A Guide: why?
A few months after the revision of the laws of bioethics of 2004, planned
for end of 2009 or beginning of 2010, some people are very interested in
these delicate subjects and others avoid them thinking that "it is too
complicated for me" or "all is already done, so what‘s the point?".
It is true that the revision of 2004 was not an example of democratic debate.
Yet, this time some signs let hope the debates will have another tone and
the Guide politique de bioéthique (Political Guide of bioethics)
published by the Association for the Foundation of Political Service in June
2008, proposes us to decode them. Under the direction of Elizabeth Montfort
and Pierre-Oliver Arduin, the file is enriched with numerous philosophical,
scientific or legal contributions. The persons who collaborated: Nicolas
Forraz, Henri Bléhaut, Jean-Marie Le Méné, Tugdual Derville, Nicolas Mathey,
Aude Mirkovic, Miroslaw Mikolazic and Jean-Frédéric Poisson. This Guide is
aimed at enlightening the citizen and at helping him to fully participate in
a debate which must not be confiscated by the legislator and the scientists.
To really build the debate, it is useful to dare to ask various fundamental
questions: what is bioethics? Why a revision every five years? Is the object
of these laws to better protect the human being or, at the contrary, to open
new breaches in the wall of protections that the law has always guaranteed?
Today the law follows the habits and the progress decides for the human
person. Yet, is it correct to say or to let people say that the legislator
and the scientist would have the "right to a child" and "the right to health"?
Ambiguities
From the ambiguity of the word "bioethics" developed by Elizabeth Montfort,
to the confusion of words described by Jean-Marie Le Méné, the reader says
that it is now time for him to try to enlighten it, if she/he wants to
assume his elector liability. Because the relationship between words and
things reveals the intentions of the one who talks or writes, the elector
must be informed. Jean Marie Le Méné mentions the "fighting words"
which are empowered to not only describe the reality but also to create it.
The best examples being the abortion transformed into VTP or MTP, and of
course cloning called "therapeutic" to try to make it accept whereas it is
not therapeutic at all. Tugdual Derville mentions the French "quicksand"
which makes the debate difficult and sometimes impossible, in particular on
the questions of medically assisted procreation (MAP). Too often, the
appearing "good feelings" are sacrificed to bury the thought, the affect
prevailing over the rational, regardless of the biological or psychological
reality. Nicolas Mathey, in his legal analysis, notes that the law of 2004
is very ambiguous and that it contains numerous inconsistencies which lead
it to prevaricate the reality and the scientific results. Idea also
developed by Aude Mirkovic who shows that some practices are authorised by
law whereas others are not, without understanding what justifies the
accepted solutions. The Council of State recognises itself that "the
current texts have difficulties (...) to find a total internal
consistency"2. The research on embryo is an evident example
and the chapter dedicated to the status of research on cord blood and adult
stem cells by Nicolas Forraz illustrates it in a good way.
Embryo: human being, person?
Obviously everything relies on the respect we give to the embryo. Human
being? Human person? Doctor Henri Bléhaut, invite us, on the scientific
level, to consider the humanity of the embryo. It is not a question of faith
nor the result of a philosophic demonstration, but only the evidence of a
reality of a being that exists, biologically, physically and regardless of
us and of the name we want to give it.
And to know if it is a person, Aude Mirkovic wonders: "why when it deals
with the embryo, we think that we have to decide if it is a person or not?".
As if we mistake too often the notion of human person for the legal person.
The legal personality "does not exhaust" the entire human person. Then, it
is advisable to wonder: Do we want a society where some human beings would
not be recognised as human persons?
Reversing the burden of proof
Jean-Marie Le Méné shows how the defenders of the embryo would take
advantage to refuse proving the evidence. "To those who require a proof
in due form of the humanity of the embryo, answer that by principle you
refuse to follow this way. Take refuge with insolence beyond Aristotle’s
words: "It is to be a boor not to distinguish between what requires a
demonstration from us, and what, at the contrary, exempts us from it"".
At the contrary it is the one who wants to destroy the embryo who have to
prove first that the embryo is not a man. But, it is impossible.
Bioethics and law
The contribution of Miroslav Mikolzik, European deputy and member of the
Environment, Public Health and Food Safety commission, shows how these
debates are lively in France and in Brussels. The Resolution on the trade of
human oocytes and the vote for the 7th Frame Program for research and
development generated lively ethical discussions in the European hemicycle.
Finally, most of the Parliament voted in favour of financing research on
embryonic stem cells.
What’s the point in France? Jean Frédéric Poisson, deputy of the Yvelines,
shows us that bioethics is a real political issue with the meaning of
Georges Pompidou: The peculiarity of the political responsibility is only to
choose between disadvantages. But "bioethics – as various other fields
with heavy symbolic meaning – asks for the affirmation of limits, because
humans must understand, including by the law, their conditions and
requirements".
1- Guide Politique de bioéthique, Association pour la
Fondation de Service Politique, Editions Privat, juin 2008
2- Réflexions du Conseil d’Etat sur le droit de la santé, Rapport public,
1997, La Documentation française, Etudes et Documents n°49, p.286
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British deputies adopted, in a
tense atmosphere and after several hours of lively debate, at the end of
May, a new law on human fertilisation and embryology.
Abortion
British legislation – the most liberal in Europe – authorises the voluntary
termination of pregnancy (VTP) until the 24th week of pregnancy. Deputies
rejected the amendment supported by more than 200 members of English
Parliament from different political parties and health specialists,
gynaecologists and obstetricians, who aims at reducing this time limit to 20
weeks and which settled a 10-day period of reflection after a woman decides
to abort so that she can be advised and informed, in particular about the
risks. Former nurse at the origin of this amendment, the deputy Tory Dorries,
underlined the fact that a growing number of babies survive at 24 weeks at
least. "Now we are in an absurd situation where physicians fight to save
premature babies at a certain place of the hospital, and others terminate it
in another place, at the same duration of pregnancy." Prime Minister,
Gordon Brown, was opposed to a modification of the law on this point.
Civil status: facultative father
At the same time, deputies voted, with 290 votes against 222, that the name
of the father on the insemination application form and on the registry of
birth is not obligatorily written. From now, another name than the father’s
one can be written. Health Ministry, Dawn Primarolo, indicated that this
measure "will concern all persons who search a treatment, for people of
the same gender, lone women or heterosexual couple".
Selection of embryos
Then the Parliament authorised the parents of children with serious diseases
to select the embryos, according to their gender, to serve as a graft for
their ill brother or sister.
Man-animal hybrids
Finally deputies approved the creation of man-animal hybrid embryos, coming
from the integration of human DNA into animal oocytes. Conceived for
research purposes, these hybrids must be destroyed after 14 days of
development and cannot be re-implanted. We remind that this practice has
already been authorised, in last September, by Human Fertilisation and
Embryology Authority (HFEA) and that two laboratories have a licence to
conduct these researches.
From the beginning of July, HFEA gave the green light for the creation of
man-pig embryos. After the man-cow and man-rabbit embryos, it is the third
kind of hybrid embryos authorised in Great Britain.
The Catholic Church, and the deputies of the opposition, denounced a "Frankenstein
experience". The bishop of Edinburg, Keith O'Brien, talks about "a
monstrous attack against man’s rights and human dignity". His Eminence
Elio Sgreccia, as President of the Pontifical Academy for Life, declared
that this measure was particularly serious at the ethical level as "it
constitutes an offense to the man dignity", "it is an offense to the
fertilisation between species, which until now was prohibited by the laws on
artificial fecundation".
The supporters of this interspecies engineering put forward that, enabling
having embryonic stem cells in the genotype at 99% human, they will
facilitate the researches of treatments for some affections like
mucoviscidosis or Alzheimer’s disease. H.E Sgreccia was against this "media
lie" which does not rely on "any scientific foundation", calling
"not to create, in the name of human compassion, illusions, on ways which
yet did not lead to any result".
Thus, in the name of a theoretical therapeutic advance, the barrier which
separates the human species from the others has just collapsed: Today, there
is no positive clinical trial on man using human embryonic stem cells
compared to cord blood and adult stem cells. There are various scientific
obstacles before human embryonic stem cells are authorised for a possible
clinical use. How to make believe that man-animal hybrid embryonic cells
would be more compatible with man?
If today such researches are prohibited in France, Ministry for Research,
Valérie Pécresse, declared, in last September, following the authorisation
granted by the HFEA, that she wished "that the Agency of Biomedicine
treats right now the ethical issues that the British decisions creates,
particularly as they "could emerge within the framework of the revision of
the law of bioethics foreseen in 2009". On the eve of the Convention of
bioethics which will prepare, from the beginning of 2009, the revision of
the law of 2004, it is necessary to stay vigilant…
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