15 December 1995
The opinion analyses the ‘coming into the world’ of a human being understood not as the mere consequence of facts, but as a unique ‘global’ event, taking on the bioethical paradigm that recognises an intrinsic bioethical value to the child, which extends into that of the adolescent, adult and then the elderly subject, but does not anticipate it, nor can it be reduced to it.
The act of procreation that determines birth is defined as a natural and at the same time cultural phenomenon involving the parents’ responsibility and is influenced by the variables of the social and economic system. It requires social, juridical and medical protection, in a context of efficient services. Starting with the awareness that the birth of a child is the ‘phase of extension of the family’s life cycle’ the ICB considers its most controversial aspects: the preparation before becoming parents and the duties of a parent; the protection of the product of conception in the first phases of its development; the rights of the unborn child; medical assistance at the moment of birth; the risks of pregnancy and delivery and the limits of medicalisation; the newborn baby at risk, its capacity to live, the dignity of its life and the quality of its future life; the distribution of medical care among hospital and primary areas; the culture of the healthcare professional present at the birth, from conception to the baby’s being born.
In particular the ICB recommends the association of education programmes for reproductive health with parenthood education. It furthermore considers that it is morally obligatory on the part of the national healthcare system to plan interventions for the identification of risks during pregnancy and delivery in order to protect the health of the mother, the foetus and the baby being born, without any excessive medicalisation of the event.
The Committee stress the doctor’s duty is to give medical assistance for the wellbeing of the child that comes to light healthily, so as to facilitate the process of bonding and to ‘familiarise’ the event as much as possible. In the case of pathologies, the child must be guaranteed immediate transport to a neonatology centre where advanced therapy is available and, as far as possible, personalised and simplified so as to foster the bonding process. With regard to the child with very serious problems, there is the question of the life/death decision in view also of the quality of future life: in these cases, the opinion of different figures and competences is always required (representatives of the child, doctors, nurses, social workers, psychologists, ethicists) and the involvement of the parents in decision making.
The ICB highlights the crucial ethical problem of training professionals with adequate epistemological competences for the purposes of encouraging case by case evaluations, flexibility in approach, the ability to listen and the exchange of values. Therefore it considers that it is the duty of schools to modify the syllabus, integrating scientific, technological and technical culture with a culture of bioethics and human sciences. For the same reason, it considers that it is useful for the staff to be given bioethical guidelines, including references to deontological regulations and codes.