The purpose of my assignment with the World Congress for Freedom of Scientific Research was to research legislative changes that took place between April 2014 and May 2015 relating to abortion, end-of-life decisions, stem-cell research, and assisted reproduction technologies. By studying past news articles and websites dedicated to such topics, I had to determine whether or not answers to the research questions, previously formed by the World Congress, changed at all during the past year for individual countries. Any change in answers had the potential to change a country’s overall score, and thus change its’ ranking on the website. While many developments and trends developed throughout the past year relating to the aforementioned topics in various countries, not all developments effected a country’s score. In order to still capture such developments on the website, I posted news articles discussing them, which I linked to the relevant country so that they can be found under the “recent news” tab on a country’s individual profile page. After I believed I captured the major developments and trends from the past year, I started writing country overview reports for individual countries that did not already have such a report, starting from those missing in the top 10 and working my way down the rankings list.

Research Methods:

Two website primarily provided me with information regarding legislation changes for individual countries. One is BioEdge, a weekly newsletter that captures stories about bioethical issues throughout the world. It is an independent newsletter with various aims, including “to prevent evidence-based ethics in medicine” and “to provide high-quality, up-to-date information.” The second source was the Center for Genetics and Society, a nonprofit information and public affairs organization. They encourage “responsible uses and effective societal governance of human genetic and reproductive technologies and other emerging technologies.” In February 2015, I went through all of the posts made on both websites since April 2014 and have since checked the websites weekly for any other relevant updates. Once I found a topic that appeared relevant to World Congress’ study on these websites, I would search for news articles from major news sources, such as BCC, the Telegraph, Times, etc. to verify information about the topic and to find a strong article to post on World Congress’ website. In addition to using BioEdge and the Center for Genetics and Society, I continuously searched keywords and phrases, such as “abortion in Latin America,” and “euthanasia,” in Google News in order to find more developments from the past year.

To write country reports, I used a variety of resources that gave a general overview of a country’s regulations regarding abortion, end-of-life decisions, assisted reproduction technologies, and stem-cell-research. I captured some of the main sources in the “Further Readings” section in individual country reports.

Score and Ranking Changes:

Overview of Overall Ranking/Point Changes (Top 43-44 are listed on Research and Self Determination Index):

• Canada moved up to #8, going from 127 to 133 points
• India now ties with China at #10 with 129 points, up from 125 points.
• France moved up to #14, going from 115 to 125 points.
• Dominican Republic is now on this list as #44 with 31 total points.
• Israel stayed in place at #18 but went from 116 to 120 overall points.

Other Changed in Point for Countries Not on Overall Ranking List:

• Thailand went down to 74 points, for 76 points
  • Moved down from #20 to #22 on ART ranking
• Nigeria went down from 36 points to 35 points.
• Poland went from 29 to 42 points.
• Luxembourg went from 47 to 49 points in abortion category.  

Details on Point Changes:

• Canada:

Changes in Canada’s total score and ranking all occurred with the end-of-life decision category. In February 2015, the Supreme Court, in Carter v. Carter, struck down Canadian law prohibiting assisted suicide, giving Canadian adults who are mentally competent and suffering intolerably and enduring the right to a doctor’s help in dying. This decision will not be in effective until 2016. As a result, I change the physician-assisted suicide answer from “legally prohibited” to “unclear.” If the law does actually change in 2016, this answer should further change to “yes.” Moreover, research suggests that doctors do engage in passive euthanasia in Canada and are not prosecuted, even though it is illegal. Hence, although this is not a change that occurred over the past year, I changed the answer to the passive euthanasia question to fit the research.

• India:

India’s total score changed due to developments in euthanasia legislation, particularly with passive euthanasia. In December 2014, the Indian Supreme Court ruled to allow passive euthanasia for patients who are in a permanent vegetative state or are declared brain-dead. The decision was in response to the case of Aruna Shanbaug, who had been in a vegetative state for the past four decades.  

• France:

France saw developments with both its abortion legislation and end-of-life legislation, causing the country to increase in the overall ranking on the website. In terms of euthanasia, France passed legislation in March 2015, giving doctors new power to place terminally-ill patients in a “deep sleep” until they die. Not all legislators in France generally agree that that legislation classifies as euthanasia, so the questions to the physician-assisted suicide and active euthanasia questions are now marked “unclear.” In terms of abortion, legislation in France was passed in August 2014 that allows a woman to request an abortion for any reason during the first trimester of a pregnancy. This was done in an effort to increase gender equality in the country.    

• Israel:

In December 2014, an Israeli court approved passive euthanasia foa terminal ALS patient, the first decision of its kind in Israel. I thus changed the answer for passive euthanasia to “unclear,” giving Israel an increase of 4 points.

• Thailand:

In February 2015, Thailand banned commercial surrogacy agreements for foreigners as a result of two high-profile cases, including one case in which Australian parents abandoned an unhealthy boy born from a Thai surrogate, but brought home his healthy twin sister. This decreased the country’s score slightly for the assisted reproduction technology category since some commercial surrogacy agreements are no longer legally enforced.

• Nigeria:

I found a source that said RU-486 is not legal in Nigeria. This is not a recent development, but I found it when I came across an article recently written about the use of misoprostol in the country.

• Poland:

Poland did not have much information under the assisted reproduction technologies category. I was able to answer some questions from various sources found through Google News. I was encouraged to conduct this research due to recent legislative changes taking place in Poland regarding ART. The Polish government approved a draft bill in March 2015 to regulate IVF. Poland is the only country in the EU not to have IVF regulation. In general, the bill would make IVF available to married and unmarried couples, and ban sales and destruction of human embryos, cloning of human embryos and manipulation of human DNA.

• Luxembourg:

In December 2014, Luxembourg, similar to France, passed legislation no longer requiring women to invoke a “situation of distress” in order to get an abortion within the first 14 weeks of pregnancy. This slightly increased Luxembourg’s score in the abortion category.

Trends:

Assisted Reproduction Technologies:

            Much of the past year’s trends in terms of ART legislation involved IVF and surrogacy. As mentioned above, Thailand, a country that up until now was popular for commercial surrogacy internationally, has banned commercial surrogacy for foreigners. This occurred due to very high-profile cases in which babies born from surrogacy with birth defects were abandoned. The second major trend in terms of ART legislation involved Poland, the only EU country currently not possessing any regulation for ART. In March 2015, the Polish government has started to draft a bill regulating ART as described above. The Roman Catholic Church and other conservatives in Poland are expected to block the passing of this bill. Prime Minister Ewa Kopacz is expected to seek support from her Civic Platform (PO) party to help pass the bill.

            A major trend in terms of ART, which did not affect the website’s data, was the fact that the United Kingdom became the first country to approve three-parent babies. In general, a healthy mitochondria of a donor woman can be combined with DNA of two parents. As a result, mitochondrial diseases can be prevented in IVF babies.

End-of-Life Decisions:

            Many nations saw changes in euthanasia legislation this past year. Brittany Maynard sparked the debate in the US, and internationally, when she decided to take her own life in November 2014 after being diagnosed with stage four malignant brain cancer. Many people, including government officials and courts internationally, are beginning to recognize the “death with dignity” debate in favor of different forms of euthanasia.

            Three of the major legislative changes that have taken place in the last 12 months regarding euthanasia occurred in France, Canada and India. In France, doctors now have power to put terminally-ill patients into a “deep-sleep” until they die. This is part of President Francois Hollande’s commitment to have the terminally-ill afflicted by “unbearable” pain “to benefit from medical assistance to end their lives with dignity.” In Canada, the Supreme Court struck down the Canadian law prohibiting assisted suicide, saying that terminally-ill people who are mentally-competent can request a doctor’s help in assisted suicide. Lastly, in India, passive euthanasia was made legal for patients who are brain dead, or in a deep-vegetative state, due to a Supreme Court decision. None of the legislation in all three countries allows complete freedom for euthanasia, but it is a step to having more laws to allow for it.

            While other countries have not passed legislation, or had Supreme Court decisions, regarding euthanasia, they have been debates and talks of such legislations. Reports in February 2015 claim that the Columbian government, which has been in legal limbo regarding euthanasia since 1997, is strongly leaning towards legalizing euthanasia. Scotland is also leaning towards pro-euthanasia legislation. 

Stem-Cell Research:

            Not much of my research pointed me to new trends in terms of stem-cell legislation. As part of the ART bill being drafted in Poland, stem-cell research may become limited in the country. This would result due the ban of selling and creating human embryos. Despite the potential for this legislation to pass, the California Institute for Regenerative Medicine (CIRM) and the Medical University of Warsaw (MUW), a Polish state institution, have entered a collaboration in November 2014 to focus on advancing stem-cell research.

            In September 2014, Denmark is reported to soon begin first ever stem cell trials on humans. The patients tested will have multiple sclerosis (MS) who have suffered brain damage due to their illness. Scientists hope to begin these studies in 2015.

            Very recent news as of April 2015 is that Chinese scientist genetically modified the genomes of human embryos. This is a highly debated issue. While some argue it could lead to eradicating genetic diseases before a baby is born, others say that it could result in unpredictable effects for future generations.

Abortion:

            Abortion in the past year continues to become legalized with less limitations in countries throughout the world. Luxembourg and France, two counties that already had legalized abortion, now allow women to request abortions, no questions asked, during the first trimester of a pregnancy. Other countries are beginning to look into revising abortion laws to ensure safer abortions, and less deaths from backstreet abortions. One such country is Morocco, whose Islamist-led government has recently formed a panel of clerics, doctors, and legislators to look into relaxing a 50 year old abortion law that bans abortion unless there is a threat to a woman’s life or health. Some Latin American countries, with a strong Roman Catholic presence that fights to uphold age-old laws banning abortion, are also starting to explore relaxing abortion restrictions. Chilean President Michelle Bachelet, for example, sent a bill to Congress in February 2015, that would decriminalize abortion in some select cases, potentially removing Chile from the very small list of countries that still retain a complete ban on abortion. Dominican Republic President Danilo Medina is similarly proposing legislation to allow abortion in cases of rape, incest, a deformed fetus, or when a woman’s life is in danger.

            Stricter regulations for abortion laws have also been proposed over the last 12 months. The most prominent example is in Spain, in which the PP conservative party spokesperson, Rafael Hernando, has presented an amendment by which women aged 16 and 17 years old would need their parents’ authorization to undergo an abortion. In addition, Iran recently banned personal forms of birth control.