Bioethics: Ramifications of Permitting ART without Medical Infertility Criteria

Excerpts from the hearing at the French Senate, pronounced by Alliance VITA’s Assistant General Delegate, Caroline Roux, regarding the bioethics bill:

Alliance VITA was founded in France at the end of 1993 when the first bioethics laws were introduced. We are very preoccupied about any pending changes in this new law, especially concerning procreation, disabilities, and the treatment of human embryos, to ensure that the most vulnerable are acknowledged and protected.

The way bioethical laws have evolved since 1994 cries out for a genuine revaluation. Legislators have become increasingly indifferent to ethical boundaries: the dikes continue to be breached, and no one has yet bothered to assess the social and humanitarian consequences.

I would like to highlight two points:

1. ART is still an uphill battle

We cannot underestimate the burden that ART represents, both physically and psychologically, for the woman as well as the couple. In addition, keep in mind this technique is only a palliative measure and does not actually restore fertility.

Certain couples who have recourse to ART procedures have also voiced their desire to be autonomous for procreation, when possible. This should incite us to endeavor to reach this objective.

It may be rewarding to see joyful parents when a child they have longed for is finally born. However we cannot disregard the pain and suffering that some parents experience when they are confronted with difficult and often unanticipated choices, on the future fate of their supernumerary embryos.

2. Multiplying screening tests for prenatal diagnosis increases stress and anxiety during pregnancy

Whether or not a disability is proven, when a potential risk is discovered, it can spark a real upheaval for the mother and the couple, both emotionally and for the couple’s relationship.

It then becomes vitally important to have support from families and loved ones, to evaluate possible solutions, without being pressured to have a “medical” abortion. This cannot substitute for real therapeutic measures (feasible in certain cases) nor does it replace genuine ways to help parents accept and care for these children.

However, this bill is not leaning in this direction. Indeed, it marks a complete reversal to our previous laws.

This law intends to relinquish the medical infertility criterion for having access to ART. Infertile couples would thus be thoroughly neglected. This represents a real paradigm shift, which generates injustices and multiple setbacks such as:

  • An escalation of ART with third-party donors: currently only 5 % of children are born by ART annually. The ART procedure is burdensome for couples, as well as for children who are now requesting that the anonymity of donors be lifted. Nevertheless, abolishing anonymity does not eliminate the injustice of a confusing and fragmented filiation for the child and may prove to be a ticking time bomb.
  • It also opens the door to the procreation market in order to acquire the necessary gametes. Conversely, it should incite us to perform research to avoid this recourse as much as possible, and to especially focus on the causes of male infertility.
  • Injustices for children who are intentionally deprived of their biological origins via double gamete donation, with some children being totally deprived of any paternal reference by ART with third-party donors for women without a male partner and who are not medically infertile;
  • A failure for women, since there is growing pressure for medicalization of women’s bodies with oocyte freezing, with its’ unfounded and elusive promise of maternity: 3 out of 4 of these women will never give birth to a child.
  • Abducting our medical practice and practitioners as well as our citizens’ health insurance funds.

On what criteria can doctors refuse ART? The legislation does not currently specify any conditions. This bill signifies an unprecedented attack on medical ethics. Do we still want to pretend that we are not paving the way towards surrogacy and surrogate mothers?

This means that legislators have to assume the responsibility of their acts, keeping in mind that the suffering or the desire of some citizens cannot be the only discernment criterion to the detriment of a child’s best interest. Legislators must not capitulate in favor of trends and pressure by the minority, but fulfill their role to serve the common social good for all.

This headlong rush is not bioethical and 3 fundamental issues are being obscured:

  • The battle against infertility
  • The battle against eugenics, and a genuine consideration of disabilities
  • The protection of the integrity of the human species.
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