Problem does not only concern worldview
The mass media discuss the issue of in vitro fertilisation. Journalists, philosophers, theologians, lawyers and ethicists express their opinions on this matter. In the recently published instruction of the Congregation for the Doctrine of the Faith ‘Dignitatis personae’ the Church, without interfering into the science of medicine as such, reminded all those that are interested in this problem of ‘the ethical and social responsibility for their activities.’ Some columnists try to convince readers and the public opinion that the whole problem concerns mainly Catholics and their worldview because for others it is not an important ethical and legal threat. Is it really so and can it be actually so?
Dangers of in vitro fertilisation
The method of in vitro fertilisation is a process by which egg cells are fertilized by sperm outside of the womb, the result of which is a human embryo – a new human being. Such an embryo can be implanted into the reproductive organ of the woman who cannot conceive in a natural way and can grow there. The so-called extra embryos are usually created in this procedure; they are frozen and can be used when the first implantation fails. The consequence of using this method is a huge imbalance between the number of the frozen embryos and the possibility of their use. In order to have one successful conception at least a few embryos, and many a time many more fertilised embryos, i.e. human beings, are used. In Poland the frozen embryos, which have not been used in implantation, are assuredly preserved sine die. It is estimated that currently there can be ca. 55,000 frozen embryos in our country. No one knows the exact number because of the lack of any control and official procedures. According to many experts in medicine and biological sciences, using supported reproduction in medicine by in vitro fertilisation is an experiment on man in unprecedented dimensions. This procedure is conducted by breaking normal physiological conditions, commencing from the stimulation of multiple ovulation (the so-called hyper stimulation) to growing the embryo in vitro. It is known that any artificial intervention into the natural physiological balance of the organism often brings about unfavourable results in the cell processes of the human organism. The oogenesis is best protected against such an external influence in the mother’s body. The ripening of the eggs outside her organism and then the development of the embryo in vitro often causes unfavourable changes in the physiological processes, testified by the fact that in vitro fertilisation is successful only in several per cent. Babies conceived by in vitro fertilisation are more frequently prematurely born than other babies. They are under-weight at birth, have frequent disturbances in the development of their cordial-vascular and muscular-osseous systems. The children conceived by in vitro fertilisation have defects of the urinary system seven times more than other children. In the opinions of the American scientists at Cornell University the genetic defects of the children conceived by in vitro fertilisation are caused by the medicaments used to stimulate the oogenesis and making the implantation easier. Serious damages can also be caused by the microenvironment in which the embryos live before being implanted into woman’s organisms and their preservation in liquid nitrogen. The effect of the excessive hormonal stimulation of the ovaries that is used within the in vitro procedure is often multiple pregnancy. Consequently, the fundamental risk connected with development of a multiple pregnancy is pregnancy ending before term. The pregnancy of fertilisation outside of the womb carries the risk of frequent complications, e.g. bleeding in the first trimester, diabetics of pregnant women, anaemia or the necessity of surgical delivery. The researches also showed a considerable increase in the risk of cancers, e.g. breast cancer of those women who were in vitro fertilised. All pregnant patients, artificially fertilised, take hormones maintaining pregnancy up till 10-12 week, which is not required for women who have conceived in the natural way. The in vitro fertilised pregnancies more frequently end in Caesarean section. The analysis of the growth of children until their fifth year of age in five European countries, presented in 2005 and comparing ca. 500 children born as result of in vitro fertilisation and as result of the natural way, states that the former more often have children’s diseases, undergo surgical treatments and are hospitalised because of cerebral palsy, epilepsy, asthma, cancers, inflections and inborn defects. However, the monitoring of the children born as result of in vitro method is difficult because their parents do not want to reveal their way of conception. Therefore, we lack complete data about their growth. According to experts manipulations concerning the beginning of human life can cause biological consequences for future generation, which are hard to predict. Moreover, problems concerning the identity of a child conceived in vitro by using a genetic material, which does not come from its parents, can also be important. It can result from the difference of adherence and feelings of particular parents for the child and the feelings of the child for its parents. In the future, one of the parents (it concerns more the father who generally learns to love his child and does not get love together with pregnancy) can have a different attitude towards his child and the child can experience troubles with its own identity. The evidence for these problems is the search for biological fathers (also for mothers) by the children who were conceived through in vitro fertilisation.
In vitro fertilisation is illegal in Poland
The bioethical problems connected with the permissibility of conceiving human being through in vitro fertilisation are mentioned by the Bioethical Convention, i.e. Convention for the protection of Human Rights and dignity of the human being with regard to the application of biology and medicine: Convention on Human Rights and Biomedicine, accepted by the Council of Europe on 4 April 1997. In fact, it is not a fundamental issue of this document. One should stress that the regulations of the Convention embrace first of all the protection of the dignity of every man, including the conceived life in the light of the contemporary discoveries in the field of medicine and biology and aim at using these contemporary discoveries for man’s good and not only for the advancement of science itself. Thus the Convention outlines the limits of medical, scientific and genetic interferences including the embryo period of the growth of human being. It establishes general principles of conducting medical experiments and research on people, defines patients’ rights and doctors’ obligations as well as the rules of taking and using organs in transplantation. The method of in vitro fertilisation concerns article 18 of the Convention, stating ‘where national law allows research on embryos in vitro the law must ensure adequate protection of the embryo. Paragraph 2 of the Article prohibits the creation of human embryos with the aim to carry out research on them.’ Another article ‘affirms the primacy of the human being over the sole interest of science or society.’ Article 11 of the Convention says, ‘any form of discrimination against an individual on grounds of his or her genetic heritage is prohibited’ and article 14 reads, ‘it is not permissible to use a technique of medically-assisted procreation in order to choose a future child's sex.’ It is true that Poland signed the Bioethical Convention 10 years ago like other European countries. But until now the Convention has not been ratified by the Parliament, i.e. there are no legal regulations concerning the protection of human embryos in Poland. The term ‘in vitro’ does not appear in the Polish law at all, which means that one can do anything with the human embryo without breaking the law. One can throw away the extra non-used human embryos because there is no obligation to preserve them in Poland. Similarly, we have no law forbidding trade of embryos through in vitro fertilisation or choosing a future child’s sex or particular features. The private clinics in Poland that carry out in vitro fertilisations have no obligation to report the treatments and so we do not know how many fertilisations have been made. They establish the rules what to do with the embryos by signing civil agreements with future biological parents.
The opinion of the Bioethical Expert Team of the Polish Bishops’ Conference
The stand of the Bioethical Expert Team of the Polish Bishops’ Conference, issued on 22 December 2008, is very important in the discussion in question. The team expressed a unilateral opinion that because of the protection of dignity and life of every man, considering the moral norms, the in vitro method should be legally completely prohibited. However, it does not change the conviction that in spite of the protest against in vitro fertilisation that destroys human dignity, every human life, including the one conceived through this method, should be accepted with love because every person deserves full respect and dignity. The consequence of such an attitude is the protest against abortion and euthanasia as well as against in vitro fertilisation and experiments on human embryos. According to the experts the consent to destroy human being at any stage of its development is not permissible in any case. In this context one should support the law-making attempts aiming at creating regulations that will protect every human embryo. Therefore, the project of the bill under construction will be accepted only if the prohibition concerning killing and freezing human beings is maintained. Parents’ desire to have a child, justified from the perspective of their personal relationships and social expectations, cannot be put above the unalienable dignity of every conceived human life and cannot make man an object of various biotechnological manipulations.
Today no one can claim that whatever is medically possible should be ethically permissive or every scientific research and experiment if they ultimately aim at making the quality of human life better can be exempt from any ethical-moral evaluation. The problems connected with life outside of the womb require quick solutions and establishing legal acts regulating all problems related to protection of embryos – new human beings – in Poland. We want to believe that this important problem will be worthily solved. Since this is not a problem of worldview but an extremely important medical, social and ethical problem because it concerns the fundamental right to life for every man regardless of his/her religious convictions, including the right of the newly conceived life in the form of a growing human embryo.
The Author is a professor of Collegium Medicum of the Mikolaj Kopernik University in Torun and the President of the Bioethical Commission of the Medical Chamber in Bydgoszcz.