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5 Years ago this month on the CLR – US and them…Stem Cell Research on both sides of the Atlantic and why we might be a little more similar than we think. July 22, 2011

Posted by WorldbyStorm in Bioethics, Social Policy.
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Here’s an issue that’s not going to go away, although, as with many others the intervening crises have to some degree made them fade in the public imagination.

It’s Alive! August 19, 2010

Posted by WorldbyStorm in Bioethics, Religion, Social Policy.
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I was given a copy of Alive! by Jim Monaghan the other day. It’s odd, but where I live I don’t seem to see it as much as I used to. Anyone have any thoughts on why that might be?

Anyhow, a few pieces caught my attention. Actually a whole heap of them, from the surprising news that ‘Europe’s Left [are] pushing a cultural revolution’.

There’s more, ‘with the collapse of the socialist project to re-make the economy, the Left has ‘replaced socio-economic revolution by sexual, moral and cultural revolution'”. Really? Clearly the memo from the Left didn’t reach me, for this was the first I heard about it.

And wait, the news is that ‘family structure, bioethics and the role of religion in society will be the major divisive issues in the US and in Europe this century’. Ah yes, us leftists, just gunning to rip apart traditional family structures. Which will be news to those around me.

Moreover, ‘the view that the struggle beetween violent Islamism and the West was a religious clash [was rejected]. Rather, it was the very secularism of the West which hindered dialogue with other societies, which continue to be religious’.

Now you might think that dialogue between the West and other societies is something rather different to the ‘struggle between violent Islamism and the West’ [sic]. But clearly this conflation doesn’t trouble the speaker.

All this was stated by Philosophy of Law professor at Seville University, Dr. Francisco Contreras. And he was speaking at a seminar ‘sponsored on behalf of the European People’s Party by’… Gay Mitchell MEP.

Meanwhile, and there’s more which I hope to address over the next while, what of the following?

And…

Here’s the original editorial in the Mullingar/Athlone Advertiser. Perhaps it’s an odd topic for the paper to be dealing with, but… on the other hand… (and what of the risible comments about the Examiner? Hard to know what is more so, perhaps the idea that it’s part of the ‘leftwing’ Irish media) Some might find it disturbing that the very expression of opinions on abortion being boycotted or campaigned against is – whatever ones views on the issue itself – something to be concerned about.

Speaking of science, bioethics to be precise, consider this… December 17, 2009

Posted by WorldbyStorm in Bioethics, Science, Social Policy, Society.
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A small country on the edge of Europe, a supposed leader in certain technologies, has a remarkably impoverished oversight regime in place as regards a raft of areas. Times are tough, but the issues that such oversight is necessary to address keep on coming up. Why, only some days previously a landmark case appears in the highest courts in the land which has significant implications for some citizens of the state.

The response of the government in this state? Shut down one of those oversight instruments.

And lo, it comes to pass, for as reported in the Irish Times today:

THE IRISH Council for Bioethics is to close at the end of this month after a decision by the Department of Enterprise, Trade and Employment to terminate its funding.
Its director, Dr Siobhán O’Sullivan, said the move was a retrograde step that would leave Ireland as the only EU country without an independent oversight body for bioethics.

And it’s not as if this is a simple talking shop, for as noted by O’Sullivan…

“You would really want to question the wisdom of shutting down such a body in light of the Supreme Court ruling this week,” she added, in a reference to Tuesday’s ruling on access to three frozen embryos.
The fact that Ireland does not have good regulatory controls on bioethical issues could hurt foreign investment in high-tech medical areas, Dr O’Sullivan said.
“No body will want to invest if there is no governance system. People do not want to invest without regulatory control and there is no regulation in this area.”

And as noted by the Supreme Court…

the failure to legislate in the area of fertility treatment as “disturbing”.
Dr O’Sullivan added: “We will be the only country without a council for bioethics.”

That may be an exaggeration, perhaps she means the only country in the EU…

So. How did this we reach this pretty pass?

Last April the department indicated to the group led by economist Colm McCarthy that savings could be achieved if the council was closed. The McCarthy report subsequently accepted that view in its report.

And it’s most illuminating to read the entry in Vol. II of the McCarthy Report on these matters:

A.2 Discontinuation of funding for the Irish Council for Bioethics
D/ET&E proposed a saving of €0.4m through discontinuing the funding of the Irish Council for Bioethics and this is accepted by the Special Group. The further issue of assigning some of its functions to the health sector would have to be considered, if necessary, by the Department of Health & Children within existing expenditure and staff resources.

‘If necessary’? Well, other states appear to believe that this sort of oversight is necessary and that it necessitates specific Councils. Why Ireland is sui generis is an open question – albeit note that the initiative came originally from the Department of Enterprise, Trade and Employment. But the paucity of any explicatory rationale by the McCarthy Report as to closing the Council is telling too.

The overall thrust of the Report argues that:

The Group has reached the conclusion that there should be radical rationalisation of the delivery of STI starting with the allocation of total responsibility to a single Government Department and the streaming of all funding through a single agency under that Department’s remit. Furthermore, all STI expenditure should be prioritised on the basis of likely commercial return over a 3 to 5 year period.
Rigorous targeting of STI will permit savings through the removal of duplication in both administration and research, the logical prioritisation of resources and the measurement of outputs and outcomes.

Which is all very fine. But when we arrive at a situation where there is an apparent gap between closure of the Council and any successor instrumentalities, either within or without this so far anonymous Government Department and ‘single agency’, then it would appear that far from the much trumpeted ‘reforms’ we’re sliding back, as in so many other areas (and the however nominal quid pro quo’s for Government supporting Independents is indicative of this dynamic too), to business as usual. I’ve heard anecdotal stuff that this is in part due to pressure from the socially conservative right, uneasy at developments. Perhaps true – who can say? But whatever the motivation it seems bizarre.

And that this happens at a time when bioethics issues are achieving a prominence never seen before isn’t merely an unfortunate coincidence but a central feature of how things will be from here on out. I’m not sure about others but I feel entirely uncomfortable, even uneasy, living in a state where such basic precautionary measures are not taken – and I speak as one who has personal experience of dealing with issues relating to bioethics… for better as it happens.

Abysmal.

You might have been wondering what COIR were up to… wonder no more. June 22, 2009

Posted by WorldbyStorm in Bioethics, Irish Politics, Social Policy, Society.
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You know, whatever peoples views on the issue, in the context of a state where the notion that abortion is anywhere near likely to be introduced, with an assist from the EU or not, is absolute nonsense you do have to wonder about this sort of activity…

CS21032

CS21031

Stem Cell research exercises the Irish Times… a lot… May 20, 2008

Posted by WorldbyStorm in Bioethics.
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You might have caught a letter in the Irish Times last week. It started:

The Irish Council for Bioethics (ICB) recently issued an opinion – “Ethical, Scientific and Legal Issues Concerning Stem Cell Research” – which recommended that frozen IVF embryos could be destroyed for research to generate human embryonic stem cell lines.

It continues that:

The fact that the opinion was unanimous (13-0) – curious, given the diversity of opinion on the topic – might signal to legislators that the recommendations represent a general consensus in the academic and biomedical communities.

And then…

This is not the case, and we are writing to express our strongest possible dissent from the ICB with regard to destructive research on human embryos. This opinion has no sound ethical, medical or scientific basis. Incidentally, 69 per cent of respondents in the council’s own public consultation believe the embryo attains “full moral status” at fertilisation.

They continue:

Scientifically it is a fact that a new, unique, human individual comes into existence when the DNA from sperm and ovum come together at fertilisation. The ICB report recognises this and accepts that the embryo has a “significant moral value”, but then asserts that the embryo does not “have the same moral status as those already born”. No valid reasons are given for this extraordinary assertion.

Which leads to the proposition that:

The embryos are human individuals. The disturbing suggestion (from sources referred to in the ICB’s document) that the value of an embryo might be contingent on the attitude of parents is not consistent with any valid concept of individual human rights. Neither the fact that many embryos die, nor that twinning can occur, changes the fact that destroying IVF embryos is destroying the lives of human individuals.

It gets better:

There is, in fact, no need to destroy IVF embryos. With the recent advances in egg freezing and the option of adoption of frozen embryos (if the parents do not wish to have them all implanted), IVF without left-over embryos is perfectly feasible; and the Government should legislate on this basis to protect the interests of parents and of the embryos generated by this technology.

And it concludes that:

The issue of the rights of embryos is often portrayed as a religious one, but our position is based on scientific principles and concern for fundamental human rights, not on religious dogma.

So, there we have it. Science has determined that rights for embryos is a scientific one.

And who is responsible for this letter? Why none other than:

MARTIN CLYNES, Professor of Biotechnology, Dublin City University; WILLIAM REVILLE, Associate Professor of Biochemistry, University College Cork; KEVIN KAVANAGH, Senior Lecturer in Biology, NUI Maynooth; DONAL Ó MATHÚNA, Senior Lecturer in Ethics, Decision-Making and Evidence, Dublin City University; DESMOND O’NEILL, Associate Professor of Medical Gerontology, Adelaide and Meath Hospital/Trinity College, Dublin; KEN CARROLL, Senior Lecturer in Biology, ITT Dublin; GERRY WHYTE, Associate Professor of Law, Trinity College, Dublin; ROSALEEN DEVERY, Senior Lecturer in Biotechnology, Dublin City University; WILLIAM BINCHY, Regius Professor of Laws, Trinity College, Dublin; METTE LEBECH, Lecturer in Philosophy, NUI Maynooth; JOHN KEHOE, General Practioner, Naas; SEAN Ó DOMHNAILL, Consultant Psychiatrist, Louth/Meath Mental Health Service; RONALD GRAINGER, Consultant Urologist, Adelaide and Meath hospital/Trinity College Dublin; DES MacHALE, Associate Professor of Mathematics, University College Cork; PETER CHILDS, Senior Lecturer in Chemistry, University of Limerick; TERESA IGLESIAS Director, Newman Research Centre, School of Philosophy, University College, Dublin.

Hmmm… some of those names seem awfully familiar. For example, doesn’t William Reville write a science column in the Irish Times. Isn’t that the column which seems to have some problems integrating scientific knowledge and… er… religious… well, maybe not dogma, but certainly religious…er talk… stuff… whatever?

For example barely a month ago we were treated to his thoughts on… stem cell research.

Here he stated that:

Human life begins at conception when a sperm cell and an egg cell unite to form a zygote – the first embryonic stage. The embryo grows and develops. After several weeks it is called a foetus, which continues to grow and develop until born as a baby about nine months later. The baby grows and develops into an adult, who grows old and eventually dies. The whole process is a human continuum between the boundaries of conception and death, and is programmed to proceed automatically under normal circumstances.

And…

Each stage along this continuum is fully human, having the full human properties and potential appropriate to its stage – zygote, foetus, baby, adolescent, adult and old person. All the genetic information in the human adult is already present in the single-celled zygote. Each point on this human continuum is dependent on the preceding part of the continuum and determines the succeeding part of the continuum. Interrupt the continuum at any point and nothing happens beyond that point. These are biological facts.

Which led him to the conclusion that:

Accepting these facts, it seems to me to be wrong to arbitrarily pick any point on this continuum and claim that it marks the boundary between the preceding “not fully human and not deserving of protection” section and the succeeding “human enough to deserve protection” section. Obviously, my position on this is not universally accepted amongst scientists or the general public.

Interesting, so the basis on which letter number 1 reproduced in part above is put foward as regards being based in science, not religious dogma, is somewhat more nuanced here in that he accepts:

my position on this is not universally accepted amongst scientists or the general public.

And this isn’t a minor matter for:

But, unfortunately, in order to harvest the embryonic stem cells you must kill the embryo. I consider the embryo to be fully human, hence my ethical problem with HESC research.

The Irish Times hasn’t been behind the door on all this either. It recently ran a piece by FF Senator John Hanafin on just this topic.

For the Senator there was little concentration on the destruction of embryo’s but rather the more exotic outcomes that raised his ire:

The [UK] Bill also makes provision for “saviour siblings”. This would allow for children to be created for the sole purpose of helping to treat a sick sibling. First, it would involve pre-implantation testing of numerous human embryos to find a match for the existing sick brother or sister. The embryos deemed suitable would then be implanted in the womb of the mother, in the hope a baby would be born with a cure for the sibling. Needless to say, the embryos that fail to match the needs would be routinely destroyed.

It is not overstating the case to say that this will inevitably sanction the creation of “spare-part children”.

And it wasn’t just that, but also:

What is taking place in Britain begs some questions. Where are we going as a society? What do human rights mean any more? Surely we meddle with the miracle of human life at our peril? Is it surprising there is growing disregard for human life when we do not value it at its most fragile beginnings?

And then…

The fact that the creation of human-animal hybrid embryos is an affront to human dignity doesn’t seem to matter at all. In the Human Fertilisation and Embryology Bill, it appears the end justifies the means with one simple proviso – regardless of what the practice actually entails, it must be presented as ethical, necessary and progressive.

His core argument was that:

This underlines the complete absence of any principle when it comes to defending life.

But herein lies the problem, because it is not actually lack of principle, but rather different definitions, as indeed Reville points to.

And the letters pages have not been quiet. There has been a wading in by those on the anti-side of the balance sheet. Dr. Séamus Murphy SJ, Senior Lecturer in Philosophy, rather curiously suggested that:

The council’s report fails on that score, for it offers no ethical reasoning on the key issue.

Its ethical flavour appears post-modern, even relativist, as though its authors think there are only different moral opinions and no possibility of reasoned moral judgment.

Post-modernist you say? And then follow it up with ‘reasoned moral judgement’.

Professors Desmond O’Neill and Martin Clynes, signatories to the first letter also appear arguing that:

However, the report lacks a wider perspective on challenges to those with neurological disease, particularly those major brain diseases associated with ageing, such as Alzheimer’s and stroke.

Much of the difficulty of appreciating personhood in dementia lies in an often utilitarian, hypercognitive approach to personhood, rather than a wider sense of what constitutes our human nature. This approach has been expanded by some moral philosophers to support rationing care away from those with Alzheimer’s disease, and another has likened people with dementia to dogs.

It is ironic that those with Alzheimer’s disease and stroke are quoted as primary targets for the use of embryonic stem cell treatments, as outlined by the council’s document. For their well-being and care is threatened by a lack of appreciation of their personhood: such a qualified approach to personhood is mirrored by a qualified (or, as they term it, a gradualist) approach to personhood at the beginning of life.

Stem cell research holds great promise for our understanding and eventual treatment for the major neuro-degenerative illnesses of later life. However, it remains important that this is not done in a way which erodes the universality of our moral status as persons at the extremes of age, vulnerability and co-dependency.

Now, perhaps it’s me, but the points they raise about certain moral philosophers is a curious one… and hardly more than a hairsbreadth away from alarmism.

A response to the good Professors from Dr. Richard Hull and Dr. Siobhán O’Sullivan who are on the Irish Council for Bioethics argues the blindingly obvious that:

There are many other differences between issues at the beginning of life and issues toward its end, which reinforce the point that they should be treated separately. It is also worth noting that being hopeful about the future therapeutic applications of stem cell research is not in the slightest bit incompatible with a strong desire to see a society that is more inclusive and sympathetic with respect to all of its members. The council’s report encourages reflection on these and other issues.

Still, that doesn’t help. For another letter writer argues that:

The problem, as I see it, is that science moves faster than moral understanding. There is a real genuine problem and moral dilemma involved in the mindless art of “engineering” our human nature. This problem cannot be glibly glossed over merely by a facile reference to secular humanistic arguments based on utility. Perhaps we really need some kind of “spiritual” values if we are to put the brakes on humankind’s “will to mastery”. Although what is proposed sounds repugnant on a gut level to many, the “gut” is a flimsy thing to build arguments around. In the end, perhaps those who are opposed to what the council is proposing must fall back on something like a genuine moral plea for reverence and humility in face of the mystery of life, rather than a lawyer’s watertight “case against”.

And the even more, to me, unsatisfying:

The council is advocating the destruction of living embryos “for the good of society” – specifically for the purpose of health; the health of sick individuals. But the line between health and enhancement may be in the end impossible to draw. Indeed health itself is a form of enhancement. Perhaps we ought, at least, to think about the line, however imaginary – and think about where, in a hyper-competitive world, re-engineering our natures will ultimately lead

Okay.

But one letter cuts to the heart of the obfuscation. Dr. Dolores Dooley suggests the following:

The letter of May 10th from a group of Irish academics raised a number of issues in relation to the Irish Council for Bioethics’ (ICB) opinion document on stem cell research. We take issue with the assertion that the council’s stem cell report “has no sound ethical, medical or scientific basis”.

She continues:

The letter claims “it is likely” that therapies for diseases will be developed using adult stem cell research and induced pluripotent stem cells, thereby obviating the need for embryonic stem cell research.

Science is based on the systematic testing of hypotheses and observation and does not rely on likelihoods for its results. While induced pluripotent stem cells hold significant promise, they will not provide a replacement for embryonic stem cells in the short term.

She notes:

There was also a reference to the possibility of IVF without the need for supernumerary embryos. Again, while future progress may indeed alter IVF practices, egg-freezing is a new technology and is still considered experimental. Thus, until sufficient data show there are no increased genetic or congenital abnormalities in babies born using frozen eggs, it will not become mainstream IVF practice. In addition, a significant body of research has also demonstrated that the majority of couples are not willing to donate their supernumerary embryos for other people’s parental projects. Both these issues are discussed in some depth in the ICB opinion document.

And she concludes:

The assertion that the council gives “no valid reasons” for its opinion that embryos do not have the same moral status as those already born is incorrect. We would direct the signatories to pages 34-41 of the report, which discuss issues such as moral status, personhood, potentiality and human dignity, which form the basis of our conclusions.

But look, the ‘group of Irish academics’ are arguing from a scientific position, not from one based in religious dogma. Although they appear not to have read, or at least to have understood the actual report… which somehow I in my non-technical way managed to.

And this, as Dr. Dooley notes;

…this places an ethical responsibility on all sides of the debate to provide balanced and accurate information.

Yet this is not sufficient for Reville, for on Saturday he wrote:

I refer to the letter of May 14th from my former UCC colleague Dr Dolores Dooley, chairperson of the Irish Council for Bioethics (ICB), regarding the recent opinion published by the council entitled The Ethical, Scientific and Legal Issues Concerning Stem Cell Research, and in reply to a joint letter from 16 Irish academics, including myself (May 10th).

He argues that:

The debate on the ethics of human embryonic stem cell research hinges entirely on the moral status assigned to the early human embryo. The joint letter charged that the ICB opinion “gives no valid reason” why it assigns less moral value to the embryo than to the born person. Dr Dooley denies the substance of this charge and directs readers to pages 34-41 of the ICB opinion to prove her point.

Which he finds insufficient because:

It merely lists a wide range of the diverse opinions of many people on issues such as moral status, potentiality, personhood and human dignity, before plumping for its own position of “granting significant moral value rather than full moral status to human embryos”.

And continues:

The ICB opinion does not tell us how and why its authors were unanimously persuaded to come to that conclusion and I remain happy to stand over the charge made in our joint letter of May 10th.

There is no definitive judgement on these matters, and Reville has noted this way back when. But as ever there is the effort to leverage opinion into certainty – and note the significance to him of the fact that it was “…a joint letter from 16 Irish academics”. And it seems to me to be near-specious to pretend that there is, or that this lack of definitive judgement leaves us in other than a contingent area.

And what of the report that raises such heat? On the pages Reville refers to we read:

A range of positions can be taken with respect to the moral status of embryos. At one end of the
spectrum, is the view that embryos are balls of cells that have no more moral value than any other
piece of human biological material. At the other end, some would consider embryos to have the
same moral status as any adult. This is the view that embryos have “full” moral status from the
moment fertilisation is complete. Others grant significant value to early embryos but not the same
status as they would grant to an adult. In this view, embryos will acquire full moral status at a later
point during embryonic development.

It goes further and makes a point that Reville one presumes must implicitly hold to, yet curiously does not enunciate:

In the view that embryonic life must be preserved from the moment fertilisation is complete, it is
implied that embryos have an absolute right to life, which cannot be violated at any cost. Proponents
of this view would object to current AHR practices because many of the embryos produced through
IVF will not be used and, as such, will never develop and are, therefore, denied their right to life.
The use of several types of contraception, such as intra-uterine devices and the “morning after pill”,
for example, can lead to the destruction of embryos in their earliest stages of development. Thus,
their use also violates this ethical position. It is often argued that, given that human development is
continuous from fertilisation to birth, any point at which full moral status were to be granted, other
than at fertilisation, would necessarily be arbitrary and, therefore, unsound.

There is more, and here’s a taste of it…

However, others have argued that the acquisition of moral status is as continuous a process as
biological development and that embryos gradually gain their moral value. This is referred to as a
gradualist view of moral status. Within this broad ethical position, some people do not think that there
is a single point at which full moral status can clearly be attributed to the embryo. Where research on
embryos is considered, it is argued that the relative moral value of the embryo should be considered
in the context of the other values that can be realised through stem cell research in order to decide
whether or not to proceed with it.

Anyhow, cutting to the chase:

On consideration of the various arguments relating to the moral status of the
embryo, the Council adopts a gradualist position, granting significant moral value
rather than full moral status to human embryos. The moral value they are seen
to possess is based on recognition of their potential to develop into persons, as
well as the value they derive from representing human life in its earliest stages.

This seems a rational and sensible position. To suggest that it is simply plucked from the ether is unfair – there are pages after 41 which deal with other issues relating to, for example, the nature of acts and omissions in moral terms (and raises some important points i.e. “Nonetheless, it can be argued that moral consistency does not always lend itself well to practical
policy solutions, especially when a plurality of opinion exists within society.”). Would more explanation on the discussions be useful? To a degree. But, again, Reville recognises that difference exists. So it appears his gripe is that he and the other ‘academics’ appear to hold the differing view.

And lest this seem to be a gratuitous lash at Reville, et al, let me be straight about it. I’m not entranced with stem cell research. There is an ‘yuck’ factor (discussed on page 51 of the report) that makes me wince to some degree. That said I have some experience as regards embryos and the implications of same and that perhaps colours my view. I can see situations where embryo’s are massively precious dependent upon circumstance. But that’s the thing. Precious dependent upon circumstance. The human body itself sheds embryo’s with an incredible profligacy. And this alone makes contingency perhaps of greater importance than Reville and co. might like to pretend. That contingency, to me at least, belies the absolutism of their arguments. I don’t know for sure what the answer is, or whether one exists. I suspect that like many many medical/bioethics issues this is one beyond clear resolution, and that there will always be different camps on it. But, we are sweeping into the future, and flawed as the ICB opinion document may well be, and wrong as it may well appear to some, at least it constitutes an honest effort to put some structure on these issues and to quote Dr. Dooley once again…the seriousness of these issues, and how they strike at the root of many many difficult individual and familial circumstances:

…places an ethical responsibility on all sides of the debate to provide balanced and accurate information.

Meanwhile… John Waters, reinventing the wheel of life… yeah, right. April 18, 2008

Posted by WorldbyStorm in Bioethics, Social Policy, Society.
10 comments

I can’t let this go past, following on from Chekov’s comments earlier. The article Chekov referred to is by John Waters in today’s Irish Times. It’s about the lesbian couple who won their case in the High Court as regards guardianship, and it really is a piece of work. Most stuff I can tolerate, but this?

At the hear of this case is the agreement by the father, purporting to waive most of his natural claims in favour of ‘uncle’ status. Of course it is morally impossible for the father to do this.

Er… no, actually it’s not, and perhaps out from under the shade of whatever tree Waters has been most of his life he might recognise that sperm donation is not new, it’s not particularly different and that his talk of ‘natural’ claims and ‘moral’ impossibilities is just that – talk (incidentally, what is it about men of a certain age who move from nuance to absolutism, and that’s a big hallo to Nick Cohen too).

We need to be clear that what has happened in this case is that a man’s child has been, in the language of creation, stolen. The fact that he colluded in this wrongdoing is beside the point.

Nah, mate. This is talking the language of bollocks. The fact that he ‘colluded’ is absolutely central. Again. Get out of the shade John. What too of adoption? What of single parents, where a father (or mother) is denied access for one reason or another? What of children in foster families? What of the universe of complexity in human relations which leads to family building and shaping that somehow despite everything tends to work out broadly speaking for the best. Optimal? Perhaps not, but we live in an entropic universe. Nothing is optimal. Not for John, meat and two heterosexual parents, Waters though. Dismiss everything beyond the specific, the normative, the familiar. Ignore the reality that sperm donation has been a fact of human life (incidentally, what does JW make of statistics printed some time back in the Guardian that showed the percentage of children genetically different to their purported parents – due to who knows what, well, okay, they suggested affairs – was remarkably high? What of the sacred wheel of life in that context? Is that ‘natural’ or ‘moral’?).

Drunk with liberal hubris, have we reinvented the wheel of life, deciding that two lesbians playing House can trump the claims of the forces that create human life?

This last is perhaps the most pernicious aspect of his piece (uncharacteristically – and go look at the printed version – clearly lacking at least three or four paragraphs, one wonders if the Senior Counsels the IT employs were chewing on the top of their pencils into the wee hours of last night about that missing text). “playing House” is so revolting dismissive, so teeth-grindingly ignorant that it is beyond redemption. And all smothered in a sort of pseudo-Biblical, pseudo-New Age language that no doubt read well at 12.30 am this morning, at least in our correspondents head. Well, two can play at that game.

By his words ye shall know him.

smiffy adds:

It really was a phenomenally nasty article ( “playing house” ) even by Waters’ standards.  One or two quick additional points, though. What’s notable in this is the stark hypocrisy of Waters’ argument. He is quite happy to throw around pseudo-philosophical terms like ‘the wheel of life’, ‘the language of creation’, ‘the natural order of things’. What he seems blithely unaware of is the fact that such arguments can easily be turned against him (and let’s not mince words here – this piece is entirely about Waters own domestic situation. I’m surprised he didn’t open by saying ‘Speaking as a sperm donor myself …’).

Waters has spent the last decade complaining about the bias against fathers, particularly unmarried fathers, in the family law system, and such a bias certainly exists. However, surely if there’s any justification for such an approach it comes precisely from the same ‘natural order’ that Waters clings to in this piece. Mothers, fans of the ‘wheel of life’ view of the world might argue, are the ‘natural’ rearers of children and when relationships break down surely the civil law should reflect this. Indeed, given that men are ‘naturally’ poor caregivers, why should they have any ‘natural’ claims on children at all? At a push, one might even argue that a family ‘naturally’ contains two parents who live together, so the female couple at the centre of this case could be seen as a more ‘natural’ family than two biological parents of a child who don’t live under the same roof.

In the hope of avoiding confusion, I should state that the positions listed above aren’t ones I would necessarily share. However, unlike Waters, I don’t share them because I find terms like ‘wheel of life’ to be utterly devoid of meaning and irrevelant to any debate between rational adults. What’s his view?

Similarly, and more insidiously, for all that Waters derides ‘liberals’ and ‘feminism’, his plea for equal treatment rests entirely on a liberal position if it is to make any sense at all (admittedly, quite an ‘if’ in Waters case). The only reason the general principle of sexual equality, which Waters relies on, achieves such an overwhelming consensus of support is the struggle of various minority and otherwise oppressed groups in demanding equal rights, usually in the face of opposition from people just like Waters. Now he’s piggybacking on their achievements while denying them the same respect and equal treatment he feels is his due.

One quickly notes that Waters rejection of the judgement in this case is based solely on what he perceives the rights of fathers to be. Nowhere does he refer to the best interests of the child in question (other than to note that the court – unlike him – felt it was important). A rather telling omission.

As a minor aside, for someone who is fond of throwing the term ‘Kafkaesque’ about, I don’t think he has any real understanding of what it means, other than as an alternative to ‘Orwellian’ in the Waters catalogue of cliché.

It’s an ‘optional’ kind of civil rights violation December 28, 2007

Posted by franklittle in Bioethics, Ethics, Ireland, Judiciary, Technology.
5 comments

The Irish Times has an interesting piece today (Sub required) with Justice Minister Brian Lenihan laying out his priorities for the year to come in an interview with former left-wing revolutionary turned Irish Times Legal Affairs correspondent Carol Coulter. The interview flags up the forthcoming Immigration and Residence Bill and points to the benefits this will have in the area of human trafficking, two items I intend to return to in coming weeks as it happens. But it is the proposed DNA database, which is dealt with at the very end of the article that struck me:

“However, he said legislation on a DNA database was coming. “Admissions are declining as a source of convictions. Science will play a greater role. I will be bringing proposals on a DNA database to Government. “People who are convicted will have their DNA taken. But I think there is a reason for a much broader database – not on a compulsory basis, but we could promote people voluntarily giving DNA. That could exclude people who innocently left traces at a scene.””

Ahh….voluntarily.

Little has been heard of this proposal since last August when the Irish Human Rights Commission (IHRC) issued its observations on the Criminal Justice (Forensic Sampling and Evidence) Bill 2007, which aims to establish just such a database. The IHRC makes clear its concerns about the human rights implications of such a database not being understood by the wider public and points to a lack of safeguards in the existing legislation. Two aspects of the legislation in particular terrified the Hell out of me when I first read it.

The first was that DNA samples provided would be held indefinitely. So, hypothetically, I decide in the interests of assisting the Gardaí to provide my DNA to rule me out as a suspect in a case where a rape took place at a party I attended. It saves the police time in considering me a suspect and from my point of view eliminates me as a suspect saving me time and grief. Yet though I gave my DNA for this specific reason, my DNA can be stored indefinitely. With increased EU level legislation around the sharing of data held by police and security forces such as the proposals on air passenger data retention, it is likely that at some point my DNA could be transferred to police forces outside of this jurisdiction if they felt it was necessary. Indefinite retention of DNA samples is not the international or European norm. And if, by the way, I choose to exert my right not to give a sample, does this make me more of a suspect? One assumes it does in practice whatever about in legal theory. Yet rights not exercised can fade away, overtaken by the ‘practice’ on the ground.

The second is that under the Bill the Forensic Science Laboratory can out-source or delegate responsibilities around the creation of the database to other parties inside or outside the state. In theory my DNA in the above case could be sampled by a person working for a private company hired by the Gardaí to carry out the taking of samples, sent to another private company who carry out the analysis and then stored with another private company who are responsible for the storage. There’s just no end to the gravy train for private companies being fattened up with the people’s money. Would these private companies be most concerned with ensuring my rights are protected or with maximising their profits by cutting corners? I think history can answer that for me.

And even if the proper safeguards are in place, what price incompetence? In November the British lost two computer discs with the personal details of every family with a child under the age of 16, containing the bank account and insurance details of a mere 25 million people. What price corruption? As we reported here in August Gardaí and other government officials routinely access confidential information which ends up in the hands of insurance companies, private investigators and the media.
The DNA database debate will, in all likelihood, be one that is ill-informed and hysterical in much the same way as the one on Anti Social Behaviour Orders, on which I remember no less a luminary than Gerry Ryan giving his two cents arguing that anyone opposed to them was supporting anti-social behaviour. But the IHRC, who are not opposing the idea of such a database, deserve to have their call for an informed debate heeded.

Didn’t anyone see the movie? It doesn’t go well for humanity… November 14, 2007

Posted by WorldbyStorm in Bioethics.
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From today’s news … Yikes!

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The media discourse about IVF: desperate women, bad men… July 5, 2007

Posted by WorldbyStorm in Bioethics, Culture.
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An article in the G2 section of the Guardian yesterday reminded me yet again that there is a very special discourse concerning IVF, and those who of necessity must turn to it, within the media.

Let’s consider the article first. This was a fairly lavish four page spread which under the title Taking on the baby gods discussed new techniques in IVF.

It started with the proposition that:

IVF is expensive and harrowing, and carries significant health risks. That is why some fertility experts are turning to an alternative method called ‘mild IVF’, which they say is cheaper, safer and equally effective. But Britain’s most powerful fertility doctors remain to be convinced.

Then it noted that one – fortunately – very rare side effect of IVF hormone treatments used to stimulated the ovaries in order to produce eggs is a condition know as Ovarian Hyperstimulation Syndrome which ranges a spectrum from mild and unpleasant symptoms to death.

As the article notes:

The biggest risk factor is the hormonal drugs women are given, first to shut down their reproductive system – throwing them into a sudden and unpleasant temporary menopause – and then to stimulate their ovaries to produce multiple eggs instead of a single one, which can be surgically collected and fertilised with the partner’s sperm in a lab. It’s like slamming on the brakes in a cruising car and then whacking it into gear and putting your foot down hard.

This is entirely true. What is also entirely true is that studies show that the incidence of serious OHSS is exceedingly rare. How rare? We’ll come to that.

However, the article contends that:

Probably, nobody was to blame for … deaths. The fact is that IVF carries risks. That is not something most women, so desperate for a baby they will try anything, want to hear. They probably don’t hear it when they are told. But IVF, as it is usually practised today in the UK, is an experimental medical intervention and there is a chance of becoming ill as a result of it and a very rare possibility of death.

To counterpoint this the article suggests that:

The liberal use of drugs and the return of multiple embryos to the womb have been the norm for decades. But a growing band of fertility experts are now saying that it doesn’t have to be this way. Women can have a little gentle drug stimulation and just one single healthy embryo replaced, removing not only the risk of unpleasant side-effects but also the danger of multiple pregnancies, which can result in very sick babies.

and that :

This is “mild IVF”, and a recent paper in the Lancet showed that the results can be just as good as the more aggressive approach. Bart Fauser, a consultant at the University Medical Centre in Utrecht in the Netherlands, headed a study comparing the outcomes for 200 women given mild IVF treatment and a single embryo transfer, with those of 200 women who had the conventional drug dosing regime and two embryos put back in the womb. Those having mild IVF were given four (shorter) treatments while the others had three. Over the course of a year, 45% of both groups ended up with a baby. But mild IVF costs less. In the UK, such treatment might cost half as much as the usual technique.

And then the question is asked….

So why has it gained little more than a toehold in the UK? Can there be some truth in the popular image of the “baby gods” – the macho fertility experts who see the patient as a Petri dish or an incubator, little more than an essential piece of equipment in their medical experiments? It is difficult to understand why the expensive London clinics have not gone for minimal disturbance to a woman’s body. In any other field of medicine, the rule is to give the lowest possible dose of drugs and increase it if necessary. In IVF, amazingly, the recommended dosage is not stipulated in the doctors’ prescribing bible, the British National Formulary. These are the only drugs where safe limits are not listed. Fertility doctors do what they think fit.

Firstly, let me say that I actually think ‘mild IVF’ is a good thing. It makes sense to diminish the pressure on the body from hormone treatment. And IVF, while not quite the hell painted here, is a difficult, time consuming and frustrating business with no guarantee of success…it’s sort of the inverse of the gift that keeps on giving, more like the curse that keeps on taking…

But… I have a real problem with this article on four specific issues.

Firstly, I must admit I have some knowledge of this area, and while I would entirely agree that there is indeed an element of desperation to anyone who has to resort to IVF it is also true that the procedures are set within a framework of multiple consent forms, a considerable emphasis on the nature of the processes engaged in and the fact that there are risks. So it is not quite a question that ‘That is not something most women, so desperate for a baby they will try anything, want to hear’. (I particularly like the ‘anything’ in that sentence as if recourse to IVF were somehow the most cutting edge and risky activity possible).

Yet…and I was in hospital at Easter myself for a medical procedure which, like all invasive procedures, also carried a risk of serious and unpleasant complications. IVF is hardly more of an ‘experimental medical procedure’ (and here the article is curiously opaque as to precisely what it means by that term) having been practised widely for a quarter of a century. A further thought. The sort of procedures practised in Ireland and the UK are utterly mainstream – and moreover are overseen by the HFEA in the UK (and intriguingly the Irish clinics abide by HFEA standards). The US and Eastern Europe are a little more ‘experimental’, running to egg donation and various other techniques which ironically use less hormones, but not in terms of hormone protocols. OHSS in all its variants has an incidence of 1 to 5% in all IVF treatments utilising typical hormone treatments. For death rates I can only refer to a report [it’s in PDF format for those as worry about such things] commissioned for the UK HFEA which noted that:

I have made general enquiries and to my knowledge there have been two deaths in the
U.K. following OHSS. So far there have been in excess of 425,000 cycles of
stimulated IVF that have been undertaken in the U.K. (HFEA, Dr Peter Mills,
personal communication). Apparently there was a death in 2004 reported to the
HFEA, due to cerebral oedema and ischaemia, pulmonary embolus and pelvic vein
thrombosis, which were secondary to OHSS (HFEA, Dr Peter Mills, personal
communication). The other death was in about 1991, I believe the patient was
undergoing drainage of a pericardial effusion and suffered complications and
subsequently died. I also believe that the treatment received was ovarian stimulation
alone and not IVF. Data on the overall number of gonadotropin stimulated cycles for
ovulation induction, intrauterine insemination (IUI) and gamete intrafallopian transfer
(GIFT) are not available and so it is not possible to give an accurate incidence of
mortality from ovarian stimulation other than that for IVF. Thus the mortality from
OHSS in the U.K. currently appears to be 1:425,000 IVF cycles

One death is one death too many, and there is no cause for complacency on this issue whatsoever [I won’t make a comparison with other medical techniques, having looked it up the rate is very very low indeed, but the UK mortality rate from MRSA was 12.5 per half million per annum]. As already noted ‘mild IVF’ is a good thing but overstating the risk, as this article does by implication, appears part of the current media discourse.

Secondly, the article ignores one crucial aspect. There exist a group of women who can be termed ‘poor responders’ to fertility hormones. Generally, but not exclusively, these are women who are over 35, a point where egg production and quality decreases sharply (actually there is a strong body of evidence to suggest that post 30 also sees a dip). In order to produce eggs it is necessary in some of these cases to increase dosages. No ‘mild IVF’ is going to do the job here. Only an ‘aggressive’ regime will produce any results. Here the issue of risks becomes more significant, and yet, look again at the figures above.

Thirdly, there is the issue of the ‘baby gods’, “- the macho fertility experts”. Well, I can’t speak for the UK, but in Ireland and other European countries this is certainly not the experience where there is a preponderance of woman doctors involved in this area. And this I think is part of a discourse which seeks to pit ‘desperate women’ against ‘macho fertility experts’. I find this discourse demeaning and patronising, effectively presenting women as passive subjects in the process with limited or no autonomy.

I have known a number of women who have had to go through IVF and, while it has indeed been a difficult and frustrating experience both physically and mentally, the characterisation the media attempts to project appears to me to be wide of the mark. Nor are they supine but take an active and engaged role in the process. But the characterisation feeds into a broader societal discourse relating to women and reproduction, one which even from progressive sources (such as the Guardian) cannot quite resist falling back on more archaic concepts of how women act in certain situations and how at root women are ‘desperate’ for children at ‘any cost’ or risk to themselves. Not so.

And to conclude, there is one other aspect. As the Guardian article notes, but does not emphasise, there are reasons why the ‘mild IVF’ protocols are gaining greater acceptance in parts of Europe and that is economic. Simply put they are available in medical healthcare environments such as Holland where IVF is not considered an expensive and essentially voluntary add-on but as a fundamental right for women who require it. In such a context there is greater pressure on clinics to get results because the costs of treatment are paid for in the main by patients with little or no state subsidy or availability on the NHS.

Ironically another economic process, the falling UK birthrate has led to calls for wider free availability of IVF up to three cycles in order to bolster the future working population.

Abortion debate takes to the streets. July 4, 2007

Posted by franklittle in Bioethics, Feminism, Gender Issues, Irish Politics, Medical Issues, Religion, The Left.
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There have been a number of good discussions on the Cedar Lounge about issues around abortion and the strength or weakness of the pro-choice lobby in Ireland. The latest contribution to the debate was WBS’s piece at the start of the week going through some of the contributions to the letters debate in the Irish Times.

But the last couple of weeks have seen the debate emerge from the sterile corridors of the Times and back onto the streets again to an extent not seen since the last abortion referendum, motivated no doubt on both sides by the Ms D case.

Last Saturday I went along to the pro-choice rally organised by Choice Ireland in Dublin’s city centre where a good crowd of a little under 200 heard Senator David Norris and likely Senator Ivana Bacik call for a the introduction of a woman’s right to choose in Ireland. Some pictures on Indymedia available here. Interestingly, there was a complete absence of party banners, with the exception of the Connolly Youth Movement of the Communist Party. I saw Labour, SWP, SP and Sinn Féin people but unusually for a city centre demo where everyone is normally fighting to get their banner to the front of the march, party badges were kept under wraps.

Pleased though I was to see the pro-choice movement back out on the streets, and as well as the demo Choice Ireland had a very successful couple of media interventions over the week, it needs to be seen in the context of the strength of the anti-choice forces in Ireland.

Youth Defence is currently concluding a ‘pro-life roadshow’ that has seen them hold a range of leaflet drops, demos, stalls and public meetings in 16 towns and cities across the country, culminating in a rally at the GPO in Dublin this Saturday with a public meeting in the evening ‘after Mass’ (Of course). Bear in mind too that this is merely one part of the anti-choice movement in Ireland, and not necessarily the strongest, though certainly the most prominent.

The roadshow has not been without controversy. Gardaí in Galway City shut down one of their information stalls and a Youth Defence demonstration outside a family planning clinic in Limerick was the subject of a peaceful counter-demonstration.

As Smiffy pointed out in a previous post on the subject there is some evidence of an emerging pro-choice majority in Irish society, certainly among 18-25 year olds according to a recent MRBI poll. Yet the growth in support for the pro-choice position has had little, if any, effect on the positions taken by the major political parties. Nor has it seen the emergence of a campaigning organisation that can match Youth Defence on the streets.

Choice Ireland holds out the possibility of being just such an organisation even if it is still very much in the first phase of growth. But the other problem is neatly summed up by Yeats. “The best lack all conviction while the worst are full of passionate intensity.”

Whatever about the rights and wrongs of the abortion argument, one cannot question the near fanatical determination of the anti-choice movement motivated in large part, though not entirely, by religious belief. And at one level, you have to admire their determination and commitment to what they see as saving lives.

Against this, the pro-choice movement relies less on emotional or faith based appeals but on what we would perceive as political concepts such as equality, feminism, rights and so on. All very correct, but it makes it harder perhaps to appeal to voters to back your cause and activists to get stuck in than something that gets to people in their gut.

How is the pro-choice movement to attract activists, most of whom if taken from the traditional left in Ireland have party or organisational commitments elsewhere? To compete with the likes of Youth Defence, does the pro-choice movement needs it’s own fanatics?

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