[extropy-chat] The state of ART in Italy

[Amara Graps]

One of the things that supported my positive views about Italy
before I arrived 2.5 years ago was the country's innovative medical
sciences; very good doctors were free to try new technology.
Unfortunately, during the time I've been here, that arena has
shifted drastically, into an environment I'm finding more and more
technophobic and xenophobic. Italy has now the most restrictive
assisted reproductive technology (ART) laws in Europe.

Next month is a referendum, to allow Italians (the Italian taxes I
pay mean nothing for my helping to contribute to this society, and
I'm prohibited from voting on anything) for some of the most
controversial parts of the assisted reproductive technology laws
to be removed. The timing of the law coincides nicely with the
start of the summer holiday :-\   My Italian friends (not enough)
are voting in this referendum to try to change the laws; the
details of the law is here:

http://www.kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=27656&dr_cat=2

but I'm not very hopeful for a change in the laws. I spent the
weekend (I spoke on another topic about volcanoes) at the Italian
National Book Fair in Torino, and saw the many carefully packaged
religious books and pamphlets portraying  ART as terribly dangerous
for the existence of mankind. (Another note: out of the 1500 book
publishers there, only _one_ was a publisher that published solely
technical topics.)

Last week, the every-evening discussion program titled "8:30", on
the only independent (Berlusconi controls the rest) television
station featured Severino Antinori, a very well-respected doctor
(gynocology), where he presented his opinion about assisted
reproductive technology. He was clear and focused and sharp
however, on the program, he drowned in a sea of phobic people, who
would not consider his arguments in a rational way. Even the
moderator, a relatively freethinking smart guy, showed his fear and
ignorance about technology and assisted reproductive methods, and
argued, along with the rest of the people on the show, from an
emotional base. How disappointing.

This article sums up the current state of assisted reproductive
technology laws in Italy and Antinori's views.

Amara


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http://www.theamericanmag.com/article.php?show_issue_id=3&show_article_id=14

The Right To Bear Opinions
By Paul Virgo

May 2004

The Right To Bear Opinions
By Paul Virgo

May 2004

Italian embryologist and gynecologist Severino Antinori is among
medicine's most controversial figures. The Rome-based fertility
expert made headlines in 2001 when he proposed human cloning as a
way around male infertility. Antonori's claim that he could clone
humans was met with skepticism and hostility (many in the medical
community labeled it unethical) and helped usher in legislation
banning reproductive cloning in Italy. Antinori has countered that
resistance is based wholly on prejudice. He has also received
support from unlikely sources, including Noble laureate and DNA
pioneer James Watson and in vitro fertilization (IVF) pioneer
Robert Edwards. In 1986, Antinori infuriated the Roman Catholic
Church by developing a microinjection fertility technique for men,
earning the nickname "father of the impossible children." In 1994,
he helped 62-year-old Rosanna Della Corte become the oldest known
woman to give birth. Antinori chatted with The American's Paul
Virgo in Rome. These are excerpts from their conversation.

Q. How do you respond to those who claim Italy is the Wild West of
fertility treatment?

A. The Vatican invented the name Wild West. It can no longer do as it
once did and bully people like Galileo, whose ideas they
disapproved of. They use another strategy to fight science and
people that think differently. They use this name to defame this
field. I reject the Wild West accusation. There are good people.
The Swiss international body ISO, which rates the quality of care
at IVF clinics, found that half were of high quality. In Italy's
general hospitals, only 20 percent fell into this category. Wild
West ... is a name invented in an attempt to destroy people's right
to fertility treatment, which in my opinion is a basic human right.
Don't forget that Italy is the country of Machiavelli. What does
this mean? If you want to destroy someone, you don't do it
directly, but you use other ways, damaging their reputation.

Q. But Italy's new law on assisted fertility was meant to rein in such
a Wild West. How do you see its effect?

A. Paradoxically now we have the most restrictive law in the world in
terms of assisted fertility: It [restricts] human rights, freedom
of research, freedom to have therapy, freedom to reproduce.

Q. How so?

A. It limits the use of much technology and brings down by 50 percent
the childbearing chances of people with fertility problems. The law
limits the number of eggs that can be used to three; it limits the
number of embryos; it bans the freezing of embryos, and so on. If
you can only use three eggs, the chances of success with IVF drops
from 30 percent to about five percent. This is bad for women,
because they are forced to repeat the treatment, with the risks
that involves. It's a return to the dark ages. The spirit of this
law, inspired by the Vatican, is, "Don't touch the embryo." For
them the embryo is human two days after fertilization. But 90
percent of scientists consider life to begin two or three weeks
after fertilization, not simply when the spermatozoid enters the
egg. Another important restriction is the forbidding of gametes
outside the couple. It's unbelievable. And the best bit is that you
can do pre-implantation genetic diagnosis, but if you find a
problem in the embryo you must transfer it to the woman's uterus
anyway. Even if you know it's unhealthy and will abort. Dangerous
stuff.

Q. To what extent do you think Vatican views influence national
policy?

A. Too much. The Vatican established this law. It's incredible that
this can happen in a secular state. And it's incredible that a
government that calls itself "House of Freedom" (Casa Della
Liberta), with [Silvio] Berlusconi as prime minister, becomes the
"House of Restrictions." Berlusconi wanted to give the Vatican a
present with the law, but he didn't consider the three million
couples in this situation [of wanting a child]. I think it's
unconstitutional. Fortunately, there are lots of legal checks and
balances that stop this sort of tyranny. I'm hopeful the
constitutional court will overturn the law.

Q. Why is infertility such a widespread and growing problem?

A. There are a number of factors, related to lifestyle - smoking,
drugs, diet, smog and pollution - which in particular reduce sperm
counts. And in women, a higher number of sexual partners increases
the number of infections, which in turn affects fertility. Don't
get me wrong, though. I'm totally in favor of sexual freedom.
Contraception obviously affects the number of children being born.
Again, I wholly favor birth control and the right to plan when to
have children. But fertility declines with age. In fact, in Italy
the situation is that more people are dying than being born. For
this reason people don't want too many restrictions on fertility
treatment. We should be trying to promote life not prevent it.

Q. How have people's attitudes to the problem of infertility changed?

A. It's now easier to diagnose infertility and its causes in men. In
the past, men always wanted to blame their wives if they could not
have children, because being potent was a question of pride. You
couldn't find out before; men became offended. But in half the
cases the problem is the man.

Q. You've been criticized for helping post-menopausal women conceive?
Isn't it irresponsible to help women in the later stages of their
lives bear children they might not be able to care for?

A. My work is not aimed at helping all older women. We only use it in
cases where a woman's biological age is not her chronological age.
Let me explain. Some women in their 50s are still in good enough
shape to give birth and care for their children for at least 20
years. By contrast there are other younger women, 31, 35, 40, say,
who are in no condition to have babies. We judge whether to help a
woman on the basis of her biological age. I'm happy that in Britain
the Human Biology Authority has accepted these criteria. Now it's
possible in Britain for a woman in her 50s to have children if
she's in shape to bear them.

Q. Under what circumstances, if any, is it acceptable to let parents
decide the sex of their unborn children?

A. This takes us back to the new law again. Now it's illegal to
determine a child's sex, even when there are genetic diseases that
only arise in one sex. There are diseases of this kind that are so
grave they are incompatible with life. In such a case, it's right
to determine the sex of the unborn child.

Q. Does the vertiginous rise of Caesarean sections in Italy trouble
you?

A. No, I'm not worried. Caesarean sections enable us to avoid
dangerous births, malformations and handicaps. It's an advance. I
also approve of epidurals to have birth without pain. I don't agree
with the Bible, which says women should go through pain when they
give birth.

Q. Medical research is often criticized in Italy. Is it justified?

A. In the field of fertility it's a disaster. In the past, Italy ...
along with Britain was a leader. But the new law has ended all that
for now.


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Amara Graps, PhD          email: amara at amara.com
Computational Physics     vita:  ftp://ftp.amara.com/pub/resume.txt
Multiplex Answers         URL:   http://www.amara.com/
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"Man creates God in his own image."  -- Ernst Heinrich Haeckel