An interesting journal article that came across my desk analyzes the ambiguous guidelines issued for assisted reproductive technologies (ART) in Ireland. As it stands, there is no controlling legislation for ART in Ireland, so the guidelines issued by the Medical Council (the group responsible for setting professional and ethical medical guidelines in Ireland) are what reproductive scientists and clinicians must follow in their work. “The Evolution of Health Policy Guidelines for Assisted Reproduction in the Republic of Ireland, 2004-2009,” by David J. Walsh, Mary L. Ma, and Eric Scott Sills in Health Research Policy and Systems compares the policy guidelines set forth in 2004 to the most current guidelines issued in 2009 by the Medical Council, arguing that copious guidelines need to be established.
A positive change that can be seen in the revised guidelines issues in 2009, is the Council’s support for more accreditation for ART practitioners and better record keeping and auditing practices. However, the overwhelming ambiguity placed on surplus embryos, donor compensation and embryo disposition may restrict access to IVF services. While the Medical Council states that the ultimate responsibility for the regulation of ART falls to the Oireachtas (national parliament or legislature of Ireland), the Oireachtas have remained silent on these issues leaving the burden up to the Medical Council.
Another dynamic to add to the mix is the reconfiguration of the Medical Council. The Council has 25 members historically comprised of physicians; however, new legislation passed in 2007 requires that 9 of those members cannot be medical practitioners in Ireland or elsewhere. Thus the guidelines set in 2004 and those set in 2009 were established by 2 completely different groups, the first being made up of mainly “pro-life” members. This informed many of the original guidelines such as limiting IVF treatment to unexplained infertility and the stipulation that embryos must be donated before deliberately being destroyed. In 2009, the guidelines state that IVF is available to individuals when “no other treatment is likely to be effective,” and the option to donate embryos was retracted making destruction more favorable to donation.
Although the authors agree that ART legislation is the ultimately responsibility of the Oireachtas, they argue that enacting such legislation could take years. Thus, the authors conclude that the Medical Council should be the deciding body setting comprehensive guidelines for ART in an attempt to address the complex ethical issues that are either being overlooked or underscored. To read, “The Evolution of Health Policy Guidelines for Assisted Reproduction in the Republic of Ireland, 2004-2009,” please click here.