Sir, - Medb Ruane (July 19th) is to be commended for her column on the plight of couples seeking to conceive a child by means of artificial reproductive technology. The enormous financial burden and bitter disappointment imposed by often repeated attempts using procedures which, at best, have a success rate as low as 15 per cent, should not be forgotten.
Ms Ruane also raises some very pertinent and still unanswered questions about the rights of the children born from any one of the limitless permutations and combinations of laboratory-determined couplings.
However, I would like to comment on some of the statements made by Ms Ruane in her article, not out of a desire for "theological point-scoring", but because her analysis contains much that is fallacious and is therefore a disservice to the people most affected by infertility.
It is misleading to suggest that infertile couples in this country would have easier access to artificial reproductive techniques if the debate were not entangled with abortion. The close connection between reproductive technologies and abortion is not peculiar to Ireland. IVF and related procedures per se depend on abortion, i.e., destruction of surplus or defective human embryos and, in other jurisdictions, the selective abortion of foetuses in the womb. The abortion process is an intrinsic part of artificial reproduction, and there are many childless couples who have decided not to avail of IVF precisely for this reason. Ms Ruane is either being disingenuous, or else has not researched her topic sufficiently.
She rightly states that the ethical issues involved "are not in themselves a subject which needs to be medicalised". But they do need to be rationalised. The difficulties of childless couples and the rights of their children are of fundamental importance, but the right to have children (if such aright exists) is not an absolute imperative which can over-ride all else. Emotive arguments such as those used by Ms Ruane do not address the rights of those children conceived by artificial technology and who are not allowed to be born, such as those who are stored (cryo-preservation), destroyed or, as in other jurisdictions, used for research purposes and tissue harvesting.
The consensus model proposed by Ms Ruane, citing the UK committee chaired by the philosopher Mary Warnock, has been clearly shown to be inadequate. The rules established for the treatment of embryos were based neither on science nor philosophy, but on the simple utilitarian principles of which Mary Warnock was a leading exponent. These arbitrary parameters for deciding which embryos are human and which are not have led to the destruction of thousands of embryos in the UK alone. Committees may save us the hassle of debate, but they do not necessarily lead to just solutions.
With great courage, in my opinion, Ms Ruane cites the reasons for increasing infertility, such as the use of IUDs (leading to pelvic inflammatory disease), sexually transmitted diseases and prolonged use of contraceptives during the years of maximum fertility. But it is surely misleading to present artificial reproductive technology as the only solution to problems whose roots actually lie elsewhere. Ms Ruane points to the lack of awareness of factors which can cause infertility and which should be made known to people. This preventive approach would appear to be a more intelligent way for society to deal with infertility, rather than pouring massive resources into techniques which have such poor results and such appalling collateral damage.
Finally, as a further support for infertile couples, it would perhaps have been appropriate for Ms Ruane to have referred to infertility treatments other than those of artificial reproduction, such as NAPRO technology. With take-home-baby rates as good as IVF, and without the associated embryo "wastage", such developments deserve greater support from a society which wishes to help childless couples. - Yours, etc.
Dr Orla Halpenny, Monkstown, Co Dublin.