Human Fertilisation and Embryology Bill [Lords]
Robert Key: I strongly endorse the comments of the hon. Member for Bolton, South-East. I served on the Select Committee to which he referred in the last Parliament. The inquiry into human reproductive technologies and the law visited both Sweden and Italy and met their national bioethics committees. In Italy I was quickly aware that the committee was not what it seemedseemed to me, anyhow. I think that I recall, for example, that there was only one woman on the committee, which reflected the political reality of Italian democracy, but convinced me that it was not a satisfactory way of proceeding in this country. I also recall that when the Joint Committee scrutinised the Bill last summer and produced our report, the Government listened. The Government took us seriously. They gave the Bill a new title and binned a huge chunk of their proposals. That surely shows the virtue of such a Committee. I commend the Government for listening to Parliament.
Both Houses of Parliament are, de facto, the national bioethics committee of this country. We should be jealous of that. It would not be possible to create another body, independent of Parliament, that would have anything like the authority that we have, with the authority of democratically elected Members, representing
At the other end of the spectrum, I endorse what the hon. Member for Bolton, South-East said about local medical ethics committees. I do not think that members of the public generally realise that in every hospital or clinical research establishment there is a local ethics committee which considers all the factors as they are legislated for and played out in their local communities and establishments. They are extraordinarily influential bodies, and they are localised to a degree that makes them credible to our constituents at a local level.
That is the approach that we ought to take in future. We should not rely on the setting up of a joint Committee for the pre-legislative scrutiny of a particular bit of legislation; we should have a permanent Standing Committee of both Houses to deal with such bioethical issues, which will only get more complicated and arise more frequently. It will not be another 18 years before more legislation. Mark my words, Mr. Hood: we will be back within 10, maybe five years, because something else will have happened. Medical technology and science will have moved forward so fast that once again Parliament will have to catch up. The voice of Parliament should set the ethical and moral framework and the regulatory authority should decide on individual cases within it. That is the way we should be going, and that is why I strongly support the new clause.
Dr. Ian Gibson (Norwich, North) (Lab): I, too, support the new clause. I do not think that there will be any problem with the Nuffield Council on Bioethics, which has done lots of work that I shall explain in a minute. It is quite independent, is financed independently and does fine work.
In the Joint Committee, while we were discussing the Bill, high-octane meetings were held with people from the Lords and the Commonseveryone who had some ethical view about everythingand it was good to have the opportunity to talk about things. There was nothing more tendentious than the need for a father. That evoked some heavy stuff, and there was a lot of disagreement on both sides, but it was important to have that debate. We have never had such a debate properly in Select Committees and so on, because there just aint time. We need a place to discuss those issues.
I could say lots about bioethics. It is the fastest growing profession in the medical world at the moment. People are suddenly realising more and more that biology and the biological sciences are developing new technologies and ideas that will have to be considered in terms of societynot just this society but other societies, such as in the developing world and so on. I think that such a Committee would have a lot to say. Some of the things that it would look at include genetic screening and age discrimination. When do we start and stop breast screening? Do doctors behave differently depending on the age of
The Chairman: Order. As we are getting to the end of the Committee, I ask the hon. Gentleman to stay in order when addressing the Committee.
Dr. Gibson: Then, of course, there are stem cells and so on, and pharmacogeneticsit is almost a continual processand the DNA database. There has never been a more important arena. More and more information is being brought to our notice. We need a place where people can contemplate and think about those issues and build them into hard science and medicine. I am glad to support the idea of a joint bioethics Committee in this place.
Dr. Pugh: I warmed to the proposal when it was mentioned on Second Reading, but since then, scepticism has grown on me. I accept that the remit should be wider than defined in the new clause and that the HFEA, the Nuffield Council or whoever do not actually do the jobs envisaged by those who tabled the new clause. Most ethical committees, as I understand them, are basically endowed with a set of principles that they apply with respect to a certain group of professionals. What I think that we are asking for, implicitly, is a bioethics commission, parliamentary or otherwise, to formulate a set of principles to take us out of the moral mire that we are in.
Generally, ethics is a tricky business. I have spent a lot of my life studying it from the philosophical point of view. There is no agreement about what it is or how ethical disputes should be resolved, even where consensus has arisen. For example, in the Warnock report, Baroness Warnock states clearly that she applied utilitarian principles to resolve the moral dilemmas. But if we are not utilitarians, we would simply not buy into that in the first place. There is nothing blindingly obvious with the moral consensus that we have at present, but there might be a pious hope that we can have a bioethics group and, through that, a consensus or solution from a group of moral experts who will just tell us what framework we need to work within.
The existence of moral experts has been a matter of debate since the time of Plato and it is still yet to be resolved.
Dr. Pugh: No, he is not, nor is anyone who we can be assured knows what is good and what is right. A group of moral experts does not get Members of Parliament off any moral hoof of thinking ethically ourselves. If we think of the committee as a mechanism for reflecting ethical opinion, encouraging ethical debate or ensuring that decisions are made in an ethnically informed way as opposed to pragmaticallyI take on board the comment made by the hon. Member for Norwich, North about scientists not being purewe would have a modest committee that could do a useful job.
However, our difficulty, which no committee can resolve in connection with the legislation, is that we are not working within a clear, ethical framework. There is no clear ethical thread binding all the various moral decisions that are made in the context of the Bill. That is not only my view. I read the evidence presented to committees on draft legislation and the remarks of Professor Haldane and others, and that is exactly what they picked up. There is a series of ad hoc commissions and things that we believe are right on balance, and a series of case-by-case arguments, but if we went for the position that we wanted in respect of the Mental Health Bill and said, Here is a piece of legislation but, before we get into the detail, let us put in the Bill the moral principles that will guide us, and explained why we made various decisions in the clauses, we would be in serious difficulty. We would be incapable of taking such action, and many people who reported on the draft legislation said precisely that.
A bioethics committee that is prepared to fill a modest role might have a place in the mix. However, what we shall not achieveand perhaps what hon. Members are hoping foris a cast of modern Solomons. We might reach the position when people know why they are making such decisions, as a result of which ethical rationale would be laid out with greater clarity, but we would not achieve wholesale agreement on what is right unlessthis is the fear of some peoplewe rig the committee in such a way that it would be guaranteed consensus.
In the past, many of the debates on ethnical committees have been about whether they are set up fairly or whether the balance is such that the democratic verdict goes in one direction rather than another. I do not know how that can be resolved. A great deal of hard work has to be done. On the assumption that we have something that adds grist to the millthat adds something to the general picture and informs the decisions of Parliamentthere would be nothing wrong with it, but it will not take us out of our current bind of making hard, moral decisions for all time on particular issues.
Dr. Harris: I declare an interest as a member of the British Medical Association medical ethics committee. The hon. Member for Salisbury mentioned local ethics committees. He is right; they are well developed in research ethics. I was a member of one of those committees for many years. They are moving on apace in respect of clinical ethics in hospitals.
I was on the same visit to Sweden and Italy to which the hon. Gentleman referred, and the system was not ideal. I support the thrust of the new clause, but I want to put it in the context of the Select Committees recommendation on human reproductive technologies and the law in 2005. The hon. Member for Bolton, South-East read out a recommendation. We argued that the HFEAs policy-making aspects and the Human Genetics Commission could be combined usefully in one commission that would advise a standing parliamentary committee.
The problem with the HFEAs current policy-making role, as some people see it, is at least twofold. First, because primary and secondary legislation can cover only a certain number of things, the HFEA is called
The second problem is that, as a result of that lack of debate and the fact that the HFEA makes policy in sensitive areas, it is liable to be criticised by politicians. That is the nature of things; politicians criticise those whom we have set up and given the power to make decisions for us. Perhaps that is unfair, given that we have voted for a measure that gives the HFEA discretion to make policy. There was one occasion when the Science and Technology Committee criticised the HFEA for making a decision about pre-implantation genetic diagnosis. The Committee was provoked into doing that partly by the combative performance of the former chair of the HFEA, now Baroness Deech, my constituent. She is a woman whom I greatly respect, but she was quite combative and there was a critical report, which I thought was unfair because the HFEA was only doing what it had been asked to do in the 1990 Actto make policy.
To avoid that problem, one could have the best aspects of the HFEAs policy-making function combined with the Human Genetics Commission. It is hard to see a distinction between those two, and indeed, the Human Genetics Commission provided evidence and a view on hybrid embryos during the HFEAs consultation. The best elements of those could be combined into a committee or commission that gives advicea Standing Committee of Parliament. Such a Committee would have the advantages of being in Parliament. It would also, because of the way in which such things work, be able to capture all the strands of opinion, so that those, for example, who were not supportive of embryo research would not be excluded from policy development, which the HFEA has to deal with.
For those reasons, the Science and Technology Committee of 2005 was right in its report to say that the policy-making functions could be taken away from the HFEA, which could then concentrate on regulation and inspection, but that that was worth doing only in the context of a parliamentary Standing Committee. For the reasons that have been given in the debate already, there are huge advantages in creating such a Committee.
What would be the powers of such a Committee? Another Select Committee making recommendations mainly to the Government, which the Government felt they had a mandate to accept or reject as they saw fit would not be ideal. That is why a model like the Joint Committee on Human Rights is a good one. In its reports, the Joint Committee on Human Rights does not simply make recommendations to Government and other organisations as other Select Committees do; it gives specific advice to Parliament on human rights issues. In that sense, it goes beyond the normal role of a Select Committee and both Houses can choose to accept or reject its advice.
The second merit of the Joint Committee on Human Rights is that it was set up by statute. I do not know what advice the hon. Member for Bolton, South-East received, but it may not be possible within the scope of the Bill to give a Committee statutory functions. The
There are significant merits in the idea of a parliamentary ethics committee. It would enable Parliament to visit these issues on a more structured basis and far more regularly than we otherwise do. I do not share the confidence of the hon. Member for Salisbury that we will be back in five years with another Bill. I think that he is right that science will progress quickly in the next five yearsperhaps even in the field of IV-derived gametes, but I will not open that up again. Science will move on, but I suspect that we will not be able to come back in the next five years, or even 10 years. However, a parliamentary Standing Committee with authorityeven without statutory powerswould put pressure on the Government of the day to enable a free vote to take place, even if it had to make majority decisions. I think that my hon. Friend the Member for Southport was right to say that there would never be unanimity, which would probably be unhealthy, on some of these fundamental issues. They are generally free vote issues so it is difficult for parties to seek a mandate at a general election and say, This is what we are going to do, because the matter would be subject to a free voterightly, in my opinionwhich requires that the Government do something. It is quite difficult to do that, for reasons of the parliamentary timetable, the pressure of legislation and that such measures contain yuck factors, which Governments run a mile from. It is to the Ministers credit that she has not run as fast as some Ministers might have, from taking on the issues. I am sure that she enjoyed the prospect of dealing with the Bill.
I do not think that we are in a moral mire. If we are, I think that we are climbing out of it with measures such as the new clause. There is a clear basis for establishing such a Standing Committee. Its remit should be wider than simply embryology. I accept the point made by the hon. Member for Norwich, North that it might have been difficult to raise the issue within the scope of the Bill if the Committee proposed in the amendment had not been restricted to embryology. If this is a probing amendment, I hope that the Minister is listening and will come back with a proposal that has the support of a number of Select Committees. I echo the view of the hon. Member for Salisbury that not only did the Joint Committee that considered the Bill do good work, as did the Science and Technology Committee on the hybrids issue, but that it was good that the Government listened and changed their position. They were not accused of a U-turn, but were applauded for listeningI repeat that. I pay tribute to all the members of the Joint Committee, especially the Chairman, my hon. Friend the Member for Harrogate and Knaresborough (Mr. Willis), for his work.
Although I understand that the new clause is probing, I would like to associate myself strongly with the thinking behind it. I hope that we see something like the Committee that the hon. Gentleman proposes, to give Parliament the ability to debate emerging ethical issues transparentlyso that the public can see us debating itand with some effect .
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