A new form of inequality?

The new law envisaged to allow for embryo freezing will not include specific criteria about which embryos are to be implanted and which embryos are to be frozen, according to Parliamentary Secretary Chris Fearne (Xarabank, November 13, 2015). No choice will be made according to gender, eye colour etc.

However, we would like to point out that there will still be a form of selection: some embryos will be offered a chance of life by being implanted in the security of their prospective mother’s womb, while others will be stored in the freezer. This can be considered as an unfair treatment of offspring and siblings. They are not being treated equally.

The laws of Malta recognise the embryo as a person (Article 43 of the Civil Code) and classifies him/her under the category of a “child” (Article 128A).  Apart from their legal status, embryology books confirm that embryos are human beings. “The development of a human being begins with fertilisation, a process by which two highly specialised cells, the spermatozoon from the male and the oocyte from the female, unite to give rise to a new organism” (Langman, Jan. Medical Embryology. 3rd edition.

Baltimore: Williams and Wilkins, 1975, p.3) The small size and different appearance of these male and female embryos does not make them less human or less important. Their vulnerability should urge us adults, to offer them love and protection. The current proposed law changes can easily convey the inherent message that not everybody’s life is equally important but rather, that some lives are more important than others.

In all this discussion about freezing, we can also fail to realize what it means to have human life stored in a freezer. The frozen embryos will be exposed to a number of health, safety and environmental risks.  Dr Maureen Wood, research embryologist in the Department of Obstetrics and Gynaecology, Aberdeen, in her article: Embryo freezing: is it safe? states that “Embryos may be damaged by the processes of freezing and thawing or by technical or human error. There is also a remote possibility of contamination with pathogens (bacteria, viruses etc) during storage in liquid nitrogen. They are placed in solutions of potentially toxic cryoprotectants, before cooling to -196° C… the cells must withstand… temperature and pH. Thawing reverses these processes.”

Are we sufficiently aware that we are speaking about exposing human life to these conditions? Are we, as a society, comfortable to expose a human being to this unsafe and unrespectful freeze-thaw process? Research shows that about 10% of the embryos which are thawed die in the process. This is very different from dying a natural death in the womb: dying during freezing/thawing is man-induced.

Moreover, the fact that many people die naturally in life does not mean that exposing human life to a practice which risks death is justified. Other risks include identification tags of frozen embryos breaking off and embryos being implanted in the wrong patients. (Such incidents have been reported – see BBC on-line, Couples face embryo dilemma, 2003 and the Paul & Deborah case in England in 2009 among others.)

The second dilemma is what will happen to spare embryos. Parliamentary Secretary Fearne says they will be given for adoption.

This is another level of inequality: Some will enjoy life with the biological connection with the natural parents, others will be a priori destined to a life with an unrelated couple. While fully acknowledging and admiring the courage and altruism of parents who adopt and foster children, we cannot but point out that workers at Appogg, psychologists and therapists often relate how many young people and children are affected by not knowing their biological parents, even though they are raised in a loving family. The fact that this reality already exists does not justify the fact that we can consciously choose to create similar and probably painful situations. 

The question of what will happen to those embryos who will not be adopted also remains unanswered. Some countries abroad have had many ethical and legal dilemmas to face over these issues. A number of genetic parents might simply not wish their off-spring to be adopted. Legal conflicts over embryo ownership have also been reported when couples split up. Another case involved a man whose spouse had died leaving him in an ethical dilemma about what to do with the frozen embryos.

As the Commissioner for Children also pointed out: “since the embryos that are selected for freezing tend to be the least healthy of all the embryos produced through a treatment cycle, the chances of such embryos being adopted are slimmer” (Times of Malta, December 15, 2015). These frozen unused embryos may be unwanted, rejected, extra, spare, unloved, unneeded. Thus, embryo freezing gives a message that some babies are wanted and some are not. 

Egg freezing remains the better option in IVF. Investments should be made to improve this procedure. Clinics which are gaining experience in this method are reporting high success rates. The USC fertility clinic which uses both egg and embryo freezing reports the following: “Our initial 65% frozen egg pregnancy rate is above that of fresh embryos and twice that of frozen embryos.” (www.uscfertility.org)

Legislators have a duty to cater for the needs of even voiceless minorities such as embryos. These too have the right to support from the State. We wish to promote a culture in favour of the lives of all embryos, not only the ones who fulfil our desires of parenthood, leaving aside those who are not needed.

With the current law, infertile couples can adopt, foster, make use of IVF at Mater Dei Hospital or privately, and access Napro technology at Birkirkara Health Centre or Gozo General Hospital or privately.  We are intrigued to see such urgency on embryo freezing, when the current practice is giving good results.

We are aware that such changes can yield financial gain to business sectors profiting from these practices. However, this goes against the principles of good medicine which ethically needs to consider the rights and needs of all the parties involved including those of embryos. The current IVF law gives a chance to infertile couples while the baby still enjoys the connectedness and nurturing of his/her biological parents. Changing the law will change this balance. People are to be treated and received as gifts. They are never a right. We hope that our laws continue to hold this value and respect the dignity of every human being by treating us all equally.