Evan Harris MP is a frequent and vociferous contributor to media debates over life issues. Often he is pitched against speakers from LIFE or similar organisations, and one of his favourite tactics is to suggest that the pro-life position lacks a sound scientific basis. In the recent debate over the need for a father, for example, he suggested that all the relevant evidence supported his view that children brought up by gay couples did not have worse prospects than those brought up by male/female couples, and challenged his opponents to show otherwise.
Whatever the subject – family structure, the psychological consequences of abortion, public support for euthanasia – he, and others of like mind, will demand that his opponent produce academic support for their position. On more than one occasion, pro-life speakers have been made to look foolish or ignorant by their inability to support their arguments with strong research, or their citing of research which was irrelevant, out of date, or discredited.
Dr Harris is not always fair or consistent in this approach: when the issue of survival rates for very premature babies arose, he argued that there had been no significant change in these survival rates, in line with the research from Leicester Royal Infirmary published by the British Medical Journal. Here Dr Harris is guilty of the same cherry-picking and slippery arguments that he supposedly deplores in others. What he says is just not true. He ignores the evidence from the soon-to-be-published Epicure2 (the most authoritative and comprehensive study based on all premature births in the UK) that survival rates at 23 weeks are rising. This conclusion is also supported by findings from the American journal Paediatrics.
It is worth noting at this point that the justification for the 24-week limit is that 24 weeks is the earliest point at which a child can survive on their own outside the womb. Of course, a 25-week foetus cannot truly survive outside the womb “on its own”, any more than a six-month-old baby can, but that has been judged to be the point at which survival becomes much more likely. Hence the fierce debate over survival rates of very premature babies, i.e. those born at 24 weeks or below. If modern technology has led to significant improvements among these infants, then the logic – such as it is – behind the law would no longer apply.
Dr Harris likes to point out that only the very best neo-natal units are achieving high survival rates at 23 weeks, and that national policy must be based on national averages. In the same vein, Health Minister Dawn Primarolo commented that drawing attention to increasing survival rates could engender “false hope” in parents of very premature babies. This statement is both patronising and vacuous. In any case, both comments seem to me to represent a counsel of despair. In any other area of public service or business, the response to a department or sector that achieves outstanding results is to study it, to emulate, to find out what makes it so good and try and diffuse its methods as widely as possible.
A more interesting criticism is the suggestion that high-performing neo-natal units are only high-performing because only infants who have a better than average chance of survival are transferred to them. There may be something to this (although one might ask where the units’ good reputations came from in the first place). However, there are similar potential biases at other levels of the data, which those in favour of the status quo seem less keen to explore. In EPICure 1, for instance, 55% of all infants who died did so because of active withdrawal of intensive care. It is not explained why care was withdrawn in each individual case, and it cannot be taken as read that all of these infants would necessarily have died had they been treated more aggressively. A second factor which should be borne in mind is the fact that some neo-natal units have a policy of not even attempting to resuscitate infants born before 24 weeks.
Ambiguity in the data cuts both ways.
It might therefore appear slightly dishonest for Dr Harris and Ms Primarolo, both of whom have a vested interest in playing down increased survival rates, to claim that many neo-natal success stories are illusory, while refusing to consider the prospect that many potential 22 and 23 week survivors are being denied the chance to access the very best care.