Bioethics law: passed, the extension of the PMA promises to be delicate



► When will the law come into force?

After four years of reflection and six readings in Parliament, the government seems to want to move quickly. “Many women are waiting. For some, it’s already too late ”, like to recall associations. The executive claims to have heard the message. “I have asked my services to work as of now on the application of important decrees, in particular that relating to the assisted reproduction”, told Olivier Véran to The cross, June 27.

→ TESTIMONIALS. Law of bioethics: tensions, disappointments, relief… Story of three years of debates

However, there remains an unknown: if the Head of State or deputies and senators seized the Constitutional Council, the implementation of the new legislation would be delayed for the duration of the procedure. Several parliamentarians The Republicans are already considering this recourse.

► What do we know about the psychological impact on children born to assisted reproduction?

The question stirred the hemicycle and gave rise to extensive discussions. Studies have existed for more than fifty years on children raised in homosexual or single-parent families by choice, but they have not ended the debates. Among the experts mentioned, “Susan Golombok, professor at the Center for Research on the Family, Cambridge, has followed cohorts of children from infancy to adulthood,” observes the deputy Jean-Louis Touraine, co-rapporteur of the bill. Findings of the researcher? Good-the psychological being of children raised in these families is quite comparable with that of children raised in so-called traditional families ”, she confided during her hearing before the deputies. In other words, they wouldn’t get better or worse.

“Many of these studies are biased and one-sided”, contests the child psychiatrist Pierre Lévy-Soussan. This specialist claims to observe a ” over-representation “ children born from medically assisted procreation with a donor in consultations. “PMA is a risk factor, because it blurs the genealogical story of the origins”, he decrypts.

The new legislation would only complicate matters by lifting anonymity. “Take the example of parentage. Until now, it was based on the principle of biological plausibility. By establishing a double maternal filiation in homosexual couples, the law henceforth eliminates the figure of the father and risks plunging the child into what I call an “original abyss”. For he cannot be born of two mothers. “ For the practitioner, the interests of the child are neglected, in the name of the suffering of adults.

→ EDITORIAL. Bioethics, a fight to continue

A speech that ulcerates the associations of homoparental families. “The quality of interpersonal relationships within a family is more important for a child’s development than the structure in which he grows up”, assures her side Susan Golombok. “Some children are doing well, admits Pierre Lévy-Soussan. But this law will contribute to the failure of a necessary precautionary principle around assisted reproduction. It is a scientific eradication of the father who makes the child take all the risks, this law will contribute to the failure of a necessary precautionary principle around assisted reproduction. “

► Will the medically assisted procreation centers be ready?

No, if we listen to the professionals of reproductive medicine. In 2018, 1,270 children (5.1% of children conceived by PMA) were born thanks to a donation. It is difficult to precisely assess the new demands that will arise from this new law, but by extrapolating from the number of women going abroad so far, the French Federation of Cecos (Center for Studies and Conservation of Eggs and human sperm) expects requests to multiply by at least 2.5.

“We have the will to respond, but how? asks Catherine Guillemain, the new president of the Federation. We have been alerting the legislator for months. We need administrative and medical staff to study the files (any request for assisted reproduction does not receive a favorable opinion, editor’s note) and take charge of new patients. Our current resources are not scalable. “

For an infertile couple, the waiting period currently fluctuates “Between 6 and 18 months”. Since then, “I do not see how the first pregnancies could take place before the end of the year, as the Minister of Health wishes”, doubts the specialist.

► Will there be enough donors?

In 2018, the 28 centers specializing in collecting gamete donation counted 386 sperm donors in France. Undoubtedly insufficient, if the demands increase. Especially since the new law adds, for children born of donations, the right to know their origins: when they come of age, the child will be able to have access either to non-identifying data (age of the donor, physical characteristics, etc.), or to his identity. With what consequence on donations?

→ TRIBUNE. Medically assisted procreation: “Growing up without a father or being conceived without a man, that has nothing to do with it! “

The law provides, as a first step, that the men who made a donation before the entry into force of this new text are recontacted, and their agreement obtained retroactively. But for future donors? An eye towards the stranger allows some predictions. “Countries which have changed their legislation in this direction, such as Great Britain, have indeed seen a change in the number of donors: first, a decline, then a recovery, with new profiles”, observes Catherine Guillemain. Campaigns to raise awareness of gamete donation are already planned for the start of the school year, with the general public.

► Can the rules surrounding assisted reproduction still evolve?

Advocates of the extension of the PMA do not hide it: this easing is only a step. Many hope that several measures, now rejected, will be included in the next revision of bioethics laws, scheduled in seven years. Among them: the opening of assisted reproduction to transgender men (born women and having retained their reproductive system despite their change in marital status) or post-mortem assisted reproduction consisting, for a woman, of continuing the assisted reproduction started with her husband. , even in the event of his death.

But for Senator (LR) Muriel Jourda, like many parliamentarians, it is above all surrogacy (surrogacy) that worries. “This extension of the assisted reproduction is the start of a process, considers the parliamentarian, a lawyer by profession. We made it a measure of equality. From there, male couples, too, will claim this principle to achieve their parental project. “ Questioned on the subject on several occasions, the executive maintains that surrogacy remains a ” Red line “, on behalf of “The unavailability of the human body”.

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The other measures of the law

The text review of bioethics laws comprises 32 articles, including:

Self-preservation of oocytes without medical reason. It authorizes a person of full age to keep their gametes with a view to subsequent production, “For his benefit”, medically assisted procreation. Until now, this storage was only permitted in the event of a disease affecting fertility.

Chimeric embryos. The law specifies that the modification of a human embryo by adding cells from other species is prohibited. The reverse is however authorized. This research aims to better understand embryonic development and, in the long term, to develop grafts. The creation of chimeric embryos had been suppressed by the senators, for fear of a blurring of the species border.

The relaxed blood donation. Homosexual donors, who since 2016 had to justify a period of abstinence of 4 months before being able to donate blood, will no longer be subject to any difference in treatment.

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