Italians fail to overturn restrictive reproduction law
BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7505.1405 (Published 16 June 2005) Cite this as: BMJ 2005;330:1405All rapid responses
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I was troubled by this message, because in the cited article I made
two serious errors (concerning Italian politics) that were already spotted
and corrected. I apologize again for that.
As for the point of this latest response, I sometimes have to report
about surveys of modest scientific value, that for some reason are
important because they shed a bit of light on obscure matters, so I agree
that the study has limitations (in such cases I try to be as accurate and
clear as possible, of course within the space assigned, mostly devoted to
the real issue of the news article).
Still, I think nobody should be held responsible for not citing in
2005 data about 2006 (those you refer to).
Competing interests:
I am the author of the article
Competing interests: No competing interests
Mr Turone's article cites the results of a survey by the Observatory
of Procreative Tourism set up by Cecos Italia, an inter-clinic
association.
The figures mentioned by Mr Turone are, however, innacurate. The
survey above found an increase in the overall number of couples, from 1066
before the law to 4173 in 2006. The highest increase was in the 7 Spanish
clinics included in the survey, where the number of Italian couples rose
from 60 prior to the law, to 1356 after the law.
SOme aspects related to the survery should be raised, however. First,
the reporting is not entirely clear: The survey report does not mention
the exact time frame in which these numbers were registered. For instance,
are the numbers post-law for 2006 only, or for the period 2004-2006?
Also, there may be methodoloigcal concerns - for example the survey
included 27 clinics (in 10 countries), but the selection criteria for
these clinics is not clearly explained.
The general finding of the survey, i.e. the fact that reproductive
tourism from Italy to other coutrnies has been increasing in the post-law
period, is most likely true. What is untrue is the extent of this. Some
caution in interpreting the results may be thus recommended, and
limitations of the survery may be worth mentioning.
The original report can be found at:
http://www.cecos.it/sezioni/eventi/osservatorio.pdf.
Competing interests:
None declared
Competing interests: No competing interests
In this article about limitations to fertility treatments, Arne Sunde
was quoted as being suprised that The Vatican was intervening in Italian
Politics.
Where human rights and the defense of the innocent is concerned, the
church has always spoken clearly. If we were to overturn the argument, it
would seem that many governments are intervening in the intimacies of
human relations, reproduction and the beginning new life in an
unprecedented way. Ethics and morals have been explored, studied and
explained by the Church throughout its history, in order to guide the
faithful through the many pitfalls of life.
Suddenly it seems that these new reproductive techniques, which are very
controversial and unnacceptable to many taxpayers, are taking the place
of, and overturning basic human rights.
Competing interests:
None declared
Competing interests: No competing interests
Sir,
I write on behalf of Medicina e Persona, an association of more than 3.000
Italian nurses and physicians, which supported the present Italian law on
assisted fertilisation (AF) along with other associations of hundred of
Italian researchers (e.g. Scienza e Vita).
We were astonished by reading on the current issue of BMJ Fabio Turoni’s
paper entitled “Italians fail to overturn restrictive reproduction law”
(1). We were not surprised, because we read some similar papers by the
same author (2-4) or by S. Arie (5-7) in your journal: in particular one
(5) contained so many errors that even the former Italian Health Minister,
Gerolamo Sirchia, asked BMJ to correct them (8). Even in the present
paper, an absence of a thorough analysis and knowledge of Italian issues
appears (e.g. Mrs Prestigiacomo does not belong to AN party).
We wonder why such an important journal as BMJ cannot be objective in
reporting Italian data, avoiding to mirror only the ideas expressed by
Italian press. Italian media made a huge campaign against the present law
on AF and were defeated not by the church, but by common sense and by
millions of people who understood that human life is not a means for some
else’s health. The Catholic Church stands among the winners, but many non
religious physicians, ecologists and feminists joined the battle to
support the present law.
After the referendum, almost 80% (75% abstained and 2.5-5% voted NO; only
20-25% voted YES) of Italian people were defined “ignorant”,
“obscurantist”, “lazy”, by Italian opinion-leaders who had supported the
referendum against the AF law, and by people like the representant of the
Radical party Mr Turone interviewed. We cannot accept it. Many physicians
like us chose not to vote; many made conferences to explain the reasons
why a physician should preserve human life since its appearance, and found
thousands of people listening, participating and approving.
You can agreed or not, but this is the Italian news, and your journal
cannot affirm to be well-balanced if it defines the decision of 80% of
Italian people a failure, and if it reports only the angry reactions of
the losers. Many physicians, physiotherapists and nurses are catholic, and
with many non-catholic colleagues respect human life since its embryonic
beginning: do BMJ believe they are second-class professionals? Is there no
room for their opinion in the journal?
Felice Achilli, MD
President of Medicina e Persona
REFERENCES
1. Turone F: Italians fail to overturn restrictive reproduction law.
BMJ 2005;330:1405
2. Turone F. Italians celebrate success of treatment no longer legal in
Italy. BMJ. 2004 Sep 18;329(7467):643.
3. Turone F. New law forces Italian couple with genetic disease to
implant all their IVF embryos. BMJ. 2004 Jun 5;328(7452):1334.
4. Turone F. Italy to pass new law on assisted reproduction. BMJ. 2004
Jan 3;328(7430):9.
5. Arie S. Row brews over Italian abortion proposals. BMJ. 2004 Aug
21;329(7463):418.
6. Arie S. Woman forced to have three embryos implanted is allowed fetal
reduction to save her life. BMJ. 2004 Jul 10;329(7457):71.
7. Arie S. Crusading for change. BMJ. 2005 Apr 23;330(7497):926.
8. Girolamo Sirchia: Comments of the Italian Minister of Health.
http://bmj.bmjjournals.com/cgi/eletters/329/7463/418-a#72300
Competing interests:
None declared
Competing interests: No competing interests
Sir, the article from Turone in the current issue of the BMJ deserves
some comments. As a regular reader, I wish to know if this article is
somewhat representative of the journal policy, or whether it reflects only
the author's opinion; since dr. Turone seems to have no specific reason to
write on this theme (PubMed search), the article, who is by no means
objective, would have been better placed in a corrispondence or opinion
section of a such authoritative medical journal. Moreover, he cited some
popular scientists to support - without any prove - that "most of the
scientific community sided with the referendum". To my knowledge, neither
Rita Levi Montalcini nor Renato Dulbecco have worked in fertility
research. To listen Nobel laureates to speak in favour of the research is
as obvious as to listen Oscar Prize winners to apologize in favour of
cinema. Dr. Veronesi has served as minister of health of the previous
centre left government coalition, so he has a clear conflict of interest
on this topic.
Competing interests:
None declared
Competing interests: No competing interests
I am quite surprised by the Turone’s title (“Italians fail to
overturn restrictive reproduction law”). I guess it is frankly misleading.
It seems that actually the majority of Italian people want to cancel this
“restrictive”(?) (This is an opinion of Mr. Turone) law but for some
“mysterious” and “obscurantist” reasons this did not happen. I am Italian
and I decided, as more than 74% of Italian people, do not participate to
the vote in view to not achieve the quorum, using a strategy that our
present rules of the referendum clearly state. I took this decision for
ethical reasons only, not just for my religious belief and particularly
not in view to obey to the Catholic Church appeal. The Turone article,
instead, seems to suggest that the results of the Italian referendum
should be ascribed to integralism or to “low level of education” (sic!!)
of the people who decided for abstention. On which objective data Turone
decided that the results of the referendum are due to exclusively by a
“narrow-minded” religious behaviour? If this was the case why other
referenda, on divorce or abortion, obtained results not in line with the
Vatican view? Perhaps Turone thinks that the reason of this result could
be ascribed probably to the fact that there are now too few “cattolici
adulti” (smart Catholics) as Mr Prodi, the left party premier, has so
generously instructed us, “poor stupid Catholics”? In addition, the
article reported only declaration of people (Mrs Bonino, Mrs
Prestigiacomo, Mr Sunde) or institution contrary to the present law: I
think this is not a correct and impartial way to present such complicated
issue. It is not correct to state that the strategy of the Church, but
also the Committee against the referendum, was simply to “convince that
the issue were too complicated to be understood and decided by popular
vote” (again: probably 74% of Italian population is too stupid to
understand so complicated matter!!). Turone forget that, in fact, the
principal debate was if the embryo could have already all the right of a
living person or not: it is possible to have different opinion on that but
this is not a “complicated” issue, Mr Turone.
Sunde’s statement that “Vatican stands against biomedical research (!) and
treatment (!!)” is frankly a rash opinion: again it is really a pity that
the article did not report different opinion on this issue.
Finally, the article of Turone has also several mistakes:
· Actually the percentage of voting people in this referendum was 25.5%
(“Avvenire” Italian newspaper, June 15, 2005) (not 25.9% as stated in the
Turone’s article) (numbers are numbers)
· It is not true the reproduction law was approved by centre right
government only. This law obtained also the approval of several deputies
of the center-left parties.
· Mr Rutelli has never been, so far, an Italian Prime Minister.
· Mrs Prestigiacomo is a deputy of Forza Italia party not a member of
Alleanza Nazionale
Massimo Milani MD
Milan, Italy
Competing interests:
None declared
Competing interests: No competing interests
I'd say "75% of italians won", and not "italians failed...": this is
misleading. The majority of italian people did not vote, and supported the
present law, along with many non-catholic echologists and feminists (Enzo
Tiezzi, Oriana Fallaci...), despite the big campaign of all (all!) media.
Please, note that Mrs Prestigiacomo does not belong to Alleanza Nazionale
Party.
Competing interests:
None declared
Competing interests: No competing interests
"Italians fail to overturn restrictive reproduction law"
How about "Italians maintain proper controls over ethically sensitive
practices" OR "Italians resist slippery slope"?
Puts a different slant on things, doesn't it?
Paul Keeley
Competing interests:
None declared
Competing interests: No competing interests
Sir. The letter of your correspondent from Italy about referendum on
law 40/2004 on medically assisted procreation does not afford the simple
theme of the popular participation to referendum. Only 1 in 4 voters
effectively voted to modify this law, which needs really to be modified.
In my opinion, contrasts with abortion law and the situation of about
30.000 frozen embryos should be preliminary decided. The popular wisdom
did not accept ideas that cannot be fully understood in their
consequences. In previous referenda of general and understandable social
interest (e. g., abortion law, modifications to drug law, etc.) people
voted in very high percentage. In this case, people did NOT vote in very
high percentage, and I was among them. A student of mine, dr Stefano De
Pasquale Ceratti, wrote a chapter on this topic, and the chapter was
published prior of any decision about referendum. The matter of the
beginning of human life must be thoroughly studied from the ethical point
of view, and explained to people on all respects. Fortunately enough,
people and Parliament decide, not scientists.
Literature.
De Pasquale Ceratti S., Chapter CCXVII, La procreazione medicalmente
assistita, pp. 83- 136, in Trattato di Medicina legale e Scienze affini
(G. Giusti ed.), CEDAM, Padova 2005.
Competing interests:
None declared
Competing interests: No competing interests
Addendum Re: Re: Some more accuracy
For additional clarity:
the report I wrote for the BMJ about the 2006 survey on Procreative Tourism can be read at:
Italians are forced to go abroad for assisted reproduction
BMJ 2006;333:1192 (9 December)
Competing interests:
I wrote the news article
Competing interests: No competing interests