| Previous Section | Index | Home Page |
The HFEA is to merge with the Human Tissue Authority. We wonder whether that is a political move. The virtues of such a merger have to be explained, because—of course—the British Medical Association is none too happy at the prospect. We could think about merging the HFEA and the Human Genetics Commission—Baroness Kennedy’s group, which examines many issues, such as the new genetic science and its effect on disabled people. The bodies could all work together in harmony much better than they do.
We have heard about the problems of reproductive tourism. I think that it will be hard to stop both that and reproductive cloning, which someone will carry out successfully some day. I remember when people said that we could not clone a sheep or cat, but we have done that, so humans will be in the wings. We thus need to think about the regulation that we will need for inspecting that.
Do we need a national bioethics committee? The public now want a consideration of morality and their views to be put in the relevant arena. Everyone else seems to have such a committee, but we do not. Is that because such committees are perceived as expensive talking shops? Could we establish a body that was really meaningful? Will Parliament really be the best place to make the big decisions? Should we stop giving such issues to quangos?
Judgments are also made by local ethical committees. Are the decisions that are made at local level tough enough, or is it the case that just the great and the good—the local vicar and so on—are appointed to those committees and that they have a nice afternoon cup of tea and a biscuit and then go home? The question of how we achieve localism in such decisions is serious.
Things will
never stand still in this area because new, unforeseen possibilities
will arise and be combined with market forces and new dilemmas that
emerge. As many hon. Members have said, regulation must keep up with
that without inhibiting research—even if one thinks that that
could be stopped. I accept that scientists can be arrogant and think
that they can rule the world, but that is why they must engage with the
political process and be brought into that arena. If they are kept out,
they will have that opinion. We should not really start from where we
are now, but think about starting all over again, given all the new
developments that have taken
place.
It is lovely if there is a mum, dad and child. It is lovely when a man meets a girl and they fall in love, before there is the question of having children, and they then live happily ever after and everything is perfect in God’s perfect land, as Neil Young would say. However, sadly, it does not always work like that for some people, and there are other types of relationships. The world has moved on to accept such people and be disciplined about them. We must incorporate that in our thinking. The problem is not major, but we must take it seriously. Nothing is really sacred, not even the Human Fertilisation and Embryology Act 1990—but gosh, to hear some people talk, one would think that it had to be protected at all costs.
5.52 pm
Mr. Charles Walker (Broxbourne) (Con): Thank you, Mr. Deputy Speaker, for calling me to speak in this important debate. I will try not to inject too much emotion into it, but when we talk about human life, emotion is not always misplaced. I hope that the hon. Member for Harrogate and Knaresborough (Mr. Willis), my hon. Friend the Member for Salisbury (Robert Key) and others will bear with me.
I am a little concerned that the subject has been broached by the Science and Technology Committee, because it sounds rather abstract to talk about human reproduction in terms of science and technology; that is a rather sterile heading. Nevertheless, that is the Committee that has considered the matter.
Mr. Newmark: As a member of that august Committee, I am curious about what name my hon. Friend would come up with.
Mr. Walker: Forgive my naivety, but I would have thought that this could have been considered by the Health Committee. Perhaps it would be a good start if we were revolutionary and established a Select Committee on the family. However, the subject rests with the Science and Technology Committee; those are the terms of our debate.
I share a growing concern with many of my constituents that children are often seen as the ultimate accessory. People used to have Gucci handbags or high-pedigree Dalmatians, but now it seems that people express their individuality by going around having children. On that basis, the child’s welfare is important. Not everyone has the right to have a child. I believe, although it might be unfashionable to do so, that children are a gift. I have spoken to many people in the homosexual community about the lifestyle that they choose to lead. Many of them are perfectly comfortable with the idea that their lifestyle choice excludes them from having children. Therefore, before we go down the road of supporting the idea that same-sex couples should have access to IVF, we should realise that it is the minority of such couples who are looking to do that.
Dr. Evan Harris: Will the hon. Gentleman clarify what he means by a lifestyle choice? Is he arguing that gay people make an optional choice and that they should just choose to be straight and get on with it, as he does?
Mr. Walker: Not in the slightest. I made the lifestyle choice of getting married and having children. People make such choices. If one chooses to live in a same-sex relationship, it is difficult to have children naturally. I have a good friend who is a homosexual. He and his homosexual partner found a surrogate mother and had a child. Those two men are excellent parents and I am fond of them both, but that does not mean that I believe that children’s best interests are served, in the main, by having two fathers, or that I subscribe to the idea that gay couples should automatically have the right to have children.
The scientific community seems to have its own agenda. We read in the newspapers today that Britain is about to have its oldest mother because a woman of 60—I believe—is about to have a child. Whose interests will that serve—those of the child who is born, the woman having the child, or the scientific community? What will happen next year? Will a woman of 70 or 80 be Britain’s oldest mother? The House needs to exercise control over what the scientific community is doing in this area, because the child’s welfare should be absolutely paramount.
Dr. Harris: How old does the hon. Gentleman think that the oldest father should be by law? Should we limit the reproductive capabilities of men?
Mr. Walker: Absolutely not, because as the hon. Gentleman knows full well, men are biologically able to go on having children into their 70s and 80s. However, what is proved by deliberately taking a woman who is past her point of fertility—perhaps 15 or 20 years past—and impregnating her?
Dr. Harris: On that basis, would the hon. Gentleman support preventing men over 50 from using potency aids, given that such aids are an intervention to help them to have children?
Mr. Walker: If the hon. Gentleman really believes that giving 60, 70 or 80-year-old women the choice of having children is a good thing that will benefit the welfare of those children, I am afraid that we will have to disagree. Where we will disagree, time and time again, is about the idea that the welfare of the children should be paramount, and the fact that it is probably not in the interests of a one or two-year-old to have a 70 or 80-year-old mother.
When we have debates on reproduction in the future, I hope that we will remember that children live with the consequences of decisions made by adults. They do not ask to be born, but they will be with us for a long time. I also hope that we can have a bit of emotion in such debates, because when we talk about human life and small people, it is perfectly reasonable to get emotional about their future and their welfare.
5.59 pm
Dr. Desmond Turner (Brighton, Kemptown) (Lab): I will try to bring the debate back to the mainstream of the subject. We should remember the context in which we start. On the whole, the Human Fertilisation and Embryology Act 1990 and the system of regulation have served us well for the past 15 or 16 years. But time moves on, the science has moved on at a great pace, and the time has naturally come to start reviewing the situation. The Government had already decided that it was an apt time to do that, and so had we, especially as several controversial decisions were coming up. It was a natural time to look into the matter.
We need to continue our history over the past 16 years of having a framework that provides good clinical services for those who need infertility treatment, and a good research environment that is well regulated so that researchers know clearly what they can and cannot do. For that reason—the fact that we have a working environment that is safe and well controlled—more than any other, we lead the world in matters such as embryology research and embryological stem cell research.
In other countries there is not necessarily such an environment. There have been plenty of examples of that. Where have the threats to clone human beings been coming from? They have come not from our own regulated environment, but from countries where, for whatever reason, the Government have not been able to get to grips with the issues.
Those issues seem to come back to questions of religion and ethics. That was apparent when the Committee went to Scandinavia and then to the Vatican. The Scandinavian attitude was pragmatic. Basically, it boiled down to this: if there is no demonstrable harm to the child, it must by okay and things should be left alone. However, the Vatican had a very different attitude. In his refreshingly sane contribution, the hon. Member for Salisbury (Robert Key) described the theological progress on this issue. The Vatican position is that human life starts at the moment of fertilisation, and that even the zygote has the full rights of a human being.
That creates a great cultural limitation on what can be done, and for a long time Italy was totally unregulated and had no legislation on in vitro fertilisation. The consequence of that was some awful practice. One man was threatening to perform human cloning, and finally Italy legislated, but its legislation in this area, which it introduced just a few months before we did, was very imperfect. For instance, it demanded that all embryos should be immediately implanted once they were produced, and that they could not be stored frozen. That meant that there was a much greater risk of harm, both to the child and the mother, because it was not possible to screen out unhealthy embryos, to do pre-implantation genetic diagnosis—PGD—or to eliminate the possibility of implanting an embryo that was very genetically defective. The net result is a higher incidence of multiple births and birth defects, and greater harm, because the legislation is not sensible and has not grasped the nettles that needed to be grasped. We in this country have grasped them in the past, and we need to continue to do so.
Let us look at a
few examples of the problems that arise, which mean that we must
carefully re-examine the legislation. One problem is the PGD issue. At
present, that is strictly limited to serious life-terminating genetic
diseases, but the science has moved on so dramatically that a vast
range of diseases can now be diagnosed in the embryo—and to a
far greater extent than it is currently licensable to use that
technique. We must take stock and ask, “Is it reasonable to
avoid using the embryo that would produce a type 1 juvenile diabetic,
for instance, and to use the one that would not?” There are many
such diseases, which are survivable but clearly undesirable. That
matter must be discussed sanely and rationally. Such borders need
constantly to be revisited.
Let me give another example. In the context of tissue typing, there was the Hashmi case: the Human Fertilisation and Embryology Authority licensed an application to produce a baby who could be a tissue donor for its sibling, who already existed but had thalassemia and did not have much of a life expectancy. Tissue typing was essential; otherwise the stem cells would have been rejected.
That case has led to a succession of legal challenges, because the HFEA was working right at the policy limits of the legislation. Effectively, it was almost making law. Was it within its statutory limits or not? The High Court said no, but the Appeal Court overturned that judgment, and the case went to the House of Lords; I do not know what its decision was. We should not determine such issues through the courts. We need to make sure that the regulations and laws that we set down in this place are clear enough to keep lawyers out of this area, so that it can be left to doctors and would-be parents.
I have given two examples, but there are others. I am thinking now of mitochondrial diseases. At present, cell nuclear replacement can be used only for research purposes, but the time will come when it will be technically possible to use it therapeutically. That is not currently legal, but why should it be illegal?
As for cloning, we as a society are totally opposed to human reproductive cloning, and our report—contrary to what some people might suggest—does not suggest for one moment that we should do anything more. Therapeutic cloning is a totally different issue; that is absolutely essential if we are to pursue the production of new embryonic stem cell lines. But in 20 or 30 years, if techniques of reproductive cloning have become demonstrably safe, it is perfectly possible that Parliament and the public might want a different outcome. That is certainly not true at present, but the question needs to be revisited from time to time.
This House should play a central role in determining these issues. It should not be left to the HFEA to make policy in these difficult areas. It has enough of a job to do with its licensing and regulatory functions. I strongly subscribe to our recommendation that there should be a House bioethics Committee that should keep this area under constant review, make annual reports to Parliament, recommend amendments to legislation when it feels them to be appropriate, and conduct pre-legislative scrutiny of draft legislation as it emerges. Such a body should be the key actor in the future, but the whole of Parliament should have a vote on its recommendations. That way, we will take full responsibility for them.
6.10 pm
Mr. Brooks Newmark (Braintree) (Con): As a society, we are increasingly uncomfortable with the existence of received wisdom and moral certainties. It is probably also true to say that we are becoming uncomfortable even with the principles of secular morality—be it utilitarian or libertarian. Such secular morality is increasingly branded as an extension of “public interest”, so that it need not appear to be morality at all. The Warnock report proposed that the putative regulatory body for biotechnology should not be
“exclusively, or even primarily, a medical or scientific body. It is concerned essentially with broader matters and the protection of the public interest.”
It is perhaps fitting that a body that exists to deal with, among other things, the ethical dilemmas posed by genetic hybrids and chimeras, should be similarly heterogeneous. But it is true that scientific evidence and more traditional moral yardsticks must continue to complement one another. The ascendancy of science untrammelled by other concerns leads us into dark places.
The Committee’s investigation of eugenics and pre-implantation genetic diagnosis, for example, touched on the potential disaster of social objectives triumphing over ethical objections. Perhaps that is the danger implicit in conflating ethical, clinical and political judgments, which is why I believe that the Human Fertilisation and Embryology Authority might no longer be fit for purpose. There must now be a solid case for reconsidering its remit—and, consequently, its composition—from the ground up.
The intention to merge the HFEA and the Human Tissue Authority into a new regulatory authority provides an important opportunity to address the fundamental concerns about the biotechnology regulatory regime that the Committee expressed. The fact that the new authority will no longer be called the regulatory authority for fertility and tissue does not mean that it cannot become a “RAFT” in troubled ethical waters. The HFEA’s most important failings are not those related to the practical problems that, to some extent, afflict all Government organisations. It is no surprise that the Committee’s recommendation 66 highlights critical failings in the agency’s data management policies. Nor is it a surprise, for example, that the Government’s response lays the blame on the goose that has so often failed to lay a golden egg: IT infrastructure.
I was, however, more struck by the Committee’s findings on the HFEA’s inadequate expertise. I want to focus my remarks on recommendation 47, and particularly the following statement:
“We believe that ultimate authority on issues of public concern should lie outside of the scientific and medical communities.”
That is a sound principle, although many would argue that the scientific and medical communities do not harbour nefarious intentions of the kind that would make them incapable of self-regulation by their various professional bodies. But even if the status quo of lay dominance over day-to-day decisions is to be preserved, it is indefensible for the HFEA to lack a sound basis of scientific expertise; that must be corrected in any new body.
My concern is that insufficient parliamentary time is given to these complex ethical decisions, which are based on a rapidly evolving scientific evidence base. The introduction to the Committee’s report notes the statement, made during an earlier inquiry, that, after12 years of the Human Fertilisation and Embryology Act 1990, it was necessary to
“reconnect the Act with modern science.”
It also reiterated earlier criticism of the complacency of certain members of the HFEA, and the Department of Health’s “limp response” regarding a policy of constant review. If the HFEA is not keeping abreast of a rapidly advancing field because it has insufficient expertise or organisational capacity, it is clearly necessary to do one of two things.
The first option is to return regulation to the relevant professional bodies. The Royal College of Obstetricians and Gynaecologists stated in evidence that
“the body regulating this area should have sufficient expertise in its make up to tackle some of the difficult clinical, scientific and ethical issues presented to it”.
Does that description not include the professional bodies themselves? We should at least be asking whether regulation can safely be left in the hands of the royal colleges or the British Medical Association, safe in the knowledge that they are deemed capable of engaging with other complex areas of medical ethics. After all, the Committee made a number of recommendations concerning professional bodies’ increased involvement in the management of clinical and laboratory standards. It is only a small step from that position to professional bodies’ wholesale involvement in the development and review of an appropriate regulatory regime. It is only the Warnock principle of lay primacy over these ethical questions that holds us back.
Alternatively, we must establish a regime of regular statutory review by Parliament. It is time to turn our backs on a generation of ad hoc, laissez-faire intervention by Parliament, which relies on the initiative of Back Benchers to ensure that the law is kept in touch with science. That is particularly apposite in the case of the law relating to abortion. I am not an expert on accepted parliamentary practice concerning Back-Bench initiation of legislation, but it seems in this instance to be a convenient caveat to justify the Government’s inertia.
I do not want to go too far off piste and into the dangerous territory of advocating a review of the time limit applicable to abortion, about which we have heard much already. The decision whether to allow abortion up to 24 weeks, 20 weeks or even 18 weeks should be based on the available scientific evidence and should, if anything, err on the side of caution when it comes to the protection of a potentially viable foetus—in other words, a potential life. But, above all, I do not believe that the Government should absolve themselves, or Parliament, from the responsibility of regularly engaging in the ethical debate on the regulation of human reproductive technology. I believe that Parliament, not the HFEA, is the only crucible in which these questions can be discussed fully, because we are uniquely placed to respond to the scientific evidence, as well as to ethical problems and public opinion. The HFEA is quite wrong to view its role as insulating Parliament from difficult ethical choices.
I am heartened by the strength of support of witnesses called by the Committee for Parliament’s increased participation in difficult ethical situations. The Committee’s recommendations about parliamentary involvement are very welcome, particularly on the need for Parliament to be able to revisit contentious issues. But more than that, I am pleased that the Committee recognises the benefit of the increased public confidence that stems from greater parliamentary involvement in difficult ethical questions. It is, after all, easy to lobby a Member of Parliament on a free vote—and much less plausible that anyone should lobby the HFEA.
The HFEA is an unhappy compromise between scientific, evidence-based decision making and the Warnock principle governing the primacy of lay ethical opinion. If that primacy is still required, its proper forum is Parliament—a point that the hon. Member for Bolton, South-East (Dr. Iddon) alluded to earlier. The Government must now take steps to see that Parliament is entrusted with the regular review of the legislation governing biotechnology. Only Parliament has the resources to co-ordinate and balance the available scientific evidence, the ethical concerns, and the vagaries and inconsistencies of public opinion that are vital to this area of law. More importantly, only Parliament has the moral authority to ensure that the law keeps pace with scientific advances, without exceeding ethical boundaries or failing to meet public expectation.
6.19 pm
Emily Thornberry (Islington, South and Finsbury) (Lab): I appreciate the opportunity to address the House on recommendation 77 of the Science and Technology Committee, which calls on both Houses
“ to set up a joint committee to consider the scientific, medical and social changes in relation to abortion that have taken place since 1967, with a view to presenting options for new legislation.”
I take the opportunity to examine that recommendation, and particularly the suggestion that there might be a case for reducing the time limit. I want to put on record some facts about how many late abortions there are, and I want to consider whether there really have been scientific, medical or social changes of sufficient importance to warrant serious consideration of changes in the law. I do not believe that there have been.
It is important to recognise the passion that is provoked by the subject. It confronts many people’s core beliefs, and that includes me. It is one of my core beliefs that it is important for every woman to be able to control her fertility. Without such a basic right, women have no chance of equality. No contraceptive method is 100 per cent. effective, and no woman should be forced to carry and bear a child that she profoundly does not want. Abortions must therefore be available. It is right for everyone involved in the debate to declare their own interests, not in the Alda Barry sense of declaring an interest, but as regards their core beliefs.
It is important that those on the other side of the debate make it clear where they are coming from on the issue. One of the reasons the argument for restricting the time limit is so unconvincing is that it is often put by people who themselves are not convinced by it, and who take the pragmatic stance that if they cannot make abortion illegal or criminal, they will do their best to restrict access as much as they can.
Daniel Kawczynski (Shrewsbury and Atcham) (Con): The hon. Lady says that all women should have the right to have an abortion. What about the right of the father if he desperately wants to have a child and does not want his partner to have an abortion? What rights does he have?
Emily Thornberry: The right is fundamentally that of the woman who carries and bears the child. We are not going to agree on that, just as I am not likely to agree with Cardinal Keith O’Brien who, as I understand it, is arguing for a restriction on the time during which abortion would be possible I presume that he believes that abortion should be illegal and that there should be no abortions, yet he joins the debate. I believe it is women, not Parliament or the Church, who should be making such decisions.
On the question whether there have been sufficient scientific or medical changes to support a change in the law, let me start with a few facts about late abortions. No one wants to have a late abortion if there is any other realistic option. Less than 1 per cent. of abortions take place after 22 weeks, and 87 per cent. of abortions take place before 13 weeks.
Mr. Walker: You say that 1 per cent. of abortions—
Mr. Deputy Speaker: Order. I say nothing. It is the hon. Lady who says.
Mr. Walker: I apologise, Mr. Deputy Speaker. The hon. Lady says that only 1 per cent. of abortions take place after 22 weeks. Can she give a rough breakdown to explain why those abortions take place so late?
Emily Thornberry: Yes. Women who have abortions late are very young, or women going through the menopause, women who do not speak English, women who come across the one fifth of GPs who say they are broadly anti-abortion, women who have had difficulty accessing services and women who are scared, ill educated or marginalised. It is those people who are confronted with such a decision and who, with the assistance and support of medical services, make that extremely difficult decision. It is for them and not for the hon. Gentleman to make that decision.
There have not been any dramatic scientific breakthroughs in recent years. The survival rates are still very low for babies born before 24 weeks, and those that do survive frequently survive with severe disabilities. Last June, doctors at the annual conference of the British Medical Association overwhelmingly rejected a motion calling for the upper limit to be cut from 24 to 20 weeks—77 per cent. of doctors voted against it.
The spark that has reignited the debate on time limits is not medical advances, but the beautiful and highly emotive 4D images of foetuses offered by Professor Campbell in his private London clinic. Foetuses can be seen opening their eyes, kicking their legs and sucking their thumbs, but as Allan Templeton, the secretary of the Royal College of Obstetricians and Gynaecologists has said, the images add little to the science. If we want a debate about the science, let us talk about the science. He says:
“Observing
these developments and physiological movements is not changing anything
about the time of viability. These images however have given rise again
to the question as to
whether or not there should be a reduction in the time limit
of24 weeks. It is distressing that so much of the comment has
been so
ill-informed.”
Mr. Newmark: What scientific evidence was there for the doctors who made that decision—the 77 per cent. who voted against reducing the time limit for abortion from 24 weeks to 22 weeks? Was there any scientific evidence behind that decision? [Interruption.]
Emily Thornberry: I am advised that there was a full report of the matter in the Evening Standard. I am grateful to my hon. Friend the Member for Norwich, North (Dr. Gibson). I do not have with me a copy of that well known scientific journal. The point is that there has not been a breakthrough in the science to prompt the Committee to claim that we should re-examine the matter.
At the beginning of the debate, the hon. Member for Harrogate and Knaresborough (Mr. Willis) was asked what particular medical or scientific changes his Committee refers to when it recommends reconsidering legislation. As I understand it from his response, there is none.
Mr. Willis: My response was that I do not know of any such changes. That is different. The purpose of an inquiry would be to put the issue to bed. If the hon. Lady is right and there is no new scientific evidence, that would come out in such an inquiry and would be laid before the House. If she is wrong and there is new evidence, that would come out in the inquiry and be laid before the House. For the life of me I cannot understand why the hon. Lady should even question the principle of re-examining the evidence after16 years.
Emily Thornberry: My central point is this: if we want to have a cool and rational debate on the subject and we want it to be prompted by the science, come to us with the science. If not, the debate descends into raw emotion and prejudice. I stated my position at the beginning. We have heard from other hon. Members what their position is. In the end, the decision often comes down to emotion, how people feel and their own sense of what is right or wrong. That is why I believe it is for individual women to make the decision, because it is a profoundly personal decision.
The Marie Stopes International study on late abortion provides many of the figures and stories that I have quoted. I will be happy to provide the hon. Member for Harrogate and Knaresborough with a copy. There have been studies about why women have late abortions and the circumstances that provoke those late abortions.
| Next Section | Index | Home Page |