News,

Doctors at the British Medical Association's annual conference have referred to their medical ethics committee the proposal to require the written consent of patients before a decision is made not to resuscitate them. Dr Alex Freeman, a general practitioner from Southampton, told the conference that it was unacceptable for doctors to make do-not-resuscitate orders for patients with whom they were not familiar. She said: "All too often these decisions are made by junior doctors at the request of nurses and sometimes in the middle of busy ward rounds. It is difficult to have discussions with patients about resuscitation but this is no reason why discussions should not take place." [BBC News Online, 27 June&The Independent, 28 June] In addition, the conference rejected a motion criticising the BMA's guidance on the withdrawal of food and fluids from patients with severe stroke or dementia. It also welcomed the findings of a recent meeting which concluded against the idea of physician-assisted suicide, but then rejected a motion which would have incorporated this conclusion into official BMA policy. [Medical Ethics Alliance] One in 80 children (1.2 percent) born in Britain in 1997 was the result of in vitro fertilisation treatment, and in Denmark it was as many as one in 38 (2.6 percent). Across Europe, an average of 22 percent of treatment cycles resulted in a live birth, compared with 26 percent in America. American doctors usually transfer more embryos and instances of multiple births are higher. These findings were presented by Dr Karl Nygren of the Sofia Hospital in Sweden to the European Society of Human Reproduction and Embryology in Bologna. [Daily Telegraph, 28 June] [Behind the statistics relating to the proportion of live births to IVF treatment cycles lies the fact that a large number of unborn children are generated and then perish as part of the procedure.] A British academic has voiced concerns that the decoding of the human genome could lead to more abortions. Dr Tom Shakespeare, director of the Policy, Ethics and Life Sciences Research Institute at Newcastle University, was himself born with achondroplasia, a genetic abnormality which restricts growth. His father had the same condition, as do his two children. Dr Shakespeare asked: "Will we shift towards a brave new world of 'tentative pregnancies', where women will wait to check their developing embryos for a range of genetic diseases before deciding to press ahead with birth? ... It is urgent we debate this issue now and decide where the limits on such interventions be set." [Daily Mail, 28 June] A committee of the US House of Representatives has rejected a proposal to allow federal funding for international organisations which promote abortion. The House Appropriations Committee voted against the amendment by 34 to 26. The bar on US aid to non-governmental organisations which use their own money to lobby in favour of abortion has held up payment of almost 1 billion US dollars to the United Nations. The proposal did not challenge the separate ban on US aid for organisations which actually perform abortions. [Las Vegas Sun, 27 June] The number of doctors in Winnipeg, Canada, who are willing to perform abortions has halved from 22 to 11 since 1997. Despite this, the number of abortions performed each year in Manitoba province has remained steady at about 3,000. It has been claimed that doctors have been withdrawing from the official list of abortionists after an abortion doctor was shot in the shoulder in November 1997, but Rachel Murray of League for Life in Manitoba said: "I don't think it has anything to do with the shooting. I think it's a combination of a greater medical knowledge regarding the humanity of the pre-born child and the basic moral repugnance of the act." [Winnipeg Sun, 26 June; from Pro-Life E-News] The long-awaited decision by the US Supreme Court on Nebraska's partial birth abortion ban is expected today (28 June). The case, Carhart vs Stenberg, centres on the Nebraska law passed in 1997 (but not yet enacted) which prohibits partial birth abortions except to save the life of the mother. One in 1,800 abortions performed in the United States are thought to be done this way (technically known as dilation and extraction) and so far it has been banned in 31 states. President Clinton has twice vetoed federal bans on the procedure. This is the first major abortion case considered by the Supreme Court since it reaffirmed Roe vs Wade by five votes to four in 1992. [Boston Herald&Lincoln Journal Star, both 28 June]