Select Committee on Science and Technology Written Evidence

Memorandum 20

Submission from Medical Research Council

  1.  The Medical Research Council (MRC) welcomes the opportunity to respond to the Science and Technology Committee's inquiry into scientific developments relating to the Abortion Act 1967.

  2.  The MRC is dedicated to improving human health through excellent science. It invests on behalf of the UK taxpayer. Its work ranges from molecular level science to public health research, carried out in universities, hospitals and a network of its own units and institutes. The MRC liaises with the Health Departments, the National Health Service and industry to take account of the public's needs. The results have led to some of the most significant discoveries in medical science and benefited the health and wealth of millions of people in the UK and around the world.

  3.  The following response details research of potential relevance to this inquiry, highlights some important issues, and identifies areas that the MRC considers to be currently under-researched.

    The scientific and medical evidence relating to the 24-week upper time limit on most legal abortions, including:

    (a)  developments, both in the UK and internationally since 1990, in medical interventions and examination techniques that may inform definitions of foetal viability; and

    (b)  whether a scientific or medical definition of serious abnormality is required or desirable in respect of abortion allowed beyond 24 weeks.

  4.  Whether fetuses feel pain is an important consideration. The MRC Expert Group on Fetal Pain, set up in response to a request from the Department of Health, published a report in 2001 ("Report of the MRC Expert Group on Fetal Pain", available on the MRC website at: The Group found that there was little direct evidence of the gestational age at which fetuses might feel pain; this would be dependent, inter alia, on the development of the central nervous system. There was no definable stage of fetal life when one set of neurons connected to another. The nervous system matured over many pre- and post-natal months to produce complete pain awareness. The Group concluded that there was still a great need for research into many areas of fetal pain. For example the basic molecular and cellular mechanisms of fetal pain were still poorly understood, as were the effects of anaesthetics or analgesics. Since then, the MRC has not received many applications in this area; one reason for this may be that such research, particularly involving humans, is very difficult to undertake.

  5.  The MRC has funded, and continues to fund, studies on embryonic and fetal development which may help inform discussions on abortion time limits. Research of this nature should be reviewed during this inquiry.

  Examples of MRC-funded research in this area include:

    —  Mammalian neurogenesis—Dr V Episkopou at the MRC Clinical Sciences Centre in London. Ongoing; £1.9 million expenditure to date (to 2005-06). This research aims to increase understanding of the molecular events that underlie early embryonic patterning and central nervous system development.

    —  Molecular embryology—Dr D P Norris at the MRC Mammalian Genetics Unit in Harwell. Ongoing; £300,000 expenditure to date (to 2005-06). This work is focussed on understanding how left-right (L-R) symmetry is broken in the early embryo.

    —  Generation of neuronal diversity in the developing telencephalon—Dr N Kessaris at University College London. Ongoing; awarded £325,000. This research aims to increase understanding of how the brain forms during normal embryonic development.

  6.  The MRC has also funded research on the effects of early delivery of fetuses, which may be relevant to this inquiry. For example, we are currently funding a follow-up study to the Growth Restriction Intervention Trial (GRIT) at the University of Nottingham[121]. The initial study evaluated the short-term effect of the early delivery of fetuses not thriving in the womb. The current study is evaluating the long-term effect on the development of the baby's brain, both the prevention of cerebral palsy and also for intellectual development. The ongoing EPICure study, also at the University of Nottingham[122], is studying developing patterns of health problems in babies born at borderline viability (25 weeks gestation or less).

  7.  A recently completed MRC study on the clinical applications of advances in human genetics at the University of Leeds[123] has aimed to identify particular genes causing specific diseases, in order to translate this knowledge into diagnostic tools which could be used in clinical practice and for genetic counselling purposes. Such early knowledge of potential genetic abnormalities may have an impact on women's decisions on abortion.

  8.  Peripheral to the main aim of this enquiry, but an important issue for medical research, is the availability of fetal tissue for research. Birth defects are the biggest cause of infant mortality in the Western world. Currently one in 30 babies is born with a significant malformation but the causes of many of these malformations are poorly understood. Studying tissues taken from embryos from the period when most malformations arise is an important step towards understanding, and perhaps eventually preventing, fetal abnormality. The MRC/Wellcome Trust Human Developmental Biology Resource at the Institute of Child Health in London helps to support research in this area through the provision of donated embryonic and early fetal material. This research not only promotes understanding of how birth defects arise, it also may lead to the development of more sensitive and specific diagnostic tests.

  9.  The MRC believes that any recommendation to change the upper time limit on abortion would require specific studies to be carried out to determine the effect on clinical advice and on women's decisions. Abortion laws vary from country to country, so findings from other countries could be informative. Specific studies on the reasons for late termination of pregnancy would need to be carried out, particularly given that some developmental problems only show up late in development, and some pregnancies are only discovered late. This would add to the difficulty of defining "serious abnormality". A secondary consideration would be the effects on the availability of fetal tissue for research.

  Medical, scientific and social research relevant to the impact of suggested law reforms to first trimester abortions, such as:

    (a)  the relative risks of early abortion versus pregnancy and delivery;

    (b)  the role played by the requirement for two doctors' signatures; and

    (c)  the practicalities and safety of allowing nurses or midwives to carry out abortions or of allowing the second stage of early medical abortions to be carried out at the patient's home.

  10.  This part of the inquiry is not directly within the MRC's remit.

  Evidence of long-term or acute adverse health outcomes from abortion or from the restriction of access to abortion.

  11.  The MRC has not funded any work recently in this area.

August 2007

121   Growth Restriction Intervention Trial (GRIT) and long-term follow up study-Professor J Thornton at the University of Nottingham. Ongoing; awarded £940,000. Back

122   EPICure: population-based studies of survival and later health status of infants of 25 weeks gestation or less-Professor N Marlow at the University of Nottingham. Ongoing; awarded £3.0 million. Back

123   Clinical Applications of Advances in Human Genetics-Professor A Markham at the University of Leeds. Ended at the end of 2005; awarded £37,500. Back

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