Claire Anne Brule

Sexually Transmitted Infections : A Worrying Increase

by Claire Anne Brule | March 20, 2024 | Uncategorized

Sexually transmitted infections : A worrying increase

Cases of sexually transmissible infections (STI) are increasing in Europe, according to a report issued by the ECDC (European Centre for Disease Control). That agency, which was established in 2005 and is based in Stockholm recently published detailed figures for Europe for 2022. These reports are part of its mission for the yearly monitoring of infections, with the publication of some 65 reports available on their web-site.

How are STI classified?

According to the web-site of the French health insurance, STI, previously often known as STD (sexually transmissible diseases) are those “infections which may be transmitted during sexual intercourse” and “there exist about thirty of them”.

According to the same source, the most frequent STI are caused by miscellaneous infections:

bacterial sexually transmissible diseases. The best known being syphilis, gonorrhoea, chlamydiosis and mycoplasma infections, which, when diagnosed, can be cured;
viral diseases: B hepatitis, genital herpes, HIV and human papillomavirus (HPV) responsible for several types of cancer according to the WHO. These infections may be difficult or impossible to cure depending on the type of virus.
parasitic sexually transmissible diseases such as trichomoniasis treated by anti-parasite medicines.

What does the European report reveal?

In summary, the ECDC notes that the number of cases reported has increased significantly compared with the previous year: +48% for gonorrhoea, +34% for syphilis, +16% for chlamydiosis. The Agency is also concerned about the increase in the number of cases of syphilis transmitted from the mother to her child. For cases of syphilis, this represents 35,391 cases reported in 2022.

In detail, for syphilis, an emblematic infection, the data show that men are eight times more affected than women, the 25-34-year-old age bracket being the most prevalent. In 74% of cases, the report notes that syphilis concerns men having sexual relations with men (known as MSM). however, for the first time in 10 years, there has also been a notable increase in the number of cases in heterosexual men and women.

The Managing Director has issued a communiqué calling for reinforcement of the fight against such infections. “The fight against the substantial increase in the number of cases of STI requires urgent attention and concerted efforts. The detection, treatment and prevention are at the heart of any long-term strategy. We must prioritise education in sexual health, extend access to detection and treatment services, and combat the stigmatisation associated with STI.”

A global problem

A study published by Cambridge University in 2019 already noted the resurgence of such infections which were thought to have been relegated to the past, from the year 2000s, following their downward trends during the 1980s and 1990s. The authors, some of whom worked for the ECDC, wrote that:

“Since the year 2000s, the syphilis rates have again increased in the developed nations, the rates increasing more rapidly for men having sexual relations with other men (MSM), but also increasing in other population groups. The interaction with co-infection by HIV, the changes in sexual behaviour following the greater availability of an effective antiretroviral treatment against HIV, the evolution of means and the facility for finding sexual partners through the Internet and mobile matchmaker applications have increased the complexity of the epidemiology, and in particular its control.”

In 2022, there were 2.5 million cases of chlamydiosis, gonorrhoea and syphilis identified in the United States. Last year, the American health authorities (CDC) issued an alert on cases of newborns affected by syphilis. Over 3,700 cases were reported in 2022, ten times more than in 2012 (335 cases). The report also alerted on the disparity of situations, babies of Afro-American, Hispanic, and Indian origins were much more affected. The Medical Director of the CDC made the following statement: “The crisis of congenital syphilis in the United States has exploded at a rate which is heart rending.”

It was thought that such infections were a thing of the past. It would appear that Charles Baudelaire died of syphilis. Guy de Maupassant, also. A historian specialist of the 19^th century°, Alain Corbin, thus declared “The fear of syphilis haunts literature”. Will the prophylactic measures recommended by the authorities: use of a condom, notification to partners as required by the Higher Authority for Health (HAS) be sufficient ?

In the days of globalisation and matchmaking applications which facilitate contacts between strangers, a more general strategy would appear necessary, incorporating behaviours which go beyond the purely prophylactic approach all too often put forward by the sanitary authorities.

End of life Bill : Fraternity Abandoned

by Claire Anne Brule | March 11, 2024 | End of life, News

End of life bill : Fraternity abandoned

At a time when the French health system is experiencing serious difficulties, the announcement of access to a so-called “assistance in dying”, a smokescreen for euthanasia and assisted suicide, whilst claiming fraternity is as indecent as it is concerning.

If “the choice of words is important”, why then conceal the reality of euthanasia and assisted suicide by using the term “assistance in dying?” Why introduce such ambiguity unless it is in order to escape from the reality? The challenges which have to be confronted by the public authorities are however quite clear: the choice of providing relief from physical pain, the accompaniment of psychological suffering by those nearing their end of life and of their close relatives, support for the handicapped or the sick without ever compromising their dignity.

According to OpinionWay, the monthly opinion poll for Le Parisien, the French population put health at the top of their concerns and are extremely worried about the difficulty of access to healthcare. Who can believe that the limited budget earmarked for palliative care by President Macron will enable everyone in France to have access to it? The additional billion euros announced over the next 10 years in fact corresponds to a yearly increase of a mere 5%, which is well below the needs expressed by healthcare workers.

In fact, palliative care and euthanasia or assisted suicide are incompatible because their fundamental logics are radically different. The examples of nations which have legalised such practices show that it is not possible to maintain an ethical and effective unity for patients by combining two diametrically opposed approaches. In Canada, a mere 30 to 50% of Canadians have access to any form of quality palliative care, and even less, around 15%, have access to specialist palliative care for the treatment of more complex problems.

Concerning the eligibility criteria governing “assistance in dying”, they are already being jeopardised and there is little doubt that they will soon be swept aside as a result of the claims being made by those who consider that they are being discriminated against and who are demanding their extension. Once again wherever the prohibition to kill has been lifted, the framework initially established as exceptional has veered off course.

According to Alliance VITA, the legalisation of euthanasia and assisted suicide under cover of the hypocritical term “assistance in dying” represents an abandonment of the most vulnerable and a renouncement of fraternity, which is one of the founding values of French society. For that reason Alliance VITA, through its network of volunteer members, spread over the entire nation, will be conducting local and nation-wide awareness campaigns to promote high quality palliative care for all those in need and a commitment against “social death” by the abandonment of our fellow citizens suffering from illness, old age or handicap. It is the only truly consensual option; the only one worthy of humanity.

Abortion in the Constitution : A Denial of Humanity

by Claire Anne Brule | March 4, 2024 | Abortion, Press Releases

Abortion in the Constitution: A denial of humanity

By constitutionalising abortion as a guaranteed freedom, with no safeguards and without consideration for situations which could be avoided, the government and parliamentarians are showing a total absence of humanity. How can one believe that the “Motherland of human rights” does itself proud by concealing the fact that our humanity starts at the very beginning of existence?

Despite the indecent political exploitation of this painful question, despite the persistent questions concerning the specific conscience clause for carers and around the advent of an enforceable right to abortion, the French National Assembly and the Senate chose to engrave abortion in the slab of the Constitution.

Nearly 50 years have gone by since the law decriminalising abortion was passed in 1975, 50 years during which all the provisions initially included to accompany and inform women have been gradually deleted. Over the years, we have gone from the possibility of abortion, “to control it and, as far as possible, dissuade women” to a right to abortion, claimed “without constraints”. Registration of the freedom of abortion in the Constitution represents a supplementary and highly symbolic stage towards the commonplace acceptance of a procedure which puts human life at stake.

A concealed reality

In 2022, some 234,300 abortions were conducted and the rate of abortion reached a level never previously attained of 16.9 per thousand women of child-bearing age. In 2020, a study by DREES (Directorate for Research, Studies, Evaluation and Statistics) revealed that women on the lowest incomes are the most likely to resort to abortion. It is known that 85% of unintended pregnancies of students end in abortion and that the 20-29-year-olds concentrate the highest rates of abortion (26.9 ‰ among 20-24-year-olds and 28.6 ‰ among 25-29-year-olds). Additionally, recent studies have shown links between domestic violence and repetitive abortions.

In France, the link between abortion and violence however remains little known: very few doctors systematically question women requesting an abortion about domestic violence [1]. Nevertheless, it is known that for 40 % of the 201,000 women concerned each year by domestic violence, it began with the first pregnancy.

A freedom under pressure

Confirming these data, Alliance VITA, which has been accompanying women for over 20 years, observes that the number of women confronting unintended pregnancy reluctantly resort to abortion, very often under masculine pressure, but also from their entourage or for economic reasons. Our experience shows that not all women submit to abortion “freely and by choice” but in the absence of any alternative and for safety reasons. In view of these realities which do not appear to be of concern to the public authorities, the constitutionalisation of a freedom to abort seems quite disconnected.

Even if constitutionalised, abortion, can never be trivial, and should not be considered as inevitable.

For years we have been asking for a thorough study of the causes and consequences of abortion. A proposal for a preventive policy is more than ever necessary.

In confrontation with this political denial, and in order to allow women to speak out, we are preparing an awareness campaign on the links between abortion and the pressures, violence and discriminations which women are subjected to during early pregnancy.

International Symposium on the End of Life – Euthanasia and Assisted Suicide Worldwide

by Claire Anne Brule | March 1, 2024 | Press Releases

At a time when France is considering legalising euthanasia and assisted suicide, Alliance VITA, together with IEB (Institut Européen de Bioéthique – European Bioethics Institute) and the citizens’ network Vivre dans la Dignité (Living with dignity), organised a meeting on 28^th February at the Maison de la Chimie with some ten experts from Belgium, Canada, Switzerland, and Holland, as well as a testimony by an American for an international symposium on the end of life. Each of them explained the impact of euthanasia or assisted suicide in their home state.

The legalisation of euthanasia or assisted suicide has taken place in each of those states on the basis of a triple promise, whose credibility was evaluated by the international symposium:

Euthanasia and assisted suicide are authorised only in exceptional circumstances,
The accompaniment of the most vulnerable or those at their end of life will not be affected,
This new “individual right”, which will not take anything away from anyone, will have no consequences on the others.

The compared experience was able to confirm, through three legal, medical and social round tables, the extent to which these promises cannot be held.

Although the legal frameworks vary from one state to another, the participants from Holland, Belgium, Switzerland, the United States and Canada, all reported the inevitable relaxation of their eligibility criteria. Everywhere, the framework initially established for exceptional cases has been relaxed.

According to Léopold Vanbellingen, a doctor of law from Belgium, in charge of research at the European Bioethics Institute, “The logic of subjectivity and non-discrimination, at the basis of the legalisation of euthanasia, very quickly led to an extension to cases which would have been quite unthinkable when the law was submitted to the vote.”

Trudo Lemmens, a Canadian professor of law and health policies, stated that in Canada, “The legalisation of Medical Assistance in Dying (MAiD) for exceptional cases at the end of life has since drifted towards a virtually universal therapy for sometimes vague suffering associated with sickness and handicap.”

In Holland, the number of euthanasia has increased by a factor of five since 2002 and at least 20 percent of the diseases claimed in order to qualify for euthanasia now concern patients who are not in any terminal phase: dementia, psychiatric disorders, polypathologies associated with old age, handicap, etc.

The same trend can be observed in Switzerland where the conditions for qualifying for assisted suicide have gradually been extended, such that the overall suicide rate has doubled over a few years.

For carers, the introduction of euthanasia and assisted suicide has an impact not only on palliative care at the end of life, but also on the accompaniment of those suffering with suicidal tendencies.

Johannes Irsiegler, a psychiatrist and psychotherapist, reported that in Switzerland any person in distress who considers that life is not worth living can find a network to facilitate resorting to suicide.

Catherine Dopchie, a doctor in palliative care in Belgium, noted, with witness accounts, that in care homes, euthanasia has become a “right” for residents and a duty imposed on doctors.

In Belgium, euthanasia has become an option among others in the planning of healthcare.

In Canada, a mere 30 to 50% of Canadians have access to any proper form of palliative care, and very few, perhaps 15%, have access to specialised palliative care for the treatment of more complex problems, as explained by Leonie Herx, a palliative care doctor.

Finally, far from being a mere new right which does not remove anything from anyone, the practises of euthanasia and assisted suicide, represent a fundamental change to society. Steve Bobillier, a Swiss doctor of philosophy and social science and ethicist stated that suicide is not an individual act, but it has a consequent impact on close relations, carers and society as a whole. Through the mimetic suicide effect (a phenomenon which has been widely documented over the years by research workers), the legislation covering assisted suicide leads to its becoming dangerously commonplace at the detriment of its prevention.

In the words of Theo Boer, professor of healthcare ethics in Holland, who supported the law in his state before becoming disillusioned: “Euthanasia has an impact far beyond the 6 % of Dutch people who end their life through euthanasia. The vision which we all bear on old age, fragility, dependence on care and the very notion of humanity has changed. Even those who die of natural causes consider the choice of euthanasia since it is available.”

Tugdual Derville, the spokesperson for Alliance VITA summarised “The precious warnings given to France by the experts from the states concerned: against any naivety regarding the unavoidable impact on society as a whole caused by the ending of the prohibition to kill, the so-called freedom to die which is in fact liberticidal.”

He concluded the symposium with the following statement:

“When the accelerated death of those who have become dependent, diseased or aged is put forward as a solution, an advantage, a form of despair is inevitably insinuated in people’s minds regarding vulnerability. The first victims of such despair are the most fragile, those threatened with suicide – in all its forms – and euthanasia.”

The press file for the symposium and the videos of the speakers are available on Rencontre internationale fin de vie (End of life International symposium)

Abortion in the Constitution : The Forgotten Debate

by Claire Anne Brule | March 1, 2024 | Press Releases

In voting for the constitutional bill to register abortion in the French Constitution, the Senate have submitted to pressures and put an end to any democratic debate. By registering a “guaranteed freedom” for women to resort to abortion, the Senate have in turn diverted the Constitution from its purpose by creating an enforceable right to abortion.

By that vote, the Senate has failed in its specific mission for the defence of freedom and fundamental rights, such as the freedom of conscience of health workers, which is endangered by this bill. By constitutionalising a “guaranteed freedom” whose impact is not precisely known, who can guarantee that we will not one day end up with abortions with no time limitation or according to the sex of the foetus?

Surely, the question of abortion deserves better. Remember that women with the lowest incomes are the most likely to resort to abortion, according to the DREES (Direction de la recherche, des études, de l’évaluation et des statistiques – Directorate for Research, Studies, Evaluation and Statistics). Note that abortion may also sometimes be the consequence of violence against women. For 40% of the 201,000 women concerned each year by domestic violence, it initiated during the first pregnancy.

By acting as the registration chamber for the Government and the National Assembly, the Senate has completely missed the reality and the difficulties which push women towards abortion.

According to Alliance VITA which for over 20 years has been providing support for women in difficult situations, the registration of abortion in the Constitution is not only unjustified and dangerous but also totally disconnected from the social urgencies. Through this constitutional revision, the government is obstructing any policy for the prevention of abortion at a time when the abortion figures have never been higher.

Alliance VITA is calling for an investigation into the causes and consequences of abortion and the establishment of a true abortion prevention policy.