The division in a medical committee set up to examine the ethics of fertility treatment has highlighted the need for the establishment of a regulatory body to govern practices in this area.
The nine-member committee was divided on a number of issues in a report on assisted reproduction presented to the Institute of Obstetricians and Gynaecologists.
The chairman of the institute, Dr Harith Lamki, of Belfast, wrote at the beginning of the report that there were some members of the institute who were not happy with either all or part of its contents.
"However, the majority have accepted it, and I have agreed to have this note inserted at the front of the report." The next step, according to Dr Lamki, was to try to set up a regulatory body on assisted reproduction.
A committee member, Dr Denis Cusack, pointed out yesterday that the report did not contain guidelines.
Dr Cusack, director of forensic and legal medicine at the UCD Medical School, said: "How could there be when there was majority/minority opinion contained. There will still be discussion, I presume, with a view to establishing guidelines. The discussion was not acrimonious: people gave their opinion. Because there was no consensus the chairman very properly decided to do it in that way."
He said the committee wanted to look at the rights of the couple, as well as of the child, before and after birth, and the implications legally, ethically and otherwise. "It is a very complex area: you are unlikely to have unanimity."
It had been intended that the report would advise the Medical Council when its ethics code was being reviewed. The Medical Council guidelines were published in November. However, despite being established in June 1996, the committee did not report until late last year. The report was debated a number of times by members of the institute before it was finally adopted at the end of April.
A majority view on the committee considered that legislation was necessary in the area of assisted reproduction to lay down boundaries of what society considers acceptable, as well as giving guidelines to doctors.
The committee favoured the establishment of a licensing authority, which would initially be voluntary but eventually statutory. The overall view was in favour of the freezing of sperm, but not the posthumous use of it.
It was unanimously agreed that embryo-freezing should be introduced. A small majority was in favour of freezing at the pro-nuclear stage. Those who favoured freezing at the zygote stage - before the egg grows to more than eight cells - based their views on the benefit to patients arising from the ability of those involved in the treatment to be reasonably certain that a zygote was present at freezing.
A majority believed that donor insemination should be made part of assisted reproduction techniques. However, the committee was divided equally on whether egg donation should be made available. All were against any commercial business being practised in relation to egg or sperm donation.
