Examination of Witnesses (Questions 720
- 739)
WEDNESDAY 15 SEPTEMBER 2004
REV DR
JOHN I. FLEMING,
RT REV
DR MICHAEL
NAZIR-ALI,
MRS JOSEPHINE
QUINTAVALLE AND
DR HELEN
WATT
Q720 Dr Harris: Let me re-phrase
my question then.
Mrs Quintavalle: Evan, I did not
say that.
Q721 Dr Harris: Let me re-phrase
the question. Presumably, nature intended someone to be lesbian
and therefore—
Rev Dr Fleming: We do not know
that.
Q722 Dr Harris: Just like nature
intended a very sick, premature child to die without huge amounts
of expensive medical intervention; and therefore is it your view
that if nature has indicated something quite clearly, whether
it be that someone is lesbian or that a child is going to die
without an incubator, that we should just let that go?
Mrs Quintavalle: No.
Q723 Dr Harris: Secondly, are you
aware of the work that we have heard of from Professor Susan Golombok
showing that in fact there is no adverse impact on children, and
the welfare of children, born to loving, stable lesbian couples;
and that therefore the opposition to allowing them to use IVF
might be seen to be pure discrimination against them because of
their sexuality?
Rev Dr Fleming: When we were first
introduced to the idea of donor conception, we were told there
was no evidence that these children would be in any way damaged.
I am afraid a negative does not cut it. Later, as time goes by,
we now find the fact that those children claim that they have
been damaged. We have a long way to wait yet before we see what
happens with the children of same-sex couples and what the psychological
and social implications will be.
Q724 Dr Harris: You have seen her
work?
Rev Dr Fleming: Yes.
Q725 Dr Harris: Do you think it is
shoddy or wrong? She says there is evidence that they are well
adjusted, as well adjusted as all heterosexual—
Rev Dr Fleming: We will have to
wait a while before the studies come in.
Rt Rev Dr Nazir-Ali: I want to
comment on the research. I think all the evidence is that the
samples are very small. They are mainly volunteers from the gay
and lesbian communities. The research has not been tested against
controls to a very great extent; and of course there is other
research, which is considerably greater in scope, Tomorrow's
Man for example, the Australian research, and the work done
by Rutter and Smith on how children fare when there are both parents.
Chairman: We have the message. You do
not accept that research which has been presented to us.
Q726 Mr Key: Can I ask Bishop Michael
to expand a little on the Church of England's position? Bishop
Tom Butler, in the evidence that we have received, said: "The
Church of England would like to have reassurance that the Committee
is asking key questions about human purpose and meaning."
We are talking about the law as it stands rather than theology
or anything else. How could the law incorporate these concepts,
which the Church of England wishes us to address?
Rt Rev Dr Nazir-Ali: This has
to do with human dignity and respect. Apart from any other body
of law, the HFE Act itself and the code of practice that flows
from it certainly recognises things that are teleological. That
is what we mean; that human-beings are not merely means to an
end, but ends in themselves; and the HFE Act recognises that.
We would want that retained in any future legislation, any modification
of the Act in fact. That is the kind of concern that is behind
paragraph 14, not to move towards the direction of instrumentality
in the way that I was discussing with Dr Turner earlier.
Q727 Mr Key: Josephine, you say in
evidence that the HFEA has strayed beyond its remit. Do you think
that the remit should be extended to cover those areas, and who
should take on those functions?
Mrs Quintavalle: I believe in
absolute that the HFEA should not be making decisions; I think
they are far too self-interested, and they are inevitably going
to be accused of conflicts of interest every time they make a
decision. Their recent decisions, one on `designer' babies, and
one on cloning, were as secretive as ever, as difficult to untangle,
as complex and obscure as any that have gone previously, so I
do not find any indication that they are willing to engage in
public debate. I simply think that they should just regulate and
leave the decision-making to another body that I think needs to
be created. Most countries in the democratic world have national
bioethics committees. I have attended recently the UNESCO deliberations
of their International Bioethics Committee. I have spoken to members
of the Bush Bioethics Committee, the Italian National Bioethics
Committee. I think this is the way forward. I do not think we
are well served by the HFEA making these kinds of decisions.
Q728 Dr Turner: I would like to know
who panellists think should make these decisions. The implication
from Dr Watt earlier was that Parliament itself should not delegate
that responsibility to anybody. Could I have your views, please?
Rev Dr Fleming: I agree with Dr
Watt.
Mrs Quintavalle: My ideal of a
bioethics committee is as an advisory body without any power whatsoever,
and the very big issues—and I do think designer babies is
a very big issue—there was no public consultation of any
kind on that. Every decision regarding designer babies, the use
of PGD for designer babies, was taken behind closed doors. This
is extraordinary.
Q729 Mr Key: The Catholic Bishops'
Conference has recommended that we should follow the example of
Italy and go down the route of combining a mandatory limit of
three embryos for transfer, with an obligation to re-implant all
produced embryos, cryopreservation of excess embryos being prohibited,
and the use of assisted reproduction to sterile heterosexual couples
in a stable relationship. Is this something you would all agree
with, that we should go with the Italian model?
Rt Rev Dr Nazir-Ali: I speak from
my experience of the HFEA, obviously. It is clear that Parliament
must provide the parameters for both regulation and ethical decision-making,
and I think the HFE Act tries to do that, perhaps unsatisfactorily,
but it has an attempt at it, and I would be very sorry if primary
legislation like the Act did not have matters like respect for
the embryo, the need of the child for a father, and so forth in
it, as it does now. However, the value of the HFEA is that it
brings together expertise and decision-making. If you separated
regulation from ethical decision-making, we would need to ensure
that there was enough expertise present, if any body were to be
created, so that decisions were informed and not just romantic.
Q730 Mr Key: I should declare an
interest as a fully paid-up member of the Church of England, but
I am bound to say that some of the comments I have heard this
morning have shocked me, and the implications, for example when
we heard reference to conception of the best kind. What is the
best kind? It implies there is a worst kind and that there is
some sort of difference in the child that is born. Given that
it is estimated that half of all conceptions are unplanned or
unwanted, is producing wanted children then your best option?
Rev Dr Fleming: The question is
not that we are recommending that people should produce unwanted
children or that people should be irresponsible in their sexual
behaviour. It simply does not follow from the proposition. We
were called here to give evidence on a particular course of action,
and I think we have done that. In answer to your previous question,
parliament in my view has the responsibility to set down the fundamental
parameters or benchmarks that would govern the decisions that
a body like the HFEA would make, and to that extent therefore
I completely agree with what Dr Watt is saying on behalf of the
Catholic Bishops, that the fundamental ethical issues are properly
determined by the parliament and not by an unelected, delegated
group.
Q731 Paul Farrelly: A very interesting
question was asked by Rob Key as to whether the panel would prefer
to go down the Italian model, but it was not really answered,
and perhaps the other three members might like the chance to give
an answer.
Mrs Quintavalle: I am happy to
answer that. Bishop Michael, at the beginning of his evidence
reminded us that the HFE Act was instigated to afford some protection
to the embryo. The Italian legislation provides maximum protection
to the embryo, and I ask whether an Italian embryo is any different
from an English embryo?
Q732 Mr Key: Or Australian one?
Rev Dr Fleming: Particularly so!
Dr Watt: IVF as practised in Italy
still is not Catholic IVF because we do not agree with IVF at
all, but it is a matter of focusing in on the worst abuses IVF
involves—experimentation, discarded embryos, and things
affecting the identity of the child such as surrogacy, donation
and so on. Despite the fact that there is no such thing as Catholic
IVF, we would be much better off with the Italian model than the
law we have got now.
Q733 Geraldine Smith: I can understand
how desperate people must get who want a child and who are prepared
to go through IVF, but do you think they realise what they are
getting themselves into? I have had friends that went through
the treatment and it was pretty traumatic for them. Do you have
any evidence about what effect destroying the discarded embryos
has on the parents? Presumably, they want the child so much, so
to think that the other embryos are just being destroyed must
have a terrible effect on some people, and you certainly do not
have to be a Catholic or a religious person necessarily to suffer
those traumatic effects.
Mrs Quintavalle: I can give an
anecdotal response to that of a couple who rang me, of the mother
who said, "I have embryos in the freezer and I am looking
out my kitchen window at my two children playing in my back yard.
I do not have enough money to continue with IVF treatment to have
those embryos implanted, and I know that they are my children's
brother or sister and I am now being asked to throw them away."
In fact CORE intervened in that case and persuaded the IVF clinic
to do the IVF treatment at a reduced rate; but she certainly personalised
the position that an IVF patient has. They do not consider it
is a bit of nothing; it is to them a sibling of the child that
they may already have or that they hope to have.
Q734 Geraldine Smith: Are those parents
given enough information at the beginning?
Rev Dr Fleming: Consumer groups
in other parts of the world have indicated that they have not.
There is overwhelming people evidence that people do not know,
from the woman's point of view, what she is getting herself into
by virtue of the process itself, the feelings they will have when
it fails, as it most often does, and certainly quite unaware of
the implications of what in the end will happen to embryos that
are in deep freeze, or even increased risks of disability and
the perinatal morbidity and mortality which attends IVF. The literature
is replete with that evidence, but it is on the whole not really
made generally available to people for them to consider.
Q735 Bob Spink: I want to move things
on a bit and will put a proposition to you and let you respond
to it very briefly, because you have already indicated your views.
Is the HFEA membership representative or biased? Is it accountable,
or are its processes very obscure and not transparent? Does it
reflect public opinion in its decisions, and, if so, how does
it gauge what public opinion is before taking those decisions?
Could I have your responses to that proposition?
Dr Watt: Unaccountable, secretive,
unrepresentative—everything you have said really.
Rev Dr Fleming: That says it really.
Bias is too strong a word for me. I would say that there are strong
interests of the people who are on it, which are not necessarily
representative of the community as a whole, and issues of conflict
of interest are not well handled.
Q736 Geraldine Smith: I think there
is a lot of public concern that this group is completely unaccountable
and making decisions with huge implications, and that even Parliament
is having no say in this. I am quite interested in Josephine's
recommendation of an ethics committee. Can you tell us how you
see that operating with a group of philosophers, theologians and
qualified ethicists so that we can have a complete debate before
we make some of these huge decisions?
Mrs Quintavalle: I have often
said that I would prefer at least in the first instance that the
Human Genetics Commission took on this role. It is a body that
I have considerable respect for. I have spoken to some of the
Bush Bioethics Committee members who were there and attended when
the chair of the HFEA gave evidence to them, and they were seriously
shocked at the idea that the HFEA does not have representation
from alternative points of view. In my submission, I have quoted
from the website. The Bush Bioethics Committee—I know that
Bush is not a popular word in England at the moment, but I would
really recommend that you look at the composition of that committee.
It does not come up with majority pro-life rulings; they frequently
come up with decisions that I get very agitated about; but it
is a very, very prestigious collection of academics, and the great
thing about them is that they can make all the recommendations
they like but they cannot implement any. Comparison, with the
greatest respect, between a group like that—and I could
also give you details of the Italian Bioethics Committee—and
the HFEA just does not come out in our favour.
Q737 Chairman: Are these people in
the States hand-picked by government?
Mrs Quintavalle: Each president
has his bioethics committee.
Q738 Chairman: He will pick his—
Mrs Quintavalle: Yes, they are,
and there have been accusations at the current committee and its
advice, but if you look at their deliberations it is very difficult
to uphold that. In particular there has been a lot of controversy
over stem cell issues.
Q739 Bob Spink: Since CORE took a
legal action recently and won it originally—and we all now
what has happened since—do you think that in taking that
legal action you provided a public service, and what does the
fact that you have won your legal action tell us about the current
state of the law?
Mrs Quintavalle: We won, and then
subsequently on appeal we lost; but I also draw people's attention
to the fact that the case is going to the House of Lords in March
on the so-called designer baby. I quite frankly making a reference
to Buckingham Palace: I think it might be cheaper to stand on
a balcony at Buckingham Palace to make a point, and you get more
publicity. It is a very expensive way for the public voice to
be aired, and this is a thing that I object to very strongly.
I want to conduct my debates with politicians; I do not want to
conduct them with an unelected body, which the HFEA is. This is
all I ask for at this stage.
| 
