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ACT Right to Life AssociationSUBMISSION |
Preamble
In making this submission the ACT Right to Life Association would stress that it should not be assumed that the Association supports or approves of the In Vitro Fertilisation (IVF) programs as presently practiced in Australia. Recent statistics show a very low success rate, ie. successful pregnancies as a proportion of embryos produced, for these programs. The Association deplores such a great and unnecessary loss of life.
Unfortunately, the Terms of Reference of the Select Committee are couched on the assumption of a continuing IVF program and seek comment on possible embryo experimentation within that framework.
General principles
1. The ACT Right to Life Association affirms its conviction that a human subject constitutes an end in itself and is worthy of utmost respect.
2. Governments should legislate to protect the existence and the proper development of each human subject in the society for which they are responsible. A human being should not be treated as an ‘object’ or ‘thing’ as happens when a human being is used as a means to achieve some end outside his/her own good. This is the case when human individuals are regarded as useful ‘material’ for the expansion of knowledge in itself or for some practical application eg. research into drugs, surgical procedures, provision of organs or tissue for transplantation.
3. It is surely a mark of a civilised society that this respect and protection is afforded to each and everyone of its members. Involuntary subjection of human subjects to the purposes of others is abhorrent eg. the institution of slavery, medical experimentation as conducted in Nazi Germany. In all such instances there is strong argument in defence of such practices, justifying them in terms of the good which would flow to others: economic wealth or leisure, the attractive prospects of medical advances promising relief to humanity as a whole, and so on.
4. In Western societies, nonetheless, it has normally been the agreed position - whether of Christianity, liberalism or humanism - that human beings not be used as means to achieve good for others except in exceptional circumstances. Primarily, the matter of consent has received extensive examination. Humans can be generous in agreeing to undertake certain courses of action involving some risk to themselves in order to benefit others. Since generosity of this kind is a moral end chosen by the person himself, then such freely volunteered `usefulness' is not regarded as demeaning him.
5. The conditions appropriate for donation of body parts have been the subject of wide discussion in Australia and have been the subject of model legislation (initiated by the Australian Law Reform Commission) in the Australian Capital Territory (Transplantation and Anatomy Ordinance 1978). That legislation does not cover the use of human ova or tissue or body parts obtained from human embryos or foetuses. It is our opinion that legislation is necessary to control the production and use of human embryos.
6. The issue of informed consent is a particularly critical issue when the subject is a minor or is incompetent in some way. Moral generosity is not really within the reach of such subjects; our laws must protect them from being `volunteered' for the use of others. It appears to us a fundamental principle that a child not be sold or donated partly or wholly for body parts nor for risky drug research, unless the risk involved was inherent in the search for some cure or palliative for that child when conventional treatments prove ineffective. To use an immature human as a `laboratory' for humanity's benefit should be prohibited.
7. We consider that the basic rights of human beings - life, freedom, self-determination - should be protected at all stages of an individual's life. As the United Nations Declaration on the Rights of the Child states: "... 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." The human embryo also is entitled to such protection.
8. A human being remains a human being regardless of the circumstances of his/her conception. Every living person necessarily was conceived and progressed through the stages of embryonic and foetal life. The elements of reproduction and the status of the embryo remain the same whether the embryo is conceived in utero, in vitro, or wherever. The law should extend its protection to human beings regardless of the circumstances of their conception. That some embryos are conceived as a consequence of deliberately structured procedures in the medico-scientific units does not change their essential humanity nor the task of legislators in their deliberations about appropriate protection of such humans.
Problems with the Terms of
Reference
9. Holding these principles, we are confronted with a persistent difficulty in addressing the Terms of Reference of the Committee. The necessity and/or desirability of research on embryos is cast in the question of "the purposes of the in vitro fertilisation (IVF) program" [Terms 1(a) and (c)]. Any amendments to preserve the general prohibition on embryo research must apparently take effect "without halting the IVF program" [Term 1(e)].
10. We assume that the term "IVF program" in the Terms of Reference means a program in which human embryos are produced outside the body of the mother (ie. in vitro) with the intention that some, or all, of these embryos be implanted in women so that their growth and development continue to birth. We assume, further, that this terminology is adopted in distinction from any program in which the "production" of embryos is directed solely for research and/or experimentation.
11. We acknowledge the great interest in, and ready sympathy for IVF programs in the community. This favourable perception is of course due to the well publicised birth of children to women participating in the program; this attitude should not be exploited by scientists presuming that the popularity of one aspect necessarily includes approval for all parts of the programs.
12. Bearing in mind the difficulties mentioned in para 9, we trust that our submission will be given consideration even where adherence to the principles stated above (paras 1-8) would result in the rejection of certain features of some IVF programs currently operating in Australia. The entrenched practices of a scientific or medical team should not be permitted to pre-empt the decisions of legislators as to what is necessary for the proper protection of individuals in the community.
Responses to the Terms of
Reference
13. "1(a) ... whether it is necessary, or (ii) desirable to carry out research on relevant human embryos by manipulation, dissection or administration of drugs;"
No procedure conducted on a human being which is not for his own good is ever to be deemed "necessary", especially where no proper consent is obtainable. "Manipulation" might mean simply handling the embryo in the achievement of fertilisation and implantation; in this sense it is not to be considered "experimentation" nor should it be prohibited since it would be directed at the survival of the embryo. Where "manipulation" indicates handling of an embryo in order to select/reject embryos for implantation it involves a judgement made on the worth of an individual human life and consequent, deliberate destruction of some embryos. We reject such procedures.
Even though the rationale advanced to defend dissection of, and administration of drugs to embryos is that this research is aimed at the good of present and future humans generally, we reject this argument. Human subjects are not objects to be used for others' good without regard for their own welfare.
In general if the research has the probability of assisting the human subject involved (eg. testing of a new medium to support the embryo until implantation), then it should be considered legitimate. After all, pioneering of this kind is practised already in medicine; it is assumed, of course, that clinical trials on humans are conducted only when all other preliminary stages of investigation indicate a favourable outcome.
14. "1(b) if it is necessary or desirable to carry out such research, whether any guidelines can be formulated to govern such research;"
If the Select Committee judges some forms of embryo research or experimentation to be undesirable then it should be possible to use a form of words with sufficient clarity, such as Senator Tate's proposed amendment to the Bill in s.5(c), to give effect to those intentions of the Committee.
Men and women of integrity and goodwill should experience no difficulty in testing their programs or proposals against the principles underlying such prohibitions. We assume that such principles would be explicated in an Explanatory Memorandum accompanying the legislation and/or in the Second Reading speech.
15. "1(c) for the purposes of the IVF program, whether it is: (i) necessary, or (ii) desirable to freeze relevant human embryos;"
For the essential purposes of an IVF program to be effected it is clearly not necessary to include freezing of embryos as a component procedure. Such programs operated successfully prior to the development of the freezing techniques. Whether freezing is desirable depends upon the particular outcome. There are a number of possibilities:
(i) freezing may decrease the success rate, ie. the proportion of babies finally born to the number of embryos originally produced. We consider this definition of "success" to be the most accurate one as it directly reflects the number of human embryo lives involved in obtaining a baby by IVF. Yet the procedure may carry advantages to the mothers since a woman could return repeatedly for attempted implantation without further procedures to recover ova (see, however, the final sentence to section 17 of this paper);
(ii) freezing may leave the success rate unaltered; it would carry the same advantages for the women as above;
(iii) freezing may increase the success rate of attempted implantations;
(iv) freezing could be used to store "surplus" embryos resulting from the production of more embryos than the woman could safely carry in a pregnancy.
We submit that the outcome described in (i) is neither necessary nor desirable. The savings in cost and/or convenience to the mother would not be justification for the greater loss of embryonic lives. We submit that the outcome described in (ii) should be permitted for the good of the mother since no harm is suffered to the embryo(s) greater than if freezing were not applied. The outcome outlined in (iii) is acceptable since it would be aimed at the good of the subject undergoing the procedure.
16. Certain caution should be exercised here: it is critical to distinguish between a general and a particular approach to the probable outcome of freezing. It may be general truth that the success rate of implantation of embryos after freezing is better than where freezing is not applied before attempted implantation (an interrupted cycle can be less than an ideal situation for implantation); some practitioners of IVF therefore attempt implantation of the embryos in the appropriate phase of the woman's next cycle. Yet the truth, in practical terms may be that no attempt will be made to implant many if not most of the frozen and stored embryos.
17. We condemn the use of freezing as described in 15(iv). IVF operators have justified the freezing of embryos surplus to what can be implanted as being the only method by which these embryos can avoid destruction. The better solution is that IVF operators be constrained to limit the number of embryos produced in any one procedure to those able to be implanted for the intended pregnancy. The survival of human embryos ought not to be left to the vagaries of human intentions no matter how sincere; who can safely say what children they may want or be able to care for in the future?
The development recently of a successful technique for freezing human ova brings into serious question the practice of the principal IVF teams in Australia in producing more embryos than are needed for any one implementation attempt.
18. "1(d) whether it is (i) necessary or (ii) justified to discard relevant human embryos ..."
We wish to comment on two groups of embryos whom some might argue ought to be discarded.
(i) "surplus" embryos.
We think that procedures ought be such that pressure to discard some embryos is minimised. We repeat our recommendation in 17 in regard to 15 (iv) that restrictions should be set on the number of eggs exposed to fertilisation so that freezing and/or discarding of embryos is avoided. If, despite such restriction, embryos were to be produced which could not be placed with a natural or surrogate mother and it were not possible to continue freezing, then such embryos should be allowed to die naturally.
(ii) defective embryos.
We do not consider it proper for the operators of IVF programs to engage in differentiating "fit" from "unfit" embryos to the end of destroying the latter. Such procedures have been justified by reference to the growing practice of pre-natal destruction of foetuses through abortion. This is to presume that such practices are legal and desirable. We strongly dispute such presumptions.
19. "1(e) whether the Bill requires amendment to preserve its general prohibition of research on relevant human embryos ..."
We strongly support the Bill in so far as it would give effect to a general prohibition of research on relevant human embryos. In pursuit of this purpose we find considerable merit in section 5.1(c) as amended by Senator Tate. We urge the Committee not to be deterred from endorsing such a general prohibition, even if some of the practices of existing IVF programs were found to be in breach of such a prohibition.
No medical or scientific practice, especially one directly involving human life, is beyond the law. Neither Parliament nor its committees ought to be pre-empted in their decisions by appeals to existing practice(s) or vested interests. IVF programs might become involved in research and/or experimentation in a number of ways:
(i) an IVF program could use, or provide to others to use "surplus" embryos for the development of what is loosely termed "reproductive technology". This can embrace research on new contraceptives, abortifacients, prevention of miscarriage, the effects of venereal and other diseases in the mother or any number of related matters. All such research involving relevant human embryos should be prohibited.
(ii) "surplus" embryos might be used in research aimed at improvement of techniques directly related to the production of other babies in that and/or other programs. At first consideration this appears a more ethical proposal than the research described in (i); closer examination, however, obliges us to reject such research or experimentation in accordance with the principles stated above;
(iii) research and/or experimentation on relevant human embryos might be intended to improve directly the survival or health of themselves. We consider this work acceptable (see comments on Term (b) beginning with 13).
20. "1(f) what sanctions, if any, should be imposed for the breach of any prohibitions imposed in the Bill ..."
We consider it appropriate that sanctions should be imposed for the breach of impositions that should be imposed in the Bill. The prohibitions do involve abuse of, or destruction, or both, of human lives and the penalties should be sufficiently severe to constitute an effective deterrence. We would suggest that the penalties should include provision for disqualification of the medical practitioners involved from entitlement to receive any medical benefits payments for a period of several years.
21. "1(g) whether legislation is desirable to control research on relevant human embryos ..."
We consider legislation on this matter to be essential (see 14).
Recommendations
22. The numbering of our recommendations follows that of the Terms of Reference of the Select Committee.
1(a)
Embryos should not be subjected to manipulation, dissection or administration of drugs unless the procedures are aimed at the better survival and/or health of the same embryos;
1(b)
(i) While freezing is not strictly necessary for the conduct of an IVF program it should be permitted only where it involves no reduction in the survival rate of all embryos conceived in the IVF procedures and subsequently frozen and is accompanied by some advantages to the particular mother;
(ii) availability of freezing techniques must not be used to excuse the production of embryos in numbers greater than can reasonably be expected to be implanted in endeavouring to establish one pregnancy;
1(c)
Adoption of the restriction in b(ii) should remove the problem of "surplus" embryos; if, nevertheless, they are produced they should be allowed to die naturally if there is no reasonable prospect of their implantation;
1(d)
Discarding of embryos on account of probable defect should be prohibited;
1(e) and (g)
Legislation similar to the Human Embryo Experimentation Bill is necessary; such legislation must carry a general prohibition of research on relevant human embryos even if this requires abandonment or substantial modification of any practice(s) of current IVF programs;
1(f)
Penalties in the legislation should include disqualification of medical practitioners from entitlement to receive any medical benefit payments for a period of several years.
Addendum to the Submission to the Senate Select Committee on the
Human Embryo Experimentation Bill 1985
This Association is concerned that neither the Bill, as proposed by Senator Harradine, nor the amendments to it put forward by Senator Tate, cover the subsequent use of human embryos generated in the Australian Territories when those embryos are exported from those Territories.
Our concern is, we believe, not esoteric. An IVF unit has recently commenced activities in the ACT; it is located at the John James Memorial Hospital at Strickland Crescent, Deakin. The Canberra Times of January 23, 1986, reported a statement made the previous day by Dr Martyn Stafford-Bell, apparently the spokesman for the doctors involved in the IVF program in the ACT.
The report gave the impression that the doctors seem to regard human embryos more as "products" than as human beings: they intend to produce more embryos than can be used immediately by the mother and to freeze the "surplus" for up to five years. Dr Stafford-Bell is quoted as saying "if either (parent) has no further use for them ... the embryos become the property of the ethics committee". The doctors' intention is then to dispose of the embryos by sending them interstate.
We would submit, therefore, that the possible transfer of human embryos from the Australian Territories should be subject to regulation to prevent their use for any purpose other than implantation in a human foster mother.
26 May 1986
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