Dr Josie Muscat files Judicial protest on IVF - 10/7/2005

link to judicial protest reported in The TIMES

link to judicial Dr. Muscat's position in The TIMES

Infertility treatment: at what cost?
Dr Josie Muscat, managing director, St James Hospital Group, Zabbar.

After Dr Paul Soler used Bondiplus (TVM, June 7) to inform an astounded nation - and an even more astonished panel - that due to in vitro fertilisation (IVF) intervention "children were dying like flies" and doctors were pocketing millions, I called a press conference to put matters straight as to what the St James Hospital Assisted Conception Unit has been doing for the last 18 years to help childless couples achieve their dream of having children.

All the media were invited and reporters were encouraged to seek illumination on any part of the subject. Dr Soler (The Sunday Times, June 26) chooses to interpret this as a PR exercise, conveniently forgetting how he used Bondiplus to broadcast his own agenda nation-wide at one sitting. Although my press conference was simply an attempt to balance the enormous impact of that programme, it was in fact nothing new to St James Hospital.

Throughout the years, various people, including members of the medical profession and others prominent in the media, had contacted us and visited our laboratory to see for themselves the processes involved and to ask whatever questions they deemed pertinent.

The St James Conception Unit was hardly a secret site. Dr Soler could have visited it at any time of his choosing and asked his own questions. Instead he preferred to attack the Conception Unit for not publishing its data. I clearly stated when I faced the press that I had nothing to be ashamed of, much less anything to hide.

I have always held Malta's medical practitioners in great respect, united as we are in trying to alleviate humanity's problems to the best of our abilities with the tools science provides. I therefore do not intend to indulge in disparaging nuances. Nor do I intend to enter into a never-ending scientific controversy over the benefits and side effects of assisted reproduction technology.

The various contributions in the papers over this subject and allied controversies, all by honest, capable people, are enough to prove the diversity of opinion. Is it only this particular procedure that carries benefits as well as side effects? For every article quoted by Dr Soler, one can cite just as many, and indeed more, carrying a contrary opinion. That is the nature of scientific investigation. I pride myself on being one of the thousands of doctors world-wide helping couples whose prime wish in life is to have children.

I am also extremely proud of the fact that, in my 20 years in politics and in my 38 years as a doctor, no one has ever managed to tarnish my name as far as money is concerned. The mud Dr Soler is slinging at me will slip off like water off a duck's back. I have thrown down the gauntlet, but Dr Soler seems to have refused to take it up. I categorically stated in my press conference that if Dr Soler proves that my IVF medical fees have yielded millions, I will write a cheque for one million liri for him to buy ventilators for the SCBU at St Luke's Hospital, which seems, from what he keeps repeating, to be rather under-resourced. Am I to blame for that?

Yes, let's legislate and the earlier the better, for then Dr Soler will belatedly discover that the twins, triplets and quads finding their way into the SCBU will no longer be blamed on IVF intervention, but on other methods of assisted conception practised nation-wide and which no law can control or predict. And the SCBU will still have to gear up for the unexpected multiple births that, at present, it finds difficult to cope with.

So far, most of the discussion seems to have centred around babies and the scientific interventions available to us, money and, dare I say it, a certain amount of professional jealousy. One important aspect has been almost completely left out - the desire of husbands and wives, especially the latter, to have children, what the poets call "the immortal part of us" for in them we live on.

I am on record as having stated that I never cease to wonder at the tremendous sacrifices (and not just financial ones) that women are prepared to endure for the sake of having a child. I believe that no man can really understand this desire so unique to the female of the species. It is something that only women can describe.

This, of course, does not excuse anybody for being insensitive to the maternal instincts of women. One of my last patients had an ectopic pregnancy and lost her child. She tried IVF and lost all the three she was carrying. Surprising? Nature itself aborts 50-75 per cent of all embryos. This patient however was determined to try again. We transferred three embryos on the second cycle.

"Why?" I asked.

"Look doctor" was her answer, "God has already taken four of my angels. If His wish is to take the next three so be it, but I would be extremely thankful if He allows me to keep at least one."

The patient is now pregnant and, so far, doing well. Perhaps God has heard her prayer.

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