A clear “No” on pre-implantation genetic diagnosis

A clear “No” on pre-implantation genetic diagnosis

Federal referendum on 14 June 2015

by Dr med Susanne Lippmann Rieder

On June 14, 2015, the Swiss people will vote on the question whether Art. 119 of the Federal Constitution should be amended, so that in future embryos can be produced in an undefined number outside the mother’s womb, without having to be implanted immediately after their creation. This constitutional amendment provides the basis for the approval of pre-implantation genetic diagnosis (PGD), which is currently prohibited in Switzerland. The amendment, which at first glance seems to be insignificant, is vaguely formulated and concerning the Implementing Law of Art. 119, the Reproductive Medicine Act (FmedG), it includes a large scope for the selection of life “worth living” and “not worth living” and the possibility of unlimited production of embryos. On 14 June, we can and must stop this dangerous trend with a No!

Valid:
Art. 119 BV is constitutional basis
–    For artificial insemination (in vitro fertilization, IVF)
–    For the ban of pre-implantation genetic diagnosis
The Implementing Law, Reproductive Medicine Act
–    Governs the IVF in detail
–    Limits the production to a maximum of 3 embryos
–    Bans the cryopreservation (deep-freezing) of embryos

Proposed constitutional amendment – Art. 119 para. 2c and proposed amendment to the Reproductive Medicine Act

The constitutional amendment of Art. 119 para. 2c and the change of the Reproductive Medicine Act were discussed in Parliament at the same time, aiming at the permission of pre-implantation genetic diagnosis in Switzerland. With respect to the two bills there is only one message of the Federal Council: “13,051. Message on the amendment of the constitutional provision on reproductive medicine and genetic engineering in human medicine (Art. 119 BV) and of the law on reproductive medicine (pre-implantation genetic diagnosis) of 7 June 2013.”
On 12 December 2014, the Parliament adopted the Federal Council’s alternative to the constitutional amendment. We will explain in more detail below, what the amendment of this nondescript half-sentence means.
However, when changing the Reproductive Medicine Act (rFMedG), the Parliament opened the barrier originally set by the Federal Council: In its draft law, the Federal Council wanted a restriction of pre-implantation genetic diagnosis for couples with hereditary handicap; i.e. PGD only for hereditary diseases (50 to 100 couples per year), not for chromosomal abnormalities. And he set a limit for the production of embryos outside the woman’s body: 3 embryos, if the genetic material of the embryos is not being examined, 8 embryos if the genetic material of the embryos is being examined. The rFMedG, now adopted by Parliament, goes far beyond the practice in our neighboring countries:
–    It allows genetic testing for the examination of hereditary diseases and chromosomal abnormalities for all couples making use of IVF (today more than 6,000 per year).
–    It increases the scope for embryos produced outside the body to 12 per cycle (an open number upwards was still rejected).
The ban on cryopreservation was revoked according to the proposal of the Federal Council. This is essential for the so-called storage of embryos.
This means: In the future, in principle all embryos created outside the mother’s womb could be examined and selected in the test tube by means of all technically available genetic tests! And a huge number of so-called supernumerary embryos would be created. What for?
The parliamentary debate was marked by a huge commitment in favour of the constitutional amendment and the revision of the law on the part of Felix Gutzwiller, responsible President of the Commission for Science and Education of the Council of States. Considering the controversial debate, it is amazing how rapidly this “business” has been adopted, namely after ¾ years and already after the second round. It remains an open question, what has been the reason for the Council of State’s change of mood, that, as premier legislative body, voted against an expansion of FMedG. What is certain is that the committees were repeatedly visited by advocates of a so-called liberal regime of reproductive medicine and that also the opinion of the National Advisory Commission on Biomedical Ethics has contributed to this change of mood.
If the people and the Council of States say No to the constitutional amendment, the changes of the FmedG, as already adopted by the Parliament, will not enter into force, that is, that the ban on pre-implantation genetic diagnosis will persist. Thus, all those who work for a reproductive medicine à la “liberal eugenics” or those who want to especially gain commercial benefits, would not be supported by the Constitution.
If the constitutional amendment was accepted, the Federal Council would enact the revised Reproductive Medicine Act (rFMedG), unless the referendum would be taken up against this amendment. Several organizations have already announced that the referendum would be taken up. We can not allow to have a law in our country that would allow the eugenic selection and destruction of unwanted embryos!
Therefore, with a No to the constitutional amendment of Art. 119 on 14 June, you will also say No to one of the most far-reaching laws on reproductive medicine in Europe.    •

Federal Constitution Art. 119, par. 2c  Yet:
“[...] no more human egg cells may be developed into embryos outside a woman’s body than are capable of being immediately implanted into her”. Proposed amendment: “[...] no more human egg cells may be developed into embryos outside a woman’s body than are necessary for medically-assisted reproduction”.


What is pre-implantation diagnostics?
Pre-implantation genetic diagnosis (PGD) is the genetic profiling of an embryo formed by in vitro fertilization prior to implantation into the uterus. For this, 1-2 cells are taken by biopsy from the embryo in the 6-8 cell stage and subsequently examined in a laboratory. Thus it is possible to find out if the embryo is carrying a congenital disease or some modification of the chromosomes. This facilitates the selection of the child’s sex or other inherited features. PGD can also be used for the creation of a so-called “saviour sibling”, a genetically compatible donor of stem cells for an existing affected child.


As a physician I am warning of the usage of genetic tests, be they for prospective parents, interested singles or unborn children: there is an error rate, both for so-called false positive and for false negative results. And the tests are misleadingly supporting the idea of having everything under control. In Great Britain, for example, there are so-called assay kits searching for 250 or even 448 diseases. Which of them should “justify” elimination? And the list is growing and growing.


What is eugenics?
Eugenics is the ideology of improving the genetic endowment of human population through the selection of supposedly healthy and valuable humans.


What happens to the tested embryos?
Only the “desired” embryos will be implanted into the mother’s womb after the genetic tests (in most cases on the 5th day after fertilization) or frozen as spare. The deep frozen spare embryos can be used for another pregnancy. Or they can, according to the “Stem cell research law” (originally “embryo research law”), be used for the isolation of embryo stem cells – that is, also for research – if the affected couple has approved this in writing. “Undesired” embryos are destroyed – we are not aware of any legal foundation for this.


In principle, the rFMedG law already passed by the parliament would allow to examine and select all in vitro fertilized embryos with all available genetic tests. Thus there would be embryos with “desired” genome which are either implanted into the mother or deep frozen. And there would also be embryos with “undesired” genome who are singled out and discarded (?) in a laboratory.

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