The silences surrounding FIVET
Gonzalo Herranz, group de work de Bioética. School de Medicina. University of Navarra.
lecture Delivered at the I Corso Internazionale di Bioetica.
Bologna, 15-16/29-30 April 1988.
I. The silences around the FIVET clinic internship
II. The silences around the research clinical
III. The silent struggle for supremacy
IV. The silence around the staff of mankind
V. The silence around the human embryo
First of all, I would like to express my gratitude to the E. Manfredini Cultural Centre for the invitation to participate in this Bioethics course. My gratitude is very sincere and has at least three reasons: The first is that it has allowed me to visit Bologna: a university student should make a pilgrimage to the Bolognese Alma mater at least once in his or her life; to visit it as it celebrates its ninth centenary is a gift. The second reason is that it is an honour for me to participate alongside eminent colleagues from other European and Italian universities in the analysis of certain ethical problems in medicine and biology. The third reason is that the organisers of the Course have offered me a very interesting topic to discuss here: the silences surrounding FIVET. Perhaps they were aware of my deafness and my particular skill to listen to the silences.
Why is it interesting to discuss the things that are little talked about or omitted in the scientific and ethical discussion around in vitro fertilisation? The answer is obvious: silence is a marker of problems. Therefore, issues surrounded by silence usually need to be brought up for discussion. Critical function is to medicine as the heartbeat is to the body. We are all responsible for it, but it is particularly incumbent on those of us who are interested in medical ethics. It is our duty to break certain silences, to bring unpopular issues to the fore and sometimes to say things that many do not want to hear. In medicine, the voice of the moral conscience, which is both sensitive to the intrinsic values of biomedical science and respectful of the human being wounded by illness, cannot be silenced. If we did not exercise this function, medicine would be impoverished both scientifically and humanly.
This critical task is very demanding. Society has a confident attitude towards science, justified by its efficiency and its fabulously favourable balance of well-being and knowledge. We trust it because we know that it has mechanisms, slow but sure, to detect and reject the impurities that can contaminate it: fraud, distorted data , fanciful constructions. People also live in peace because they assume that everything that is done in science is transparent, public and that scientists are only interested in scientific truth. It is assumed that in the scientific business nobody has to keep quiet about anything or carefully sweep under the carpet crumbs of reality that do not match the desired forecasts.
It is to speak of the silences surrounding assisted human reproduction that I am speaking. The scientific adventure of in vitro fertilisation is full of contrasts: in order to acquire a semblance of respectability, it has had to hide some of its shortcomings behind silences that are already very loud. It is not easy to systematise them. That is why I have chosen the ones I believe to be the most significant. Some are linked to the feverish activity of doctors: they are those that surround the clinical internship , those that accompany the research, those that are used in the fight for professional supremacy. Others refer to ethical or doctrinal questions: they are the silence surrounding the staff of man in reproduction or the silence on the humanity of the embryo.
I. The silences around the FIVET clinic internship 
Leon Kass complained, as early as 1971, that most of the articles on in vitro fertilisation published up to then remained strangely silent on certain ethical issues. They said nothing about how the cooperation of oocyte donors was solicited for research: how their informed consent was obtained or what they were told about the fate of their oocytes. Curiously, this strange silence has persisted around IVFET even after its spectacular triumphs. In 1980, when FIVET had already gained popular favour, Steptoe and Edwards recounted the prehistory of FIVET in their book A Matter of Life. Their silence on the questions raised by Kass remains complete: they reveal some fragmentary data on the issue of human embryos produced, but these data are insufficient to reconstruct the development history of the technique. Steptoe and Edwards insist that they obtained women's cooperation, persuading them that their financial aid was necessary to solve the problem of infertility, but they have never published the protocol they used to obtain women's informed consent or the issue number of embryos consumed in the research.
Even now, FIVET is not free of this reticence. The information offered to potential users of these techniques remains stubbornly silent on the "hard" aspects of the technique. It is not easy to obtain information on this matter: I have order to some Spanish clinics that perform FIVET the protocol they use to obtain informed consent. I have not received any written response. From my conversations with some clinical embryologists in Spain, I gather that it is usual to consider that the couple's wish to register on the waiting list for internship FIVET is considered as test sufficient informed consent. It is true that users are given a general description of the techniques applied. But it is a watered-down version, which does not inform about the low fees success rate, nor about the possible psychological conflicts that may arise in the course of and after the failure of IVFET, nor about other treatment alternatives. reference letter Nor is there any mention of the Church's moral judgement on assisted reproductive techniques, the inevitable loss of embryos, or the fact that a variable proportion of infertility cases (between 5 and 11%) have offspring while waiting their turn for IVFET.
These aspects of reality are hidden from married couples in order to spare them psychological trauma or torturous ethical dilemmas. They are thus expropriated of their right to give genuinely free and informed consent. This strikes me as bad paternalism. I have always maintained that one of the most positive achievements of contemporary medical ethics is the elevation of the patient to the status of a mature moral subject. I believe that respect for the moral autonomy of the patient makes the doctor-patient relationship more humane and more open to moral responsibility, particularly when the patient has a richer and more sensitive moral life than the doctor. It is therefore regrettable that in many centres for assisted human reproduction, certain circumstances of fundamental moral significance are being silenced and patients are being deprived of making their moral decisions responsibly.
II. The silences around the research clinical
The search for new and more effective remedies for illness is one of the most precious values of medicine, in which the scientific vocation and the healing vocation of the doctor meet quotation . But we know that neither the desire to know nor the desire to cure is enough to guarantee a truly humane clinical research : the research on the sick person must be subject to certain ethical rules, otherwise the scientific and beneficent endeavour could degenerate into uncontrolled passion.
Such an ethical commitment takes on particular importance in the area of assisted human reproduction. Those working in this field consider themselves fortunate to have the enviable opportunity of attend to witness the birth and rapid development of a scientific adventure that will radically change the way of life of humankind. The research to improve the performance of clinical techniques is also a very attractive field, as the one who takes the lead will not only gain fame and social recognition, but also a lot of money.
Logically, bibliographic production is growing at an accelerated rate. It is already too large to cover comfortably. There is so much research and writing that the journals of Gynaecology, Fertility or Andrology are no longer sufficient to contain it, and journals specifically dedicated to disseminating articles and reviews on assisted human reproduction techniques have had to be created.
A careful and critical examination of the quality of the research reveals mixed feelings. There are certainly many articles that are well thought out and well executed, even elegant. But it is worrying to see that many others lack scientifically or ethically significant elements. I will limit myself to commenting on two of them: 1. The fall in scientific quality determined by the rush to publish and 2.
1. The articles to which I refer seem to have been conceived without due reflection and executed with undue haste; their results are tentative and their discussions appear full of insufficiently substantiated suggestions; the whole appears unconvincing. They often deal with technical innovations which are claimed to be superior to others, but which have not been subject to controlled verification.
When we study them, we find that the body of the article does not demonstrate what the introduction promises or what the discussion claims. They usually include a reassuring clause stating the need for the promising results reported to be further confirmed in a rigorously controlled clinical essay . But it is often the case that neither the authors of work seem to have the interest or the time to do so, nor are other scientists seduced by the promises. In fact, no one is willing to spend their time and skills to determine the true value of the recommended procedure .
This does not prevent some of these procedures from being incorporated into the internship of some doctors. And herein lies the harm: applying promising intuitions as if they were proven remedies has serious consequences for the scientific soundness of medicine.
Let's look at an example. I choose it because scientists from the Universities of Bologna and Melbourne have participated in its realisation.
This is a research about the advantages of using amniotic fluid as a medium in which to carry out the fertilisation and culture of human embryos and as a vehicle for their intrauterine transfer. The idea behind this work is simple and brilliant: if amniotic fluid is the medium in which the embryo is housed for almost the entire duration of its intrauterine development , then amniotic fluid seems to be candidate with many merits to be the ideal medium for the initial embryo in vitro. How has this interesting idea been verified or refuted? Firstly, by testing in the animal. The excellently designed work demonstrates the superiority of amniotic fluid over a standard culture medium for the development of the young mouse embryo. In contrast to the experimental part, the clinical section of the work is very weak: impatience to report interim results has prevented the authors from reaching firm conclusions. Following the above-mentioned routine, the article draws the following conclusions: "It is possible that the amniotic fluid, without any supplementation, possesses the correct composition, both ionic and non-ionic, and the necessary growth factors to optimise the development of the pre-implanted embryo. Large-scale controlled trials are needed to determine this... our results with amniotic fluid were better than could be expected.
But when you examine things closely, you see that such conclusions are an unwarranted extrapolation of what is shown on article. The results section ends by stating that the issue of cases studied is insufficient to make valid statistical comparisons. What a pity that the rush to publish ruins the quality of so much work!
Premature publication is common in the field of assisted human reproduction. The bibliography is full of unfinished work. There is, for example, a long list of media for human embryos: some are synthetic, with a well-defined composition, but varying in terms of the ingredients they contain or the addition of human serum or plasma from different sources; some are protein-free, designed to facilitate the transfer of the embryo into the uterine cavity; others mimic the composition of the tubal fluid, the microenvironment that naturally surrounds the embryo in the first hours of its development development. The media are subjected to different processes of sterilisation or inactivation by heat, gamma rays or ultraviolet light. There are almost as many media as there are groups of researchers. There is a lack of cooperative and systematic programs of study to determine which are the ideal media for the culture of young human embryos or to define the specific properties and applications of each of them. The confusion is great: no one can claim today that a particular medium is superior to others. We do not know and will probably remain ignorant of it as long as the prevailing non-cooperative attitude persists in this field.
This has very serious practical and ethical implications. The end of this pioneering and anarchic period does not seem near. Alan DeCherney recently made a strong critique of this uncooperative attitude in a article publishing house in Fertility & Sterility, entitled "Anything you can do I can do better... or differently!" Although the article commented on certain aspects, not of IVFET, but of fallopian tube repair surgery, it reflects very well the competitive, rushed, innovate-for-innovation's sake ethos of reproductive medicine.
The ethical implications of this mentality, I insist, are not negligible. We are not working with animals from laboratory, but with embryonic human beings. Will we ever count the number of embryos that have perished as a result of the lack of coordination of research in the choice of the ideal medium for the in vitro phase of extracorporeal reproduction? This is a thorny ethical problem about which there is a conspiracy of silence. There are hardly any critical voices in this field. But I am sure that, sooner or later, there will inevitably be a scientific maturation among researchers.
2. The second point of analysis concerns the blurring of the boundary between experimentation and internship ordinary. In medicine, we are obliged to distinguish between experimental treatment and accepted treatment. This is very important from the point of view of the quality of services, but above all as an ethical issue.
In its Declaration of Helsinki, the World Medical Association association has set out unequivocal ethical guidelines to guide research on human beings, guidelines that are different from those that regulate the application of treatments already accepted in the lex artis, in the accepted uses of the orthodox internship of medicine. The experimentation/internship borderline separates two territories in which the doctor-patient relationship has different features: according to the Declaration of Helsinki, no one can be included in a clinical essay without having previously and formally given their free and informed consent to receive the treatment in the phase of essay. On the contrary, the service contract underlying the ordinary doctor-patient relationship authorises the doctor to use and apply what is deemed to have been received according to the state of the art at the time.
What are the consequences of breaking down the boundary between experimentation and ordinary internship ? There are at least two: one harms respect for the patient as a person. The other erodes the scientific character of medicine.
If I deprive the patient of the information I owe him on certain significant points (that the procedure to be applied is in the experimental phase, of the advantages and potential risks of the procedure at essay and its merits in relation to others in use, of his freedom to participate in the essay or to withdraw from it, etc.), I make my decisions for him, I replace his convictions with my own, I annul him as a person. The public's disgust at the phenomenon of the human guinea pig expresses the rejection of this expropriation of freedom: however well-intentioned he may be, the doctor who abuses this status runs, in the eyes of the public, the risk of being thought of as a Dr. Frankenstein.
But, in addition, the blurring of this boundary erodes the scientific and critical character of medicine. It is not good that innovations enter the orthodox internship through the back door, that we find installed in the medical orthodoxy and as proven remedies what are only promises that have not successfully passed a seriously designed experimental essay . Tolerance at this frontier allows the clandestine migration to the field of medical internship of techniques of good appearance but of dubious efficacy, so that after a few years we would find ourselves in a regressive status , similar to the times before modern clinical pharmacology: we will again have our medicine cabinets full of useless or harmful drugs and in our hospitals empirical medicine will be practised again. Simply put: if I make an inflated estimate of an inconclusive essay provisional and people listen to me, no one will be willing to dispense with it when a random essay is then planned to test its real efficacy.
Only recently has the tolerant silence in the face of so many procedures smuggled into the clinic been broken. Very few voices are saying things like this: "Some approaches to new treatments are essentially anecdotal or empirical. They forget that spontaneous pregnancies have been observed in virtually all populations of infertile couples. Rigorous clinical trials are needed to establish the value of each treatment for each specific clinical status . These trials are, of course, very difficult to conduct, because patients are reluctant to participate if they are told that they may be relegated to a control group for a significant period of time. Many researchers are also discouraged because of the high patient issue and the long duration of research required to demonstrate unequivocally fees increased gestation" (Haney AF. What is efficacious infertility therapy. Fertil Steril 1987; 48:543-5).
We cannot forget that research on assisted human reproduction is perhaps one of the most complex and difficult to design. But this goes unsaid: there is a complacent silence on this point and publishers tolerate the publication of research of poor quality.
III. The silent struggle for supremacy
The Spanish Code of Medical Ethics condenses a common deontological doctrine at article 14th, when it states that "Medicine is a noble and elevated profession. Its internship can in no case and in no way be exercised as a trade". However, in certain countries or in certain environments, assisted human reproduction runs the risk of being drawn into the gravitational field of economic interests. It is said to be one of the most promising areas of the so-called "medical industrial complex". A few years ago, surveys showed that a very large proportion of mankind, around 15% of married couples of fertile age, will have to resort to assisted reproduction to overcome sterility.
In the face of such a large potential market, a high level of efficiency must be demonstrated in order to secure the largest possible clientele issue . In the struggle to secure a large and permanent clientele to ensure the profitability of the large investments and high operating costs of specialised clinics, unethical practices have begun to manifest themselves, including the inflation of good results and silence about failures.
Certain assisted reproduction centres have been accused of distorting their success figures, by skilful manipulation of the reservation mental . In reports published in the popular press or in letters sent to doctors and potential clients, it is claimed that there are many more pregnancies than are actually achieved. Here is an example of such publicity: "Doctors working at the XXX Clinic report that a relatively simple modification of the in vitro fertilisation technique has catapulted their gestation rate to around 40%, 10% higher than that of any other test-tube clinic worldwide. This is 5 per cent higher than the natural rate of pregnancies.
This is silencing reality. But this does not only happen in the mainstream press. Some articles published in scientific journals are also infected by the tendency to present data in such a way as to show its profile favourable side and hide its disadvantageous side. Amidst this other complacent and somewhat complicit silence, voices of protest are beginning to be raised. Two years ago, a article by Michael R. Soules appeared in Fertility & Sterility graduate "The IVF pregnancy rate: let's be honest with each other". An English group has order to formalise the way in which information on IVFET results is presented, so that the public is aware of the levels of efficacy achieved by different centres and can choose the one that suits them best.
There are certainly many honest people in human assisted reproduction services. But there are also many who are pressured by the need to succeed in order to survive or to place themselves at the top group and who do not hesitate to silence reality by skilful use of language in order to attract clients. We keep talking about "fees approximate success". But what is meant by success: the achievement of a biochemical, subclinical or clinical pregnancy or the birth of a child? Others claim that "it is still too early to evaluate the results", despite having been practising IVFET for more than two years. There are certainly many honest people in the service of assisted human reproduction, but some are silencing the reality.
IV. The silence around the staff of mankind
There are many well-meaning people who do not understand the message on the dignity of procreation contained in the Vatican Instruction Donum vitae. One of my recommendations for them to come to understand that message is to reflect on some of the silenced aspects of IVFET: the psychological and anthropological aspects of assisted human reproduction.
Until now, the buzz of euphoria, the applause for the technological and sentimental triumph of test-tube children, has been ringing out. Hardly anyone - a few moralists, psychiatrists and feminist groups - has paid attention to the psychological problems affecting women who have seen their illusions dashed when reproductive technology failed them.
That this failure causes great moral suffering is logical: the reproduction of laboratory has been born and developed under biotechnological notions and has paid little attention to the somatopsychic and spiritual nature of man.
The deafness to human values manifests itself very clearly in the silence that has hitherto surrounded certain aspects underlying the conduct of the in vitro fertiliser. He works ordinarily without wanting to realise that he is playing God, who has assumed the role of Destiny. He decides who is born and who is not, or who is born now and who is born later; he determines who is worthy of having a child and also who, for economic, genetic, socio-cultural, or simply random reasons, is refused such an opportunity. The in vitro fertiliser establishes the selection criteria for providing financial aid technology: a certain level of mental health or economic stability, the order of registration on the waiting list, marital status, the intensity of the desire to have a child, or the most appropriate age. She usually works forgetting that she has taken on the role of Destiny for certain men. He decides that the life of a child whose parents do not have much money is less valuable and full than that of a child whose parents live well off, and grants the latter and denies the former. If he thinks that a child born to parents who are somewhat unbalanced cannot have a meaningful biography, he will refuse to father him, to the benefit of those who conform to his own notion of normality.
This is an enormous responsibility, but almost instantaneous. Once the child is created, the artificial fertiliser refuses any responsibility for it. From an anthropological point of view, the doctor plays a much more active role than the parents in the process of generating certain human lives. After all, the parents function as simple, even distant, providers of gametes: the in vitro fertiliser is the immediate concretiser, the architect of the new life. What is his anthropological responsibility? Until now there has been only a technical reading of the doctor's role. Perhaps there will never be many lawsuits for "wrongful life" against the fertilisers of laboratory, because they avoid them by virtue of the selective elimination of defective test-tube children by means of eugenic abortion. But as soon as there is jurisprudence on the matter, the responsibility of the physician in the artificial production of human life will begin to emerge. Then the silence on the role of the physician in the artificial creation of human beings will have to be broken and the ethical responsibility of the man who sets himself up as Fate for other men will have to be determined.
V. The silence around the human embryo
If one were to ask experts in clinical embryology today at survey about the ontological and ethical nature of the human embryo, i.e. what it is or who it is, and what moral demands it makes of us, most experts would answer with the silence of "Don't know, don't answer".
This specific ignorance is a recent phenomenon. Because until the advent of FIVET, any book on human embryology began more or less as follows: "The development of a human individual begins with fertilisation, a phenomenon whereby two highly specialised cells, the spermatozoon of the male and the oocyte of the female, unite and give rise to a new organism, the zygote". But this is no longer the case today. It seems as if direct visual observation of the ever surprising phenomenon of fertilisation produces opposite effects among scientists. For some, it brings a lasting smile of amazement as they contemplate the indescribable and mysterious simplicity with which a new man is engendered. To others it causes a kind of incredulous disillusionment, as if they would not accept such a humble genesis for man. The latter, including in vitro fertilisers, go so far as to claim that the zygote is irrelevant, a molecular product devoid of human form and value, and that fertilisation is a moment virtually devoid of meaning.
There are thus two polar attitudes towards the human embryo: those paradigmatically established by report Warnock, on the one hand, and the Vatican Instruction Donum vitae, on the other.
The decisive influence of report Warnock on public opinion is based on the fact that he made the humanity of the embryo taboo. After Warnock there is a pact among "educated" people not to talk about topic. The committee agreed by majority vote that the human embryo is not a human being, deprived it of ontological consistency and reduced it to a functional notion. With this decision, the human embryo becomes an ethically neutral entity and our relations with it have no moral significance. The committee condemned us all to keep a complicit silence when we see someone manipulating or destroying young human embryos, as long as it is done with the authorisation of an administrative control body.
In contrast to the utilitarian warnockian doctrine of the embryo-thing, the Vatican Instruction imposes respect as an ethical attitude towards nascent human life, towards the human embryo. According to Donum vitae, all human beings are to be loved equally and all are to be respected as human persons from the moment of conception. Wherever conception takes place - in places as morally disparate as within marriage or outside it, in the aggressive injustice of rape or in the aseptic conditions of the tube essay- conception always inaugurates a human life, which is not that of the father or the mother, but that of a human being who develops on his own and who would never become human if he were not already a human being. The embryo is ethically an equal to us. If it is sick, we must treat it according to the best and most beneficial advances of biomedical science, that is, diagnose it and apply appropriate therapies, always respecting its uniqueness staff. Prenatal diagnosis and therapeutic interventions on the human embryo are licit if they respect its life and integrity, if they seek its cure and well-being.
The Instruction speaks in simple language, made of respect and compassion, but open to scientific audacity and modernity. It does not volatilise the embryo or plunge it into a subhuman stratum. On the contrary, it confers full rights on the embryo and makes it share in all the ethical requirements conferred on human beings. The human embryo is not considered as an experimental animal or a cellular complex, but shares the general privileges of humanity.
source It is a source of dismay for me to see that this most encouraging and positive doctrine of the Vatican Instruction has been the victim of an unjust and aggressive silence, while report Warnock has been given a flattering and gratuitous propaganda. But I will not tire of insisting that, amidst the exuberant proliferation of guidelines and recommendations on human embryo experimentation, only Donum vitae is maximally open and consistent. Apart from Donum vitae, no other has shown fidelity to the Helsinki Declaration. The Vatican Instruction endorses the idea that the interests of science or society can never prevail over those of the individual, including the embryonic individual; it points out that research cannot become a destructive manipulation of human beings; it advocates free and voluntary consent of the subjects of experimentation.
I am sure that these ideas will eventually prevail. It has been a great joy for me to see how different the 1985 and 1987 versions of the project Declaration of the association World Medical Association on FIVET are. The 1985 document, which was discussed in Brussels, accepted the inhuman Warnockian rules that require fail experiments to be carried out after 14 days and to refrain from transferring embryos that have been subjected to experimentation into the uterus. He also recommended embryo experimentation to improve assisted reproduction techniques and to develop genetic screening methods or new modes of contraception. Together with many esteemed colleagues, I fought in Brussels to improve this document. It did not seem at the time to have achieved much. But the text of the Declaration presented in Madrid in 1987 appears free of all those ethical aberrations and clearly states that the Helsinski rules apply not only to the mother, but also to the embryo.
We must therefore speak out, not remain silent. We have in the Donum vitae an inexhaustible source of inspiration to develop a good anthropology of the embryo and procreation, and for a good Medicine.
Some have reproached me for my unqualified enthusiasm for the Vatican Instruction. I must point out that there is one point in it with which I do not agree agreement: the acceptance of the term pre-embryo. The Instruction states in a footnote grade that "The terms 'zygote', 'pre-embryo', 'embryo' and 'foetus' in biological language can indicate successive stages in the development of the human being. The present Instruction uses these terms freely, attributing to them an identical ethical meaning".
I agree. I agree with agreement, but I disagree with the inclusion of the term pre-embryo. It seems to me to be a poisonous term, in which secularist ethics have found the solution to all problems. That is why I will never use it, because it was not introduced by Penelope Leach to designate a biological reality, but to evaporate a moral responsibility. The Lancet, in a article publishing house , stated that "it is appropriate to use the less emotionally charged term pre-embryo for the product of conception in its first 14 days .... The term pre-embryo has done more than anything else to lower the temperature of discussions around research about embryos". But it seems to me that if there is one thing the discussion around research on human embryos needs, it is a little warmth.
The word pre-embryo is a semantic trick to expropriate the embryo not only of its human condition, but also of its biological entity. Thanks to this verbal artifice, the human embryo is reified and ontologically annulled and is automatically deprived of all its privileges and human rights.
It is also a weapon for dialectical combat, an effective weapon for imposing silence on those who disagree with the official point of view. Let's look at an eloquent example.
In the Symposium "Human Embryo Research. Yes or No?" published by the Ciba Foundation, a brief discussion on Embryo or Pre-embryo? is transcribed. It is a demonstration of how civil service examination is literally crushed by the use of that word. I reproduce part of the dialogue, in which apart from moderator, Sir Cecil Clothier, several leading figures intervene: Robert Edwards, the pioneer of FIVET, Anne McLaren, a committed embryologist, and John Maddox, publisher of the journal Nature.
Sir Cecil Clothier opens the dialogue: "It would be interesting to know what you think of the ... expression pre-embryo".
Maddox: "I think it's a cosmetic trick".
There follows a brief but confusing discussion in which Anne McLaren, Robert Edwards, and Maddox express different views on the ambiguity with which scientists and the public use the term embryo, on the questionable acceptability of the term pre-embryo, on the sufficiency of the vocabulary of common Embryology to designate the different stages of development. Not a single word is said directly in favour of the term or on the legitimacy of its use in biology. However, Sir Cecil imposes the law of silence when, in order to close the discussion, he pontificates: "We all think that 'pre-embryo' clarifies the problems".
The term pre-embryo does not clarify, but suppresses the problems. The term pre-embryo is a typical product of materialist ideology, an ideology characterised by deliberately ignoring an important part of reality. Chesterton said to this purpose that some men of science, when confronted with vulgar but highly complicated realities, such as first love or the fear of death, overcome the difficulty by reducing these realities to their easiest aspect. And so they will call first love the sexual instinct, and the fear of death the instinct of self-preservation. "That there is a strong physiological element in both romance and memento mori, makes them, if possible, more puzzling than if they were purely intellectual facts. Precisely because these realities are animal, but not entirely so, the difficulties are accentuated. Materialists analyse the easy part, keep silent about the hard part, and go off to tea." So much for Chesterton.
Colophon
We are not materialistic, but the programme forces us to take a tea break. I am finishing now. We must put an end to these silences around FIVET. Embryos have no voice. Not many of us speak up for them. Sometimes it seems that our message in favour of respect for nascent human life and the dignity of procreation is heard by very few. That is why we cannot remain silent. We must speak out tirelessly to put an end to certain complicit silences.
Thank you all for your attention and your tolerance.