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Italian referendum result undermines choice, safety and progress

13 June 2005
By Dr Kirsty Horsey
reproduction editor, BioNews
Appeared in BioNews 312
The outcome of Italy's referendum on its fertility law means that Italy retains its position as one of the world's most restrictive nations on fertility treatments and related research. It is - and will now continue to be - wholly out of line with most of the rest of Europe on these issues.

What is a shame is that the negative result can largely be put down to terrible timing, voter apathy, and the influence of the Church. Does this mean that the majority of Italians simply do not care about infertile people - about whether and under what circumstances they will have access to treatments and, if we cut to the chase, whether if they are allowed treatments in the first place, the treatments will be safe? Does it also mean that they didn't mind when the Government, reluctant to hold the referendum in the first place, scheduled it for a summer Sunday, when many were on holiday or enjoying a day at the beach? Or that the church has deliberately tried to influence voters to abstain from using their vote? Is this democracy?

It is understandable (and even laudable) that the Italian government wanted to put laws in place to prevent 'abuses' of fertility treatment by maverick doctors and easily accessible treatments - to end Italy's reputation as the 'Wild West' of infertility treatments. But it is shameful that this has led to laws that undermine choice, safety and progress. Not long after the laws came into force, a couple of stories broke that vividly illustrate the lack of respect for patients' (women's) safety, by promoting the interests of the embryo above those of the mother.

First, in June last year, a couple were told by a court that they had to transfer all their IVF embryos, even though they knew that they both carry a beta-thalassaemia gene mutation, so there was a one-in-four chance that each of their embryos would be affected by this serious genetic condition; the woman later miscarried. Secondly, last July, a woman underwent a selective termination of a triplet pregnancy in order to protect her health after all three of her IVF embryos successfully implanted. The 26-year old woman had to apply to a court for permission for the termination procedure, which ruled that if her 11-week triplet pregnancy continued, the mother's life would be put at risk.

What remains to be seen, however, is the extent of the impact that the negative result of the referendum will have. It will obviously mean that infertile Italian women will continue to have fewer choices than most of their European counterparts, as well as having their health compromised more than it should be if they undergo treatments (not forgetting the health of their developing fetuses). It also seems likely, stemming from this, that increasing numbers of Italian women and couples will continue to travel for treatment in other countries. But the impact could extend further - if embryos have a protected right to life, but the fetus currently doesn't, after laws on abortion were relaxed (following another battle between church and state) in the 1970s, this leaves a legal inconsistency. As I see it, such an inconsistency can only be resolved in one way - by protecting the fetus' rights too - and this has very strong implications for abortion in Italy, and therefore, for choice.

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