If a specially selected multi-disciplinary subcommittee appointed by the executive council of the Institute of Obstetricians and Gynaecologists cannot, after several years of work, come up with a coherent report on the subject of assisted human reproduction, it can reasonably be assumed that it will take some considerable time before any kind of national consensus can be developed on such subjects as the treatment of infertility, "test-tube" babies, artificial insemination by donor (AID) and all the newly-developing technologies available to assist those couples otherwise incapable of conceiving a pregnancy. And when the chairman of the institute has to insert a note in the report pointing out that not all members of the institute are happy with either all or part of the report, then even a professional medical consensus on the issues involved must still be a long way off. The becoming honesty of the report lies in the fact that the chairman of the expert committee felt it necessary in so many instances to set out how many members of the committee were in favour, and how many opposed, and how many were undecided on the issues discussed by the committee in the long course of its work.
But the net result is a report that, in effect, merely outlines what some of the issues are, without being able to define a consensus, never mind a recommendation, on how the issues should be dealt with. This is not to devalue the hard work undertaken by the distinguished members of the committee on a voluntary basis, but it has the effect of rendering the outcome of that work less valuable than it should have been, not least to those who may wish to avail of the various techniques of assisted reproduction to enable them to have their own children, or those individual doctors whose vocation is to provide such services.
It is not reassuring to learn from the report that a majority of the committee members felt that legislation was necessary "to lay down the boundaries of what our society considers acceptable in the field of assisted reproduction" - and this only after extensive research into medical, legal and ethical considerations. It is as if these members were saying that there must be legislation but only after lengthy research. Which could be another way of saying that infertility treatment of this kind must be governed by laws which cannot be drafted in our lifetimes. And, no law means no treatment? What other medical procedures, or group of procedures, are governed by laws specially drafted to control them? With the technologies of assisted reproduction changing and developing so rapidly, what statute law could possibly ensure the provision of the best possible treatment to those who need it at any given time? Shall we have statute law to point out to cardiac surgeons what they may and may not do by way of heart transplant or bypass surgery? Or to tell psychiatrists what modalities they may or may not use to relieve serious clinical depressions in their patients? Or to let nephrologists know when they may or may not use dialysis machines to treat patients in otherwise irreversible kidney failure? The very thought of it is nonsensical. General medical ethical principles can as well be applied to technological means of assisting conception as to any other medical methods of relieving distress or preventing death. It simply requires significant clarity of thought. It certainly does not require legislation which can take months or years to alter in an already busy Oireachtas.