I. INTRODUCTION
3.1 The unique and unprecedented features of IVF place substantial obstacles in the way of achieving just and effective regulation of its procedures. It is not an established medical practice whose regulation is being updated. It is an entirely new treatment whose first success was recorded barely ten years ago. The law as it stands is barely equipped to deal with the issues it raises. IVF brings about human reproduction, and the attitudes of many people to it are influenced by strongly held moral, ethical and religious views concerning sexual behaviour, family formation and the bearing and raising of children.
3.2 Such views tend to make artificial conception techniques such as Artificial Insemination (AI) and IVF, the subject of concern and dispute in the community. This is in part evidenced by the large number of official inquiries set up to investigate the techniques, and is reflected in the substantial public interest we have found in the development of this reference.
II. SUBMISSIONS TO THE COMMISSION
3.3 Chapter 1 outlined how our work on artificial conception has been conducted to allow substantial participation by the public.1 This has included wide publication of discussion papers2 which invited public comment, the organization of public hearings prior to the publication of this report and the Commission’s earlier report on Artificial Insemination, and extensive research by the Commission’s staff. In relation to the Discussion paper on IVF, the Commission received 30 written submissions in the initial consultation period, and a further 16 in the wake of the public hearing, making a total of 46. These submissions came from individuals, community groups and church groups and contained a wide variety of viewpoints. Some responded favourably to the discussion paper, while others were critical. All submissions were carefully analysed, tabulated and summarised,3 and consideration was given to all views expressed in the formulation of our final recommendations. Reference is made to the submissions in Part III of this Chapter.
3.4 Many of the issues arising from IVF are shared with AI and are considered at length in the AI Report. However, IVF presents its own discrete issues, some of which overshadow the concerns of AI. In vitro fertilization is technically a much more complex Procedure than artificial insemination. As well, it involves the fertilization of an ovum outside the human body and, typically, the storage of embryos and the possibility of their disposal. These aspects have generated much of the IVF debate. Matters dealing with the recording of information raise few new considerations. However, certain issues such as donation and storage of reproductive tissue and research go far beyond their counterparts in AI, presenting wider moral and ethical problems. The Commission noted in its AI report4 the opinion that general acceptance of our recommendations for reform in this area will be governed to a significant extent by the acceptance and credibility of the principles underlying them.
3.5 This Chapter will again outline the basic principles that have guided the Commission in its work on this reference. They are the same as those described in our discussion paper on AI, the AI report and the discussion paper on In Vitro Fertilization. We will also outline some of the objections to IVF voiced in the literature and some of the arguments put to the Commission in the submissions received.
III. THE IVF DEBATE
A. Concerns raised by IVF
3.6 The relationship between the law and IVF cannot be discussed without reference being made to the moral debate surrounding the new birth technologies. As well as questioning the mean used in IVF, and often IVF itself, this debate is concerned with the ethics and morality of the practice of IVF. It began before the birth of the first IVF child in England,5 and has intensified as new developments occur in the technology.6 A full account of the state of the debate was given in the IVF discussion paper.
3.7 The Commission cannot attempt to resolve this debate nor to make any final statement on the moral issues.7 They are too diverse and do not lend themselves to compromise. Our terms of reference permit us to take the social, ethical and legal issues into account.8 This we have done through our consultation and research programs. In this Chapter we present the results of that work before drawing it together in Chapters 4 and 5 to form the basis of our recommendations. Our primary task, has been to consider these issues in order to be able to make recommendations on the means appropriate to regulate the new birth technologies. In this process we have considered both legislative and non-legislative solutions. We believe we have achieved a reasonable balance between the two. We also believe that the strongly held moral views of most can be accommodated within the scheme we propose. It is sufficiently flexible so that no individual should be forced to make a compromise of his or her ideals and does not close the door to further debate. However, we believe our recommendations also offer sufficient structure to overcome the need to reopen the fundamentals of the debate.
3.8 One ingredient in our attempts to ascertain community attitudes has been the reference made to the results of public opinion surveys. These reveal that there is no public consensus or “identifiable community morality”9 on the issues involved in IVF. While we can agree with several of the submissions made to us, that no great significance can be given to the results of these surveys, we also believe it would be foolhardy to simply ignore them.10 Between 1981 and 1987, 8 separate surveys were conducted by the Roy Morgan Research Centre into Australian attitudes to IVF.11 All showed that a substantial majority approved of IVF as a procedure to relieve infertility in cases in which the sperm and ova of a husband and wife are used to make the wife pregnant by IVF. Separate surveys in 198312 and 198613 yielded similar results. In relation to some of the more controversial aspects of the process, results were predictably mixed.14 What we take from the results of these surveys is the added caution that in formulating our recommendations we should be careful to avoid imposing prohibitory or regulatory solutions where no clear community consensus exists to support them.15
3.9 The diversity of views in the community on IVF is also made clear in the submissions received by the Commission. Their individual emphasis varies greatly. What is agreed, or accepted in critically or expressly by one, is strongly criticized by another. For example, the discussion paper’s treatment of eligibility for IVF procedures,16 is regarded by some as undermining the traditional family unit because of its willingness to include de facto couples.17 At the same time, the proposals were condemned by other groups for placing too much emphasis on the traditional family to the exclusion of single-sex and single-parent families.18 Several submissions commended the discussion paper’s full discussion of IVF, and its balanced approach to the issues,19 while others thought it was unnecessarily sympathetic to the medical profession and did not sufficiently represent some of the more telling criticisms of the IVF procedure.20 This divergence of opinion reflects not only an absence of agreement on the issues, but also a deep division in attitudes in those responding to the discussion paper. In what follows we present a brief overview of the arguments and views which have been put to us.
B. Major Objections to IVF
3.10 Many of the strongest criticisms of the IVF program can be attributed to q distrust of science and scientific research. This attitude arises from the perceived failure of science and scientist- to live up to earlier promises, as well as an increasing recognition of many negative by-products of what is seen to be inadequately controlled scientific development.21
3.11 In vitro fertilization, conspicuous among developments in the New Biology, and relating to the means of human procreation, which is a condition of human survival, has received more than a small share of this criticism. Some opponents argue that IVF is built on the destruction of human life and that it threatens the traditional family;22 others question the social and psychological implications23 and criticize the process as one which makes women objects of scientific curiosity and subjects of scientific experimentation.24 The real problem, it is argued, is infertility, and scientists should be aiming to prevent this, rather than seeking to perfect artificial conception techniques. Allied to this argument is a very real concern that patients on IVF programs are in a vulnerable position, reliant on the advice of their doctors, and therefore may be easily persuaded to agree to treatments without being fully aware of all the consequences.
1. Status of the Human Embryo
3.12 The target of the strongest criticism of IVF is the moral argument concerning the status of embryos created by use of the technique. The legal status of the embryo was discussed in our discussion paper where it was shown that while the embryo and the foetus have received from the law a degree of respect, neither has been given legal recognition as a human person, at least until after live birth. Numbers of recent attempts in courts in Australia and the United Kingdom to obtain rulings that would endow an embryo or foetus -with legal personhood have failed.25
3.13 There is no ground in the common law to recommend that an IVF embryo should be given legal status as a person in any proposed legislation on IVF.26 The call to accord the embryo status must therefore be based on moral and ethical grounds which are generally accepted by the community if we are to feel justified in reversing the established trend of the law. A number of these moral and ethical arguments were described in our IVF discussion paper.27 They have been clarified and expanded in many of the submissions received by the Commission. Their main thrust is that at and from the time of conception a person exists who should be accorded the rights and status of a human. There is also said to be a related duty owed by those involved in IVF programs, to allow embryos to develop fully to become human beings. On this reasoning there is, morally, no difference between a fully-developed human person, a new born baby, a 7-month foetus and a single-cell fertilized ovum.28 These, however, are not the only views which the Commission must accommodate. It has also been put to us that the recognition of foetal rights and the assignment of a legal status to the embryo, would have a serious and detrimental effect on the interests of women involved. The granting of legal status to an embryo, and consideration of its interests- in isolation from the woman who is to carry it, reduces women to mere “vessels” to contain embryos.29 In most of the arguments outlined above women and women’s roles are rarely mentioned, or are given little importance.30 if enacted in legislation it is argued the grant of legal status to the embryo would see a further deterioration in the rights of women to control their own bodies, the interests of the embryo conflicting with those of the women.
3.14 As stated in the discussion paper, the Commission subscribes to the views put by the Ethics Advisory Board of the United States Department of Health.31 The Board, in its report in 1979, recognized the special nature of the embryo and accepted that it should be treated as different from other human tissue. The embryo, according to the EAB, was entitled to “profound respect”, but this did not mean it was entitled to the “full legal moral rights attributed to persons”.32 Because of its uniqueness, and its capacity to develop into a human being, it ought to be “accorded respect” as a symbol of respect for human life generally.33 This opinion was influential in the formulation of the Australian national guidelines on IVF published in 1982 by the National Health and Medical Research Council.34
3.15 This approach accepts the special status of the embryo, and recognizes that its handling - whether for implantation, storage or for research - should be a matter of special consideration. That the embryo can be distinguished from other human tissues is not in doubt. At the same time, however, this approach is not in conflict with the current law, which denies the embryo the legal status of a human person.
2. Costs of IVF Treatment
3.16 Disquiet over the cost of IVF programs, both to the community and the individuals involved, is another major concern the Commission has addressed. It is argued that the benefits of the IVF programs cannot outweigh the costs of the treatments: both financial and personal.
3.17 The actual financial cost to an average IVF patient undergoing a single treatment cycle is approximately $3,000-$4,000.35 This was examined at some length in the discussion paper. Some consider this calculation misleading, as the individual price is only a small part of the overall cost to the health system.36 In May 1988 , the Federal Minister for Health, Dr Blewett, released a report outlining the costs of IVF treatment.37 The estimates made in this report of the cost of an average treatment cycle, were similar to those made in the discussion paper.38 The most publicized of its findings, however, was the statement that each child born through the use of IVF techniques had cost the Australian community $40,500.39 Critics of IVF present these financial costs in conjunction with the extremely low success rate of IVF, in a health system where there is increasing competition for a decreasing number of resources, to raise serious doubts as to its viability. It is argued that IVF is a luxury that few individuals can afford, and which our society should not support, amounting to a misallocation of resources that should be addressed by diverting more funds to establishing the actual causes of infertility, and investigating treatment for it.40
3.18 The Commission doubts the utility of applying this economic argument to in vitro fertilization. The costing in the Blewett report related the charges made for each medical procedure to the cost of developing the IVF program. Such figures could be calculated for any medical treatment or area of scientific endeavour, from cancer research to cosmetic surgery. They could be used to demonstrate the poor economic viability, of many medical programs. Liver and heart-lung transplants for example are also very expensive, and benefit only a small minority of the population, vet they are strongly supported by the community as worthwhile. The question ultimately must be the value placed on the end result of the treatment; in the case of IVF the value seen could be the new human life or it could be the relief of infertility. Those who would prohibit IVF because of its monetary cost must be prepared to persuade the community that the children born by the IVF procedure are not worth the money.
3.19 These financial costs are not the only costs of IVF treatment. Also disturbing are the criticisms made of its physical and psychological side effects. It has been established that a child born following IVF is more likely to suffer physical disability than a child born following sexual intercourse.41 There are also fears on the part of some concerning the possible psychological problems for the children and their families which may stem from a donor assisted conception, something which can only be fully assessed in the future.42 Amongst other important costs to be considered are the physical and emotional effects on the woman undergoing IVF treatment. Many patients have commented on the intrusive nature of the technology.43 It is both tiring and stressful, and the low success rate means that most women never become pregnant. Those who do must often undergo at least two or three treatment cycles.44 Even when the procedure is successful, IVF patients face a much greater than normal risk of premature births and multiple pregnancies,45 with the attendant risks.
3.20 Finally, there is increasing evidence of prejudicial side effects suffered by some patients from the drugs and processes used in artificial conception techniques. Of particular concern is the link between the super-ovulatory drugs used and cancer, and the dangers involved in the laparoscopy procedure.46 IVF procedures use a variety of super-ovulatory drugs. At the 1988 ANZAAS Conference47 a number of serious side effects were listed in relation to these drugs, including dizziness, nausea and loss of vision. At the IVF Public Hearing Dr Ditta Bartels referred to reports which gave examples of women who developed cancer of the ovaries after treatment with super-ovulatory drugs.48 As yet, the nature and extent of the link is unclear. It is argued, however, that until the full effects are known, these super-ovulatory drugs should not be used. It is also important to note that the problem extends beyond the individual IVF patient, as women encouraged to volunteer to donate ova are also given hormone treatment to superovulate.49
3. Other Implications
3.21 Another attitude evident in some submissions to the Commission is unease about the aims and morality of the scientific community.50 Often ill defined, this unease focuses in part on the alleged “dehumanizing” effects of IVF, the degradation of parenthood51 and the traditional family, the destruction of “human life”52 and the loss of control by individual human beings over their basic rights.53 Several submissions listed a number of abhorrent (and currently impossible) adaptations, including cross breeding of human beings with animals, the creation of a “super race”, and the use of IVF and gene therapy to create a race of subhuman drudges to do dangerous work or to be used as “spare parts” for the more privileged.54 Some of the other social implications of IVF which have been suggested to the Commission are not so far off in the future. One such view is that IVF, and the media publicity it generates, reinforces a view of women as being somehow incomplete without children. This means increasing social pressure on the infertile to undergo treatment in order to conform to a social stereotype, and degrades the choice to remain childless. Another danger for the near future is the use of IVF in combination with gene therapy. There is already discussion of using reproductive technology to eliminate genes which cause a number of serious genetic diseases. The fear expressed is that these processes could be developed into fully-fledged eugenics programs, in which parents could use IVF to create the perfect child.55 Another concern increasing in the wake of recent IVF-surrogacy cases is the potential for use of IVF in conjunction with surrogacy as a tool to exploit women from poor countries or lower classes, who would be used as surrogates for wealthier families.56
3.22 These concerns are serious, but they are difficult to assess. It is clear, however, that fear of the long-term consequences of the intrusion of technology into human procreation has influenced some of the views described above, particularly those concerning the costs and status of the embryo. In formulating its recommendations the Commission has tried to ensure that the views of all have been treated fairly. The impact each submission has had is reflected, we hope, in the reasons we give for them.
4. The Debate on Embryo Research
3.23 The debate on IVF is often reduced to a debate on IVF research. The spectre of research and experimentation on human embryos is the basis of many arguments asserting a legal status for the embryo. The Commission has considered these arguments in detail. As outlined in Chapter 5, we have decided by a majority of the Commission on each recommendation:
(i) not to prohibit research on the IVF embryo.
(ii) to allow the creation of IVF embryos solely for the purpose of research.
(iii) to allow the transfer to a woman of an embryo that has been the subject of research.
3.24 Our reason is for these decisions accompany our recommendations on research in Chapter 5 at paragraphs 5.24 to 5.42. The minority opinion relating to (i) and (ii) appears in Appendix A. The major reason for these decisions is that the Commission has not been persuaded by the arguments put to it, and those contained in the Senate Select Committee Report, that the human embryo should be accorded such status that no research should be permitted on it at any time in the future. As noted above, we have taken the view of the Ethics Advisory Board of the United States Department of Health,57 that an embryo is entitled to a profound degree of respect, but in our view this should not prevent research on the embryo until the fourteenth day of development in vitro.
3.25 The basis of the Commission’s view is twofold. we feel that as IVF technology is in its very early stages of development, further research is essential to permit advances in knowledge and to allow the development of more effective, less dangerous and more cost efficient processes. It may be that some of the concerns voiced in this Chapter will be resolved as the science develops. Secondly, the recommendations in Chapter 5 contain a very strict regime for the regulation’ and control of research by an independent organization, to be called the New South Wales Biomedical Council. With such a system imposed, in addition to existing ethics committee and NHMRC guidelines, fears of unnecessary or exploitative research should be allayed.
3.26 As the council we propose will be making decisions on the basis of its knowledge of scientific development and community attitudes current at the time approval for a research project is sought, its decisions should be better grounded and more reliable than those we can make now. The council will have a clear responsibility to keep itself well informed of these matters, for it is only by maintaining its knowledge at this level that it will be able properly to protect the interests of the public. For details of our reasoning on the issue of research see paragraphs 5.24-4.42 and also Appendix A.
5. Conclusion
3.27 These brief passages cannot reflect the depth and complexity of many of the arguments put to us nor the skill and care with which they were put. They have, however, enabled us to conclude that IVF ought to be regulated and controlled as evenhandedly as possible, and without an unduly restrictive approach which itself could result in serious consequences for the community. Ultimately any law, whether prohibitive or permissive, will only be as effective as its social context will permit.
IV. UNDERLYING PRINCIPLES
3.28 At the outset of its work in the Artificial Conception reference, the Commission established four principles to guide its progress. These have been referred to in all our earlier publications, and in greater detail in our AI report. They are as follows:
- It is desirable, where possible, to alleviate the consequences of infertility through practices such as AI and IVF.
- The formation of stable families is socially desirable and necessary.
- The paramount consideration in the practice of AI and IVF shall be the welfare of the child.
- Personal freedom and individual autonomy should, so far as possible be respected.58
3.29 Of these four principles, the last two received the most comment in the submissions on IVF.
A. Paramount Welfare of the Child and the Formation of Families
3.30 The laws of New South Wales and Australia have long reflected a commitment to the principle that the welfare of children should be the paramount consideration in relation to legal questions concerning their guardianship and custody. Expressions of this principle are to be found throughout family and adoption law. The interpretation of the meaning of the welfare of the child may have changed over the centuries but its basis has remained the same, namely, that the interests of the child are to prevail over those of other people involved in litigation.
3.31 In relation to the “formation of stable families” the Commission has been criticized both for being too conservative and too liberal. As stated by the AI Report we remain of the view that:
Stable family formation whether in marriage, a de facto relationship, an extended family or some other household has generally been considered by the community as necessary to provide a child with the best conditions in which to grow up. Even with divorce and family breakdown the law attempts to foster continuity and security in the child’s life through stable custody arrangements. It is therefore appropriate that the Commission pay due regard to the desirable goal of stable family formation and encourage this so far as possible.59
B. Personal Freedom and Individual Autonomy
3.32 One of the basic features of Western democracy since the 18th century has been respect for personal freedom and the autonomy of the individual.60 In relation to IVF programs and treatment, the principle has been described as follows:
Our society recognises the general moral notion that all people are autonomous beings who have a right to, and indeed should, make their own decisions. In the field of medical treatment this means that a competent adult person is entitled to decide what shall be done with his or her own body. The law reflects this principle.61
3.33 When an increase in legislative control is being considered, allowing government more power over individual affairs, this principle should not be ignored. The law is limited in what it can and should do in enforcing views of private human conduct, and in our view it has been generally accepted that on this subject strict legislative solutions are not always the most appropriate.
V. CONCLUSION
3.34 In the formulation of the recommendations in this report, the Commission has attempted to weigh, and to give room for the operation of, genuinely held moral legal and social concerns put to us through the period of public consultation. in some cases it has not been possible to balance quite contradictory views. We have also tried to follow the principles described above as well as to maintain an awareness of the practicalities of law making and law reform.
FOOTNOTES
1. See paras 1.4, 1.10.
2. The Commission has published two discussion papers in the course of this reference, these being: Human Artificial Insemination (DP 11, 1984); In Vitro Fertilization (DP 15 1987); a third Discussion Paper, Surrogate Motherhood (DP 18 1988) is to be released in late July 1988.
3. Each submission was read, analyzed and summarized according to the issues it addresses, and the chapter referred to. A final summary, running over 200 pages was then produced, and used by members of the Division in conjunction with the discussion paper when the Commission formulated its recommendations.
4. Human Artificial Insemination (LRC 49 1986) at para 3.2.
5. The practice and intentions of the Dr Patrick Steptoe were widely criticized in the lead up to the birth of the first IVF Child. R Edwards and P Steptoe, A Matter of Life (1980).
6. See for example, the recent intensification of the debate following the use of the micro-injection technique in Victoria. “Latest IVF process jumps gun on law”, Sydney Morning Herald (5/4/88) at 4; “Laboratory Embryos banned’, Sunday Telegraph (3/4/88); “New In-vitro technique tested in Sydney” Sydney Morning Herald 10/7/88 at 4.
7. Some comments in the submissions to the Commission have suggested that this should have been a part of our task; see Transcript of Proceedings, NSW Law Reform Commission Public Hearing on In Vitro Fertilization. See especially speakers on behalf of Right to Life (NSW) and the Women’s Advisory Council; See as for n9, also Submission of Ms R M Albury (SB 2, 1987); Rev Fr T V Daly, “NSW Law Reform Commission Invites Discussion on the Embryo” (1987) 5, and see also St Vincent’s Bioethics Centre Newsletter 9 (SB 26, 1987).
8. See xv; paragraph 3(l) of the Commission’s Terms of Reference on Artificial Conception allows the Commission to take into account “social, ethical and legal issues” relating to AI, IVF and surrogate motherhood.
9. This is a term used by Lord Devlin, to identify a “community sense of what is right and what is wrong”, which he argued the law ought to reflect. See P Devlin, The Enforcement of Morals (1965) at 15-18. Also see the opposing view set out in HLA Hart Law Liberty and Morality (1963).
10. See Women’s Advisory Council (SB 4, 1987) at 7-8; Uniting Church of Australia (SB 6, 1987) at ; Submission by Mr Brian Maher (SB 20, 1987) ; Right to Life (NSW) (SB 25, 1987) at 12.
11. Roy Morgan Gallop Poll (9 April 1987, finding No 1550). For details see summary in In Vitro Fertilization (DP 15 1987) at para 4.6.
12. R Rowland and C Duffin, “Community Attitudes to Artificial Insemination by Husband or Donor, In Vitro Fertilization, and adoption” (1983) 2 Clinical Reproduction and Fertility 195.
13. M Brumby and M Levine “Australian Attitudes Towards IVF: A Comparison of the Valves of Supporters and Opponents. (1986) 11 Australian Journal of Early Childhood 24.
14. For details see In Vitro Fertilization (DP 15 1987) 4.6-4.7.
15. Several submissions were critical of this approach. See Right to Life (NSW) (SB 25, 1987) at 12; Australian Catholic Social Welfare Commission (SB 29, 1987); Council of Churches in NSW (SB 18; 1987).
16. At 6.3.
17. See Knights of the Southern Cross (SB 3, 1987) at 25; Presbyterian Women’s Association (SB 16, 1987) at 2.
18. See Women’ s Legal Resources Centre (SB 1, 1987) ; Ms R M Albury (SB 2 1987)
19. See Seventh Day Adventist Hospital (SB 28, 1987) CONCERN (SB 17, 1987); Ms L Sullivan (Parents Centre Australia (SB 23, 1987).
20. Most notably Right to Life NSW (SB 2 S ,1 9 8 7 )see especially introductory pages.
21. This is especially true in the area of medical science, where increasing numbers of treatments and prescribed drugs are shown to have serious negative effects. T Roszak, Where the Wasteland Ends: Politics and Transcendence in Post Industrial Society (1972); Leo Marx, “Reflections on the Neo-Romantic Critique of Science”, Daedalus (1978) 107, 61; both cited by Gustav Nossal, “The Impact of Genetic Engineering on Modern Medicine” Text of the first Ian McLennan Oration of the Melbourne University Engineering School, Centenary Foundation (Melbourne, 4 October 1983) Quadrant November 1983 22 at 26.
22. SB 25; SB 19.
23. Australian Family Association “Submission to the Committee of Inquiry on In Vitro Fertilization” (1982) 3 The Australian Family 6; but see also J F Hollinger “From Coitus to Commerce: Legal and Social consequences of Non Coital Reproduction” [1985] 18 Journal of Law Reform 865 at 923.
24. M O’Brien, The Politics of Reproduction (1984); R Koval, “Women Birth and Power” (1985) 4 Australian Society 6.
25. Attorney General for the State of Queensland (Ex rel Kerr) v T (1983) 57 ALJR 285; Re K; C v S; Paton v British Pregnancies Advisory Service [1979] QB 276. See also the recent decision of the UK Court of Appeal in Re F (in utero) (1988) 2 WLR 1288 May, Balcombe and Staughton LJJ.
26. The Senate Select Committee Report, however, thought it “prudent” to treat an embryo as a “human subject”; Senate Select Committee on the Human Experimentation Bill 1985, Human Embryo Experimentation in Australia (September 1986), 3.18. See also the treatment of the subject in the Minority Opinion in Appendix A, para 2 et reg.
27. See Chapter 4.
28. Submission No: 25.
29. Barbara Ehrenreich, “The Heart of the Matter”, Ms (May 1988) 20.
30. See especially Knights of the Southern Cross (SB 3 1987); Right to Life (NSW) (SB 25 1987).
31. See In Vitro Fertilization (DP 15, 1987) at 8-12-13.
32. Ethics Advisorv Board, Department of Health, Education and Welfare, HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer (4 May 19/9) at 101.
33. J A Robertson “Embryo, Families and Procreative Liberty: The Legal Structure of the New Reproduction”. (1986) 59 Southern California Law Review 942 at 971.
34. National Health and Medical Research Council, Ethics in Medical Research (1983), Supplementary Note 4.
35. See IVF Discussion Paper at 3.22 based on information supplied by Dr B Burton; Also IVF Friends (April 1988) at 3-4.
36. See especially Presbyterian Womens Association (SBI6 1987); Womens Advisory Council (SB 4 1987); Right to Life (NSW) (SB25 1987).
37. Department of Community Services and Health (Cth), Commonwealth Perspectives on IVF Funding: A Discussion Taper A (Summary) at 4.
38. IVF Discussion Paper 2.22.
39. Note 37 at 4.
40. Rebecca M Albury (SB 2 1987); Womens Advisory Council (SB 4 1987); G Corea “Priorities”, paper delivered at the New South Wales Law Reform Commission, 6 May 1986. See also G Corea The Mother Machine (1985).
41. The incidence of major congenital malformations in liveborn and stillborn IVF infants was 2.6% compared to a national incidence for non-IVF infants of 1.5%. National Perinatal Statistics Unit Report (1987) at 13; IVF Dangerous for mother and child” SMH (3 May 1988) 3.
42. IVF Discussion Paper 4.23-4.24.
43. “Ten Years on IVF: is it worth it?” Leta Keens, Australian Womens Weekly (May 1988) at 91, 93.
44. “The Gruelline Baby Chase” Jean Seligmann, et al Newsweek January 1988 144-146.
45. See note 41.
46. “Teratogenic Effects of Clomiphene, Tamoxifen, and Diethylstilbestrol on the Developing Human Female Genital Tract”. G R Cunha et al, Human Pathology Vol 18 No 11 (November 1987); “Warning on in-vitro drug effects” Sydney Morning Herald (17.5.88) 8.
47. Dr R Klein, “The Exploitation of Infertility: The New Reproductive Technologies and their Impact on Women”; Dr R Rowland, “Living Laboratories: The New Reproductive Technologies and their Threat to Women’s Autonomy”; both papers given 16/5/88 at the ANZAAS Centenary, Congress, University of Sydney, 16-20 May 1988.
48. Transcript of Proceedings, NSW Law Reform Commission Public Hearing on In Vitro Fertilization.
49. See note 47.
50. Right to Life (NSW) (SB 25, 1987) at 2-4; Submission of Women’s Advisory Council (SB 4, 1987) at 1; Submission of the Knights of the Southern Cross (SB 3, 1987).
51. Australian Catholic Welfare Commission, (SB 29, 1987).
52. Ibid. Also United Church in Australia (SB6 1987); Council of Churches NSW (SB 18 1987).
53. Rebecca M Albury (SB 2 1987); Womens Advisory Council (SB 4 1987).
54. Right to Life (NSW) (SB 25 1987).
55. C Ewing, “IVF Genetic Engineering and Eugenics” paper given 16/5/88 at the ANZAAS Centenary Congress, see note 47.
56. “Woman to bear her sister’s baby” SMH 8/4/88; “Doubts over legal parentage of IVF baby” AGE 8/T788; “Victoria’s first be IVF Surrogate Mother may also the last” AGE 20/4/88; “Surrogacy: Adultery by remote control” AUST (13/6/88).
57. Ethics advisory Board Department of Health, Education and Welfare, HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer (4 May 1979) at 101.
58. NSW Law Reform Commission, Human Artificial Insemination (Discussion Paper 1) (DP 11 1984) at 34; Report on Human Artificial Insemination (LRC 49 1986) at 3.4, also 3.10—3.15.
59. Ibid.
60. J S Mill On Liberty, Chapter 1.
61. Law Reform Commission of Victoria Informed Consent to Medical Treatment (DP 7 1987) at 1.
