Law of Bioethics: 1st reading in the French National Assembly

On 15^th February, 2011, MPs have adopted, in first reading, the bioethics bill with 272 votes against 216. Let’s go back to the main provisions of the text which will be submitted to the Senate before the summer.

 

 

Against the government opinion, MPs have opened the organ donations between living beings to “any person having a close, stable and proven affective relationship with the receiver.” Until today, these donations were limited to a strictly familial framework.

 

 

MPs have adopted the amendment 70 according which the PND can only be proposed “when the medical conditions requires it“. The bill foresaw a systematic generalisation of the PND by proposing it to all pregnant women. On this theme, the MP Marc Le Fur has extensively intervened, by talking to his peers on the capacity of our society to consider the vulnerability, to welcome and accompany vulnerable persons: “we will be judged and the degree of civilisation of our society will also be judged to this regard“. Bernard Debré has insisted, for his part, on the risks inherent to the systematic screening.

Several amendments foreseeing, when the risk of particularly serious affection has been proven, to give to the pregnant woman a list of specialised associations have been discussed at great length. Here the challenge was to rebalance the information given to women and couples so that they make the good choice. Finally it is the one submitted by the rapporteur Jean Léonetti which has been adopted.

The amendment by Paul Jeanneteau proposing, after the announcement of a documented risk of a particularly serious affection affecting the foetus, a one-week reflection period to the pregnant woman before deciding to terminate or to carry on with her pregnancy, has also be accepted.

Finally, an article has been added, at the initiative of Dominique Souchet, according which, “within one year from the publication of this law, the Government delivers its report to the Parliament concerning the financing, particularly public, and the promotion of medical research for the treatment of Down syndrome“.

 

 

MPs voted against the lifting of anonymity of gamete donation. On the other hand, gamete donation by women and men without children was authorised. Concerning the processes used within the framework of the MAP, the ultra-rapid freezing (vitrification) of oocytes is authorised.

An amendment, adopted by the special Commission and presented by the MPs Jean-Sébastien Vialatte, Olivier Jardé and Jean-Luc Préel, foresaw to limit to three the number of embryos conceived during an in vitro fertilisation process in order to “avoid a too big number of supernumerary embryos“. But in plenary session after a lively debate, this provision has been rejected.   It has been replaced by an amendment of Jean Léonetti stating that the number of embryos conceived “is limited to those strictly necessary to the success of the medically assisted procreation, taking into account the implementation process“.

The access to MAP remains prohibited for homosexual couples and single women. Jean Léonetti noted that “medically assisted procreation is only made for medical infertility“. Transfer of post-mortem embryos was authorised and this against the government opinion. Finally, surrogacy remains prohibited.

 

 

Fundamental challenge of this bill and divide between the majority and the opposition, the research on the embryo was subject to a particularly lively discussion, retaining MPs in the hemicycle until 4 a.m. It was about either maintaining the prohibition principle with derogations as the bill foresaw it, or to move to an authorisation scheme. Without satisfying all present MPs, the compromise of the prohibition principle with derogations prevailed. Let’s note that several amendments applying for the total prohibition of this kind of research had been submitted by around thirty MPs, among whom Marc Le Fur, Xavier Breton and Jean Marc Nesme. Thus the adopted text recalls that the prohibition of researches on human embryo while adding that these researches “can be authorised when they are liable to allow major medical advances and when it is impossible, in the state of the scientific knowledge, and provided that is expressly established, under the control of the Agency of Biomedicine, the impossibility to reach the expected result through a research without using embryonic stem cells or embryos“. Thus the 5-year moratorium was removed and the derogation conditions extended: the foregoing condition of “major therapeutic advances” was replaced by the less restrictive one of “major medical advances “.

During the debate, M. Le Fur denounced the hypocrisy of the formula: “the affirmation of a principle just represents the mask we wear to organise the derogation”. “The real debate is: either the embryo is a human becoming, and in this case, the research with destruction is not legal, (…), or it is not a human being and in this case, the logics can be the one of the authorisation“. He noted that on 20^th September 2010, Europe had in a directive (EU 2010-63), prohibited the research on the embryos of great apes.

From their hand, Xavier Breton and Dominique Souchet recalled that no relevant scientific result has been reached with these researches and that, since 2004, “alternative methods have been discovered, for expectation of therapeutic applications with adult stem cells and cord cells, as well as for pharmaceutical research, with induced pluripotent cells”.

Jean Léonetti and Xavier Bertrand recalled that those who call for an authorisation scheme -Marc Peschanski and Philippe Menasché – recognised within the framework of the information mission on the revision of the bioethics law, that the provision of the law of 2004 never disturbed the researchers. During his hearing, P. Menasché indicated that he wanted an authorisation scheme to allow a more important commercial and industrial development.

 

 

If the majority widely approved the text, more than 70 MPs (UMP, NC and MPF) refused it. Among them Marc Le Fur, Hervé Mariton, Christian Vanneste, Philippe Gosselin, Jean-Marc Nesme, Xavier Breton. J.-M. Nesme explained the reasons of his vote: “I voted against the hypocrisy of a text that prohibits the research on the embryo while authorising derogations, against the ambiguity of a text which tends to organise a State eugenics in case of prenatal diagnosis (…). I also voted against the silence of a text on the possible conflicts of interests between the scientific community and the pharmaceutical industry. From their hand, Véronique Besse and Dominique Souchet (MPF), estimate that “the few amendments adopted in session do not reach to hide the scale of the new transgressions contained in the text. They refuse the approval of the oocyte vitrification, which will “allow increasing more the number of frozen human embryos in our country” and “encouraging the drifts to eugenics”. Finally they denounce the provisions of the research on the embryo: “Only the ideological considerations and financial interests which have nothing to do with the needs of the science could inspire the maintenance and the expansion of this experiment.”