Reviewer's report
Title:Italian law on medically assisted reproduction: do women's autonomy and
health matter?
Version:3Date:24 November 2015
Reviewer: Caroline Jones
Reviewer's report:
This is a really interesting area for consideration. I hope the authors will take the
comments in the manner intended - there is a potentially rich seam of material
here, but at the moment it is somewhat under-developed.
• Major Compulsory Revisions
1. More clear linkage needs to be made between the various bans and other
observations and the impact on women’s autonomy and health throughout the
text. For example, p11 on DI and (non-)anonymous donation – how does this
relate to women’s autonomy or health? There are links that could be made, but
these are not yet done so in this version of the paper. Line 221-229: this critique
of the law could be usefully developed in order to illustrate your point(s) about
autonomy, and arguably also re health. Ditto lines 261-270; and lines 290-297,
and the points made here. There was a tendency to state arguments rather than
to show them. Further, what is meant variously by ‘autonomy’ and ‘reproductive
autonomy’? Some (brief) explanation would be beneficial.
2. This may be a disciplinary specific comment, but I found the background
section was not sufficiently robustly set out: e.g., no names and citations were
provided for the cases noted on lines 65-67; no information is provided in support
of the assertion regarding the intention of the legislature (line 68); what is the
number of embryos permissible for use (line 76); nor are specific details gives of
the bans cited, i.e., where could a reader find these within the law if they were to
look for them? Also, insufficient linkage was made to the title of the paper, i.e.,
the potential impact on women’s autonomy and health. For example, on line 71 it
is noted that a national register was set up of authorised centres, but there’s no
explanation as to why this is a ‘valuable aspect’. It is possible to assume what the
authors mean, but it could be more clearly expressed in order to make the point
more forcefully and persuasively. Linked to this point & #1 above, is that what
may be problematic for women’s autonomy and health also needed to be made
explicit in this coverage. Some of this emerges later on in the text, but could
usefully be flagged up at the outset in order to frame the parameters of the paper
more clearly.
3. Similar comments regarding the need for support for assertions could be made
elsewhere in the text, e.g. on line 85 as to the heated debate; 128 ‘on several
occasions’; 139-141 on the Constitution (where exactly in the Constitution are
these rights found etc); 155 when was the judgment that amended the law?; line
158-9: is this a quote?; line 179-182 in which cases?; 186 why is there ‘great
trepidation’ re this ruling, and how does it link back to the main focus of the
paper?; further examples are found line 227 (‘some Italian courts’), and on p11
on the rights aspect of the discussion on lines 246-7, and examples of those who
argue to the contrary on line 250 would be a useful inclusion; 292: which
decision?; 294: studies to support women’s feelings of discrimination?
I wondered if the authors had read Patrick Hanafin’s book ‘Conceiving Life’
(2007) on this area of law, and if not it might a be useful addition to the literature.
Also Golombok et al’s work may be useful re line 193.
4. Some brief explanation is necessary as to how and why the cases came
before the judges. Reading the paper literally it seems as though judges were
only focusing on PGD and DI, but no clear reason as to why. Who brought these
cases, on what basis, and why did some issues fall within the purview of the
findings and others fall away? Given the constraints of space it is unlikely the
authors can address all these questions, but at the very least some context of the
case law would be beneficial for the reader.
• Minor Essential Revisions
5. Abstract: would suggest revising the abstract to start with the 2004 legislation,
including specific reference to it as Law 40/2004 when first noted, then move
forward to judicial rulings and commenting then that ‘little remains’ of what was
originally enacted. Also, some indication as to why PGD and DI have been key
would be useful: is it simply that the cases brought have focused on these
issues? Or cases have been brought on other issues, but which have impacted
specifically on these aspects? (there’s a suggestion later in the text re the latter,
but this could be made clearer from the outset). Also the context of the ‘three
embryos limit’ should be made explicit – someone who does not know the field
may have some difficulty in grasping the point being made without further
explanation. Also, are the criticisms alluded to on line 41 simply those that follow
on lines 42-44? If so, the link could be clearer. If not, then it would be useful to
flag up what those criticisms might be. As the abstract stands it isn’t entirely clear
if the focus is on women’s autonomy per se, or couples’?
6. Some linguistic slippages, e.g., line 44 of the abstract, suggest you change to
‘these subjects access to MAR’, etc. In the main text there are slippages between
different tenses – e.g. present tense is used, yet the authors are referring to how
the law previously was outlined, and so this could be tightened up a bit in the
writing. Also the discussion between lines 240-243 seems a little contradictory!
Line 284: is this ‘admitted’ or ‘funded’?
• Discretionary Revisions
7. Keywords: would ‘autonomy’ and ‘discrimination’ also be useful to include in
the list?
I hope you will revise and resubmit and wish you well with the re-drafting.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.