter government and end up governing themselves.

“They come up with laws that change the definition of the best interest of the child to suit themselves. Instead of having benchmarked standards about what the best interest of the child is, we get something else. I have looked at draft legislation in Ireland, where there is a proposal to reframe the welfare of the child as: ‘the welfare of the child will be taken into consideration where practicable”.

Photos by Michael Camilleri

 

Gifts, not entitlements – Arthur Galea Salomone

The desire to bear and rear children is indeed a noble desire. The provision of IVF services to assist infertile couples to have children is therefore laudable.

Attempts to increase the success rate of IVF practices are also to be encouraged, but not at all costs and definitely not at the expense of the rights of the unborn child.

Children are gifts and not entitlements. IVF policies should therefore not relegate the rights of the unborn child to the desire to bear children at all costs, no matter how noble that desire may be.

The Embryo Protection Act, enacted in 2012, regulates IVF in a manner which strikes a balance between the noble desires of infertile couples and the rights of the unborn child by allowing the freezing of as yet unfertilised female ova but not the freezing of embryos.

The proposed amendments contemplate the possibility of embryo freezing, which inevitably leads to embryo stockpiling, and no amount of rhetoric can dispute that.

Stockpiling has been the experience of all countries where embryo freezing has been introduced.

The proposed amendments contemplate the imposition of embryo adoption on vulnerable couples opting for embryo freezing in an attempt to render embryo freezing more palatable, but it is unlikely that this will eliminate unwanted, unutilised, leftover embryos, with all the ethical dilemmas that come in their wake. 

Human embryos are therefore destined to become frozen orphans in violation of the dignity with which every unborn child should be treated. 

Besides embryo freezing, two other objectionable proposals are anonymous gamete donation and surrogacy.

Both practices deprive children of being brought up by their natural parents and the right to know the identity of their biological parents. The practices have been discouraged and banned in a number of countries, but in pseudoliberal Malta, fools rush in where angels fear to tread.

It is indeed painful to see the vulnerabilities of infertile couples being abused to promote pseudo-rights which have nothing to do with infertility.

A homosexual couple is unable to have children without the collaboration of somebody from the opposite sex, not necessarily because of infertility but because nature has dictated that it takes two persons of the opposite sex to procreate.

Two male homosexuals may be perfectly potent but are unable to procreate without a female ovum and surrogate mother. Lesbians may be perfectly potent and able to go through with gestation but they cannot procreate without male gamete donation.

Promoting surrogacy and gamete donation to homosexual couples within the context of infertility is typical of the deception which surrounds the entire debate relating to the current amendments to the Embryo Protection Act, which, in truth, have nothing to do with protection of the embryo but all to do with its objectification and commodification.

The proposed amendments attempt to cancel out differences endowed by nature at the expense of children.

Far from introducing equality, the proposed amendments are intrinsically discriminatory. They discriminate between embryos that will be given a fair chance to survive by being implanted in a mother’s womb and others destined for frozen, suspended animation. 

They discriminate between children who are destined to be brought up by their natural parents and those denied the basic right to know the identity of their natural parents. The amendments will institutionalise an unknown parentage, with the possibility of traumatising children indelibly.

Rather than rush to enact pseudoliberal laws which violate the dignity of life, our parliamentarians should take up the President’s invitation to meet all stakeholders with a view to holding a constructive discussion which is cognisant of the noble wishes of childless couples while not ignoring the delicate ethical issues relating to embryos’ rights and the best interests of our children, born and unborn.

Arthur Galea Salomone is president of the Cana Movement.

Contradictory and dangerous – Jean-Paul De Lucca

The Embryo Protection Act 2012 has the stated aim of “providing for the protection of human embryos” in procedures of medically assisted procreation. Since its enactment, the law has provided for and regulated practices such as in vitro fertilisation (IVF) and the freezing of gametes.

Among other things, the law as it currently stands prohibits the cryo-preservation (freezing) of embryos. The law defines an embryo as “the human organism that results from the fertilisation of a human egg cell by a human sperm cell which is capable of developing”. This definition follows the prevalent view in embryology that embryos are human beings in the earliest stage of their existence.

The aims of the Bill tabled in Parliament entitled ‘An Act to amend the Embryo Protection Act’, include “the freezing of fertilised eggs” (embryos) and the “de-criminalisation of non-commercial surrogacy”.

While the purpose of the principal Act it seeks to amend remains unchanged, some key provisions of the Bill effectively flout, undermine and contradict the very purpose of the law of which they will form part if approved, namely that of protecting the human embryo.

This defies the basic principles of logic and good legislation.

Amendments contained in the Bill effectively expose the human embryo to risk by opening up and allowing the possibility for its foreseeable and implicitly intentional destruction. It is a statistically known fact that a number of embryos die in the thawing process.

This is, of course, in no way comparable to a natural miscarriage, since their deaths result from a procedure that envisages this very likely possibility at its outset.

Moreover, the law can offer no guarantee that all frozen embryos will be adopted, or that no accidental or intentional malfunction of storage facilities will occur, resulting in their death. On this count, too, the proposed amendments fail to fulfil the purpose of the principal Act they seek to modify. Rather than protecting the embryo, they place it unmistakably at risk.

 

Beyond the cloud of rhetoric, these amendments introduce into our law the principle that the State, through its laws, may rescind its obligation to protect human beings and sanction procedures that effectively expose them to the risk of dying. Legislators who are being called upon to vote on these amendments ought to consider very carefully the implications and ramifications of what they are being asked to assent to. 

The Bill also includes a provision that would allow for “altruistic surrogacy”, which is understood as surrogacy for non-profit and non-commercial purposes.

In recent years, countries that can hardly be labelled as conservative, such as Finland, Germany and Sweden, have banned all forms of surrogacy after carrying out a series of studies and fully-fledged inquiries.

The European Parliament has not so long ago condemned the practice of surrogacy on the basis that “it undermines the human dignity of the woman since her body and reproductive functions are used as a commodity”.

Surrogacy has also been met with opposition by an array of human rights, women’s rights and LGBT rights activists in various countries.

Those promoting the Bill on the grounds of equality surely seem to be employing this concept in a rather myopic and constricted fashion.

Here in Malta, Parliament is being given neither the opportunity nor the time to carry out and evaluate studies on the implications of so-called “altruistic surrogacy”. Members of Parliament are simply being asked to agree to authorise a minister to issue a legal notice prescribing “the manner in which altruistic surrogacy shall be effected and for any matter incidental and ancillary thereto”.

Matters of substance aside, the manner in which the Bill is being rushed through the parliamentary process is appalling and questionable. Political decency and respect for the deliberative nature of the democratic process would have dictated that a legislative initiative of such consequence must follow the most rigorous and open form of scrutiny and deliberation.

Instead, Parliament is being asked to get it over and done over two weeks. In the meantime, experts, specialists and the concerned public keep voicing their apprehension.

Current legislation may indeed require fine-tuning to offer broader access to medically-assisted procreation. However, this cannot be achieved at all costs and certainly not through rash legislation which in certain cases contradicts the very purpose of the law while reducing human beings to objects and commodities.

The decent thing to do at this stage is for Parliament to reject the Bill or at least to stall it, pending in-depth and extensive consultations that would allow for properly informed decision-making.

Anything short of that would be utterly and tragically reckless.

Jean-Paul De Lucca is senior lecturer in philosophy at the University of Malta.

Ref: https://www.timesofmalta.com/articles/view/20180427/opinion/Contradictory-and-dangerous-Jean-Paul-De-Lucca.677520