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ss Turning the Tide - Turning the Tide,  Knowing the Times

Knowing the Times

1 Chronicles 12:32 tells us about the men of Isaachar who 'understood the times' and 'knew what to do'. This training material is geared at these two ends. But we need first to be aware of what is actually happening in the world of medicine today - so here is a quick overview.


Euthanasia

Despite mounting public pressure euthanasia remains illegal in Britain.

However in the Netherlands there has been a steady escalation in euthanasia since the mid 1980s. According  to the Remmelink Report, commissioned  by  the  Dutch  Ministry  of Justice, there were over 3,000 deaths from euthanasia in the Netherlands in 1990 of which more than 1,000 were not voluntary.  These figures pre-date February 1994 when euthanasia  in that country was legally sanctioned.

Holland is moving rapidly down the slippery slope with the public conscience changing quickly to accept such action as acceptable. Handicapped  neonates and comatose patients are regulary euthanased without their consent and case reports have included killings for 'having abnormal genitalia' and 'mental suffering'.

Euthanasia was briefly legalised in the Northern Territory of Australia in July1996, but the legislation was overturned by the Australian Federal Parliament on March 24 last year after only four patients had died. The Supreme Court of the United States made unanimous rulings last June that there was no fundamental right to assistance in committing suicide. So far Oregon is the only state to succeed in making physician assisted suicide legal but the law is still held in abeyance by legal challenges. In spite of this Dr Kevorkian has presided over more than 50 such deaths without conviction in the last few years. In its  1992 Statement of  Marbella, the World Medical Association confirmed that assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession.

Elsewhere Colombia passed a law allowing euthanasia in May 1997 and the Phillipines and South Africa have also been considering legislation.


Abortion

Although abortion has been practised at some level by most societies, legal abortion on a massive scale is a relatively recent phenomenon. Since the Soviet Union first legalised abortion in 1920, much of the rest of the world has followed suit: Scandinavia  in  the 30s, Asia beginning in the  40s  and  Western Europe from the late 60s. By 1982 only 28% of the world's population lived in countries where abortion was largely illegal - mostly in Muslim countries, parts of Africa and Latin America. There are now estimated to be 55 million legalabortions performed each year worldwide.

Britain was the first non-Scandinavian Western country to liberalise its abortion laws in 1967. Since then almost 4 million abortions have been performed in England ,Wales and Scotland and there is currently one 'legal' abortion for every four live births.

  In England and Wales the annual total has stabilised at about 170,000. The majority (98.6%) are performed on the grounds of risk of injury to the mental or physical health of the pregnant woman or her existing children. Only 0.1% are done  because  of fetal handicap and 0.013% to save the life of the mother. For 58% of women it is their first pregnancy and 67% have never been married. Most  abortions (61%) are carried out in the private sector.

The typical woman having an abortion in the UK today is single, under 25, in her first pregnancy and having the procedure performed in a private institution for reasons of 'risk of  injury to the physical or mental health of the mother'.


Fertility Treatments

There are about 2 million infertile couples in the UK; about one in nine being affected. Artificial insemination has been available for some time and under the Human Fertilisation and Embryology Act human embryos may be created for treatment or research, and frozen, experimented upon or disposed up to 14 days after fertilisation. Donor eggs are widely used for fertility treatment and eggs from aborted fetuses and deceased women can be used legally for research.

Over 21,000 'test-tube' babies have so far been born in Britain using the techniques pioneered in Cambridge in 1978. Overall 18.5% of IVF patients become pregnant and 15% have live babies. The treatment costs about £2,000 per cycle and over 300,000 embryos have so far been produced. So in other words about 280,000 have either been used for research or have died before birth. Over 3,000 unclaimed frozen embryos were destroyed in mid 1996 when their five year expiry date ran out.

Many unmarried and lesbian couples have had IVF and AID respectively.


Prenatal Selection

Diagnosis of genetic diseases by amniocentesis (at 16 weeks) and chorion villus biopsy (8 weeks) are now commonplace in Britain and as a result the number of Down's Syndrome children alone being born in England and Wales fell from 764 in 1989 to 615 in 1993. 92% of cases diagnosed prenatally now end in abortion.A massive review of antenatal screening has called for the establishment of 35 screening centres throughout Britain so the practice is likely to become even more common.

Fifty-five couples have now had pre-implantation genetic diagnosis at the Hammersmith Hospital and almost 100 babies have been born after the procedure world wide. 'Treatment' licenses have been granted to two other London Hospitals, University College London and Guy's/St Thomas's.


Genetics

The Human Genome Project which will unravel the 100,000 genes in the human genome by the year 2,004 will cost £3bn. Information on more than 8,000 disorders is already available on the internet and rates of identification of 600 genes per day are possible with computerised technology. The knowledge base that the project promises to create has potential use in the screening, prevention and treatment of genetic disorders but only a handful of patients with rare conditions have benefited so far. While the future holds promise, there is a very long way to go, and the inevitable result is that more and more effort is being directed to prenatal search and destroy strategies.

Cloning by nuclear replacement has now been done in sheep and research in humans is underway and as yet effectively unregulated.

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