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This new technique of cloning using the interspecies embryo does not need that to occur because the cell is taken from the skin, perhaps, of an individual suffering from Parkinson's disease, diabetes, Alzheimer's disease or one of the other serious neurological disorders with which we are concerned. It could be implanted into a donor ovum from which the nucleus has been removed. However, as the noble Baroness said earlier today, it is not easy to obtain ova from even the most public-spirited of women. Now, if one can use animal cells to produce the type of capsule or framework in which the nucleus
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I must mention in passing the crucial importance of mitochondrial disease. Some 99.9 per cent of human DNA resides in the nucleus of the cell. About 0.1 per cent of DNA resides in the mitochondria, which are tiny structures in the cytoplasm of the cell outside the nucleus but within the cell membrane. These structures are concerned with energy production and metabolism within the cell. Fifty-four genes have been isolated within mitochondria and a large number of mitochondrial diseases have been described. I have seen these in the course of my professional careerdiseases that cause epilepsy, paralysis, dementia and a whole variety of devastating conditions.
Since mitochondria exist only in the ovum and not in the sperm, mitochondrial diseases are inevitably transmitted by every affected woman to all her children. Now, it is becoming feasible to take an ovum from a woman carrying abnormal mitochondrial genes. One can take a donor ovum from which you have removed the nucleus and put the nucleus into that donor ovum, which has normal mitochondria in the cytoplasm, and then allow that to be fertilised by the partners sperm, thus allowing these women to have normal children. That is not yet feasible, but licences are already being awarded for the animal research and one of my former colleagues, Professor Doug Turnbull at the University of Newcastle upon Tyne, is already doing that crucial animal research, just as others are doing work on the interspecies embryo in that particular centre.
I commend to you an article by Julian Savulescu, director of the Oxford Uehiro Centre for Practical Ethics that was published in the Parliamentary Monitor in October. He said that creating these interspecies embryos as a,
This is a crucial Bill. It carries enormous potential benefits for human health. This field of embryo research is one in which the United Kingdom leads the world. The Bill maintains and indeed greatly enhances that position. It is our duty to generations in the future to see this Bill enter into law.
Lord Winston: My Lords, I first apologise to the noble Lord, Lord Walton, for being so rapidly out of the stocks. Secondly, I declare an interest as a fellow of the Royal College of Obstetricians and Gynaecologists, a fellow of the Royal College of Physicians, a fellow of the College of Surgeons of Edinburgh and as someone who has held and still holds a licence to do stem cell work under British legislation and regulation.
My noble friend is introducing an extremely good Bill. It is a very courageous Bill in many ways. But it is wrong to suggest for a moment, as a number of noble Lords have done, including the right reverend Prelate the Bishop of St Albans and the noble Lord, Lord Hastings, who is not in his place, that this has been a rapid discussion. That is far from true. We have discussed this issue over many years, really since 1989. Indeed, I doubt whether there is a single scientific paradigm that has been more discussed in the general press, on television, radio and in the media. It is important to see that in context. The public has a pretty good idea about what is going on and in general it is fairly clear where people stand on most of these issues.
I have always had problems with regulation. I find it difficult to justify why a single medical practice should be singled out in this way for regulation. Although embryos become babies, we do not single out obstetric practice for regulation. We do not single out paediatric care for neonates, which raise much greater ethical problems than in vitro fertilisation in a practical way. We do not regulate intensive care, where people are dying in this kind of way. Therefore, for a regulatory authority to regulate clinical practice is questionable given that other aspects of infertility such as tubal surgery, the admission of drugs and other treatments that are routinely given are not subject in any way to this kind of regulation.
Having said that, I add that the same applies to research practice. What is the purpose of having research committees at the Human Fertilisation and Embryology Authority if we, as researchers, must first apply to local and national ethics committees to get ethical approval for the work? Is it suggested that the Governments own ethics committees are not adequate for the purpose? That does not seem right. Indeed, they have often been much more skilful in looking at these issues than the HFEA, which has sometimes arrived at conclusions that seem to many people to be somewhat odd. I accept, as a practitioner, that it is reasonable to have regulation, but I plead with the Government that, during the Committee stage of this Bill, we ensure that the regulation is done with a light touch. The real things that need to be regulated are not regulated, and I will come to that later.
We have heard a great deal from many speakers about how Britain leads the world in this research and how we lead in regulation. However, given that, it is surprising that so few countries have adopted our model in their regulatory framework. It is simply not true: they have not done so. Britain does not lead in this research any longer. It may have done originally, but at the moment, the United States, where there is a complete ban on embryo research involving human
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Israel, a country with a population two-thirds the size of London, publishes more papers than we do. Scandinavia publishes an equal numberI mean Scandinavian countries individually not collectivelyso do Belgium, Singapore and Australia. Indeed, science in this country is suffering in some ways because it has been very difficult to get through a prolonged and protracted regulatory framework, which I hope the Government will take note of during the course of the Bill.
The key things that affect patients are not being regulated and cannot be regulated. The first is the transfer of multiple embryos leading to multiple births, which affects small babies very adversely. A premature baby in an incubator costs the National Health Service a large sum of money and runs the risk of being seriously damagedone in 23 twins is born dead and something like one in 13 is abnormal. Triplets carry a very high risk indeed.
One has to accept that if the regulation becomes too tight, fertility tourism results. People go to Russia, Spain and other Mediterranean countries where they can get this treatment cheaper, but they face greater risk when they come back and have their babies under the National Health Service.
There is also the exploitation of patients. This is burgeoning, largely because, as my noble friend Lady Jay said, we did not have in vitro fertilisation under the health service from the start. Had we done that, I doubt whether this regulation would have been necessary. As it is, grotesquely inflated prices are being charged in some clinics. We have heard about the childs need for a father; how about the desperation of a fathers need for a child? In the Book of Genesis, Abraham asks:
He uses a Hebrew word meaning abandoned, desolated, because he does not have a genetic son. There is a notion here that he has lost his immortality, and that is something that infertile patients feel. This desperation leads patients to try all sorts of treatments which are not justified. That is one of the problems with the current regulation. The West End of London, for example, abounds with treatments which have no scientific justification, no proven success rate and simply exploit the desperate desire of these people to have children. That seems to me a crucial problem.
The HFEA has failed very critically in another area. The failure to collect adequate data is a real problem. Frankly, the data that have been collected under regulation are almost entirely useless. We need much better follow-up data on children born by in vitro fertilisation. The problem of confidentiality with regard to the Bill is very worrying and we shall need to consider that in Committee. If you have very strict confidentiality, doing research follow-up on children becomes well nigh impossible, but it is very important. We now know that it is not just a simple question of genetics but of epigenetic effects on embryos. We now know that the condition of children in utero before
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This is a good Bill, but adjustments need to be made. I hope that we can ensure above all that the Government accept the need for much more research in this country. This country has a unique research base, but the Minister will be aware of something that has happened in my own department at Hammersmith hospital, of which he has been director. I retired from my clinical chair in the health service two and a half years ago. As the Minister knows, that chair, which is a research position, is still vacant because this field of medicine is not attracting good enough applicants for one of the best universities in the countryImperial College.
Baroness O'Cathain: My Lords, before I deal with a particular issue in the Bill I wish to make some general points. This is a Bill fraught with ethical, moral and religious concerns and leads one to believe, as the most reverend Primate the Archbishop of York noted, that law is completely separate from morality and religion.
I listened with great interest to the speech of the right reverend Prelate the Bishop of St Albans, who gave a brilliant analysis of the place of ethics in this Bill. We must get the ethics and other issues in the Bill in balance.
The Bill has raised concerns throughout the United Kingdom. My mailbag and Outlook box have never experienced such volume on a single Bill in my time in your Lordships House. A huge proportion of those who took the trouble to write to me, and to whom I have repliedother than those who communicated with me this morningurged me to vote against the entire Bill at Second Reading. I am sure that many of your Lordships have received such letters. I have written back to them making the point that it is a convention of this House that a government Bill should be allowed normal progress through its whole parliamentary passage from First Reading to Third Reading. I said that I would neither encourage nor support a vote on Second Reading. I am firmly of the view that it is imperative that all the issues are scrutinised and debated with intellectual robustness, bearing in mind the sensitivity of the views of those who are deeply concerned.
We cannot, and must not, disregard the massive antipathy created by this Bill. I know that we are not democratically elected but the tenor of the letters and e-mails received indicates that the general public feel utterly ignored and helpless. How can they be heard? They believe that they are not listened to by this Government, who, if I may be so bold as to remind the opposite Bench, were elected by only 22 per cent of those eligible to vote.
I give notice that in the later stages of consideration of this Bill I shall pursue, tenaciously, the issues which I believe have the potential to unleash unforeseen consequences and to damage the values, standards and beliefs of this country. Having given that promise, or is it a warning, I will concentrate on only one issue in my contribution today; namely, animal/human hybrids. On 3 May 2007, I spoke on this issue. I said:
We all know that the difference between an animal and a human in genetic terms is very small indeed, and it is not far-fetched to imagine a situation where a court could rule that an embryonic entity is actually an animal and allow it to develop past the 14 day cut-off period for human embryos.[Official Report, 3/5/07; col. 1182.]
The Bill proposes, for research purposes, the creation of a number of interspecies combinations involving animal and human tissue, even including the creation of an embryo using either animal eggs fertilised by human sperm, or human eggs fertilised by animal sperm; that is to say, true animal/human hybridisation. As if that was not alarming enough for the majority of us, there is also built into the Bill a level of flexibility which would permit the extension of many of the quasi-prohibitive aspects of the Bill, without the need for full parliamentary approval. Is this not opening the door to creating legislation without true limits? It would permit the regulatory authority to make decisions in the light of future technological developments in this field rather that in reference to concise decisions of Parliament as expressed in law. This is not a scenario that should be supported, particularly in an area as sensitive and potentially dangerous as interspecies creations.
One of the many letters I received enclosed an article from the magazine America. The article is entitled Stem Cell ResearchHype and Reality. It is a most readable article for a non-scientist. It points out that,
Those who have known me for years know that I also look at issues from a religious perspective. I will not disappoint them today. The noble Lord, Lord Winston, is no longer in his place but he mentioned Genesis, from which I shall also quote. God created man in His own image and likeness, and, as is written in Genesis 1:28, He ordained that man should have,
What other country in the world is taking the step that the Bill promotes? It is imperative that such a momentous and serious action cannot be taken by the Secretary of State without the full involvement of
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Then, we voted for a prohibition on human reproductive cloning, and it is extremely worrying to see in the current Bill a statement that the Human Reproductive Cloning Act 2001 ceases to have effect on the enactment of this new Bill. I know that the Minister stated in his opening speech that the Government have not changed their mind, but surely cloning animal and human tissue is but a step away. As the Bill gives such wide-ranging power and discretion to the Secretary of State, can we be confident that in the future, not necessarily under this Secretary of State, this step will not be taken? Let us not forget the recent Korean fraud.
Finally, I have four questions for the Minister. First, has the development of adult stem cell technology ceased in this country, and do the Government not know about the advances detailed by the noble Baroness, Lady Williams? Secondly, as the increase in the range of therapeutic remedies using adult stem cell technology has not come to a halt, will the Government inform the House of the number and details of new therapeutic treatments since January 2001? Thirdly, what is the current situation worldwide of the research into and use of animal/human hybrids? Fourthly, are we world leaders in basic research, as seems to be the aim, and in an area in which no one else is engaged? I have a very healthy respect for science, scientists and scientific research, but are there no limits to which they will go? I suggest that playing God is one limit that should not be breached.
Baroness Emerton: My Lords, I speak, having heard the erudite contributions from the House this afternoon, feeling very much a novice and lacking depth of information. I have carefully read the Bill and the findings of the Joint Committee and the Select Committee, and I have listened carefully to the Ministers excellent introduction to the Bill this afternoon, but I still have concerns which I wish to express.
The findings of the Select Committee and the Joint Committee illustrate that there is not only dissension, including a minority report, but a lack of scientific backing to some of the statements and an absence of bioethical views, which the right reverend Prelate the Bishop of St Albans very clearly expounded this
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Many speakers have already mentioned the welfare of the child. UNICEF recently drew attention to the well-being of children, and stated that Britains position is very low compared with that of other developed nations. It is hard to see how the Bill can remedy this when, instead of proposing greater access for the child to the father in IVF treatment, Her Majestys Government show no proper regard for the child. How could a child ever be able to discover his or her genetic identity? Is it not the right of every human? This requires special scrutiny.
As I said, I in no way profess to be an expert in this subject, but I am concerned that this legislation might lead to a significant change in the Abortion Act. Although the Bill does not mention abortion, it replaces the Human Fertilisation and Embryology Act 1990, which changed the Abortion Act 1967. That could open up the Abortion Act to possible amendment. Here I declare an interest as a retired nurse and midwife. Abortion is always a contentious issue, with one lobby for further liberalisation of the law, including abortions on demand and abortions performed by nurses and midwives not solely medically but by surgical intervention. The other view is that it is time to review the Abortion Act because abortion rates in this country have rocketed to an all-time high of 200,000 a yearroughly 600 a daywhich gives rise to the growing concern of the public and indeed of parliamentarians.
We live in an era of social change and medical and scientific advances in understanding the development of the unborn child. European statistics on social abortions show that we have the highest rate in Europe, where the average upper limit is 13 weeks. Ours is 24 weeks. We have greater knowledge of the medical and psychological effects of abortion on the woman and an ever increasing number of teenage pregnancies, many for the second time or more. Does this not point to the urgent need for an audit of the options presented to women going to an abortion clinic, such as whether they are ready for an abortion or will consider adoption, and whether they have had proper contraceptive advice? Surely there is an opportunity for a committee to consider the information if we move towards a review of abortion.
Nurses and midwives are regulated by the Nursing and Midwifery Council within the current legislation. Neither nurses nor midwives can carry out abortions; it is against the law. There is also the conscience clause, which allows the nurse or midwife not to take part in the process of abortion. Both nurses and midwives can progress through post-registration education and training programmes to become advanced practitioners, but
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