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Costa Ricans Debate In Vitro Fertilization

Categories: Latin America, Costa Rica, Citizen Media, Health, Human Rights

For several years, a discussion has been ongoing in Costa Rica about whether to approve the medical treatment of in vitro fertilization [1] (IVF). The Legislature, whether through lack of interest or ability, was not able to reach an agreement on this, and the time limit imposed by the Inter-American Court on Human Rights (IACHR) expired. Because of this, the country was sued [2] and currently is in the process of conclusions and resolutions by the judges.

The country is clearly divided on the issue, so much so that the actual percentage for and against cannot be stated; there is practically a tie between those who support and those who oppose this technique.

The webpage Amelia Rueda [3] [es] reports that according to Ofelia Taitelbaum,
the Ombudsman [4] [es] of Costa Rica, “the new application of IVF is clearly a discrimination against women”.

Taitelbaum expresó que el no poder tener hijos es una enfermedad y comparó el procedimiento de FIV con operaciones clínicas más complejas, como el caso de una operación a corazón abierto.

Taitelbaum stated that not being able to have children is an illness and she compared the IVF procedure to more complicated clinical procedures, like open heart surgery.

In 1995, Costa Rica issued a decree that allowed and regulated the IVF technique. However, in 2000, the Constitutional Chamber of Costa Rica issued a decree [5]on the issue and stated that the technique violates the right to life of the unborn, making the country the only one in America which prohibits this treatment.

On September 5 and 6 the IACHR listened to the parties, [6] leaving a final resolution pending. The Jamaican judge, Margaritte May questioned [7] [es] the Attorney General of Costa Rica, Ana Lorena Brenes, whether Costa Rica prohibits the death of gametes in all forms. The attorney responded that of course it did and the judge then asked how one could manage to avoid their deaths in a woman's uterus. The judge inferred sarcastically that Costa Rica, in order to avoid the waste of zygotes, it should stop couples from having sex.

On the radio program Amelia Rueda, Gabriela Arguedas, a biotechnology expert, asserted [8] [es]:

Que no se permita la FIV en Costa Rica es discriminatorio y viola el derecho de cada quien de elegir en su vida

To not allow IVF in Costa Rica is discriminatory and violates the right of each person to choose in their lives

On the radio program Nuestra Voz, a live debate was organized and led by journalist Amelia Rueda. Many Costa Ricans expressed themselves via Twitter, broadcasting their opinions and showing the clear division in the country.

[translator's note: all Twitter references are in Spanish]

Alejandro Gutiérrez (@agutierrezmata [9]) said:

@agutierrezmata [10]: @ameliarueda [11] Increíble que a estas alturas no se permita la FIV por un tema religioso, que medieval se escucha eso

@agutierrezmata [10]: @ameliarueda [11] Unbelievable that by now IVF is not allowed because of religion, that sounds so medieval

On the other hand, Jota Pe Zeta (@barvak [12]) stated:

@barvak [13]@ameliarueda [11] Yo me opongo a la FIV porque creo en la vida a partir de la fecundación no por una cuestión de religión.

@barvak [13]@ameliarueda [11] I'm opposed to IVF because I believe in life at fertilization, not because of religion.

Rita Chaves Casanova (@chavescasanova [14]), a deputy in the Legislative Assembly, asked:

@chavescasanova [15]@ameliarueda [11] ¿Si FIV 18% de efectividad y otras ejemplo Naprotecnología 64%, porque insistir en la menos efectiva?

@chavescasanova [15]@ameliarueda [11] If IVF is 18% effective, and others like NaProTechnology is 64%, why go with the less effective?

While Carlos Chacón (@charlie350z [16]) thinks:

@charlie350z [17]: #CostaRica [18] tendrá que pasar ‘una verguenza’ internacional para entrar en razón con el tema #FIV [19] #nuestravoz [20] @ameliarueda

@charlie350z [17]: #CostaRica [18] It will take an international embarrassment to come to our senses with the issue #FIV [19] (IVF) #nuestravoz [20] @ameliarueda

On June 16, 2012, thousands of people marched [21] in San José against discrimination in various forms, including those who claimed to have been affected by the IVF ban.

Thousands marched for Human Rights in Costa Rica. Photo by José Daniel Clarke CCByNC

In the blog Animal Político [22] [es] Geraldina Gonzalez de la Vega writes about the issue and says:

La decisión de Costa Rica de prohibir la FIV viola el derecho a constituir una familia, el derecho a la intimidad y el principio de igualdad y no discriminación. Para ello la Comisión considera 4 cuestiones:

  1. La decisión de tener hijos biológicos y acceso a los medios para realizarla, está protegida por la Convención Americana (artículos 11.2 y 17.1).
  2. ¿Significa la prohibición IVF una restricción o interferencia a estos derechos?
  3. Es la restricción o interferencia compatible con la CADH? Para determinarlo se deberá establecer si la prohibición absoluta persigue un fin legítimo y si es necesaria, idónea y proporcional.
  4. ¿Es la prohibición una violación al principio de igualdad y no discriminación? Para ello, debe pasar el test de escrutinio estricto, es decir, valorar la razonabilidad y objetividad de la medida.

Costa Rica's decision to prohibit IVF violates the right to form a family, the right to privacy and the principle of equality and non-discrimination. The Commission therefore considers four issues:

  1. The decision to have biological children and access to the means to do it, is protected by the American Convention (Articles 11.2 and 17.1).
  2. Does the prohibition of IVF create a restriction or interference with these rights?
  3. Is the restriction or interference consistent with the ACHR? To determine this, it must be established whether the absolute prohibition pursues a legitimate purpose and whether it is necessary, appropriate and equitable.
  4. Is the ban a violation of the principle of equality and non-discrimination? For that, it must pass the strict scrutiny test, i.e., assessing the reasonableness and objectivity of the measure.

Miguel Mejía Carballo, one of the victims, gave his testimony at trial [23] [es]:

“El anhelo de todo hombre es ser padre, cuando se casa, formar un hogar como toda pareja. Si no es por la ciencia, no es por un médico, yo no voy a poder tener un hijo.”

The desire of every man is to be a father, when you marry, to create a home as a couple. If not for science, if not for a doctor, I won't be able to have a child.”

Costa Rica is in a time of change. Society is calling for it, especially with human rights issues. An example of this is that on August 3, the group Citizens for Human Rights [24] [es] organized the campaign “Human Rights Now!” [25], in which different Costa Rican personalities called on the State to guarantee human rights for all.

As of this writing, the country is waiting for the final resolution by the IACHD, which has two months to issue its final decision. In November we will know the end of this long story, which has had the country at the center of criticism by human rights defenders.