APPENDIX 73
Supplementary evidence from Professor
J K Mason, University of Edinburgh
QUESTIONS
1. How workable is the welfare of the child
provision?
I very much doubt if it is workable insofar
as the criteria cannot be applied universally. The fact that different
clinics will apply different standards is one reason for abandoning
the provision.
2. If it is retained, could the welfare of
the child distinguish between the social environment of the prospective
child and the clinical and psychosocial risks associated with
the treatment? Who should decide what amounts to "welfare"
for the purposes of the Act if this provision is retained?
One thing that seems certain is that a medical
clinic should not be assessing the social factors involved. Should
anyone be doing so ? I am very doubtful if we should do any more
than we would normally do in a natural situation. Thus, the government
intends to provide an ever-widening series of genetic tests in
pregnancy. The IVF clinic might, therefore, legitimately consider
the health of the prospective child and could refuse treatment
if the child was sure to be born disabled. The problem then is
—should this be extended to a probability of disablement?
My inclination would be to agree to this.
3. How could a distinction be made between
the application of the welfare of the child provision in determining
the regulator's policy and its use by clinics in determining which
patients not to treat?
I think this conflict would largely disappear
if the provision was limited as above.
4. How could a revised HFE Act be used to
address the long-term psychosocial implications for children,
families and donors?
This is not the function of the Act. The psychosocial
implications depend on public attitudes that will change irrespective
of legislation. Currently, one has to ask if there are implications
that are not man-made. It is only when we start forcing doubts
on children that the doubts flourish. Very few of the older generations
doubt their parentage but I fear that considerably more of the
coming generations will do so as a result of the publicity showered
on donor insemination. My personal view is that absolute donor
anonymity should be retained but I am clearly in the minority.
Perhaps the only answer to the question posed is that special
emphasis should be placed on counselling. I am toying with the
idea that clinics should be allowed to refuse DI unless the parties
concerned are, at least at the time, agreed as to their policy
in respect of later disclosure.
5. It has been suggested that the criminal
provisions in the HFE Act should be removed. What issues would
this raise? Why do you think there has been only one prosecution
under the HFE Act?
Personally, I can see no purpose in having regulations
unless there is a criminal liability in the event of their being
flouted; the example of the Human Tissue Act 1961 should be sufficient
justification for this view. Some acknowledgement of the humanity
of the human embryo is surely enough to justify, say, criminalisation
of disregard for the 14-day rule or of hybridisation. Effectively,
the human embryo would be unprotected absent the criminal provisions
in the Act. The answer to the second question is probably that
the workers in the field are dedicated medical scientists who
actually want to practice within an ethical framework. On the
other hand, it could be that it is a negative effect in that the
Act does not cover treatments given in a private capacity; but
so far as I know there is no widespread abuse in the DIY treatment
field.
6. The professional bodies are keen to take
responsibility for setting standards. What mechanisms could be
employed to ensure compliance with these standards?
7. If the law is revised,
what would be your ideal regulatory model?
This is another paper in itself. I believe that
the concept of an "Authority" is a good one. The almost
insoluble difficulty, however, is to decide to what extent the
Authority is a strategic or a tactical instrument—and this
is tied up with its membership. Currently, I have only somewhat
negative views. Primarily, I do not believe in the value of the
"pure lay-person". I think every member should be meaningfully
associated with the work of the Authority; this, of course, is
very difficult to define but could include anything from academic
ethicist to molecular biologist. As a correlate to this, there
is no reason why members of purely technical committees should
have to be full members of the Authority. I also believe that
this is such a sensitive area that some mechanism should be in
place to obviate, so far as is possible, an impression of appointment
at the whim of the Secretary of State. Might there be a place
for a modified Commissioner for Public Appointments whose job
it would be to establish the member's credentials and to ensure
a broad spread of interests? But these are very ephemeral thoughts.
November 2004
| 
