Læknablaðið - 15.02.1987, Page 25

LÆKNABLAÐIÐ
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that matters of ultimate value are not susceptible
to proof.
A strict utilitarian view would suppose that, with
certain procedures, it would be possible to
calculate their benefits and costs. If, however,
such a calculation was possible, it could not
provide a final answer to the question of whether
it is right that such procedures should be
performed. They could be unacceptable,
whatever their longterm benefits might be. There
is obviously a very wide diversity in moral feelings
about these new techniques and these may arise
from religious, philosophical or humanistic
beliefs. What I think is common is that people
generally want some principles or other to govern
the development of these new techniques. There
must be some barriers that should not be crossed
and some limits fixed beyond which people must
not be allowed to go. If society has no inhibiting
limits, especially in the areas which the Warnock
Committee considered, i.e. questions of birth and
death, of the setting up of families, and the
valuing of human life, this would be a society
without moral scruples and this nobody would
want. While we recognise that there should be
limits, in a pluralistic society it is not to be
expected that any one set of principles can be
enunciated which are completely accepted by
everyone. The law, itself binding on everyone in
society whatever their beliefs, is the embodiment
of a common moral position. It sets out a broad
framework for what is morally acceptable within
society and in recommending legislation the
Warnock Committee recommended a kind of
society that we could all praise and admire, even
if, in detail, we would individually wish that it
were different. Within the broad limits of
legislation, there is room for different and
perhaps more stringent moral rules.
What is legally permissible may be thought of as
the minimum requirement for a tolerable society.
Individuals or communities may voluntarily
adopt more rigid standards. It is therefore agreed,
I think, that barriers have to be set up but there
will not be universal agreement about where these
barriers should be placed. Basically, the question
is what kind of society can we praise and admire?
In what sort of society can we live with a clear
conscience. That, Ladies and Gentlemen, is our
basic premise in attacking the problems of
artificial reproduction. What, therefore, is
artificial reproduction?
It is reproduction where some third party has to
intervene to assist in the reproductive process. It
could also, of course, be called assisted
reproduction.
I would like to start off by talking about artificial
insemination by husband (AIH), husband
provides sperm and someone else inseminates his
wife with it. This is a commonly performed
procedure - too commonly performed in my view
because it would seem to me that if a husband can
inseminate his wife without any difficulty, and
the quality of the sperm is good and the wife
seems to be ovulating then AIH cannot contribute
any advantage. If the sperm quality is poor but
the husband can inseminate his wife naturally,
then artificial insemination is of no advantage.
However, if the husband has some psychological
problem which makes it impossible for him to
inseminate his wife, then, if he can produce
seminal fluid, it is possible for a third person (a
doctor or nurse) to use that seminal fluid and
artificially inseminate his wife. The resultant child
of this particular procedure, of course, contains
the genes of both husband and wife and is carried
and delivered by the wife so that, apart from the
initial procedure, it is similar to natural
conception. There is, therefore, very little
opposition to AIH and it is seen purely as a
therapeutic help to usually the husband, but
sometimes the wife, usually due to a coital
problem of some description. I therefore do not
think we need to discuss AIH further because
there are no real ethical problems in this.
The position is somewhat different with artificial
insemination by donor (AID). This is where the
seminal fluid of a third person is used to
inseminate the wife of a man who is infertile.
The resultant child is not the genetic child of the
husband of the woman although it may be the
social child. In the United Kingdom in law, this
child is illegitimate at the present time. One of the
recommendations of the Warnock report was that
the child of such a procedure, provided the
husband agreed to his wife being inseminated in
this way by material from the donor, should be
considered to be legitimate in law. This is a
recommendation that I very strongly support
because, at the present time, what in fact happens
is that the child of such a procedure is usually
registered by the husband as his child. He is thus
deceiving society and the child as to the origins of
this child. If he enters on the register of births that
he is the father he is committing, in British law, a
criminal offence - that of falsifying a birth