Finally, I turn to amendment No. 31. It is linked with amendment No. 32, which would amend schedule 2. Amendment No. 32 is the key one; it is very important, but I do not have time to give it its due. It would insert a new provision that would enable the HFEA to give a licence for therapy as well as for research. The problem with the current Bill is that if, one day, the research works, and it is possible to derive from embryos stem cells that could be used to treat, say, diabetics by
providing new, insulin-producing cells, or Parkinsons disease, it is not clear whether it would be possible to create embryos and use or store them for the purpose of therapy. Clearly, clinical trials are covered by the term research, so it will be possible to create, store and use an embryo to provide stem cells for use in clinical trials. One cannot keep doing clinical trials once a treatment is known to work; it is unethical to randomise someone to placebo and someone else to a treatment that is known to be effective. At that point, one has to stop trialling, and instead deliver treatment. At that point, it is not clear whether the original embryo, from which the new stem cells are derived, will be covered, under the HFEA, by a licence, because one can get a licence only for treating infertility or for research.
The Government are right to say that the stem-cell therapies will be controlled by the Medicines and Healthcare products Regulatory Agency and, before that, by the Human Tissue Authority. That is not in doubt, and I am sure that the joint statement from those bodies and the HFEA will lead to a seamless transfer. The problem is that if, once research trials work, a company called, say, Stem Cells R Us comes along and says, We can produce embryonic stem cells for treatment and sell them to the NHS as therapy, it will not get a licence under the Bill, because it cannot show what the research ends are. It is not good enough for the Government to say that there will always be quality assurance testing on any stem cells derived and that that counts as research. Quality assurance is not research. Research must pass muster on clinical research ethics, and a clear programme of research with inclusion criteria and exclusion criteria is therefore required.
The Government gave two different answers when the issue was raised in the LordsI can send the Minister the exact quotes. That makes their position difficultif their position is that there is no problembecause if there were a challenge in court, it would be found that Ministers in the Lords said diametrically opposed things in Committee and on Report. In Committee, the Minister said that such a provision would be a step too far, because it would raise a series of issues about, for example, how many embryos per stem cell line are needed for therapy. On Report, the Government changed their mind, when the Minister said that such a provision would be unnecessary, because the practice is already permitted under the 1990 Act. The Government stuck to that line in the letter that was referred to in the point of order raised by the hon. Member for Enfield, Southgate (Mr. Burrowes) and on Third Reading.
That will not do. It is necessary to clarify the situation, which would not be a step too far. Indeed, Baroness Warnock expressed concern in Committee that despite everything we went through on cloning regulations, which related to conducting stem-cell research and providing therapies, the Government say that they would permit research but would not permit the fruits of that researchthe therapies themselvesto be used.
Lord Patel and I worked on the amendment that has since been tabled by the hon. Member for Boston and Skegness (Mark Simmonds), but my amendment No. 32 is better than that, which is why I have re-submitted
itthe two amendments do the same thing. I do not intend to divide the Committee, but whatever the Minister says in reply, will she meet me, scientists and stem-cell research funders, who are concerned, along with her officials to explain precisely whyI fear that she will not have time todaymy amendment is unnecessary?
Dawn Primarolo: The Wellcome Trust, the Medical Research Council and a large number of scientists support the Governments interpretation of the 1990 Act. While I am always happy to exchange discussion points with the hon. Gentleman over a cup of tea, I regret that I will not give him such a commitment this evening.
Dr. Harris: I am astonished. The views of the MRC do not matter, because this is a legal question. I have received legal advice stating that the Governments position will not do and that it is challengeable, and potential investors in stem-cell research have said the same thing. I think that the Minister accepts that the first answer given by the Minister in the other place was incorrect, and she is now sticking by the answer given at a later stage.
Dawn Primarolo: The hon. Gentleman is persistent. [ Interruption. ] His colleagues have confirmed that, although they do not agree with him. If he wants to draw things to my attention, then he can send them to me. However, the advice that I have received and the consultation that has been undertaken indicate that the interpretation that the Government put on allowing research to be conducted into therapies, which is the purpose of the Bill, is clear, as explained in the other place.
Dr. Harris: I am very worried now, because that is not the question. The question relates not to research but to after research has finished. Let us say that in five to 10 years time the research has worked and that the researchers want to create embryos to derive the therapies without the research stage. How would they do that, when only a research licence is available for that purpose? That is the problem. The Minister might say, Well, we will have another Bill in five to 10 years time. However, I do not think that she will want to go through this again. Furthermore, the history of legislation on the issue indicates that it does not come up very often.
I urge the Minister to recognise that she has not addressed my question. If someone wanted to produce embryos for therapy after trials had been conducted either elsewhere in the world or in this country, how would they apply, because they would not have a research project? The Minister should take this issue more seriously.
Dawn Primarolo: It is utterly outrageous for the hon. Gentleman to suggest that I am not taking the Bill seriously, simply because I am not prepared to undertake to meet him. I hope that he will withdraw that remark.
Dr. Harris: The record will show that I said that the Minister is not taking this issue seriously; so she is being unreasonable in suggesting that I have suggested that she is not taking the Bill seriously.
I have received legal advice that suggests that there is a problem, but the Minister has been unable to address it. The Government gave contradictory opinions in the House of Lords, but she will not even meet people who disagree with her. [ Interruption. ] I think that she is saying from a sedentary position that she would be happy to meet me.
I have set out why I believe it right to permit saviour siblings and why the drawbacks that have been ascribed to that approach do not apply. For a handful of families, allowing tissue typing as a form of PGD will give them the opportunity to help one child, while at the same time producing another healthy child who is also wanted.
Mr. George Howarth (Knowsley, North and Sefton, East) (Lab): Anybody listening to the debate on saviour siblings, both in Committee today and in the wider mediaI exempt the hon. Member for Oxford, West and Abingdon (Dr. Harris) from this, but there are other speeches still to comemight be forgiven for falling under the misapprehension that the moral argument lies entirely in one direction and that the legislation has been drafted by a latter-day Mary Shelley who wants to allow scientists to create monsters. I am not exaggerating in making that remarkwhen we debated the amendments to clause 4, the hon. Member for Gainsborough (Mr. Leigh) prayed in aid Mary Shelley.
When one hears comparisons between this Bill and, for example, the Third Reich, it is easy to forget that we are discussing treatments that, if successful, could save lives and prevent needless suffering. We should make decisions based on the best available evidence and put highly charged language to one side. As with most contentious issues, no one side has a monopoly on the moral argument, and it is important that we avoid such pretensions and focus on real peoples lives and the effects on real peoples lives, as supported by evidence.
I respect the views of those who have reservations about the Bill, but the three main arguments against saviour siblings are flawed. I will discuss those arguments and touch on some of the moral arguments that support our moving in that direction. The first argument that is often put is that saviour siblings would be treated as commodities. In other words, parents who choose to have a further child in the knowledge that that might save the life of its sibling are somehow driven by unacceptable motives. At the heart of that argument lies the alarming notion that the state has the right to question the motives of prospective parents. It does not take a great deal of thought to realise the odd directions in which that could take us. I strongly believe that it is up to parents to decide their own justifications for having children. In practice, to be perfectly honest,
it is unclear how it would be possible accurately to judge intentions in every specific case. I do not want to stray too far from the point, Mr. Hood, but it does not take a great deal of imagination to envisage a number of different cases where any of us would disapprove of the circumstances in which a child was conceived. However, would we have the right to condemn their birth? That example has a direct parallel with the argument that I have mentioned.
The second argument expressed by opponents of saviour siblings suggests that saviour siblings would be the first step on a slippery slope to designer babies. Frankly, that argument could be put only in a completely different context, because the rules in the Bill explicitly prevent such a development. If we went through life rejecting Bills on the basis of what subsequent legislation might propose, we would probably never pass any laws whatever.
The third argument suggests that saviour siblings may be physically and/or psychologically harmed. It is flawed for several reasons. First, the Bill includes an amendment that limits other tissue, so it does not include whole organs and will have the effect of preventing an embryo from being tested if the intention is to remove an organ from a child. Although it is true that, according to all reports, making a bone marrow donation is not a pleasant experience, there is little, if any, evidence that donors suffer any lasting adverse effects. In fact, the contrary is true: as the hon. Member for Oxford, West and Abingdon suggested, many people who can offer the gift of life report an overwhelming psychological benefit.
Does he not give any weight to the possible psychological harm to a second childa saviour siblingwho had given, say, bone marrow on a number of occasions and came to discover, be told or believe that he had been created, selected or put together primarily for a particular purpose? Would such a child not wonder about what kind of child he would have been had that selection not taken place, and would that not add to the teenage angst and turbulence that we see in too many youngsters already?
Mr. Howarth: I understand the hon. Gentlemans point, which is important. However, I do not know where the balance of the evidence takes us. I do not wish to be in any way disagreeable, but 30 or 40 years ago it could have been argued that somebody born out of wedlock would be disadvantaged for the rest of their lives. Some people might have made a value judgment, but all I can say is that I know a lot of people who were born to unmarried parents and do not seem to have suffered any psychological disadvantage at all. I return to my previous point: the one thing that we do know is that most people who have benefited a sibling through this sort of procedure report that it makes them feel good about themselves and creates a greater bond.
The issue is complicated and it is difficult to say that in every case the use of saviour siblings would be
damaging or that in every case it would be wonderful; there will be a wide spectrum of reactions to the experience. However, I do not think that the argument put by the hon. Member for South-West Devon (Mr. Streeter) seriously militates against their use.
Stephen Pound (Ealing, North) (Lab): I agree that my right hon. Friend is making a sober and considered case. However, I ask him to consider the circumstances of a saviour sibling whose creation fails to resolve the problem for which he or she was created. What psychological damage would that do the child, and how would the parents view that childcreated to save, yet unable to do so?
Mr. Howarth: I understand my hon. Friends point. I said that there would be a wide spectrum of circumstances and that cases would be different. One could equally argue that a child who had an elder sibling with a congenital disease that would lead to certain death, and who was not used for such a treatment, would suffer a bereavement that would result in an even greater psychological disadvantage. There is no easy answer to any of these problems and I do not pretend to have all the answers. However, I return to my previous point: I can foresee circumstances in which a young person would feel good about having played a part in the survival of an elder sibling.
Mr. Mark Todd (South Derbyshire) (Lab): My right hon. Friend referred to the positive feelings cited by siblings who have donated. Surely those siblings had given consent to the processin other words, they were knowingly engaged in assisting another sibling. In the instance that we are discussing, no such consent would be obtained. The decision would be made by the parents.
Mr. Howarth: My hon. Friend is correct. However, parents make all sorts of decisions about their babies and children without there being any possible consultation. I cannot see how somebody could be consulted about what could happen in their infancy before they were even born. My hon. Friends point is not strong.
John Bercow: I am extremely grateful to the right hon. Gentleman for giving way. The fact that the savour sibling would not be in a position to give his or her consent at the time for something that proved to be thoroughly beneficial does not mean that he or she could not feel a great sense of retrospective satisfaction at having done something very good. The two concepts are by no means mutually exclusive.
Tom Levitt: I agree with everything that my right hon. Friend has said. The answer to my hon. Friend the Member for South Derbyshire (Mr. Todd) is that when Siamese, conjoined twins have to be separated clinically and the chances are that one will die, I do not recall that the twin least likely to survive is consulted. The situation is difficult and parents have to make the decision. The situation is no different from that involving savour siblings.
It is important to remember that, as the hon. Member for Oxford, West and Abingdon pointed out, the only real difference between conventional IVF treatment and the process of creating a saviour sibling is in the reduction of chance at the point when eggs are selected for implantation. In my view, claiming that that is a manipulation of DNA cells or a creation of designer babies is a misrepresentation of the facts. The reality is that it simply enables an informed selection of embryos so that there is a greater likelihood of a healthy baby who also has the potential to save their siblings life. If, as I do, we accept that the principle of IVF is a good thing and if we have the technology to make this important decision in a more informedway, we should use that technology, as long as all therapeutic alternatives have been exhausted.
It is a question of using the best available knowledge to maximise the chances of saving lives and reducing suffering. As was noted in the previous debate, there are other sources of therapeutic cellsbone marrow transplants and cord blood from non-related donors provide such possibilities. However, only 20 to 35 per cent. of patients have a matching sibling by chance and the odds of obtaining matching stem cells from an unrelated donor vary according to the ethnic origin of the patient. As matching is significantly improved when the donor and recipient have the same ethnic and racial background, this Bill will have even greater benefits for people from minority ethnic groups struggling to find a suitable donor. Indeed, one of the cases that the hon. Member for Oxford, West and Abingdon referred to made that point equally well.
When we think about the principles involved, it is all too easy to forget that we are dealing with uncertainties. The best available scientific evidence can only predict the most likely future therapies. Indeed, the history of medicine shows, repeatedly, that life-transforming treatments in one area often arise from work with a very different original rationale. The obvious example is that of Alexander Flemings discovery of penicillina chance discovery from an already discarded contaminated Petri dish. The drug sildenafil was originally used to treat angina before a notable side effect was deemed to have a significant therapeutic use in its own right. For those in the Committee who are not immediately familiar with this drug, its more popular brand name is Viagra.