Monitoring freedom of research and cure in NEW ZEALAND* Table of content: A. Artificial reproduction technologies (ART) B. Research with human embryonic stem cells (hESC) C. End-of-life decisions D. Abortion and contraception A. Artificial reproduction technologies (ART) After extensive research, one can conclude that New Zealand is rather liberal on prenatal genetic diagnosis. In June 2004, the Minister gave approval in principle for PGD to be offered in New Zealand, subject to National Ethics Committee on Assisted Human Reproduction (NECAHR) developing guidelines ensuring it is safe and ethical to use. The use of PGD for non-medical reasons is prohibited. Its aim is to help carriers of serious genetic disorders having children without the risk of passing on an inherited condition. As for sperm, embryo, and cryopreservation, New Zealand has little or no regulation pertaining to these practices. There are, however, case by case approvals. So, even though there is practically no regulation, cases could be denied on a person- to-person basis depending on the ethics surrounding the couple’s circumstances. (Remark 1: According to the International Federation for Fertility and Sterility Surveillance 2007: A Worldwide Compendium of National Rules and Regulations for ART, ART in New Zealand is regulated by statute but it further is possible to withdraw licenses in many instances, and, indeed, imprisonment may occur, for 5 years or a fine of >$200,000 may be imposed in the event of a violation. ART is permitted for single women and lesbian couples. Two embryos is the rule (with occasional exceptions). Cryopreservation of oocytes, cryopreservation of embryos and cryopreservation of ovarian or testicular tissue are allowed. Posthumous insemination is allowed. In New Zealand, the specimens can only be used by a named person, and prior informed consent is essential. Case-by-case approval by an ethics committee is required in New Zealand if donor sperm and donor egg are used or for cross-generational donation. There is a limit of three couples per donor. Embryo donation is permitted. Donors become identifiable. When children are born from donor gametes, the clinic must give their name and the donor’s name to the Department of Birth, Deaths, and Marriages. Children can access the donor’s identity when they reach 18; parents may access the donor’s identity once a child is born. The donor may request access to donor children’s identity when they reach 18, but children can decline. Donors and offspring involved in donor sperm or donor egg treatment before commencement of the Act can elect to join a voluntary register. In New Zealand, PGD is publicly funded when the chance of the child being affected is more than 25%). (Remark 2: D Gareth Jones, Professor at the Department of Anatomy and Structural Biology of University of Otago notes that “there are a number of major errors. This is mainly because the information being used is out-of-date. The guiding legislation is now the HART (Human Assisted Reproduction Technology) ACT 2004. This can be found at: http://www.legislation.govt.nz/act/public/2004/0092/latest/whole.html; http://www.moh.govt.nz/moh.nsf/pagesmh/4158?Open The essence of this Act is that there are now two committees, the Advisory Committee (ACART) http://www.acart.health.govt.nz/ and the Ethics Committee (ECART) http://www.ecart.health.govt.nz/. The former is a policy making committee, while the latter makes decisions on the approval or otherwise of applications that have to go through a committee. It is true that some of the guidelines drawn up by the predecessor committee (NECAHR) are still in operation, until ACART draws up replacement guidelines that are approved by the Minister of Health. Hence the regulations covering PGD. I do not think that the NZ regulations are as liberal as your commentary makes out. There is regulation of sperm, embryo and cryopreservation; these are covered by the HART Act. There are no licences for fertility clinics, and so licences cannot be withdrawn. Posthumous insemination is not allowed. This is currently being discussed by ACART. Embryo research is not allowed. In June 2007 ACART recommended that it be allowed using surplus embryos within fertility programs, but this has never received approval by the present or previous Minister of Health. The recommendation exists in limbo. Hence the derivation of embryonic stem cells within New Zealand is not allowed. The contrast between the New Zealand situation and that in Australia is marked. New Zealand may be relatively liberal on surrogacy using fertility clinics. This is covered be the HART Act and is tracked by ECART�?). B. Research with human embryonic stem cells (hESC) When it comes to human embryonic stem cell research, New Zealand allows such research with a few guidelines and regulations that must be followed. Since research done with human embryonic stem cell can be quite a sensitive ethical issue for many people, New Zealand developed proposed guidelines that might overall affect scientists’ opportunities to develop future advances in this field. New Zealand developed guidelines such as the Human Assisted Reproductive Technology Act of 2004, which states regulations on the research involving human embryos. Although research involving human embryonic stem cells is currently undertaken in New Zealand, researchers in the country are still very much interested in research that involves embryonic stem cell lines. (Remark 3: According to UNESCO “REPORT OF IBC ON HUMAN CLONING AND INTERNATIONAL GOVERNANCE�? of June 2009, the Human Assisted Reproductive Technology Act (N° 92/2004) of 10 November 2004 as amended by the Human Assisted Reproductive Technology Amendment Act (n°63/2007) of 19 September 2007 regulates reproductive cloning in New Zealand, namely: “Schedule 1: FIRST Prohibited actions 1) Artificially form, for reproductive purposes, a cloned embryo […]. 3) Implant into a human being a cloned embryo. […] 9) Implant into a human being gametes derived from a foetus, or an embryo that has been formed from a gamete or gametes derived from a foetus. Section 8: (1) Every person commits an offence who takes an action described in Schedule 1. […] (4) A person who commits an offence against this section is liable on conviction on indictment to imprisonment for a term not exceeding 5 years or a fine not exceeding $200,000, or both�?. As for reproductive cloning, research on stem cells is not prohibited by the law which gives the authority to advisory boards in cooperation with the Ministry of Health to edit guidelines on this issue. These guidelines have been adopted in September 2006 by the Ministry of Health authorizing the use of established stem cells for research even if the use of IVF (in vitro fertilized) embryos is prohibited. Comment by UNESCO: the law sets some restrictions as the prohibition to develop an in vitro embryo after 14 days or the storage of such embryos for more than 10 years. It also sets conditions on the acquisition of embryos from donors or import. Any violation shall be liable to imprisonment penalties and/or fines). C. End-of-life decisions As for end-of-life decisions, patients in New Zealand are free to make their own decisions when it comes to refusing life-sustaining medical treatment. Also, decisions involving withholding life-prolonging medical treatment with the intention to hasten death in the patient’s interests because of their expected negative quality of life are quite free, while active euthanasia and physician-assisted suicides are illegal. D. Abortion and contraception Overall, New Zealand has a liberal policy when it comes to abortion and contraceptives. New Zealand law allows its doctors to use most of the abortion and contraceptive practices available. However, there are limitations in the use of contraceptives. For example, over the counter drugs are not available, because doctors are most apt to apply the products beneficially to their patients. They are extremely liberal when it comes to the use and distribution of abortion and contraceptive products to minors. The minors have access to the products, do not need parental consent, but are limited to its use like the adult women are. Finally, the government will subsidize abortion products and services, but not contraceptives. New Zealand is more liberal than the United States in terms of its abortion and contraceptive policies. (Remark 4: According to the report Abortion Worldwide: A Decade of Uneven Progress, by Singh S et al., Guttmacher Institute, 2009, despite the existing legal restrictions abortion is available virtually on request in New Zealand. Abortion is legally permitted to preserve physical health (and to save a woman’s life) and to preserve mental health. Access to contraceptive services is adequate). *(New Zealand was surveyed by the students of Bryant University, RI, USA. Last update: March 2009. Little remarks have been added. Any peer review of data is welcome) Missing info on: E. Therapeutic uses of narcotic drugs; F. Pain treatments