By Michele Catanzaro of Nature magazine

The Inter-American Court of Human Rights is set to decide whether Costa Rica, the only country that completely prohibits in vitro fertilization (IVF), has infringed basic rights with its ban. The tribunal — which is based in the Costa Rican capital of San José but rules on human-rights violations throughout Central and South America — met last week to hear a case brought by affected couples against Costa Rica.

The decision, expected in the next few months, may oblige Costa Rica to lift the ban and regulate IVF. But scientists are concerned that if the prohibition is upheld, it will set a bad precedent for laws related to health, including one that would lift a ban on experiments involving humans, such as drug trials, that was first brought before the country's parliament in 2011.

Although several other countries have no regulation for IVF, or don’t actually offer access to fertility therapies, Costa Rica is the only nation known to have a total ban, says Sheryl Vanderpoel a spokeswoman for the Reproductive Health and Research Department at the World Health Organization.

IVF was legal in Costa Rica between 1995 and 2000, but the relevant law was revoked by the country’s Constitutional Court on the basis of the right to life expressed in article 21 of the Costa Rican constitution and article 4 of the American Convention on Human Rights.

“The state makes a mistaken interpretation of the right to life, treating a fertilized egg as a person: in fact, not all embryos result in a newborn,” says Gerardo Escalante, director of the Costa Rican Institute of Fertility in San José, the only clinic that provided IVF in Costa Rica before the prohibition. “The current situation is discriminating against people with reproductive disability, especially those without enough money to go abroad for treatment.”

Long wait
In January 2001, nine infertile couples presented a petition against the ban to the Inter-American Commission on Human Rights. Ten years later, the commission issued a dossier stating that Costa Rica has infringed the rights to privacy, family life and non-discrimination, articles 11,17, and 24 of the American Convention on Human Rights. This pronouncement led to last week’s trial.

Alfio Piva Mesén, an animal physiologist and vice-president of Costa Rica, declined to comment on the trial. However, the expert witnesses who testified on behalf of the government defended the prohibition. “Life and personhood start at the moment of fertilization,” says one, Anthony Caruso, a reproductive endocrinologist at the Alexian Brothers Medical Center in Chicago, Illinois. “There is no way to do IVF without losing embryos.”

Gabriel Macaya Trejos, director of the Costa Rican National Academy of Sciences in San Pedro, says that most scientists are in favor of IVF, “but those opposing are more vocal, and mask religious convictions with pseudo-scientific arguments”.

Macaya worries that a win for the opponents of IVF will make it more difficult to pass a law on research involving humans. In January 2010, the Costa Rican Constitutional Court suspended all human-based experiments in the country until a specific law on the issue could be approved. Legislation was finally put forward in February 2011, but the discussion is being delayed due to objections from members of parliament. “The Costa Rican system has proved incapable of reaching consensus on health-related issues,” says Macaya.

This article is reproduced with permission from the magazine Nature. The article was first published on September 14, 2012.

20 Comments

1. 1. metamorphmuses in reply to scientific earthling 08:45 PM 9/14/12

   Great, now you want to equate atheism with genocidal bloodlust and cruelty. As another atheist, I can say none of what you advocate follows from a rejection of theism. As a secular humanist, I regard everything you state as reprehensible. Perhaps you're going for a Swiftian Modest Proposal there, but your argument is tenuous at best, in that case. The world population should be put under tight reins, I agree (China's one-child policy, adopted universally, would be an excellent and humanitarian step), but reproductive rights for all implies that everyone (all other things being equal) is entitled to pursuing child-rearing for at least one offspring. The anti-IVF law stands in opposition to that right.

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2. 2. Johnay 09:20 PM 9/14/12

   The rate of loss of embryos via IVF is probably no worse than that of natural reproduction. IVF just accelerates the process so a couple is more likely to finally have one survive.
   
   If people were truly concerned with the plight of non-surviving embryos they would also outlaw sex for infertile couples.

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3. 3. scientific earthling in reply to metamorphmuses 09:36 PM 9/14/12

   In an extremely overpopulated world every single child that remains unborn is a bonus, does not matter if unfair laws prevented the pregnancy. I accept China's one child policy as a very good thing, no matter how harsh the punishment for non-compliance. Cant have a child, and want one bad - adopt.
   
   My arguments come from a rational analysis of the rate of change of population, aided and abetted by Christian "Save the children" charities, especially in Africa. Every person who gives funds to these groups is destroying the biosphere on this planet, even though these charities usurp more than 95% of the funds for themselves.
   
   Its religion that divides and generates bloodlust and cruelty, just look what happened in Libya, Egypt and the rest of the Islamic world over the past few days. Sadly US weapons were used in many cases. In most of the Islamic world and countries like India, just being an atheist is a death sentence. Genocide against such barbaric peoples is perfectly acceptable, especially in an overpopulated world.
   
   Religions are responsible for most genocide not atheists; wars too are mainly the making of religion. I would not shy away from using a nuclear weapon against theists of the Saudi Arabian kind that attacked the USA on 9/11. It was the Saudis not the Afghans that attacked the USA.
   

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4. 4. scientific earthling in reply to Johnay 09:48 PM 9/14/12

   If you outlaw sex you create a violent society. Why do you think Catholic priests are so violent and abusive.
   
   see this: http://www.youtube.com/watch?v=lctBGAa1IwE
   
   or read the work done by James W. Prescott.

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5. 5. metamorphmuses in reply to scientific earthling 10:25 PM 9/14/12

   "Cant have a child, and want one bad - adopt."
   
   Agree 100%
   
   "My arguments come from a rational analysis of the rate of change of population, aided and abetted by Christian 'Save the children' charities, especially in Africa. Every person who gives funds to these groups is destroying the biosphere on this planet, even though these charities usurp more than 95% of the funds for themselves."
   
   I can't say I disagree with you about this.
   
   "Its religion that divides and generates bloodlust and cruelty..."
   
   Largely true throughout history, but only circumstanitally. And don't forget the irreligious Nazis and the atheist Stalin. Bloodlust and cruelty follow from inhumane values, no matter the ideological and/or religion origin.
   
   "Religions are responsible for most genocide not atheists; wars too are mainly the making of religion. I would not shy away from using a nuclear weapon against theists of the Saudi Arabian kind that attacked the USA on 9/11."
   
   See, that right there is just proof that, given the chance one atheist in particular (you) would behave in just as inhumane a manner as a theist. Most (but not all) religious folk uncritically hide behind the values they are indoctrinated with. However, atheists and agnostics must actively seek out and adopt a set of moral positions for themselves. In your case, scientific earthling, I fear you lack basic humanitarian values, and oppose your justification of violence just as vehemently as I would a Jihadist's or a radical Christian's. We may agree on rejecting theism, but - and I say this somewhat wistfully - not on fundamental moral values.

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6. 6. scientific earthling in reply to metamorphmuses 11:18 PM 9/14/12

   You are wrong about Hitler and the Nazis, read Mein Kampf, Hitler was very religious. The Nazis were not against Jews as much as against the fact that most Jews seemed to be atheists and socialists; when a Jewish family was being taken to the camps they protested they did not believe in religion, they were told you are exactly the Jews we are looking for.
   
   Cruelty is in our dna, observe a child's interaction with an insect, either fear or he/she picks it up and tears it to bits and pieces. Stalin - yes a very cruel man, I dislike him because he selectively targeted and killed the intelligent (All the professors and teachers at Polish universities).
   
   Where we depart is your unwillingness to eradicate the cancer that is destroying our biosphere. The cancers I am referring too are the religious groups who want to out-populate one another and fight it out to establish a single religion as the only way for life for all Homo sapiens on this planet, and they are totally uncaring of their impact on the biosphere.
   
   You are using the pacifist argument, it did not work with Hitler, why do you think it will work with Islam and or any other fundamentalist religion? Look what they did on 9/11 and have been doing ever since, you can not have a rational discussion with these ignorants. The fastest growing populations worldwide are Islamic.
   
   You seek to adopt a new moral position, but seem to ignore all the other lifeforms that also have a right to life & habitat. Homo sapien overpopulation is depriving thousands of species of plants and animals habitat. I am willing to be inhumane with an extreme abundance of ignorant Homo sapiens to save the biosphere for a broad spectrum of life that generates its own self sustaining biosphere for a reasonable period and eventually will go extinct when its energy source expands as it dies.
   
   You need to develop your new morality anew including all lifeforms. Recommended reading: Exploring New ethics for survival by Garrett James Hardin. Its a bit old, but here is a bit about the man: http://en.wikipedia.org/wiki/Garrett_Hardin
   
   
   
   

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7. 7. Ungolythe in reply to scientific earthling 12:42 AM 9/15/12

   @Scientific Earthling, how is it that you are so sure that in the post genocidal world that you will be one of the few deemed fit to survive? Perhaps you would want to be one of the ones choosing who gets to live? In that case neither Hitler nor Stalin would have anything on you in evil depravity for a "greater good".

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8. 8. scientific earthling in reply to Ungolythe 02:33 AM 9/15/12

   No, I have never claimed I am fit to survive life let alone genocide. If religion gets the upper hand I will be one of the first to loose my life. Anyway I shall in the near future be very dead and all the matter that constitutes me, including the trillions of life forms that live within me, will all be recycled. I believe no trace of me shall remain.
   
   I am not chosen. By the way who does this choosing? As an atheist, I do not believe in a deity that could be assigned such a task. Further if a deity existed why would it choose a single person, given the powers assigned to it, it could just speak to everyone at once, or instantly exterminate those it does not approve off. Funny deity this that allowed me to grow old, knowing fully well what I would turn out to be.
   
   You like the others believe that the Homo sapien is in some way special, and you have the right to obliterate other lifeforms within our biosphere.
   
   There is no "greater good", never has been, never will be, just another creation of religion to fool the masses to sacrifice all for the few.

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9. 9. Johnay in reply to scientific earthling 04:38 AM 9/15/12

   It was only a modest proposal.

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10. 10. Johnay in reply to scientific earthling 05:40 AM 9/15/12

    In any case, it's not a given that outlawing sex creates a violent society. Look at the Shakers as an example. As I understand it, they were pretty much on the receiving end of any violence stemming from their being celibate. I'm sure there are other examples to be found as well.
    
    As for child-molesting priests, I suspect a fair number of them entered the priesthood thinking that it would, by its nature, better their nature, but, not having their psychological problems directly addressed, ultimately succumbed to those flaws in their psyches. Others may have seen the priesthood as a good cover for their desired activity, placing them above suspicion in the community while giving them access. At least for that second group, saying that celibacy causes violence is like saying a high bridge causes people to commit suicide. It doesn't cause the behavior; it unintentionally facilitates it.

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11. 11. Bops 01:53 PM 9/15/12

    They are not as healthy as normal children. Adopt one that needs your help.
    

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12. 12. timbo555 03:35 PM 9/15/12

    I have to admire Sci-fi Earthling's tenacity. I salute you in your never ending efforts to tell everybody how to live and die, while repeating your promise to do yourself in. We're still waiting. Perhaps you could dismember and eat yourself slowly! Now there's some sustainable living and dying I could get behind!
    
    The last time I checked, Costa Rica was a Sovereign country, a representative Democracy with a WOMAN (can you imagine such a thing?) as president. Democracy doesn't seem to hold much sway with these Human rights bozos, does it? Nor apparently with this author, who might have made mention of these salient facts:
    
    A bill was put before their congress banning in-vitro fertilization. It was debated back and forth modified as such bills inevitably are, and eventually passed by a MAJORITY of the PEOPLE'S representatives, and signed into law by their WOMAN president. Those poor nine couples can have the procedure done in the states, or they can adopt, as someone above pointed out, or they can get a bunny, or a turtle. They're much easier to take care of, and don't live nearly as long as a human baby would.
    
    My suggestion to Costa Rica would be to give the court of human thugs the collective bird, and continue to ban whatever they damn well please...

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13. 13. Chryses 03:39 PM 9/15/12

    I can't begin to describe the pleasure I've had while reading the cogent Science in both the article and the comments.

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14. 14. timbo555 03:58 PM 9/15/12

    Chryses, If you find some actual science to comment on in this purely political article I will be happy to read your comments.
    

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15. 15. doug_pdq 04:46 PM 9/15/12

    This 'case' may provide us with some interesting insights into how a civilized nation deals with what has so far been a conundrum in the US. Costa Rico is the only country with real borders (I know of) that has no military at all and has quite publicly made it known they will depend on International Law and the International Courts to assure their rights. Having a neighbor like Daniel Ortega the Sandinista, being president of Nicaragua, makes this a risky proposition, as the recent seizing of their border river area shows. We will just have to wait and see how the International Court rules, although Nicaragua is dredging the river and having its way because it has a military and Costa Rico only has some poorly armed police. This has been in the courts for several years now. Still, the Costa Ricans are civilized people, even though I note they have big majority Catholic who are not known for logical analysis on birth control or other reproductive issues.
    Costa Rico is an interesting experiment. Can it take a civilized/rule-of-law position without being victimized?
    How does that very decent point of view affect its views on human rights, extending to reproduction?

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16. 16. scientific earthling in reply to Johnay 08:04 PM 9/15/12

    Like you I too once believed that people with desires for children took up the priesthood as a result of these leanings; however reading the works of James Prescott and others, and further realising the tender age at which most priests joined their orders, changed my mind.
    
    It is not the desire for intimacy with children that brought the abusing priest to the church, it is the abuse of the young novice at the hands of the church that creates the abusive priest.

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17. 17. scientific earthling in reply to Johnay 08:08 PM 9/15/12

    Sorry forgot your point about the shakers. I don't know anything about them, but they must have some sexual outlet at the minimum masturbation.
    
    There is absolutely nothing wrong with masturbation. Every one of us does it, as have I; even animals do it. A simple way to empty out the seminal waste from the system.

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18. 18. scientific earthling in reply to timbo555 08:40 PM 9/15/12

    I don't tell anybody how to live, I present you my ideas, your choice. My discussions are for rational humans, I ignore most of the religious who demand I read the bible and simply believe. I did go to a Catholic school and know the bible better than most believers.
    
    At no time did I say I would end my life for your benefit, what I have stated is knowing my age and what ageing and my medical history brings, when I believe my life is no longer worth living I will end it. I have made it clear that the medication of my choice is Nembutal,a Sodium Pentabarbital. I believe I have the right to terminate my life, even though the powers that govern my nation prohibit it, once for religious reasons and now for all kinds of fantasies, rich children seeking to inherit wealth.
    
    The reason for such action is to escape the pain and suffering of old age and the dying process. But nature also gives us sudden cardiac arrest, a very nice way to attain your inevitable end.
    
    I can not understand you surprise at a woman being the head of a state, it is 2012 not 1854. And you put too much faith in democracies, political parties are mafias and you have no options but to vote for one of them; not much choice at the end of the day. In the US the current choice is Republican or Democrat, both parties of the rich, for the rich, by the rich. The candidates are stooges who do what their party demands.
    
    Now understand this, its up to you to believe or not believe what I write here.

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19. 19. Johnay in reply to scientific earthling 09:36 AM 9/16/12

    I doubt that the priesthood engenders child molestation any more than being a scoutmaster or daycare worker or teacher or coach. Pedophiles are attracted to lines of work or other positions that give them access. The priesthood is such a position.
    
    In the case of the priesthood, I have no doubt that it attracts both pedos seeking access via their position, and pedos wishing to suppress those urges via religious devotion. Unfortunately, too many of the former succeed, and latter fail.
    
    And I believe you underestimate how young people can be when those urges manifest.

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20. 20. scientific earthling in reply to Johnay 07:52 PM 9/16/12

    As I have admitted in previous such discussions I was a victim of a catholic school, but let me hasten to say not of a priest. In fact I was aided and supported by a brother (Before they become father they are brother), who was also my maths teacher. I owe a lot to this young priest who instilled in me a love for maths. I have put this behind me and it causes me no distress, its just an experience, we all have good and bad experiences.
    
    Most of those who entered the priesthood were making their commitments at this stage of their life, around age 14-15, some were even victims of priests. Abuse at this stage without redress to justice, normalises abuse. The abused become the next generation of abusers and the cycle repeats.
    
    Imposing celibacy on priests causes them to seek other avenues to relieve sexual tension, they tend to homosexual activities because the church segregates the sexes too. Sex is an important biological function which every human needs. Its as important eating, sleeping, urinating defalcating, sweating ... Luckily for the disabled, today, we provide them with these services.
    
    The paedophile priest is a creation of the church. Don't punish the priest for what the church made of him.
    
    You need to read some of the work done by James Prescott. I have referenced it earlier.

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