The evolution of health policy guidelines for assisted reproduction in the Republic of Ireland, 2004-2009

Abstract

This analysis reports on Irish regulatory policies for in vitro fertilisation (IVF) from 2004-2009, in the context of membership changes within the Medical Council of Ireland. To achieve this, the current (2009) edition of the Guide to Professional Conduct & Ethics was compared with the immediately preceding version (2004). The statutory composition of the Medical Council from 2004-2009 was also studied. Content analysis of the two editions identified the following differences: 1) The 2004 guide states that IVF "should only be used after thorough investigation has failed to reveal a treatable cause of the infertility", while the 2009 guide indicates IVF "should only be used after thorough investigation has shown that no other treatment is likely to be effective"; 2) The 2004 stipulation stating that fertilized ovum (embryo) "must be used for normal implantation and must not be deliberately destroyed" is absent from the 2009 guidelines; 3) The option to donate "unused fertilised ova" (embryos) is omitted from the 2009 guidelines; 4) The 2009 guidelines state that ART should be offered only by "suitably qualified professionals, in appropriate facilities, and according to the international best practice"; 5) The 2009 guidelines introduce criteria that donations as part of a donor programme should be "altruistic and non-commercial". These last two points represent original regulatory efforts not appearing in the 2004 edition. The Medical Practitioners Act 2007 reduced the number of physicians on the Medical Council to 6 (of 25) members. The ethical guidelines from 2004 preceded this change, while the reconstituted Medical Council published the 2009 version. Between 2004 and 2009, substantial modifications in reproductive health policy were incorporated into the Medical Council's ethical guidelines. The absence of controlling Irish legislation means that patients and IVF providers in Ireland must rely upon these guidelines by default. Our critique traces the evolution of public policy on IVF during a time when the membership of the Medical Council changed radically; reduced physician contribution to decision-making was associated with diminished protection for IVF-derived embryos in Ireland. Considerable uncertainty on IVF practice in Ireland remains.

The Evolution of Legislation in the Field of Medically Assisted Reproduction and Embryo Stem Cell Research in European Union Members

“…It has been published first in 2004 and more recently in 2009, which represents the last version [50, 52]. …”

Comparative study of regulations of Assisted Reproduction between England, Italy, Norway and Ireland

“…In all the countries analyzed it is allowed the realization of homologous and heterologous fertilization. [10][11][12][13][14][15] The anonymity of the heterologous fertilization is required only in Ireland, 14,15 although some clinics use the gametes of a known donor, 16 as realized in England. 12,13 In Norway, 11 the people generated from the AHR technologies can contact their donor after the age of 18.…”

“…The Ireland does not have a law that regulates the AHR, although there is a conduct guide named Guide to Professional Conduct and Ethics for Registred Medical Practitioners, published by the Medicine Federal Council. The first one was published in 2004 14 and reformulated in 2009 15 . It was stipulated in 2004 that the fertilized oocytes must be used to the implantation, and could not be discarded.…”

Medical Student Experiences in Clinical Reproductive Medicine: Dual-Cohort Assessment of a New Learning Module at the Royal College of Surgeons in Ireland

“…Work conducted in the United States has shown that medical student research activities can impact favourably on future careers; this outlet is not for everyone and many students do not think a research project should be required for graduation [9]. Although completing a research project was impossible given the module's brief duration, our students used this time to frame a research concept to which they later returned for completion-this generated downstream original research which was subsequently published with medical students as first [10] or second [11][12][13] author.…”