Examination of Witnesses (Questions 740
- 751)
WEDNESDAY 15 SEPTEMBER 2004
REV DR
JOHN I. FLEMING,
RT REV
DR MICHAEL
NAZIR-ALI,
MRS JOSEPHINE
QUINTAVALLE AND
DR HELEN
WATT
Q740 Bob Spink: Comparing the designer
matching embryos and the cord blood storage solutions to curing
sick children, which do you think is a better solution?
Mrs Quintavalle: From my perspective,
obviously, I am very interested, and one of the recommendations
I brought on my little list of points today is to say I would
like to see much greater investment in cord blood storage and
research. I found material as long ago as 2001 from a body in
Newcastle doing research in this area, showing extraordinary results
from a massive national banking of cord blood. We could avoid
the whole issue of the designer baby. CORE likes to look for very
pragmatic responses to ethical dilemmas, and I think this is the
pragmatic response. It would be a service available to everybody
and not to a select few.
Q741 Dr Harris: Did nature intend
that cord blood be stored?
Mrs Quintavalle: I have no idea,
Evan, and going back to a question you asked me earlier, I am
not saying that man should not be making efforts to cure disease
and putting babies in incubators and doing things to help. I think
though that we draw the line at some things. For example, I do
not harvest organs from street children in Brazil because nobody
wants them. It is where we draw the lines that ethics is about.
Nature gave man the brains to understand, and we realise that
the cord blood stem cells are very, very valuable commodities,
and I think we should be harvesting more.
Q742 Dr Iddon: Dr Watt, in your evidence
you suggest that freezing of embryos should be prohibited. I would
like to know your reasoning for that because the evidence we save
received suggests that even though a frozen embryo may lose some
cells, that does not seem to affect the health of any baby born
of the new medical technologies. Do you know something that the
medical community does not know?
Dr Watt: Our point about freezing
was that if you did not create excess embryos, you would not need
to freeze. It is not that I am as against freezing as an emergency
response to leave particular embryos, but you should not be creating
excess embryos in the first place. In terms of the risks of freezing,
the risks to the embryo are significant, particularly if the embryo
has been subjected to embryo biopsy before freezing, in which
case they are even higher. Risks to born children—
Q743 Dr Iddon: Is there any evidence
for that? You are suggesting that children born are damaged—
Dr Watt: What I am saying is that
embryos are killed by freezing, even if you are trying to freeze
them to save their lives, and there is a lot of evidence that
this is not a healthy process for the embryo.
Mrs Quintavalle: There definitely
is evidence, which we submitted in our court case. The biopsied
frozen embryo has much less likelihood of surviving freezing than
the embryo that has not been biopsied, and that is statistical
evidence, which I am very pleased to provide the Committee with.
Like Helen, I do not think we should be creating surplus embryos,
but I would like to draw the Committee's attention to the fact
that it appears that within the NHS provision of IVF, embryo freezing
is not being offered routinely. I will submit to you afterwards
a document that is going to be published in human reproduction,
with Alison Murdoch as one of the signatories, and it is on embryo
donation and egg donation. It points out that the NHS patients
at the Newcastle infertility centre are not provided with freezing
for their embryos, and I find this very worrying. It is a very
big conflict of interest that the NHS patient is not being offered
this provision for the surplus embryos that are created.
Q744 Dr Iddon: I just want to clear
up a point from the previous discussion on the psychological effects
on a child born from these procedures. Obviously, children brought
up in many families suffer psychological damage because of the
family circumstances. Is that any different than what we were
discussing earlier?
Dr Watt: The question is, do we
create these circumstances? Obviously, some children are orphaned
and so on and you cannot prevent some things happening, but do
you deliberately create children in circumstances that you know
carry at the very least risks to those children?
Q745 Dr Iddon: Families are creating
circumstances all the time that do psychological damage in children.
Dr Watt: As Father Fleming was
saying, I am not recommending other forms of conception, for example
by men who do not intend to look after their children naturally
conceived, and I am not defending it in the natural case any more
than in the case of sperm donation.
Rev Dr Fleming: I draw your attention
to the SPUC document we have given you, which has a fair amount
of material on frozen embryos, relying on the data from Australia
from the Infertility Treatment Authority. When it comes to the
transfer of fresh embryos, 9.5% of embryos transferred fresh survived
to be born alive. In the case of embryos that were frozen and
then thawed, 3.1% of embryos transferred after freeze/thaw, survived
and were born alive. It is beyond doubt that freezing as a process
has attended with it significant increased wastage and lack of
capacity to survive. Even if they survive the freeze/thaw process,
they are less likely to implant than a fresh embryo, which is
why I think all the IVF doctors I know today would prefer to be
transferring fresh embryos and preferably one rather than three.
Q746 Mr McWalter: Obviously, the
role of this Committee is to take evidence and take your evidence
and weigh it in the balance with a lot of other evidence. Suppose
it turned out that we take evidence saying that IVF babies are
particularly unhappy or whatever, or the example just given about
embryo freezing being highly detrimental to the health of the
embryo and so on, but when we weigh it in the balance we find
out that the overall balance of evidence is, as it were, against
you, you still would not want us to go down the pathway of giving
the HFEA the green light, would you, because even if the evidence
was against you, you still believe that the moral case determines
the issue in and of itself?
Rev Dr Fleming: It is a fair question.
Q747 Mr McWalter: Would that be a
fair description of your position, so that the stuff about evidence
is really ancillary to that moral argument?
Rev Dr Fleming: It is a "yes"
and "no". I have accepted, and SPUC has accepted that
IVF and other technologies are practised in Britain and are likely
to go on being practised in Britain. We are not calling for the
outlawing of them in principle. We are saying that there are some
matters attendant upon the current practice relating to reproductive
technology that parliament could and should take action to avoid.
That is very different. If the evidence indicates—and you
are welcome to check the sources that I have richly given you
here—that there is good evidence that harm is done, then
clearly I would imagine that, as elected representatives, you
would want to say, "okay, IVF is going to continue, but are
there things we need to do to reduce harm to the woman, reduce
harm to the couple and reduce harm to the child?"
Q748 Mr McWalter: Your position is
that it is actually an intense moral wrong; it just so happens
that not all moral wrongs are not proscribed by law.
Rev Dr Fleming: Exactly, like
adultery is a great moral wrong, but I am not proposing that you
make it illegal.
Q749 Mr McWalter: Michael, your position
is significantly different from the others, in terms of the ethical
position. The SPUC position is that there is a class of persons,
and it includes four-cell embryos, whereas your position is that
at very early stages a group of cells or zygote or embryo or whatever
has only a degree of membership of the class of persons. Is that
a fair description of what you said earlier? If that is so, there
is a strong epistemological difference between you and the others,
and hence a very strong ethical difference potentially as well.
You might, a result, not agree that ethics plays as intense a
role as the others do who are on this panel today.
Rt Rev Dr Nazir-Ali: Intensity
is a subjective matter, a matter of how you feel. I am saying
that throughout much of Christian history there has been an incremental
view of personhood that emerges gradually. But there has also
always been the view that the embryo is the potential from which
the person emerges, and therefore is worthy of respect.
Q750 Mr McWalter: That is uncontested
by all parties.
Rt Rev Dr Nazir-Ali: That is right.
What we do not know of course, and perhaps can never know, is
when exactly there is a human person. So while I would not dogmatically
say there is a human person at conception or at the three or four-cell
stage or whatever, I would say that the precautionary principle
has to be exercised here because we know that this something from
which the person comes, whenever that happens. The law recognises
this precautionary principle in its present form—the 14-day
limit. The debate is, how far back to conception you extend that
precautionary limit. I suppose if there was a discussion between
us, that it would be about how far back you extend the precautionary
principle.
Q751 Mr McWalter: What I want to
draw out is the fact that because you do not believe that, as
it were, this matter is determined by the moral imperative—although
obviously your position has a very strong moral component—for
you the role of statistical and other evidence is much more significant
in coming to an overall decision about how we are going to manage
these things within our legal structure. Would that be a fair
description?
Rt Rev Dr Nazir-Ali: Absolutely,
and one comes to a moral position by looking at the evidence;
and the moral position is not independent of evidence.
Chairman: We have other business to attend
to now, which is a shame because we could have gone on for hours.
We can write and ask you if there are any further questions. Thank
you very much for coming and being frank, open and honest. It
has been extremely helpful for the Committee's judgment, and will
be reflected, I am quite sure, in the final document we produce.
We have some way to go yet and have to talk to other people, but
it is progressing. Thank you very much for helping.
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