Debates on issues relating to human reproduction have not, in this State in recent times, been noted for their lucidity. Indeed, they have left more division than resolution in their wake. Meaningless and misleading statistics have been hurled like missiles from ideological trenches into what are perceived as the enemy's lines without much real communication taking place. But that does not mean that further debates should be avoided on the many reproductive issues which have still to be resolved in terms both of professional ethics and potential legislation.
Now would be as good a time as any other to develop a national debate on the subject of in vitro fertilisation (IVF) and whether or not the embryos resulting from this technique should, or should not, be frozen for possible future use. There appears now (despite some fallible newspaper reports to the contrary) to be no immediate prospect of freezing techniques being introduced here when the Bourn Hall Clinic establishes another specialist infertility clinic at Clane in Co Kildare. The chief executive of the Clane clinic has said that the infertility treatment services to be offered there will be the same as those currently offered by other specialist clinics already established in the State and he cited the medical director of Bourn Hall, Dr Peter Brinsden, as urging a public debate on the subject of freezing embryos.
There has already been considerable debate on the issues of IVF among the medical professionals most involved in these procedures, and this debate led to the publication by the Institute of Obstetricians and Gynaecologists, in 1992, of guidelines for those doctors providing the service for the particular cases of infertility in which IVF may prove helpful. These guidelines (which urge that all embryos successfully developed outside the womb be placed in the womb) effectively preclude the freezing processes of "excess" embryos which are used in the United Kingdom. There is no apparent significant difference between the statistics in Irish, as opposed to English, clinics to suggest that the procedure which avoids freezing and storage is any less successful in terms of the outcome of pregnancy.
It may well be that there is no need to alter these guidelines at this time in terms of the effectiveness of the treatment for those childless couples whose infertility may be suitable for such therapy. Even if only somewhere between 10 percent and 20 percent of such couples can expect a successful outcome from the procedure, that still offers a very significant relief from the pain of childlessness for those people. But there would be need for caution if any effort were to be made to translate what are currently effective guidelines into legislation.
It may (and should) take some expert and informed debate to alter professional ethical guidelines; and that debate should include contributions from non medical sources. But the speed of change in many medical technologies not least those involved in human reproduction is increasing almost annually so that guidelines of this kind can require quite frequent alteration in the light of changing technology. The guidelines published by the Institute of Obstetricians and Gynaecologists in 1983 were up dated by the current guidelines in 1992.
Up dating legislation is a great deal more cumbersome and the Oireachtas is, in any case, not an ideal forum for the drafting of what would necessarily be quite detailed laws, requiring an amount of detailed knowledge of the relevant technology, and subject to fairly frequent change. But caution in this regard need not hinder debate, as long as that debate is informed by reason and knowledge as well as by the various dogmas that are bound to be involved.