Spurred by an emboldened Roman Catholic Church, Italian voters Monday effectively gave their seal of approval to a law that gives embryos the status of "full human beings."
In a controversial referendum aimed at relaxing a 2004 law that tightened restrictions on fertility treatment, and bans cloning and embryo stem-cell research, most Italians appeared to heed the Vatican's call to boycott the vote. Polls estimated that only 26 percent of 50 million eligible voters turned out. To be valid, at least half of the electorate had to vote on the referendum.
Critics fear that the law may pave the way for an attempt to reopen the debate on whether abortion should be legal in this country.
Italians, while nominally Catholic, tend to ignore church doctrine regarding family life. They voted en masse to approve laws on abortion and divorce passed in the 1970s. And today, they are among the most habitual users of contraception in Europe.
By giving the embryo the same status as a person, the legislation, known as the Medically Assisted Reproduction Law (MARL), appears to contradict existing abortion law. Embryos created in vitro cannot be screened for genetic disorders. Nor can they be destroyed in the lab. That, critics worry, could force women to implant diseased embryos that they eventually abort.
"It is a disgrace," says Dr. Giovanni Monni, who heads one of Italy's leading fertility clinics on Sardinia. "Italy must be the only country where you cannot destroy an embryo inside a test tube but you can destroy it once it's inside a woman."
Now that the law has been upheld by the public, abortion-rights campaigners fear it is only a matter of time before abortion comes up for debate in parliament. MARL supporters insist the law was drawn up to fill a legislation vacuum on fertility treatment in Italy - not to reopen the abortion debate. Analysts say there is likely to be much more public resistance to any attempt to tighten restrictions on abortion.
"It might seem logical that if you protect the embryo you should protect the fetus," says Professor Silvio Ferrari, who heads the Observatory on Freedom and Religious Institutions in Milan, Italy. "It is probable that in coming months or years there will be an attempt to restrict the regulations on abortion. But ... if I had to bet on it, I'd say [that on abortion] things will stay the same."
The numbers of couples travelling abroad for more flexible treatment is estimated to have tripled since the law came into effect last March.
The law submitted to the referendum puts Italy clearly out of step with the rest of Europe, although different governments on the continent have taken very different approaches to the issues of fertility treatment and embryo research.
"This is a very vivid and difficult subject of discussion," says Laurence Lwoff, an expert at the Council of Europe, the European human and social rights organization. "The picture is very diverse from country to country."
But on one issue, the donation of sperm and eggs to infertile couples, Italian law is more restrictive than anywhere else in Europe but Germany, Norway, and Turkey, according to a survey by the British Human Fertilization and Embryology Agency, a government watchdog.
Only three European countries allow therapeutic cloning of embryos, for medical purposes - Britain, Belgium, and Sweden.
Research groups elsewhere in Europe decried the low Italian turnout Monday, which meant that the current law stands. "These are draconian laws that will have disastrous results," says Margaret Willson, spokeswoman for the European Society for Human Reproduction and Embryology.
But even the most fervent campaigners did not want the 2004 law abolished altogether. Some kind of law, they acknowledged, was needed to fill a vacuum that had allowed Italy to become the Wild West of fertility treatment. In the 1990s, a 62-year-old woman gave birth, thanks to maverick doctor Severino Antinori, who later claimed he was trying to clone a human.
But the law, supported by Catholics and opposed by female politicians across the political spectrum, has turned into the most open test of the Vatican's influence on Italian politics in recent history.
Monday's referendum flop was a victory for the Vatican in the most highly charged moral and ethical debate in Italy since abortion and divorce laws were passed in the 1970s.
There were howls of protest from the abortion-rights campaign, horrified that Pope Benedict XVI waded personally into the political arena in so-called secular Italy, putting pressure on this overwhelmingly Catholic nation to boycott the vote.
In the weeks before the vote, scientists, film stars, and even the prime minister's wife came out in favor of a less-restrictive law. Women's rights groups warned that Italy was heading back to the "dark ages" with a law that has forced hundreds of couples to seek fertility treatment abroad.
But at the same time, towns all over Italy were plastered with posters showing an embryo developing into a baby and urging people not to vote.
Priests called on their flocks to stay away from polling stations, hammering home the slogan: 'Life cannot be put to a vote: don't vote." Benedict XVI announced his personal support for a campaign by Italian bishops to prevent the vote reaching the necessary 50 percent quorum.
Italians were already weary of voting after a string of regional and local elections in recent months. On top of that, the technical details of the new law were quite complex. Given the choice between the ballot box and the beach, many took the easier option.
But the church's intervention seems to have ensured that the referendum failed. "The cardinal won!" said Rosy Bindy, a devout Catholic deputy in the left-wing Margherita party, referring to Cardinal Camillo Ruini, head of the Italian bishops council, who led the boycott campaign.
"Today, the Catholic Church is stronger in social and political life in Italy that is has been for the past 30 years," says Professor Ferrari. "People feel the need for an identity. And in Italy, when you ask 'Who am I?', the easiest answer is, "I'm a Catholic."
• Peter Ford in Paris contributed to this report.
• Human cloning is banned.
• Embryos cannot be frozen or used for research, including stem-cell research.
• Only heterosexual couples of child-bearing age in a "stable" relationship (not necessarily married) can use artificial insemination; they must use their own sperm and eggs.
• Surrogacy is not allowed.
• Only three embryos can be created from one cycle of hormone treatment, and all three must be implanted simultaneously.
• Embryos cannot be screened before being implanted for genetic disorders. The prospective mother does not have the option to refuse implantation of any of the fertilized eggs.
• Doctors providing banned forms of fertility treatment face fines up to $482,000 and temporary suspension from practice. Anyone who attempts human cloning faces up to 20 years in jail.