A former master of the Coombe hospital said yesterday that an embryo had all the genetic material to make a human being and if he had to choose when life began he would say it was when fertilisation occurred.
Dr James Clinch was giving evidence in the High Court in the second stage of the frozen embryo case where a woman is seeking orders preventing the destruction of three frozen embryos in a Dublin clinic which were left over after successful IVF treatment.
"In general, if in doubt, a doctor comes down on side of life," Dr Clinch said. "Who knows when life starts? Nobody does. Nobody in this courtroom does unless they have a halo. Where there is any doubt, you come down on the side of life."
The couple who had IVF treatment five years ago have since separated. Mr Justice Brian McGovern has already ruled that the estranged husband did not give his consent for the implantation of the frozen embryos in his wife.
The woman claims she is entitled to an order vindicating the right to life of the three embryos. She is also looking for an order vindicating both her and the embryos' right to family life, the return of the frozen embryos to her and an order preventing their destruction.
Mr Justice McGovern is now deciding on issues of public and constitutional law. There is also the issue as to whether the husband can be forced to become a parent against his will.
The case is set to examine the status of the frozen embryos under the Constitution along with the rights to a family and the right to privacy under the Constitution and also under the European Convention on Human Rights.
In evidence Dr Clinch, a retired obstetrician and gynaecologist and a former chairman of the Irish Medical Council ethics committee, said he had never met the woman at the centre of the frozen embryos case but he had twice attended the previous hearing because he found it interesting.
He said when IVF began the success rate was only 20 to 30 per cent and it did not appear to have improved since then.
"We hoped when IVF started it would be the great answer with a 100 per cent success rate. It is a great sadness for many people that has not occurred."
The court examined the guidelines set down by the Irish Medical Council for the medical profession. Dr Clinch said technology outdistanced the law by miles and theology more and more.
Unless there were standards,there was a danger practices would occur that were not good for patients.
Asked by the woman's lawyer, Gerard Hogan SC, about an embryo that was not implanted, Dr Clinch said a doctor must do his best to preserve life. "In general, if in doubt, a doctor comes down on the side of life," Dr Clinch said.
An embryo had all the genetic material to make a human being and he would instinctively come down on the side of the embryo.
He said the man on the street would call it a test-tube baby and the general public believed that once the sperm met the egg and it was fertilised, that was life.
A passage of the Irish Medical Council guidelines 2004 was read to the court which said: "Any fertilised ovum must be used for normal implantation and must not be deliberately destroyed."
Asked why the Medical Council had adopted that position, Dr Clinch said destroying what somebody thought might be life was not a good idea.
Asked if the Medical Council had formed a view as to when life began, Dr Clinch said there had been 17 meetings where it came up but on balance if there might be life, the doctor preserved it because as a doctor if there was a doubt, they would not do well by the patient.
"If someone told the Medical Council when life begins, they would be delighted. I would think everybody would."
He said the question of when human life began had vexed everybody for centuries. There were possible steps after fertilisation like the beating of the foetal heart right up to the age when you could vote.
"None can occur before the sperm and ovum get together. Ask a man walking along the quays when life begins and he will say when the sperm meets the ovum," Dr Clinch said. "None of the other things can occur without fertilisation."
Asked by Mr Hogan if he had to choose as to when life began, Dr Clinch replied: "In 2006, it would have to be fertilisation. In years to come we may decide it is some other time. At present without fertilisation, none of the other things occur."
Asked about the Commission of Assisted Reproduction report which gave as one of its recommendations that life be defined as starting with implantation, Dr Clinch said he was disappointed with the recommendation and it did not refer to any work which had shown that scientifically.
"An embryo is not a piece of human tissue. It can eventually grow into a human being. An embryo is more than human tissue because of its potential. It is a sweeping statement to say an embryo has not potential."
An embryo could be grown in Britain for experimentation for up to 14 days. He said that would be the start of a human being and maybe it could be grown for longer or in an artificial uterus.
Cross-examined by John Rogers SC, for the estranged husband, Dr Clinch said the area of IVF was rapidly evolving. He said the basis for good ethics did not change and new techniques were measured against the principles and the doctor did his best for the patient at all times.
Mr Rogers said in 1995 it seemed the Medical Council had ruled that freezing was unacceptable. Dr Clinch said it was possible that freezing was later allowed by the council but under extremely strict conditions.
Mr Rogers asked if the 2004 guideline, which stated that any fertilised ovum must not be deliberately destroyed, was a rule. Dr Clinch said it was written down and it could not be taken out and changed.
At one stage during the cross- examination on the question of what life was, Dr James Clinch said he was not certain and he asked John Rogers SC if he was alive.
He said he was sure if Samuel Beckett was in court "he might persuade us all we don't exist".
Mr Rogers said they were going to work on the premise that they were alive, at which Dr Clinch replied: "In this heat . . ."
Dr Clinch agreed he was giving his personal view in the case on when life started, but he could not find a better one than at fertilisation.
The case continues today.