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Baroness O'Cathain: My Lords, I did not for one moment suggest or imply that the noble Lord had any financial interest. I simply quoted an article in a December 2000 issue of the Sunday Times.

Lord Winston: My Lords, we both agree that the Sunday Times is not a completely accurate record of scientific matters.

This is probably the most important debate in which I have been involved. As I speak this evening I recognise that I have a great moral responsibility because I am the only Member of your Lordships' House who is involved in, and has an intimate understanding of, this research and is daily confronted with the issue of human experimentation. I also recognise that in truth I stand before my maker this evening in advising the House of the consequences of its vote in about an hour's time.

Essentially, the debate is about transplantation and regeneration. In order to be effective, stem cells need to be transplanted. Some noble Lords are also aware that there is a possibility that some tissues can regenerate by controlling the genetic influences. It is clear from every biological investigation that the only way to do that is to look at embryological knowledge, most of which can undoubtedly be derived from animals. Transplantation is not a new field. I believe that it was the noble Lord, Lord Habgood, who said that transplantation had gone on for some time. Blood was one of the first tissues to be transplanted in the 19th century. The problem of rejection does not much

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matter in the case of blood; it lasts for about three weeks and so is not rejected. Paradoxically, bone marrow is rejected very vigorously because it goes right to the heart of the immune system, hence the terrible fate of people who have bone marrow disorders.

There are some other tissues in which the rejection phenomenon is somewhat equivocal; for example, the liver and brain. The noble Lord pointed out that experiments had been conducted in which cells had been injected into the brain, to which I shall turn later. We all hope that adult stem cells may be used in this research, but they are incredibly difficult to obtain. For example, they would require the biopsy of the brain in a Parkinson sufferer, which would be unthinkable and impossible. It has been known for some time that they change to different tissues in certain circumstances, and they are impossible to maintain and harvest at the moment.

One of the risks with adult stem cells which has not been mentioned so far is that they are likely to carry the very genetic defects which are programmed to cause the original disease from which the sufferer suffers. We require tissues which are totipotent rather than pluripotent; in other words, tissues that can develop in every different direction. For that reason, embryonic stem cells are remarkably attractive. There is an almost overwhelming agreement among biologists that this has been one of the most important areas of science for the past two decades. Next, these cells do not overcome rejection except probably in a very few cases. Finally, one of the most crushing arguments against adult stem cells is that when they change--for example, work by Professor Wright in my own unit shows that blood cells, not the liver, can change--they do not function normally, which is very telling. Adult stem cells have not been shown to function properly.

By the by, we have heard in this debate about redifferentiation and cells becoming youthful again, as if it is something entirely new; it is not. Sir John Gurdon, Master of Magdalene College, Cambridge, described this in 1962. Since then biologists have been aware that signals may reprogramme the nucleus of cells.

Why do we need embryonic stem cells to understand the adult cells? First, we need them because of the chemical messages. At Imperial College where I work we now know that in the mouse certain chemicals can be applied as a result of using embryonic stem cells which will differentiate a tissue into bone, cartilage or heart muscle. Those substances are, unfortunately, sometimes specific to a species and are not necessarily the same in humans as in mice or other animals.

One of the reasons that we must turn to embryonic stem cells as soon as possible is to answer the question posed by my noble friend Lord Brennan who, sadly, is not in his place at the moment. He asked whether science required immediate action. The answer is that I believe it does, for the reason that this technology has already worked. I made reference to stem cells in five out of the six parts of the television programme "Superhuman". I apologise for plugging my own

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programme. There was not a single public letter of objection to that. There were letters of objection about my views on evolution. There were one or two letters of objection about animal research. But none about the use of stem cells. That is the public disquiet about which we are talking this evening.

It has already worked. We saw on that programme a man who was so incapacitated he could not get out of bed. He was completely immobilised with Parkinson's disease. He was absolutely solid. After an injection of stem cells from a pig the programme shows him driving a sports car through Florida.

I have a friend who is a very distinguished author. He actually could not write. After he received an injection of foetal stem cells into his brain he recovered from his Parkinson's disease. I maintain that it would be far better to use embryonic stem cell tissue which is going to waste from IVF programmes than using aborted foetuses. I have a serious problem about using aborted foetuses. But I think that we could use embryonic stem cells. I must emphasise that we are not talking about creating embryos for research, we are talking about using material which is to be wasted. Twelve per cent of human embryos in an in vitro fertilisation programme implant. Something probably similar happens in nature. The human embryo is not actually inviolate. By nature's standards it is not sacrosanct. I say that with the grave responsibility of someone who, like so many of your Lordships, has deeply held religious principles.

What about cloning? Cloning requires a human egg. One cannot make an embryo without an egg because it is the cytoplasm, the substance of the egg itself, which re-programmes that nucleus in a way we do not understand. Whether we like it or not, there is not the slightest possibility of human clones. Why? There are all kinds of reasons. One is because human eggs are in incredibly short supply. At Hammersmith Hospital we have patients who wait for a donor egg for four or five years. That is common across the country. There is no possibility of using donor eggs. We would not only need the ethical approval from our local ethics committee and the HFEA's approval, but we would need the patient's signed consent. Patients quite rightly will not give that consent. Nor should they. There is no possibility in this country of making clones in the way that has been suggested by the noble Baroness, Lady O'Cathain.

One of the problems with the human embryo which remains, which is why it is so apparently unlikely to implant, is that it often carries a huge number of defects. Many of the cells in the human embryo have defects which are profound and which are chromosomal. It is very likely that this happens to a whole range of stem cells. One of the reasons for needing embryonic tissue is to understand the defects which occur during development which might give rise to these chromosomal disorders. The defects in the cells are specific to humans. They do not apply in the same way to mice; and they do not apply to other experimental animals that have been looked at. It would be unthinkable to transplant an embryonic or

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adult stem cell with chromosomal abnormalities and risk a patient having a tumour. That is what would happen.

Clearly there needs to be further reflection on this area. I would argue with the eloquent speech of the noble Baroness, Lady O'Neill, when she said that the need for continuing surveillance of some kind is appropriate. I understand perhaps more than the noble Lord, Lord Alton, realises where he comes from. We differ because we have a different view of the beginnings of human life. I do not think we will ever agree about that. But I do not doubt for one moment that he is not acting in absolute good faith. I hope he will accept that I am also.

Before I sit down I say this to your Lordships--and I know that I am taking a grave moral responsibility--we need to face the fact that, as the right reverend Prelate the Bishop of Oxford said, there is no doubt that this work is essential now; the sooner it is done the better; and whether some people in the near future get a treatment which might save them from disease, or, even worse, death, depends on your Lordships' vote.

8.55 p.m.

Baroness Walmsley: My Lords, this has been a long and impressive debate. Therefore, your Lordships will be relieved to know that I intend briefly to add my voice to those who intend to support the regulations and the amendment of the noble Lord, Lord Walton of Detchant.

I am convinced on both scientific and ethical grounds that this is the right way forward. The science is very powerful, but so is electricity and somehow we manage to control that. There are three particular groups of people looking to us today to return to the right verdict on the regulations laid before us. The first group comprises many of the infertile couples who are being helped by the current legislation and would like to be permitted by the new regulations to donate their surplus fertilised eggs to be used to help sick people.

Secondly, there are thousands of sufferers of the serious diseases for which the research permitted by this change of the law would provide hope--the diabetics, sufferers from Parkinson's disease, Alzheimer's and the many others who have been listed today. Then there are the scientists, who would like to be able to widen the purposes already permitted for these delicate and difficult procedures to include not just the successful creation of human life, as now, but to improve the quality of life for thousands of people already alive and suffering.

I do not agree with my noble friend Lord Dahrendorf, who said that he thought it was inappropriate to talk about human suffering in the debate today. I think that is what this is all about. We owe it to all of these groups to make a decision on the matter now. We have been sent to this place with the duty, responsibility and privilege to decide on this and other difficult matters. We should do so now and not pass the buck to a Select Committee or anyone else.

I do not feel that I have been rushed into making up my mind on this matter. Over the past few months noble Lords have been bombarded with information,

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opinion and, dare I say, wisdom from all sides of the argument and scientific information and ethical standpoints. There has been enormous consultation, as listed by the noble Lord, Lord Turnberg, earlier in the debate. We have had numerous opportunities to hear from a great variety of experts. No Member of this House could possibly feel that we need to know more. Now is the time to decide. The negative consequences of not deciding now are many. Delay will mean that more people die without effective treatment. It will mean that researchers go abroad where there are fewer regulations. The system of controls we have in this country is strict and has many checks and balances. It is admired by many other countries. What is more, it is accepted by the community. If I thought this procedure was wrong, I would not support it being done here for fear of the work going abroad. However, I do not feel it is wrong. I believe the scientists who do this work will be doing a great service to humanity. But I would rather see it done here, where we have strict controls, than anywhere else in the world.

There has been talk of slippery slopes and cloning human beings. There is only one essential for cloning a human being. You need to implant a fertile modified egg into the womb of a human mother and grow it to maturity. The Human Fertilisation and Embryology Authority has stated firmly that under no circumstances would it allow this. The Government have promised primary legislation to make it illegal. I would echo the powerful plea of my noble friend Lady Williams of Crosby to the Minister for him to reassure us on this and make a clear commitment to prompt action.

Where then is the slippery slope? Implantation is illegal and remains illegal under the regulations. There is no possibility of it being permitted.

On another point, many people feel that they would not object to stem cell research using cells from early undifferentiated embryos if it was the only way in which the therapies about which we have heard could be developed. I believe that is the case at the moment. The noble Lord, Lord Winston, has explained it very clearly. Although there are stem cells in adult tissues, they are rare and we do not yet know enough about them to be able to use them. The beauty of the procedures we are discussing today is that they have the potential to make themselves redundant in the not too distant future. When the scientists have learnt enough from the cells from an embryo source, it is not beyond the bounds of possibility that they may in future be able to use cells from the adult to be treated, which will have no likelihood of rejection. This use of adult stem cells will be an easier and cheaper alternative than using embryos. When this time comes, the authority will no longer permit work on embryos because its terms of reference say that it will grant licences only,

    "when the work cannot be done any other way".

When it can be done another way, the authority will no longer grant licences. I believe that the work with adult stem cells will continue alongside the work on cells

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from embryo sources--the two lines of research will help each other--so that the day when embryos will no longer be needed may not be too far away.

I support the regulations and the amendment standing in the name of the noble Lord, Lord Walton of Detchant, since the appointment of a Select Committee to review these issues can only help to reassure those members of the public who still have questions about these matters. I do not intend to detain your Lordships any longer by rehearsing again the arguments in favour of the regulations so cogently explained by my noble friend Lady Northover, with which I heartily concur. But nor do I feel that it is justified to delay the regulations so that a Select Committee can go over these issues from scratch. The Human Fertilisation and Embryology Act 1990, as it stands, is well understood and supported by the country and there is no majority in favour of radically changing it or revisiting the issues that it raises. But there are many thousands of people who are looking to us to extend its provisions to allow for new therapies to be developed. Compassion and common sense dictate that we support the proposed regulations without delay.

9.2 p.m.

Lord Walton of Detchant: My Lords, in speaking in this debate, I must first declare an interest as I am the life president of the Muscular Dystrophy Campaign and I am patron or vice-patron of many other medical charities. I have in the past given limited advice on neuro-science to a pharmaceutical company but that company is not in any way involved in stem cell research or relevant issues.

I understand totally and respect absolutely the sincerity and integrity of my noble friend Lord Alton, with whom I have had many discussions on this topic. I am grateful for the fact that in his letter, which he sent with others to all the Members of the House, he referred with approval to the report of the Select Committee on Medical Ethics, which I had the privilege of chairing in 1993. One cornerstone of that report was a belief in the sanctity of human life, a belief to which I hold very firmly. It follows that human embryos must be respected and treated with sensitivity. But, as the noble Baroness, Lady Warnock, said originally in her report of 1994, that respect must be balanced against the potential huge benefit for human health that might be derived from research on such early connections of cells as we at that time in 1990 when the Bill was debated referred to as the pre-embryo or the conceptus.

Perhaps I may remind your Lordships of one or two important facts relating to human embryology. In the course of normal human conception it is common for several ova or eggs to be released from the female ovum at the time of ovulation into the uterus and often four or more of those are fertilised by the husband's or partner's sperm. Those form small collections of cells--eight or 16 cells, which are in fact early human embryos or pre-embryos--and float free in the uterus. By the fourth or fifth day after fertilisation the

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formation of blastocysts begins. A blastocyst is a structure that is almost impossible to see with the naked eye, but it consists of a small group of cells from which the foetus will ultimately develop and an outer rim of cells which will go on to form the membranes and the placenta. It is not until about the fifth day after fertilisation that normally one blastocyst becomes attached to the uterine wall and later goes on to develop into a foetus. The others are discarded or shed, so that millions of fertilised embryos are regularly lost and discarded in the course of normal human conception.

I fully understand the sincerity of those like the noble Lord, Lord Alton, with his deep Christian, Roman Catholic faith, who believe that life begins at the moment of fertilisation when the sperm enters the egg. However, we had a fascinating historical commentary by the right reverend Prelate the Bishop of Oxford. He said that until the middle of the 19th century the teaching of St Thomas Aquinas was virtually that the foetus did not develop as an independent human being and that life did not begin until the foetus was capable of independent existence outside the womb. As the right reverend Prelate said, it was a Pope in 1869 who decreed that life began at the moment of fertilisation. I understand, though I do not share, that view.

When we debated the Human Fertilisation and Embryology Bill in your Lordships' House in 1990, I referred to an article by a noted Roman Catholic Australian theologian, the reverend Professor Dr Norman Hunt, who said that in his view individuation of the human embryo did not begin until the primitive streak, a line of cells ultimately to develop the nervous system, developed at about the 14th day. It was on the basis of that and similar views expressed by many embryologists that the Bill agreed that under strict licensing conditions research on the human embryo could take place up to 14 days after fertilisation but not beyond.

I confess that I am distressed when I read statements in the public press by noted Roman Catholic clerics--I have said this to the noble Lord, Lord Alton--that discarding human embryos or allowing them to degenerate is tantamount to deliberate killing. I am a practising Christian--I am a member of the Methodist church--and that is totally contrary to my own personal faith.

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