Hard questions need to be asked about the steep rise in IVF around the world, says the Evidence Based IVF Group. In a stinging rebuke to commercial IVF in the BMJ, they write: “IVF has allowed many infertile couples to have a family. Its early pioneers persevered in opposition to scientific, societal, and religious dogma. Similar determination is needed in attempts to evaluate the extension of IVF to new indications.”.
The big issue is the exploitation of patients with unexplained sub-fertility. Most of the rise in the use of IVF is driven by unexplained subfertility. “Unexplained subfertility accounts for 25% to 30% of all couples presenting for IVF, many of whom will conceive before treatment.” If this is the case, IVF may not be cost-effective.
Iran has become the fertility capital of the Muslim Middle East, reports the magazine Foreign Policy. Its Shi-ite mullahs are far more willing to grant favourable fatwas, or opinions about fertility issues than their Sunni counterparts. Iran now has more htan 70 fertility clinic which offer their services to couples from all over the Middle East. Fertility treatment is eligible for government subsidies, so IVF cycles in Iran are the cheapest in the world – about US$1,500, including the drugs.
Iran has a very high proportion of infertile couples – perhaps as high as 20% -- which may be due to consanguineous marriages. But it also has experienced a phenomenal drop in its birth rate. Its fertility rate has declined from 7 children per woman in 1980 to less than 2 today – a decline of 70% in the space of a single generation. And about…
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This story is a bit dated but is worth a mention. In 2012 a Spanish woman was awarded 214,000 euros for a claim of negligent practice against an abortion clinic in Seville. In 2011 the woman had become pregnant after seven 'frustrating' attempts to do so via IVF. Now she was going to have twins. At 20 weeks, one of the two was diagnosed with truncus arteriosus, a serious but potentially treatable cardiac condition.
The woman and her husband decided to abort the unhealthy child due to 'the poor quality of life that it was going to lead and so that the healthy baby would be able to put on weight and grow'.
The star performer in bioethics in 2014 was clearly Belgium. At least readers of BioEdge thought so. Of the ten hottest stories we published this year, three were about euthanasia there. Here’s the complete list of our ten most popular stories.
Abbas Khan, 32, from London, was detained by government forces after travelling to Aleppo to work in a field hospital in November last year. Only two days after he arrived, he disappeared into the government prison system. After months of inquiry, his mother found him – he was demoralised and his weight had fallen to 32 kilos. He told her that he had been tortured. Although he knew that he would have been released before Christmas, the Syrian government announced that he had committed suicide.
A new law before the Turkish General Assembly may prevent severely injured protesters from being treated by medical personnel. The draft bill, accepted by a parliamentary commission last week, sets out that where “formal health services” (for example state ambulances) are present, no alternative medical care may be provided for injured people.
Hence, if a state ambulance is present at a protest, doctors and medical personnel may not assist injured participants.
Human rights monitors fear that the law will be used to prevent political dissidents from receiving emergency care. Dr Vincent Lacopino, senior medical advisor at Physicians for Human Rights (PHR), said that “This bill would not only force doctors to abandon their ethical duty to provide care for those in need, but could also have dire consequences for anyone in urgent need of medical assistance.”
Earlier this month an American animal rights group made a push to gain legal recognition for the personhood of non-animals. Representatives from the Nonhuman Rights Project filed three separate suits in New York, in each case claiming that an animal had had his rights denied by his owners.
The first to be lodged was that of Tommy, a chimpanzee, who is being held captive in a cage in a shed at a used trailer lot in Gloversville, NY. In that case, the judge rejected the claim, but expressed his sympathy for the case of NRP.
Judge Ralph A. Boniello said, “I’m not going to be the one to make that leap of faith”, but he said that the arguments of the group were sound and he wished them the best of luck in campaigning for legislative action.
One of the most respected authorities on end-of-life law in Britain has warned politicians not to legalise assisted suicide. Baroness Elizabeth Butler-Sloss, former president of the High Court Family Division, wrote in last week’s Sunday Telegraph:
"Laws, like nation states, are more secure when their boundaries rest on natural frontiers. The law that we have rests on just such a frontier. It rests on the principle that we do not involve ourselves in deliberately bringing about the deaths of others.”
"Once we start making exceptions based on arbitrary criteria like terminal illness, that frontier becomes just a line in the sand, easily crossed and hard to defend."
As the country’s most senior family judge, Lady Butler-Sloss ruled in 2002 that a woman paralysed from the neck down could have medical treatment withdrawn and die peacefully in accordance with her wishes.
The January issue of the journal Bioethics deals with conscientious objection, with an emphasis on the situation in Canada. The editors of the special issue are Carolyn McLeod and Jocelyn Downie who also run the feminist-oriented Conscience Research Group, based at the University of Western Ontario and Dalhousie University.
The articles deal with a range of topics, but all are sceptical of the claims of a conscience which would prevent an objecting doctor from refusing even to refer for abortion. Avery Kolers, of the University of Louisville, argues that “When institutions are – or we conscientiously believe them to be – merely unjust, their directives still obligate us; when they are abusive, however, they do not.” In some cases, dissenters could be granted “licenses” which would allow them to avoid certain obligations (such as abortion, which is not an abusive procedure), but if the institution…
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The panel, dubbed the ‘Conference of Citizens’, was composed of 18 people picked by commercial polling company IFOP to represent the nation.
In its report the panel said that "The possibility of committing medically assisted suicide... is, in our eyes, a legitimate right of a patient close to death or suffering from a terminal pathology, based first and foremost on their lucid consent and complete awareness”. The panel cautioned that this lucidity should be evaluated by at least two doctors.
They also suggested that in some cases, based on advanced directives, euthanasia could be provided for patients incapable of giving direct consent.