An Inadequate Law
The new law on assisted fertilization is a travesty of the terms progress, democracy and innovation, which should be more present in contemporary society.
Umberto Veronesi
Clips from an artificial insemination sequence
Technological advances have heralded an era in which new discoveries jostle to leapfrog one another, changing the face of science as they go and giving man the opportunity to influence his own life in ways that were simply unimaginable only a few years ago.
And so, as ever when poised on the cyclical threshold of historic scientific progress, society promptly discovers itself ill prepared to confront the dilemmas posed by the new boundaries of science. At times civilization has reacted to this inconvenience by stepping back and fermenting anti-scientific and anti-rational spirit. Consider the seventeenth century: Newton, Descartes and Galileo set the world on a new axis while thousands of women were being burnt at the stake as witches.
our system of ethics is struggling in its relationship with new scientific horizons, preferring to keep its distance with different sorts of intellectual ostracism
Look how even today our society is somewhat ‘schizophrenic’: while one is contemplating how to eradicate world hunger through the application of genetics to agriculture, another is off to the fortune teller to find out what his future holds.
And these days, in particular, our system of ethics is struggling in its relationship with new scientific horizons, preferring to keep its distance with different sorts of intellectual ostracism.
Such is the case of assisted fertilization, currently the focus of debate in the wake of Italy’s controversial statute no.40, which I consider profoundly unjust and totally inadequate. What is so absurd is that, despite – or perhaps because of the developments in genetics, this law represents a step in the wrong direction compared to an older law, statute no.194, on the voluntary interruption of pregnancy.
That law decreed that reproductive freedom is an inalienable constituent of individual rights and subordinates itself to the principle of individual responsibility so fundamental to democratic society. Article 4 of the new law, however, sanctions recourse to medically assisted procreation only in the case of sterility or infertility and thereby excludes, for example, couples who are fertile but are carriers of a genetic disorder, whose only hope of having healthy children lies with assisted procreation.
Giardini Pensili, “Stelle della sera”. Photos Carlo Ciavatti
I also consider willfully obstructive Article 13, which forbids any kind of selection of embryos. At a stroke, one of the great medical advances of recent years has been nullified. As I have pointed out on several other occasions, geneticists who run the gauntlet of embryonic selection have no interest in eugenics, their objective is to give the carriers of genetic disorders the opportunity to pass on unaffected genes to their children. This is the rationale behind pre-implantation selection, which is nothing other than the selection, from in-vitro embryos, of the ones not affected by the genetic defect.
Renato Dulbecco has warned that, in the case of couples who are carriers of a genetic disorder, natural conception may be a very harsh sentence for their children. Renouncing on the pre-implantation gene scan means taking an unjustifiable step backwards in terms of science, returning to a high-risk situation that can no longer lay claim to the random factor.
I believe instead that pre-implantation selection is an extraordinary opportunity, not only for life, but for quality of life.
I should ask, scientifically, what a fertilized egg is. It is an element that may generate an individual, but does not necessarily do so. The process is well-known: it must become embedded and not be rejected, it must meet with ideal hormonal conditions and be provided with a working placenta, as well as overcome thousands of biological variables capable of altering or influencing its evolution. Only upon completion of this cycle will a fertilized egg begin to develop. We note that humans are among the less fertile species and that seventy per cent of fertilized eggs do not even begin their life cycles. The biological history of every woman is filled with silent events never even perceived.
I believe that pre-implantation selection is an extraordinary opportunity, not only for life, but for quality of life
Another detail of the new law, Article 14, disregards the benefits of scientific development and, at the same time, reduces the right to individual self-determination, stipulating that embryo production techniques must not create more embryos than are strictly necessary for a single contemporaneous implantation, and in any case no more than three. Thus the freezing of fertilized eggs is prohibited, which could be useful in the case of the failure of the first implant or to have a second child. At present, after hormonal stimulation has enabled the production of a satisfactory number of mature oocytes, approximately ten are inseminated and, of these, the most promising are selected. Restricting the number of oocytes to be inseminated to three reduces the already slim chance of success and leaves the woman with no kind of ‘backup’ to make use of if things do not work out. So she must be newly subjected to hormonal stimulation and surgery to extract the oocytes, with evident harm to her physical health, without even considering the psychological aspects.
Finally, with a ban on heterological fertilization, it would appear that the new law rejects the findings of centuries of research into human reproduction. Here it is the turn of male infertility and even the oldest and simplest method of assisted fertilization, which dates back to the late eighteenth century, has been rejected. In this case I find it impossible to see with any degree of clarity what the scientific or ethical boundary is that could have inspired this proscription, which in practical terms will result in the migration of sterile couples, the ones who can afford it obviously, to other European countries (all of them, I think, certainly the majority) which maintain acceptable legislation.
To me, as an Italian citizen, the new law on assisted fertilization is an unjust law affecting men and women who have the human desire and biological necessity to have a child; as a doctor, I feel it is an attack on women’s health; and as a scientist I can discern the signs of a profound crisis in the culture and civilizing role of science, something to which no one who is committed to progress should remain indifferent.
