Editorial

There is a category of families who spend years of desperately trying to have children and, yet, after having tried everything under the sun they still fail to achieve such an end. So what do they do?

Sonia Camilleri, the Commissioner for Children, says the answer is to use "natural methods". Not unexpectedly, her remarks produced an avalanche of criticism from the medical fraternity as well as from involved individuals.

The Maltese bishops last week underlined the duty to ensure that human embryos are not manipulated and in no way subjected to interventions that may lead to their destruction or that may obstruct their natural development.

The main arguments the Children's Commissioner brings forth against the use of in vitro fertilisation (IVF) relate primarily to the known increased risks compared to pregnancy achieved through natural means, as well as to the ethical issues involved including the possibility of resorting to freezing embryos. Unfortunately, these real problems were obfuscated by a delivery of views which bordered on the trivial. Simple solutions to complex issues simply do not exist.

In the first place, as any student of economics would know, there is no such thing as a benefit without a cost. In medicine, as in everyday life, one has to balance the cost against the benefit. In the case of IVF, the benefit has been enormous, measured not only by the thousands of children born but also by the inestimable psychological benefit of providing a solution to a previously intractable problem.

The second issue refers to Mrs Camilleri's concern with complications resulting from IVF pregnancies. She would prefer a moratorium on these technologies until such time as they are completely safe. However, there is hardly any procedure in the whole of the medical armamentarium that is 100 per cent safe and, as for other procedures, the cost involved and complications expected have to be balanced against the expected benefit. No one can give a guarantee of normality even in the case of normal pregnancy.

A third concern relates to the possible accumulation of frozen embryos and the need to discard them, which Mrs Camilleri equates with murder. There is no question that, in our Catholic tradition, destroying an embryo is tantamount to murder. But is the freezing of embryos an absolute accompaniment of IVF? No!

Freezing is a convenient way of obviating the need to obtain ova and fertilising them in vitro on multiple occasions - obviously a question of convenience but not an absolute necessity.

To equate IVF technique with freezing and destruction of embryos can be confusing. Comparing the "right" of having a baby with the right to kill is not only confounding but wrong in the extreme. It is just as mistaken to indicate that IVF can be achieved only through destruction of frozen embryos.

When it comes to legislation against a particular practice, further considerations are relevant. Following Isaiah Berlin, a distinction should be made between positive and negative rights.

While there is no doubt that the embryo should be protected, one should approach serious problems with a degree of compassion and understanding. Extreme points of view are often one-sided, poorly thought out and incompatible with a philosophy of life applicable to the majority of citizenry.