Sunday’s federal vote will include an issue that has divided political parties, and may give rise to some lively debate at home. It’s about whether to allow diagnostic screening of an embryo prior to its implantation in the womb. Pre-implantation diagnostics, which analyse the cell structure and genetic makeup of an embryo, will only be available to infertile couples and to those who suffer from hereditary illness.
Presently around 80,000 children are born in Switzerland each year, and around 2,000 of these are the result of fertility treatment. If enacted, this extension of the law will allow doctors to fertilise more embryos and to select which ones to re-implant, or more specifically which ones to abandon or freeze.
Scientists see this as progress, libertarians think it will bring Switzerland’s laws into line with the rest of Europe, and politicians cannot decide whether this is a pragmatic debate or an ethical one.
Bear in mind that in a normal pregnancy there is a natural selection process within the womb whereby imperfect embryo’s tend not to make it to full term, so the issue here is mainly about how far we allow fertility specialists to intervene in this selection process, by only inserting embryos with a fighting chance of making it to full term.
The parliamentary library has released its documents of arguments for and against the vote. The argument in favour of medical intervention is built on three axes, which are that the new laws will:
- Optimise the process of assisted fertility, and so alleviate the additional sufferance of couples who rely on medical intervention to have children.
- Improve the chances of pregnancy for infertile couples by choosing the best embryo to work with, thanks to the diagnostics.
- Reduce unnecessary risks for mother and child by avoiding multiple-pregnancies (potential twins or more) since only one embryo will be inserted.
In addition, they note that this development is a fair expression of sound medical progress, and it will bring Swiss law into line with 27 of the 28 states of Europe. This will mean that Swiss couples no longer need to travel abroad to seek treatment.
And since it can help identify possible hereditary illnesses (which are sometimes the cause of infertility) this diagnosis can avoid the real ethical dilemma of whether to terminate a pregnancy, or to potentially visit the challenges of hereditary illness on the next generation.
The arguments against further medical intervention are largely based on the conviction that it is discriminatory and that it will erode basic human rights, which are enshrined in the Swiss constitution. They also maintain that Switzerland shouldn’t be required to bring its laws into alignment with the rest of Europe.
The various opposition concerns, which don’t necessarily weave into a thread, are that:
- The attempt to harvest large numbers of embryos may subject the future mother to excessive levels of artificial hormonal treatment.
- The ability to harvest additional embryos will lead to an excessive number of fertilised embryos that are frozen and never put to use.
- Diagnostic tests will discriminate between potential lives, rendering some useful and others useless.
- The judgement that imperfect embryos are not worthy of life will further compromise the perceived dignity of handicapped children.
- The screening process may deprive parents of a child that they would willingly have accepted even with a significant risk of handicap or illness.
- This procedure will be insufficient to guarantee a healthy child, since not all illnesses can be detected with diagnostics, and many illnesses only arise during the course of pregnancy.
- The additional costs will commercialise human life by requiring hopeful parents to pay even more for their fertility treatment, none of which is covered by medical aid.
- This procedure falls outside of the legitimate bounds of medicine, which is intended to prevent or treat illness, rather than to eradicate those lives that may carry such illnesses.
None of these arguments was sufficient to convince the Swiss Parliament or the Federal Council, which both recommend voting in favour of the amendment.
The new initiative gives rise to a legitimate ethical concern, since pre-insertion diagnostics may gradually be extended to more cases and more couples, putting us on a slippery slope towards genetic engineering. Some fear that it could even lead to Eugenics, a social philosophy whereby mankind uses science to improve the quality of our species, by discouraging reproduction by those with genetic defects and encouraging reproduction by those with desirable traits.
For clarity, it’s important to note that, in its present form, the new legislation is only there to help infertile couples or to protect those who are clearly susceptible to a hereditary illness. It would not allow couples to choose the gender of their child or to favour embryos, which promised any particular physical advantages on account of their genetic signature.
If this legislation carries, it will offer a far greater chance of success for infertile couples. It’s easy to underestimate the emotional and physical hardship that a fertility cycle entails. Not all procedures will lead to pregnancy, and according to the Federal Office of Health, 21.7% of those pregnancies are spontaneously terminated.
One Lausanne couple underwent numerous unsuccessful assisted fertility attempts in Paris, London, Geneva and Cape Town before finally enjoying the success of conceiving a healthy and happy child five years ago. It seems unfair to deprive other hopeful parents of any advantage that may improve the chance of that pleasure.
By James Cullinan