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Abortion in Switzerland
In 1982, abortion reimbursement was imposed to private health insurance
companies on presentation of a double medical opinion. Since 1 October 2002,
a mere signature of the mother allows abortion until the 12th week and
further, a single medical opinion is enough until the day before birth.
Moreover, minors under 16 can abort without parents’ agreement.
The real cost of abortion
Since 1988, Pro Life, an association from Switzerland, made an
economical demonstration that members are real risks for health insurance
companies. This way, Helvetian health insurance companies propose to reduce
from 10 to 40% premiums of complementary insurance for policyholders who
refuse abortion and eventually medically assisted reproduction. The
demonstration is made: people attached to respect of life have behaviour
that enables savings in health field. Actually, the cost of abortion does
not only consist of the act itself. International scientific studies
recently published deserve attention. After abortion, women’s mortality rate
globally increases by 60% in the following years, high prematurity increases
by 70%, other researches indicate a high recidivism rate for abortion1.
A responsible behaviour
Pro Life members are aware faced with the trivialization of abortion
and the rise of health expenditures: they commit themselves to refusing
their right to a possible abortion reimbursement offered by the base
obligatory insurance and to promoting respect of life at every stage.
Besides savings directly linked to abortion refusal, it was observed that
generally pro-life members smoke less, drink less and are less depressed.
The two more important Swiss health insurance companies are interested in
pro-life members with a number continuously increasing.
Since 2004, Helsana and CSS groups offer them, via their partner funds
SANSAN and Auxilia, their non-obligatory complementary insurances, with a
preferential price.
Conscientious objection
Josef Zisyadis, national counsellor of the Popular Worker’s Party (POP),
this spring, submitted an urgent proposal aimed at banning the insurers to
concede « ethical » discounts. The Federal Council (Swiss high
political authority) has just declared, on 30 May 2006, that there is no way
of calling the principle of conscientious objection into question; as it
happens, anybody has the right to refuse for himself a benefit from base
obligatory insurance. In another hand, it confirms the liberty for health
insurance companies to retrocede savings coming from a more responsible
behaviour at least for private complementary insurance companies.
1. Deaths associated with Pregnancy
Outcome: a Record Linkage Study of Low Income Women, Reardon et al. Southern
Medical Journal, vol. 95, n°8, August 2002. |
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Every
year, 12,000
in vitro
fertilizations are performed in Belgium, between 2,500 and 3,000 children
are born with these techniques and 3,700 out of 10,000 couples concerned,
come from abroad. However, until now, reproductive medicine and human
genetics were not object of a specific legislation, except two royal orders
concerning standards of the centres for medically assisted procreation (AMP)
and reimbursement modalities for in vitro fertilizations. The Belgian
Senate has just voted the first law which organizes the MAP and the text
should be definitive before the end of the current legislature.
To supervise the practices
The bill
deals with « author(s) of the parental project », a vague notion
concerning all couples, married or not, heterosexual or homosexual as well
as singles. It fixes an age limit for women: 45 years maximum for oocyte
sample and implantation; 47 years for embryo implantation and insemination.
Minor patients (under 16) are excluded, unless medical exception (for
instance, a young woman with cancer who wants to preserve her oocytes before
a chemotherapy treatment). It authorizes pre-implantation diagnosis and the
conception of “designer baby”.
Then, the text authorizes implantation and post-mortem implantation of
supernumerary embryos if the father agrees as long as he lives.
Children: subject of a convention
The law
foresees a convention between patients and centres for MAP, specifying their
identity, age, address and the method used. The status of supernumerary
embryos is mentioned, especially to settle awkward situations as a
separation, an insolvable difference of opinion between the authors of the
parental project, the death of one of them: cryopreservation during 5 years
(except derogation), affectation to research or donation. 24,000
supernumerary embryos are frozen each year. In fact, research on
supernumerary embryos and the creation of embryos for research are
authorized in Belgium since May 2003.
The costs of MAP in Belgium
The cost
of IVF is covered for people with complementary private health insurance in
Belgium, including for homosexual persons. Each treatment costs 1,587 euros
per cycle of which €170 must be paid by the patient. A woman can have a
maximum of 6 IVF treatments. For
2001,
medically assisted reproduction cost
20 million
euros
for 9,462 cycles with “fresh” embryo transfer and 2,410 cycles with frozen
embryo transfer, 452 oocyte donations and 48 embryo donations. The success
rate of an IVF is 20%. Regarding inseminations, 800 sperm inseminations with
donor have been reported in 2002; the financial compensation is 50 euros per
donation and the global price to access the sperm bank is 600 euros.
The limits
Besides
limits related to women age, the bill bans the simultaneous implantation of
embryos coming from different donors of supernumerary embryos. It foresees
that supernumerary embryos of a same donor or couple of donors cannot lead
to childbirths in more than six different women. On the other hand, the law
does not limit the number of oocytes that can be fertilized and even
promotes the production of supernumerary embryos needed for research.
The questions in discussion
concerning the rule of anonymity of the donor that opposes the “right”
of the child to know its origins and the possibility of pairing (consisting
in researching physical characteristics close to foster parents) which could
not be considered as a practice with eugenic character. Finally, surrogate
maternity (surrogate mother) is not mentioned nor prohibited.
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