Country Report – Canada:
Canada is currently one of the few countries in the world that does not place any legal restrictions on abortion. In 1969, during former Canadian Prime Minister Pierre Trudeau’s Liberal administration, a law was introduced legalizing abortion in Canada as long as a committee of doctors signed off that it was necessary for the physical or mental well-being of the mother. However, in 1988, the Supreme Court of Canada, in R v Morgentaler, ruled that the 1969 law was unconstitutional on the grounds that it violated a woman’s right to security of person. Despite there being no federal restrictions, provincial laws vary and pro-choice supports say access for abortion remains difficult for Canadian women in rural or remote communities. Since December 2012, Health Canada has debated whether or not to approve RU-486 and, as of January 2015, continues to push back the decision to legalize the drug. Liberal leaders in Canada continue to fight for pro-choice laws.
In 2004, Canada passed the Assisted Human Reproduction Act, designed to regulate human reproduction and related research in Canada. The Act is one of the most comprehensive legislation pieces in the world regarding reproductive technologies, but the Canadian Supreme Court in 2010 ruled that certain sections of the Act exceeded the federal government’s legislative power and were deemed unconstitutional. Many argue the Act also indirectly helped create a quasi-black market for assisted reproduction in Canada, and is still driving many parents to go outside of Canada for assisted reproduction. For instance, federal law makes it a criminal offence to buy sperms or eggs from a donor in Canada, but it is legal for Canadians to buy eggs and sperm from the US. Moreover, fertility services in most provinces have very little, if any, oversight and quality of the clinics greatly varies. Despite the current shortcomings in the law, egg and sperm donation is permissible and IVF surrogacy agreements are enforceable in Canada.
While advance directives are enforceable, and a physician is required to respect a patient’s refusal of life-sustaining treatment in Canada, euthanasia is typically considered murder in Canadian criminal code and is thus illegal. In February 2015, however, the Supreme Court of Canada, in Carter v Carter, struck down Canadian law prohibiting assisted suicide, giving Canadian adults who are mentally competent and suffering intolerably and enduringly the right to a doctor’s help in dying. This decision will not be in effective until 2016. Furthermore, many sources note that passive euthanasia is practiced by doctors in Canada.
In 2006, Canada enacted a law permitting research on discarded embryos from IVF procedures, but it prohibits the creation of human embryos for research. In 2010, guidelines were issued for human stem cell research, saying the embryos must have originally been created for reproductive purposes, the persons from whom the embryos were created must provide free and informed consent for the unrestricted research of the embryos created, and the embryo must not have been obtained through commercial transactions.
Further Readings:
http://www.cbc.ca/news/politics/3-things-to-know-about-abortion-in-canada-1.2635269
http://www.parl.gc.ca/Content/LOP/ResearchPublications/2010-68-e.htm
http://stemcellfoundation.ca/en/
Country Report – Sweden:
Abortion first became regulated in Sweden under The Abortion Act of 1938. Over the years, the Act was amended, and the most recent amendment, put into law in 1974, states that up until the 18th week of the pregnancy, the choice of an abortion is entirely up to the woman for any reason. After the 18th week, a woman needs permission from the National Board of Health and Welfare to have an abortion, which usually grants late abortions for cases in which the mother or fetus are unhealthy. Once the fetus is viable (generally considered to be at 22 weeks), abortion is not allowed. Swedish citizens are found to be in favor of preventing unwanted pregnancies by the use of birth control. Yet, even with the promotion of birth control, studies in 2013 showed that Swedish abortion rates continue to rise. According to the Pew Research Center, abortion has not been a politically controversial topic in Sweden.
Most assisted reproduction technologies are regulated by the Swedish Genetic Integrity Act of 2006, as well as several other acts and general advice from the National Board of Health and Welfare. Heterosexual and lesbian couples who are involuntarily childless are entitled to fertility treatment, along with single women. Egg and sperm donations and IVF treatments are all permitted in Sweden as well. Egg and sperm donors cannot be anonymous and donor-conceived children have a legal right to access the data on the donor. Surrogacy in Sweden is illegal.
In 2010, the Swedish National Board of Health and Wealth clarified that passive euthanasia is legal in Sweden, allowing doctors to halt life-extending treatment if a patient asks. However, active euthanasia in Sweden is considered illegal and regarded as murder. The BBC reported a survey in 2008 that suggests 84% of Swedish doctors would never consider helping a patient die, even if the patient asked for it and it was legal. Advance directives are enforceable in Sweden.
Human embryonic stem cells can be derived, and studied, from excess IVF embryos and by somatic cell nuclear transfer (SCNT). The Activities Involving Human Eggs for Research and Treatment Purposes Act 1991 allows for research on embryos for up to 14 days after fertilization. The Biobanks in Medical Care Act 2002 set up a national stem cell bank. The Act on Genetic Integrity 2005 allows for the creation of human embryos for research using SCNT. However, reproductive cloning in Sweden is illegal.
Further Readings:
http://abortioninsweden.org/legislation-and-costs/
http://www.eurostemcell.org/regulations/regulation-stem-cell-research-sweden
Country Report – Denmark:
In Demark, abortion was fully legalized in October 1973, making it legal for an abortion to be performed on-demand from the request of a woman as long as her pregnancy has not exceeded 12 weeks. Abortions must be carried out by a doctor at a state or communal hospital, or a clinic that is attached to a hospital. An abortion can still be performed after the 12 week period if the woman’s life or health are in danger. Sometimes a woman will be given authorization to abort after 12 weeks if she is in a poor socioeconomic condition, was a victim of rape, or if there is a mental health risk or risk of birth defects to the fetus. Such authorization must come from two doctors and one official from the local municipality. The Danish Family Planning Association provides information on sexual health, pregnancy and contraceptive methods to the public.
Demark has typically been praised in Europe for its widespread access and availability of treatment for artificial reproduction. Danish law number 460 of June 1997 regulates artificial reproduction in connect with medical treatment, diagnosis, and research. In 2006, law number 535 amended the 1997 law to allow for single women and same-sex couples to have access to ART, for the evaluation of parental incompatibility, and for the prolongation of the storage period for cryopreserved eggs from 2 to 5 years. In 2004, legislation in Denmark also made the use of preimplantation genetic diagnosis legal in association with artificial fertilization in cases related to the treatment of children with potential lethal diseases.
Physician-assisted suicide and active euthanasia are not specifically outlawed in Denmark, but medical assistance in death may be penalized. The topic of euthanasia is periodically reviewed and debated in Demark. Danish Parliament has assigned ethics panels over the years that, thus far, have advised against active euthanasia legislation. In May 2012, the panel was noted to have a heated debate about the issue. Advanced directives in Denmark are legal.
The Danish government allows for stem cell research that destroys embryos only in the case of “spare” IVF embryos and only until 14 days after fertilization. Derivation of stem cells from somatic cell nuclear transfer and non-human animal eggs is prohibited. Hoping to begin in 2015, Danish scientists could become the first ever to conduct clinical stem-cell trials on humans to try to treat multiple sclerosis patients.
Further Readings:
http://www.stem-cell-forum.net/danish-center-for-stem-cell-research/
Country Report – China:
Data published in 2013 by China’s National Health and Family Planning Commission indicate that there are more than 13 million abortions conducted in China each year. Abortion is legal in China and considered a government service available on request for women, but sex-selective abortion is outlawed. In accordance with its one-child policy to control population growth, family planning and contraceptives are also legal and widely available in China. Although forced abortions are a violation of Chinese law and are not part of any official policy, they were associated and implemented by local authorities with the administration of the one-child policy.
Assisted reproductive technologies began to be offered in China in the mid-1980s with the first IVF baby born in Taiwan in 1985. ART centers in China are dedicated to providing patients with many procedures, including IVF treatments, oocyte cryopreservation, elective single embryo transfer, and preimplantation genetic diagnosis, all of which are producers that are legally available throughout China. Despite ART being generally legal in China, the social and cultural atmosphere of the country, along with the one-child policy, has resulted in restrictions on some forms of ART and ART remains inaccessible to many infertile couples in China.
Euthanasia is a criminal offense in China and advanced directives are legal but subject to significant restrictions. The Chinese culture traditionally considers the word for “death” to be bad luck and the Chinese tend to spare no effort to get the best medical care available to extend the life of a loved one, even if he/she is very close to death from a terminal disease. Recently, however, a 2013 survey shows that more than two-thirds of Chinese have an open and tolerant perspective toward euthanasia. Doctors in China are also generally beginning to become more supportive of euthanasia practices.
In comparison to other countries, China’s regulation of stem cell research is considered relaxed. This can be attributed to the fact that most Chinese citizens do not view the embryo as containing any inherent moral value. In fact, according to Confucianism, a person begins with birth. However, the government has started to implement some regulations as a result of the increased interest in the field. In 2003, the Ministry of Science and Technology, along with the Ministry for Health, issued ethical guidelines for human embryonic stem cell research. The guidelines state that the embryos for research should come only from spared embryos from IVF, fetal cells from accidental spontaneous or voluntarily selected abortions, blastocyst or parthenogenetic split blastocyst obtained by SCNT, and germ cells voluntarily donated.
Further Readings:
http://www.chinadaily.com.cn/china/2013-12/31/content_17206128.htm
Country Report – India:
Abortion laws in India can be found under the Medical Termination of Pregnancy (MTP) Act, enacted in the country in 1971. Pregnancies not exceeding 12 weeks may be terminated based on a single opinion from a doctor formed in good faith, and pregnancies between 12 to 20 weeks require the opinion of two doctors for an abortion to be authorized. While the MTP does not allow pregnancy terminations after 20 weeks, there have been recent proposals in October 2014 for the Indian Parliament to allow for abortions up until 24 weeks of pregnancy. Despite abortion being legal in India, an estimated two-thirds of abortions performed in the country are unsafe, performed illegally at homes and/or by midwives. The annual death toll of women from abortions is 4,600. Better and safer access has yet to be universalized in the country, especially for women in rural Indian.
In 2010, the Ministry of Health & Family Welfare of India designed a bill to regulate assisted reproductive technology (ART). However, the bill continues to be tabled in Parliament each year. Commercial surrogacy in India is legal and enforceable through contracts. In 2012, a study supported by the UN estimated that the surrogacy business in India generates more than $400 million a year and over 3,000 fertility clinics across India exist. The Indian Council for Medical Research has published guidelines regarding ART in 2005, which discuss the importance and need for surrogacy.
The Supreme Court of India had ruled in 2011 that passive euthanasia is permissible by means of the withdrawal of life support to patients in a permanent vegetative state. The decision came from a verdict made as a result of a case involving Aruna Shanaug, who has been in a vegetative state for 37 years in an Indian hospital. Recently, in December 2014, the Indian government endorsed and re-validated the passive euthanasia judgment. Active euthanasia, along with advanced directives, is illegal.
India is very progressive in terms of stem cell research with research funded and supported in both the public and private sectors. Guidelines for stem-cell research are created by the Department of Biotechnology (DBT) and the Indian Council for Medical Research (ICMR). Under the guidelines, stem cell therapy is still prohibited despite the country’s fairly liberal stance on stem-cell research. The use of human pre-embryos for experimental purposes is legal, along with the derivation of new hESC lines from SCNT and supernumerary IVF embryos.
Further Readings:
http://irssh.com/yahoo_site_admin/assets/docs/18_IRSSH-392-V4N1.321102751.pdf
http://www.businessinsider.in/Stem-CellResearch-In-India-Surges-Ahead/articleshow/40278445.cms
Country Report – Singapore
In Singapore, abortion is legal and available on request during the first 24 weeks of a pregnancy. The Singapore Abortion Act, originally enacted in 1974 but since amended, does not define an age limit for abortions, nor require minors to receive parental consent. Before the procedure, the Act requires that women undergo brief counselling by a qualified counsellor at an accredited abortion clinic. A mandatory 48 hour waiting period must be taken after the counselling. The mandatory counseling and wait period have been attributed to decreases in the number of abortions being performed in Singapore annually since it was legalized in 1974. In addition, many family planning services, including various hotlines, are available to Singapore women. Emergency contraception drugs are also legal and readily available.
Regulations for assisted reproduction technologies in Singapore have recently developed under the Status of Children (Assisted Reproduction Technology) Act passed in 2013. The act states that the woman who carries a baby is considered the baby’s legal mother and several scenarios concerning fatherhood are outlined. However, critics argue that the Act needs to be more comprehensive as it fails to address many key issues of ART, such as women freezing their eggs or turning to surrogacy overseas. AR procedures can only be carried out on a married woman (not single woman or same-sex couples) and with her husband’s consent in Singapore. Women also cannot be older than 45 to pursue AR treatments.
In May 1996, the Singapore Parliament passed the Advance Medical Directive (AMD) Act, legalizing AMDs in the country. The Act has been extended to defend and legalize the practice of passive euthanasia. Active euthanasia, however, continues to remain illegal in Singapore. In the fall of 2014, the Institute of Policy Studies conducted an open debate asking the public whether is it time for Singapore to consider a right-to-die bill, of which only 34.5% of people who participated agreed.
The use of human embryonic stem cells is legal in Singapore, for both therapeutic and research purposes, as long as they are no more than 14 days old. In 2006, the New York Times called Singapore a “haven” for stem-cell research due to the country’s liberal laws and liberal government financing for the field. Since 2000, Singapore began an initiative to diversify and strengthen the economy of the country by investing in biotechnology. The country has since attracted many drug companies, and even American scientists, to conduct research through tax incentives and government funding.
Country Report – New Zealand:
About 15,000 New Zealand women abort pregnancies each year. Abortion in New Zealand is legal when a woman faces a danger to her life during a pregnancy, suffers from physical or mental health, or if there is a risk to the fetus. Otherwise, under the Crimes Act of 1961, abortion is considered a crime in New Zealand. If a woman requests an abortion after 12 weeks of gestation, it must be performed in a “licensed institution.” In addition, the abortion must be approved by two doctors, one of which much be a gynecologist or obstetrician. Other legislation passed in the country regarding abortion is the Contraception, Sterilization, and Abortion Act of 1977, which established the Abortion Supervisory Committee that reports to Parliament. They oversee the quality of abortion services and where they are available, and monitor the procedures to be adopted by a woman seeking abortion. Emergency contraceptives and counseling services are also provided to women.
In 2004, the New Zealand Parliament passed the Human Assisted Reproductive Technology Act, which provides guidelines for how people should legally engage in assisted reproductive procedures, including promoting the health and well-being of the women and children involved. Sex-selection is illegal under the Act. Commercial surrogacy in New Zealand is also illegal, but non-commercial surrogacy, motivated by reasons of compassion is legal. To be a surrogate, a woman must submit an application to the National Ethics Committee on Assisted Reproductive Technology (ECRAT), who will consider it on a case-by-case basis. Embryo and egg freezing is legal, and single women and same-sex couples also all have access to ART.
Both passive and active euthanasia are currently illegal in New Zealand, but advanced directives can be used. Under the Crimes Act of 1961, it is illegal to “aid and abet suicide.” Despite the country’s strong legislation against euthanasia, evidence suggests that many in the public support it. Surveys conducted by both Massey University and Voluntary Euthanasia Society in 2008 show that over 70% of New Zealanders support euthanasia, particularly if performed by a doctor. Death with Dignity bills have been introduced to the New Zealand Parliament in both 1995 and 2003, but both failed.
In New Zealand, legislation only permits embryonic stem cell research on imported stem cells. In November 2005, the Ministry of Health released guidelines for conducting research on stem cells and outlined the ethical issues raised by hESC research. These guidelines place considerable guidelines on researchers, including mandatory ethical review of research applications.
Further Readings:
http://www.stuff.co.nz/national/health/10155612/Is-abortion-law-due-for-a-shakeup
http://www.law2.byu.edu/isfl/saltlakeconference/papers/isflpdfs/Atkin.pdf
http://www.msi.govt.nz/assets/MSI/MoRST-Archive/Futurewatch-Stem-Cell-Report.pdf
Country Report – South Africa:
South Africa has been noted to have very liberal abortion laws, compared to other countries, with its Choice on Termination of Pregnancy Act of 1996. The Act allows abortion on demand up to the 12th week of pregnancy for a woman of any age, under broadly specified circumstances from the 13th to 20th week, and only for serious medical reasons after the 20th week. Consultation with parents, if under 18, and with spouse, if married or in a life-partner relations, is advised, but not legally required. An abortion can be performed for free at certain state hospitals or clinics. The legalization of abortion has led to a decrease in deaths from backstreet abortions, which prior to 1996 was a serious problem in South Africa, but deaths following abortions are still considered to be high in the country. In 2010, the South African Medical Research Council found that 50% of abortions undertaken by young girls aged 13-19 were performed outside of a hospital or clinic. In addition, according to a report from the Reproductive Health journal in South Africa, 30% of women in the country think abortion is illegal.
All South African women have access to artificial insemination and ART in general and altruistic surrogacy is recognized and accessible to all couples, including same-sex couples. Egg and sperm donor conception are enforced by the Human Tissue Act of 1983, permitting the donation of egg and sperm, and the Children’s Act of 2005, enacted to protect all children, including those conceived through donation methods and surrogates. Sex-selection is not explicitly illegal, but guidelines released by the Medical Research Council of South Africa advises that sex-selection through the use of technology is unethical.
Both active and passive euthanasia is legally prohibited in South Africa. A debate about whether or not it should be legalized in the country began over 15 years ago when President Nelson Mandela engaged the South African Law Commission to study end-of-life decisions. The study resulted in the proposal of the End of Life Decision, which was tabled by Parliament in 2000 and has not been advanced since. It has still never been debated or open for public debate.
The Human Tissue Act also deals with embryo research in South Africa. However, Chapter 8 of the National Health Act is set to replace the Act in regards to stem cell research. The NHA Chapter 8 will allow the Minister of Health to allow for embryos not older than 14 days to be used for research purposes. Guidelines from the South African Medical Research Council advise against the creation of embryos for the sole purpose of research. The South African courts have ruled that the South African Bill of Rights is not applicable to the unborn, which also fuels to the debate about how much autonomy scientists should be given to perform stem-cell research.
Further Readings:
http://allafrica.com/stories/201402131596.html
http://www.sajbl.org.za/index.php/sajbl/article/view/171/171
Country Report – France:
As of August 2014, in an effort to increase gender equality in the country, abortion in France became legal during the first 12 weeks of pregnancy at the mere request of a woman. Previously, a woman needed to have a medical reason for getting an abortion. Abortions at later stages of pregnancy are legally allowed if two physicians certify that the abortion will be done to prevent “grave permanent injury” to the physical or mental health of the woman and/or child. It is customary in France to schedule abortions one week after demanded by the patient. Moreover, France was the first country to legalize the use of RU-486 in 1988 and some estimate that a quarter of all French abortions use this drug today. Data from 2009 suggests that the abortion rate in France is 17.4 abortions per 1000 women aged 15-44 years old.
Several laws and decrees establish regulations of ART in France. One such law is the Bioethics Law of 2004, which strongly advocates values of respect for the dignity of a human embryo, respect for all stages of life, and respect for human rights. The Law also gives the French Biomedicine Agency the regulatory responsibility for IVF and other forms of ART, along with abortion and stem cell research. French regulations place restrictions on those who can have access to IVF, limiting its use to married, heterosexual couples who have lived together for at least two years. However, as of September 2014, France’s top civil court, the Court of Cassation, rules that children conceived from IVF can be adopted by same-sex couples. Furthermore, under the Bioethics Law of 2004, embryo and oocyte cryopreservation is legal.
Euthanasia in France is an on-going and developing issue. In March 2015, France passed legislation giving doctors new abilities to place terminally-ill patients in a “deep sleep” until they die. Although some do not completely categorize the legislation as a form of euthanasia, many agree it is a step towards euthanasia legalization. Surveys show that 8 out of 10 French citizens are in favor of allowing euthanasia. On the other hand, France has a strong presence of conservative Catholic who fear this new law and are against euthanasia in general. President Francois Hollande is committed to have the terminally-ill afflicted by “unbearable” pain “to benefit from medical assistance to end their lives with dignity.” With his political agenda, and many citizens in favor of euthanasia, more laws regarding end-of-life may be created in France in the near future.
The aforementioned Bioethics Law of 2004 also contains regulation for research on embryos in the country. The Law prohibits the creation of embryos for research purposes. However, research can be conducted in three different situation, all of which involve the embryo having been created in IVF. First, research can be conducted on “spare” embryos no longer being used by the parents, granted the parents provide written consent. Second, research can be done on embryos that are unsuitable for implantation. Third, research can be done on embryos unsuitable for storage or carry an abnormality that was detected by a pre-implantation diagnosis.
Further Readings:
http://thinkprogress.org/health/2014/08/06/3468135/france-gender-equality-law/
http://www.federa.org.pl/dokumenty_pdf/invitro/jbf_European_laws_governing_in_vitro_fertilization%5B2%5D.pdf (includes other European countries in addition to France)
Country Report – Israel
In Israel, abortion is legal under certain circumstances as limited by Clauses 3120321 of the 1977 penal code. Such circumstances include if they woman is unmarried, if the woman is over the age of 40 or under the age of 17 (the legal marriage age in Israel), incestuous relationships, rape, birth defects, and risk of health and/or life to the mother. In some of these circumstances, the state will even pay for the abortion. Regardless of the reason, abortions must be approved by a committee for pregnancy termination, of which they are 41 across hospitals in Israel. The committees are comprised of 3 members, 2 physicians and 1 social workers. If the fetus is beyond 24 weeks old, 6 separate committees have to decide on the abortion request. Criminal punishment exists for physicians and women who illegally perform and get an abortion without the approval of a committee, which is estimated to be about half of the abortions performed in Israel.
Israel is very liberal in terms of their regulation of assisted reproductive technologies. The country’s national health insurance, which is mandatory for all Israeli citizens, pays for almost all fertility treatments. Single women and same-sex couples have access to ART, and IVF costs are fully subsidized for up to the birth of 2 children. Embryo and sperm donations, as well as surrogacy agreements, are all legally permitted in Israel. See the second link under “Further Readings” for a 2012 detailed explanation of reproductive laws and policies in Israel.
The Israeli Penal Law forbids causing the death of another, specifically forbidding shortening the life of another. Passive euthanasia is also generally forbidden by Jewish law. Similar to other countries, Israel has set up commissions in the past, such as the Steinberg Commission in 2006, to research whether or not euthanasia should be legal in some circumstances. In December 2014, an Israeli court approved euthanasia for a terminal ALS patient, the first decision of its kind in the country. A bill had been proposed in June 2014 to make assisted suicide legal for terminal patients, and it was approved by the Israeli Ministerial Committee, but the bill is likely to face resistance from conservative lawmakers in Parliament.
Israel also has somewhat relaxed laws in terms of research with stem cells. In Israel, 18 companies, as of 2013, develop or market cell-based treatment products. Three of these companies develop therapies from stem cells produced from human embryonic stem cells.
Further Readings:
http://www.loc.gov/law/help/il-reproduction-and-abortion/israel.php
http://www.loc.gov/law/help/israel_2012-007460_IL_FINAL.pdf
http://www.haaretz.com/news/features/stem-cell-research-is-blooming-in-israel.premium-1.515396
Country Report – Argentina
Abortion is permitted in Argentina only when the life or the health of the woman is in danger, as ruled by the Supreme Court in March 2012. Besides this ruling, abortion in Argentina is illegal according to the Argentina penal code. Many in Argentina are currently fighting for more relaxed abortion laws and many organizations have formed a National Campaign for Abortion Rights in the country. Recently, including in November 2014, bills to legally permit abortion have been introduced and debated by the Congressional Criminal Justice Commission.
The widespread influence of the Catholic Church in Argentina, and the widespread gap between the rich and poor, greatly affects assisted reproduction technology regulation, as well as abortion regulation described above. In many Latin American countries, including Argentina, the poor do not have access to ART and it is not provided in many public hospitals. The WHO reports that a feeling of discrimination and resentment exists among the citizens of Argentina because of the lack of access. Nevertheless, embryo and sperm donation is permissible in Argentina, and both single women and same-sex couples have access to ART.
In May 2012, the Argentine Senate approved a “dignified death” law, giving terminally ill and their families more input into end-of-life decisions. In other words, patients who are dying or suffering incurable illness can refuse treatment to sustain their lives. Thus, passive euthanasia is legal in Argentina, along with advance directives. However, active euthanasia still remains legally prohibited.
Argentina possesses a strong number of researchers engaging in stem-cell research in both public and private institutions. The Transplant Act and Medicines Act in the country provide guidelines for how human embryos should be used for scientific research. In general, the use of human pre-embryos for experimental purposes is an acceptable procedure.
Further Readings:
http://www.cnn.com/2012/03/14/world/americas/argentina-abortions/
http://www.bbc.com/news/world-latin-america-18016902
Country Report – Switzerland
Since 2002, abortion has been legal during the first trimester of a pregnancy in Switzerland, with the condition that a women seeks counseling before receiving the abortion. The Swiss are noted for having a very low abortion rate compared to other countries. In 2011, the rate was 6.8 per thousand women aged between 15 and 44. Widespread access to contraception (since 2002 the morning-after pill has been permitted without a prescription), family planning services, and high socioeconomic levels have all attributed to the low abortion rate. After the first trimester, abortions are allowed for health reasons, including the risk of severe mental distress.
Most of the assisted reproduction technologies in Switzerland is regulated by the 2004 Federal Law on Medically Assisted Reproduction. The law specifies that only married couples can have access to ART. While IVF and sperm and egg donation is permissible, surrogacy agreements are not permissible.
Passive and active euthanasia are legally prohibited in Switzerland. In 1942, however, Switzerland legislatively permitted assisted suicide when the motives are altruistic, and only considers it a crime if the motive is selfish. It is also not a crime for a non-physician to perform an assisted suicide, making it the only country in the world to have an end-of-life law not requiring a physician to be involved. Also, the country has been known for “suicide tourism” because the recipient of assisted suicide does not need to be a Swiss national.
Research with embryonic stem-cells is regulated in Switzerland under the 2003 Federal Act on Research Involving Embryonic Stem Cells. The Act permits surplus IVF embryos to be used for research. However, they are subject to strict licensing conditions and the consent of the couple involved. Furthermore, the Act permits for the importation of embryonic stem cell lines for research purposes. Embryos cannot be created for research purposes in Switzerland.
Further Readings:
http://www.swissinfo.ch/eng/fertility-matters_the-secret-of-switzerland-s-low-abortion-rate/33585760
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125125/
http://www.eurostemcell.org/regulations/regulation-stem-cell-research-switzerland
Country Report – Vietnam
Abortion is legal in Vietnam for up to 22 weeks of conception. For the abortion to take place, a woman must have a permission form signed which states that she is responsible for any risks that occur throughout the abortion procedure. Sometimes a family member needs to certify the permission form. Abortion rates in Vietnam are known to be very high, which is why the government has proposed legislation to help decrease the amount of abortions taking place. In 2013, for example, a law was drafted stating that abortion is only allowed if the health of the baby or mother is threatened. The outcome of this law’s passing is unknown. In addition, RU-486 and family planning are readily available in Vietnam.
Vietnam promotes assisted reproduction technologies by legally permitting oocyte, embryo, and sperm donation, along with IVF treatments. Single women have access to ART, although same-sex couples do not have such access. The Vietnamese have a deep-seated cultural emphasis on a woman’s womb as a site for creating relatedness, known as “womb-centrism.” Laws have thus been created in the country that gives legal custody of any child conceived through ARTs to the woman who gestates and gives birth to the child. Surrogacy agreements are not legally enforceable.
All forms of euthanasia are prohibited in Vietnam.
In addition to conservative end-of-life laws, Vietnam also does not have very liberal laws regarding research with embryonic stem-cells. No laws specifically exist to permit embryonic stem cell research, but it is not specifically prohibited and it is practiced in the country. As with many other countries, therapeutics and reproductive cloning are specifically banned.
Further Readings:
Country Report – Portugal
In 2007, Portugal liberalized their abortion laws. An abortion can be performed on-demand if a woman’s pregnancy has not exceeded its tenth week, with a 3-day waiting period for all abortions. Portugal has a very strong Catholic presence and, despite abortion being legal, many doctors refuse to perform them. Later stage abortions are also legal for specific reasons, including risk to a woman’s health and rape, but an abortion beyond 24 weeks is illegal. 2010 statistics suggest that the abortion rate is 9.0 abortions per 100 women aged 15-44 years old.
Portugal remains fairly conservative in regards to regulations for assisted reproduction technologies. Portugal’s children to woman ratio is well below the population replacement rate of 2.1. 2008 data shows the rate is 1.49 children per woman. However, the number of children born through ART is very low. Surrogacy agreements are not used, and sperm and egg donations are not prohibited but used. Same-sex couples and single women do not have access to ART.
Passive and active euthanasia are illegal in Portugal. However, in March 2015, the chairman of the Portuguese bioethics association said that it is legal for terminal patients to be put into a deep, continued sedation, as the law passed in France in March 2015 entails. Since 2000, Portuguese doctors have been publicizing saying that they are open to euthanasia.
Research on stem cells in Portugal is limited to the use of frozen or surplus embryos, making it a crime for anyone to create embryos for the purpose of research. Licensure and approval for research is provided by the Portuguese National Council for Medically Assisted Procreation.
Further Readings:
http://www.theportugalnews.com/news/deep-sleep-not-euthanasia-is-allowed/34376
http://www.eurostemcell.org/regulations/regulation-stem-cell-research-portugal
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