10 reasons for a No to the Reproductive Medicine Act, RMA

cc. 11 month ago, after Article 119 paragraph 2c of the Federal Constitution had been modified and the “reproductive medicine and genetic technology in humans” within the federal constiution had been readjusted, the Swiss electors will now vote on the law (Reproductive Medicine Act) on 5 July 2016, which follows this constitutional amendment. Certainly, this bill exceeds the original suggestion by the Federal Council on behalf of the translation of the constitutional provision by far.
By their campaign, the opponents of this law address the dubious global trend towards a reprodutive medicine without any ethical limit. To name only one example: In Great Britain embryos are already genetically modified and embryos are being produced that possess the genomes of three parents.
In Switzerland, things have not yet gone as far as that. Nevertheless, the endorsement of the RMA would lead to a dangerous establishment of a selection mind-set that might gradually be extended. Added to this, the correct usage of the PGD-techniques in the field is barely manageable.
The endorsement of the revision of this law would fundamentally change our attitude towards life. For that reason, a strong resistance has been established. A non-party committee consisting of 50 members of Parliament from BDP, CVP, EDU, EVP, Green Party, SP, and SVP has amalgamated to the nationwide non-party committee “No to that RMA”. This committee assesses the new RMA as extreme, dangerous and uncontrollable. Moreover 19 socially engaged organisations and among them nearly all handicapped-organisations have allied in the committee “Vielfalt statt Selektion – Nein zum Gesetz“ (plurality versus selection – No to the law) and further opponents in the committee “PID stoppen” (Stop PGD). Also the Swiss Episcopal Conference (“Im Namen der Menschenwürde nein zur Präimplantationsdiagnostik”; [In the name of the human dignity no to the PGD] from 26 April) and the Federation of Swiss Protestant Churches (SEK) (“Fortpflanzung um der Kinder willen”; [Reproductive medicine for the sake of children] from 26 April) reject the law clearly. In the following, we publish the short line of arguments “10 reasons for a no to the revised FMedG”(source: www.fmedg-nein.ch )
 

1. The RMA leads to unlimited selection

A genetic test provides all possible information about an embryo (among others also sex). Therefore there are also test results which should not be used for selection.
Therefore, this technique can and will lead in time to improper selection. This is confirmed by the Federal Council: “From procedurally inherent reasons it can no longer be guaranteed that only embryos with features for serious hereditary diseases will be eliminated”.1 For reproductive physicians being faced with numerous desires, the scope of action is becoming dangerously wide. The new RMA is also designed in a manner that independent controls are hardly provided and that reproductive physicians are even able to “control” themselves against payment by the federal government (Art. 12.4). Should the door really be opened to this uncontrollable technology?

2. The RMA definitions are extremely imprecise and broad

Not only does it allow the PGD for couples with a sever genetic disease, it goes much further beyond that, since PGD procedures are available for all couples who make use of in vitro fertilisation (IVF). This can lead to a general test for normality! At no point you can find the meaning of “recognition of chromosomal features, which can harm the development of the embryo” (Art. 5a) . Who will be the one to decide which features are relevant for a selection? In addition, it is nowhere put down which genetic diseases are “worthy” for selection.

3. A dangerous development

Global trends on the field of reproductive medicine augur ill. In Great Britain, for instance, the Human Fertilisation and Embryology Authority (HFEA) has already approved of the genetical manipulation of countless embryos. Also embryos with the genome of three parents are being produced and inserted. In addition to that the list of allowed selection criteria are being extended by dozens of genetic diseases – also by such that enable its carrier to have a good quality of life …
The mania for feasibility must be ethically and legally be contained. What is a no-go today, will be possible tomorrow and declared even as natural the day after tomorrow.

4. Ethical and constitutional dam break

The RMA leads to a fundamental change in dealing with human life. For the first time, human life in the initial stage would be evaluated and commercialised. Therefore, the rejection of the Reproductive Medicine Act is not only a matter of human dignity, but also  a question of justice. Who has the right to say: “Because you are no ‘Top Embryo’, you cannot go on living?” Even the Federal councillor Alain Berset points out that the law has an eugenic tendency. Do we as a society really want to follow this path and engage us in such a selection mentality?

5. Solidarity with disabled people at risk

If you systematically start to eliminate embryos, the solidarity with disabled people or those who do not meet the social norm is endangered. It is not acceptable that parents are increasingly susceptible to pressure of justification to do everything technically feasible to “prevent” a child with a disability or illness. Once people with disabilities are perceived as an avoidable burden of society, refusals by the social welfare may be a logical consequence.

6. Countless surplus embryos and risks for women

In order to give birth to a single child by means of a PID process, about 30 embryos on average have to be produced according to the latest statistics.2 But there is more to it than that: For the production of over 30 embryos more than 50 egg cells are again needed. In order to win as many egg cells, women must undertake several treatments and are particularly strongly stimulated hormonally (hyperstimulation). However, hyperstimulation may lead to significant health risks.
A consequence of the new law would also be an accumulation of thousands of supernumerary embryos. According to the law, the embryos should have to be discarded after at least 10 years or should be provided for the use in research and pharmaceutical industry.

7. Business with couples’ hope for a healthy child

Different studies reveal that the chances to get a healthy child by vitro fertilisation are significantly lower, when the embryo has been checked on chromosomes beforehand.3 The European Society of Human Reproduction and Embryology (ESHRE) notes that the positive effect of PGD by using Aneuploidy-Screening (chromosome analysis) has not been proven yet. This doubtful method raises false hopes in infertile couples.

8. Prenatal tests: No basis for the unrestricted selection of embryos

The proponents for the new Reproductive Medicine Act argue that it would be better to test embryos using PGD and to weed out, instead of performing an abortion later (after a prenatal test, PND). But the PGD process is anything but safe and risk-free. Follow-up exams of IVF children show that these are more prone to have risks for premature arteriosclerosis, high blood pressure, abnormal heart function and rare forms of cancer at a young age.4 The physicians for reproductive medicine rarely inform about these risks. The PGD process additionally exacerbates these risks.
It is also wrong to do prenatal tests as a justification for the unrestricted selection of embryos. As with a striking test result during pregnancy a pregnancy conflict may occur all, too frivolous decisions are possible using PGD. The PGD is a technical selection process, where the laboratory decides between “worth of living» and “not worth of living”. Only that embryo is selected which meets the demands and complies with the “standard”.

9. Rather healing than sculling

The medical task mainly involves the prevention and cure of diseases and the alleviation of suffering where no cure is possible. The creativity of science is inhibited by the Reproductive Medicine Act, because instead of research for new therapies, any disabled and sick people would be sorted out. Not the suffering would be alleviated, but the suffering person itself would be prevented.

10. Draw responsible limits

Even if in some places abroad large selection is done already, this does not mean that we have to commit the same mistakes in our country. A “No” enables a broad social debate on a more restrictive law.

NO to RMA on 5 June 2016

1    Rexhaj E. et al., Assisted reproduction: a novel cardiovascular risk factor. Cardiovasc Med 18 (2015) 115–119. “Fertility treatment and childhood cancer risk: a systematic meta-analysis.” Hargreave, Marie et al.; Fertility and Sterility, Volume 100, Issue 1, 150–161,  July 2013 see www.srf.ch/sendungen/puls/sendungen (15 Feb. 2016)
2    De Rycke M., Belva F., Goossens V., Moutou C., SenGupta SB, Traeger-Synodinos J., Coonen E., ESHRE PGD Consortium data collection XIII: cycles from January to December 2010 with pregnancy follow-up to October 2011. Hum Reprod 30 (2015) 1763–1789
3    Harton G., Braude P., Lashwood A., Schmutzler A., Traeger, Synodinos J., Wilton L., Harper J.C: ESHRE PGD consortium best practice guidelines for organization of a PGD centre for PGD/preimplantation genetic screening. Hum Reprod 26 (2011) 14–24, quotation: “Current evidence suggests that PGS at cleavage stages is ineffective, but whether PGS at the blastocyst stage or on polar bodies might show improved delivery rates is still unclear.” Scott KL, Hong KH, Scott RT Jr., Selecting the optimal time to perform biopsy for preimplantation genetic testing. Fertil Steril 100 (2013) 608–614, quotation: “Two of every five that have day-3 blastomere biopsy will be harmed to a sufficient extent to yield them incapable of implanting and progressing to term.”
4    Rexhaj E. et al., Assisted reproduction: a novel cardiovascular risk factor. Cardiovasc Med 18 (2015) 115-119. “Fertility treatment and childhood cancer risk: a systematic meta-analysis.” Hargreave, Marie et al.; Fertility and Sterility, Volume 100, Issue 1, 150–161, July 2013    
    Further information: www.vielfalt-statt-selektion.ch  and www.pid-stoppen.ch