Bioethic information and analysis newsletter
N°61 - January 2005
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Bioethic information and analysis newsletter |
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Previous Letter |
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N°61 - January 2005 |
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Disinformation by
numbers
During the discussions on the draft law to legalise
abortions, Madame Simone Veil, in her presentation to the French National
Assembly on 26th November 1974 proclaimed :
« one
cannot turn a blind eye on the 300,000 abortions which every year mutilate
the women in our country, scorning our laws, humiliating and traumatising
those who resort to such a course» (Men
also can remember, ed. Stock 2004, p.40). This figure, which has so
often been used as a reference, influenced the parliamentary vote. It was
in the interest of those in favour of the law to quote a large number of
illegal abortions, whereas now1 a
reasonable estimate of the figure would be between 40,000 and 60,000.
We
have therefore progressed from some 60,000 illegal abortions in 1974 to
over 200,000 legal abortions today, and this figure is stable, or even on
the increase for adolescent abortions. In the 15-nation Europe, France had
the highest rate of abortions, after Sweden…
From contraception to abortion
The
widespread use of contraceptive pills has profoundly modified mentalities ;
we have gone from the child as a « gift of nature » to
« a
baby if I want and when I want » with the following fearsome
consequence : what to do when a child is on the way which was not planned,
is it not an
« unjust
aggressor » ? The establishment of a
« contraceptive mentality », « against life », leads inevitably to the
prospect of abortion:
"I have
a right to get rid of an undesirable which has become a nuisance". It
is easy to see why the numerous campaigns in favour of contraception have
never resulted in a reduction in the number of abortions. Two thirds of
unwanted pregnancies are the result of failed chemical contraception : 60%
of those lead to an abortion (Le
Quotidien du médecin, 30th April 2003). INED confirms : six out of ten
unwanted pregnancies currently end in abortion (four out of ten in 1975)2.
We leave the conclusion to the INED,
« contrary
to a naive idea, women who resort to abortion are not essentially to be
found among the less informed or the least experienced in contraception.
Contraceptive users are in fact the best « customers » for abortions,
because they are by definition the most determined to avoid pregnancy... ».3
Since legalisation …
The law dated 17th
January 1975
legalised abortions up to the tenth week of pregnancy, if the woman is in
a state of distress and the 1st article states : « The
law guarantees respect for all human beings from the very beginnings of
life. This principle must not be jeopardised except in cases of absolute
necessity and in accordance with the conditions specified in the present
law».
In 1982,
the Roudy law authorised the refund of abortion costs and the
1993
Neiertz law crated the offence of obstructing abortions, punishable by 2
to 3 years in prison and a 2,000 to 30,000 franc fine. In
July 2001,
the Aubry law facilitated access to abortions: the period for legal
abortions was extended to 12 weeks, parental permission for minors is no
longer necessary, nor is the mandatory interview for adults. The offence
of obstruction has been extended to include moral and psychological
pressure and the clause concerning medical conscience has been severely
reduced, and even deleted for heads of hospital wards. In
November 2004,
the Minister of Health P. Douste-Blazy signed a decree to authorise
medicinal abortions in the home.
What is the result ?
Today's reality is far removed from the intentions declared by Simone Veil
in her presentation to the National Assembly on 26th November
1974 :
« Although
the law admits the possibility of an abortion, it is intende to be able to
control abortions and as far as possible to dissuade the mother »,
« abortion must remain an exception, the last resort for situations
without a solution » ; « those who do everything to enable these women to
accept their maternity, we shall help in their enterprise» ; « the
government has set itself a triple objective to produce a law which is
truly applicable ; to produce a law which is dissuasive ; to produce a law
which is protective ». « Everything indicates that the adoption of the
draft law will only have a small effect on the birth-rate in France… »
Thirty years later, the number of abortions has
increased by a factor of 4 or 5 ; the information concerning the rights of
young mothers, the possibility of giving birth anonymously, to be able to
have access to associations providing material or moral support, have been
deleted from the preliminary interview. The eight-day pause for thought
has been removed, as has the obligation for a preliminary social
consultation, except for minors. Finally, regarding the birth rate, the
current rate of fertility of 1.89 is inadequate. When the number of births
per year is between 760,000 and 800,000 how can one claim that 200,000
abortions have little influence on the birth rate, when there is a lack of
150,000 births per year in order to ensure the replacement of generations ?
The silence of a shaken society
The
psychological consequences of abortion are beginning to be known and
recognised. Psychologists now refer to the
post-abortion
syndrome of women who have undergone an abortion and the
survivor's
syndrome for youngsters who wonder : "thanks
to which Russian roulette have I come into the world whereas my brother or
sister were not given such chance ?" Men are also sometimes profoundly
hurt by abortions, doctors, medical teams, social workers who, since the
Neiertz law, have no right to intervene to dissuade a woman from aborting
even if she is subject to obvious pressure. All society has been shaken by
this devaluation in the
attitude towards human life.
Thus for 30 years, the debates on medically assisted procreation,
bioethics and now euthanasia are truncated : It is no longer accepted to
question the status of the embryo or the definition of the human being,
for fear of questioning the legitimacy of abortions.
1 –
The
second contraceptive revolution, Cahier de l’INED n° 117, 1987. |
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The January issue of
La Recherche contains a review of the media claims made concerning
human embryonic stem cells (ES cells) and their potential for curing
Parkinson's, Alzheimer's, diabetes or heart diseases and concludes that
« fantasy and reality still remain a world apart »1.
The article reviews the various
research programmes conducted on human embryonic stem cells.
Differentiation of ES cells
The first challenge for
research on stem cells is to control differentiation. Remember that these
cells, which are extracted from human embryos at the blastocyst stage are
multipotent, i.e. they are capable of differentiating into any other type of
cell. The aim is therefore to multiply them before they undergo spontaneous
differentiation, explains Michel Puceat, director of the
« ES cells and heart differentiation »
team at the CNRS in
Montpellier,
« we are still a long way off from being able to direct the subsequent
differentiation of ES cells to a single and unique type of cell ».
Transplanting of ES cells
Once the ES cells have been
differentiated into a specific type of cell, a way must then be found to
transplant them into the body of the receiver, without damaging them.
Several conclusive techniques have been developed (in particular by the
teams led by Michel Puceat – CNRS Montpellier, Philippe Menasché – Hôpital
G. Pompidou Paris ; Lior Gepstein – Haïfa, Israel) :
- Clinical tests
Regarding Alzheimer's disease,
which is often upheld as an example of a disease which can be cured using
embryonic stem cells, the grafting of neurones is currently not envisageable
because the neuronic degeneration spreads too quickly to the entire brain.
The treatment needs to be applied at the very onset of the disease, at a
time when it is still too early to diagnose the illness.
On the other hand, in
Parkinson's disease or in Huntington's chorea, the degeneration remains
localised in a single zone until an advanced stage of the illness. The lost
neurones are located in a zone known as the black substance and grow
extensions into another zone, the striatum where they release dopamine. ES
stem cells could be grafted directly into this striatum where they would
differentiate and release dopamine. Although results have been published
involving rats, « in humans, although
ES cells do definitely provide potential, the process will be much more
complicated » states Philippe Hantraye, central nervous system
specialist at the Frédéric-Joliot hospital at Orsay.
-
Risk of rejection
According to Raphaël Scharfmann,
director of the E0363 unit at Inserm and a specialist in endocrinal organs,
in this field we are « pretty well at
the very beginning ». According to François Pattou, specialist in cell
therapy at the University of Lille and at Inserm, the major obstacle is the
rejection of grafts, which may not be overcome with stem cells. Nevertheless
the team led by Michel Puceat has conducted cardiac grafts of ES cells
between animals of the same species and between animals of different species
without observing any rejection problems. According to him, it is essential
to « precisely define the
immunological characteristics of ES stem cells ».
-
Creation of lineages of ES cells
bearing a genetic anomaly
on order to construct a human model of diseased cells instead of using a
lineage of embryonic mouse cells converted with the mutated human gene .
- Use of ES lineages on man
The switch to humans is likely to be
difficult due to the very production and preservation techniques of the
lineages, preserved from an animal matrix (mouse fibroblasts and bovine
foetus serum) which prevents their use on humans for sanitary safety
reasons. Teams claim to have bypassed the problem by establishing new ES
lineages on human feeder cells as opposed to animal cells.
This article, which
is based
on many experiments in progress shows the complexity of the research on
embryonic stem cells. Although certain studies have proved conclusive in
animals, they are far from being applicable to humans. To speak of therapy
using human ES cells still remains the domain of science-fiction...
Although it is not the subject
of the article in La Recherche, it
should be remembered that an alternative to research on embryonic stem cells
is research on adult stem cells. These cells, in addition to the fact that
their use does not present any ethical problems, have shown their
multipotency
and their therapeutic capabilities for the repair of cells in the context of
clinical tests involving humans, (cf. Gènéthique No. 49).
Without wishing to rekindle the debate on
so-called therapeutic cloning, claimed by certain research scientists to be
an endless source for the production of ES cells. Since the technique for
cloning is not mastered, increasing numbers of research scientists have
abandoned the term therapeutic cloning
and now use the term research cloning.
This term was adopted by UNESCO in its document
"Human cloning" issued in 2004
which states that
"since the notion of therapy
suggests that cloning may have beneficial applications, which appears today
to be completely unjustified, it is more appropriate to modify this positive
term and to use instead a more neutral term, Research Cloning."
1 - La Recherche,
C. Klingler « Stem cells,
embryonic results », January 2005.
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