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Repeal of embryo law urged after child's cure

Italian health minister's gaffe provokes call for resignation.

Girolamo Sirchia: the Italian health minister's gaffe has provoked calls for his resignation. Credit: F. POLIMENI/AP

On 6 September, Italy's health minister hailed the successful treatment of a sick child with ‘adult’ stem cells from newborn siblings. He was hoping to strengthen the government's position that embryonic manipulation is not required for medical progress.

But the minister's declaration rebounded on him the next day, when it emerged that the treatment was only made possible by in vitro fertilization of the child's mother in Turkey — using an embryo selection technique that the Italian government outlawed in February.

Now the health minister, Girolamo Sirchia, is facing calls for his resignation, and campaigners are hoping to overturn the law against embryo selection in a referendum, which could be held next summer.

The five-year-old child was treated for thalassaemia, a hereditary blood disease that causes life-threatening anaemia. Doctors cured him by using adult stem cells derived from the umbilical cord blood of twin siblings, borne by his mother.

The parents originally wanted to use cord blood from their next, healthy child, but the blood proved incompatible with their ill son's immune system. So they underwent in vitro fertilization in Istanbul, where 12 embryos were created and tested for the presence of the thalassaemia gene and immunological compatibility. Three healthy and compatible embryos were selected for implantation, and twins were born in April.

The boy was treated in Pavia in August. During a visit to the Milan clinic where the cord stem cells were manipulated before implantation, Sirchia told journalists: “This is a historical result, which awakens hopes.”

But Italy's law on assisted reproduction bans the testing of embryos for genetic disease, as well as restricting the number of embryos that may be generated for in vitro fertilization to three. Now opponents of the law are taking this chance to push for its repeal.

A few days after the law was passed, the minority Radical party launched a petition for a referendum on whether it should be revoked. The campaign has struggled to collect the 500,000 signatures that would be required before the end of September to oblige the government to hold such a vote next summer. “But this case has given a real boost to the campaign,” says Cinzia Caporale, a bioethicist from Rome who opposes the law. “It probably guarantees that the right number of signatures will now be collected.”

Sirchia says the campaigners are distorting events for political ends. “The cure of the child and the in vitro selection of healthy embryos are not correlated,” he says. But scientists point out that, without embryonic selection, the chance of producing an immunologically compatible child who did not have the disease gene would have been less than one in five. Several parliamentarians have called for Sirchia's resignation.

Amid fears that a referendum could threaten the law, a wide spectrum of politicians are trying to negotiate a compromise. Two members of Forza Italia, the party of Prime Minister Silvio Berlusconi, have called for a parliamentary debate about possible amendments on 22 September.

But Francesco D'Agostino, a philosopher at Tor Vergata University in Rome and head of the National Bioethics Committee, which helped formulate the law, is wary. “This specific case is not enough to justify a general law,” he says. “To create embryos and destroy those not useful to us is a eugenic practice and we need to think carefully about whether we want eugenics in our law.”

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Castellani, F. Repeal of embryo law urged after child's cure. Nature 431, 234 (2004). https://doi.org/10.1038/431234a

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