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The EPICure study, which is used by institutions such as the RCOG and the BMA to justify not lowering the abortion limit, was criticised in the Science and Technology Committee minority report for averaging out survival rates across a variety of UK centres. My point is this: in the best centres, such as in Minneapolis, Minnesota, we are told that 66 per cent of babies born at 23 weeks will survive. It seems bizarre that on the one hand we are condoning abortion for some babies while, on the other hand, making every effort to give the best neonatal care to other babies at exactly the same age. Something is very wrong.
We know that from 16 weeks babies will recoil from a noxious stimulus in the womb and that premature babies born earlier than 24 weeks will, if stabbed in the heel with a needle, pull their foot away and cry. It seems reasonable to assume that they are feeling pain. Experts marshalled by the RCOG and the BMA tell us that these babies are not able to feel pain and that what we are observing is just a complex reflex. They say that such babies do not have the proper neurological connections between the thalamus and the cortex to sense pain. But other experts such as Professor KJ Anand from the University of Arkansas, who spoke on the Channel 4 Dispatches programme and has
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I do not know whether fish feel pain or not, but Russells point was that we should be very wary of drawing our conclusions solely from those who have a vested interest in the fishing industry. The 6.7 million abortions carried out in this country since 1967 have been performed by doctors; most of them are members of the Royal College of Obstetricians and Gynaecologists and many of them benefit financially from the process. Might this be a subtle way of influencing their interpretation of the data? Would we not be wary about seeking opinions about the link between smoking and lung cancer only from employees in the tobacco industry?
I shall cut out the last part of my speech because my time is nearly up. But I ask the Minister to specifically assure the House that any votes on the Bills contents or possible amendments to it will be free from any government whipping.
Lord Patel: My Lords, I start by taking this opportunity to congratulate Sir Martin Evans, currently of Cardiff University, who is a joint recipient of the Nobel prize for medicine and physiology for 2007. It was he who first discovered that chromosomally normal cell cultures could be established from early mouse embryos, now commonly referred to as embryonic stem cells. He was subsequently responsible for developing what are called knockout mouse models, which started the new era in genetics and the immensely powerful technology of gene targeting. It is this research and methodology that now drives research workers all over the world, using stem cell research, to look for therapies for diseases.
I strongly support the Bill. I particularly welcome the proposals related to interspecies embryos and RATE. I shall comment mainly on the research aspects of the Bill and only briefly on other issues. However, before I do so, I declare an interest. I am a fellow of several of the medical royal colleges; I am a Fellow of the Academy of Medical Sciences; vice-president of the Royal Society of Edinburgh; chairman of the MRC Stem Cell Oversight Committee; chairman of the UK National Stem Cell Network; and I have been an obstetrician for more than 40 years.
Comments have been made that interspecies embryo and embryo research itself should not now be allowed because of recent developments and suggestions that we do not need it, particularly in the report related to the induced pluripotentiality of adult cells which was reported in todays newspapers and in science journals yesterday. This is far from the truth.
Let me briefly say why scientists need the ability to research using interspecies embryos. For any cell-based therapy it is always better to have an
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There are currently only two ways of obtaining patient-specific embryonic stem cells. One is by somatic cell nuclear transfer and cytoplasmic hybrid embryosthe so-called interspecies embryos. The reason why scientists want to carry out somatic cell nuclear transfer experimentsthe so-called SCNT experimentsusing animal oocytes is a pragmatic one: there is not a ready supply of human oocytes and large numbers of oocytes will be required. For example, an article published in Nature, a respectable science journal, andin the newspapers last week, reported the use of rhesus monkeys and SCNT technologies to produce ES cells. This procedure used 300 eggs to obtain 30 blastocysts, and from these only two embryonic stem cell lines were obtained. So the number of human eggs required using this technology will be enormous.
Readily available animal eggs provide suitable recipients for human somatic cell nucleus. Embryonic stem cell-like cells have been obtained from rabbit- enriched eggs and nucleated eggs and human skin cells. Such disease-based embryonic stem cell-like cells are ideal for studying human diseases and for the testing of small molecule drugs, which is urgently required.
There is a powerful argument for allowing interspecies embryos for research, under strict licence from HFEA, when no other means are available. Scientists who work in this kind of stem cell research are happy with that. They would much rather work in ethical surroundings and an ethically tested, regulated environment than in an open environment.
The second way of obtaining pluripotent patient- specific ES cells is by the direct reprogramming of adult somatic cells into ES-like cells. Todays Times reports the findings of two research teams, one from Japan and one from Wisconsin. This procedure was carried out by a group of scientists in Japan, led by Yamanaka, and others in the USA have achieved this using mouse skin fibroblasts and adding four factors, four genes. It is a remarkable achievement. That it has come so quickly is quite astonishing. That it has required only four genes, of the many genes that might have been tested, is also quite remarkable.
One of these genes is an oncogenea gene that causes cancerknown in technological terms as c-Myc. It induces pluripotency in the skin fibroblast. We now know that it is repeated in humans, because todays report confirms it. As I said, two papers were published yesterday, one again from Japan and one from Wisconsin, by the people who identified human embryonic stem cells a decade ago. Your Lordships are now scientifically up to date.
I wish it was all that simple. The cells that Yamanaka had derived from a rabbits skin were rather like embryonic stem cells. He injected them into a four-stage, four-cell mouse blastocyst by taking out one of the cells from the four-cell mouse blastocyst and injecting his new stem cells. They worked and differentiated just like the natural blastocyst cells, but the mouse that developed was full of cancer tumours. The reason may have been the powerful oncogene that was used as one of the factors to induce pluripotency into the skin cell.
We cannot conduct such chimeric experiments in humans. Details of research were published just yesterday where a skin fibroblast from a human was converted into a pluripotent, rather like ES cells. Such experiments would not be permissible. We need to understand how embryonic stem cells behave to be able then to understand how to manipulate cells that we have derived from human skin to behave like pluripotent embryonic stem cells. Embryonic stem cells are the gold standard against which other pluripotent cells derived from human skin will be tested. That is the holy grail that every scientist chases, and it is why we must not stop research at this stage on any aspect of any stem cell researchadult, embryonic, umbilical, cold-blood, on the cord itself or any other adult cells. We must not try to block other aspects of the Bill, including those which concern fertility treatment, because it would also block research. We must allow the Bill to pass.
Baroness Hollis of Heigham: My Lords, I was a member of the pre-legislative scrutiny committee that was fortunate enough to have had the brilliant insights of the noble Lord, Lord Patel, which the House, too, has been able to experience today. I very much welcome the Bill. It devolves regulation, subject to the 14-day rule and the no-implantation rule, under the HFEA, which affords that blend of careful scrutiny and scientific head space which is probably the nearest in this world that we will get to being able to see around corners.
I shall speak very brieflythat is why I originally put down my name in the gap on the speakers listabout an issue that has been widely referred to: whether the Bill should continue to carry a clause or a phrase referring to the need for a father. I hold what my sons would probably tell me are conservative views about the family. I say that because I regret not some of the views, which I very much respect, but some of the language used in this debate. To suggest, as did the most reverend Primate the Archbishop of York, that we need to include such a phrase in the Bill to placate Fathers 4 Justice is profoundly unwise. Families Need Fathers I respect and Fathers Direct is an admirable organisation, but Fathers 4 Justice? I think not.
Should reference to the need for a father be in the Bill? Let me be clear. Do I think that the welfare of a child is usually best ensured within a loving, stable family of a mother and father? Yes, I do. Do I also think that a single parent or a gay or lesbian couple can be a loving, stable family, as my noble friend Lord
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I emphasise that to say that the phrase should not be in the Bill is in no way to underplay or undermine the role of fathers. The matter simply belongs to a different debateand let me say why. Either the need for a father contained in a phrase or clause in the Bill carries meaning or it does not. Currently it is in the Act and I understand that it has become meaningless, vacuous, empty rhetoric. Single women receive IVF. We have been told this by the Minister and by clinicians, and the noble Baroness, Lady Warnock, has emphasised the point. It is not usually germane to the decision to offer IVF treatment. Instead the assessment is made on whether the woman is in sound physical and emotional healthor, in more conventional parlance, not flakyand has family support.
If we reinsert the phrase, we are doing so because it should be meaningful; otherwise there is no point, and why bother? It would mean that clinicians would and should question the whereabouts of the putative father. If there is no such person, what then? Will they still permit treatment, in which case the question was intrusive but irrelevant, or refuse it, which means discriminating against and denying single women and lesbian partners the right to IVF? Even if they are young and fertile enough and may have unassisted births and even though, after the most intense and rigorous scrutiny, they may have adopted a child, they may not receive IVF.
Fathers belong in childrens livesI firmly believe that. It is just the phrase that does not belong in the Bill. Either the wording is meaningless, as it is now, in which case it should not be there; or it is meaningful but the answer ignored, in which case it is irrelevant; or it is meaningful but got around and manipulated, and we end up with doctors deciding which families are desirable and which are undesirable, with some families and some children being judged second-class but perhaps smuggled under the ropes. If it is meaningful and upheld, it is utterly discriminatory.
What do we want? Do we want a question in the Bill which is meaningless but not asked, a question that is asked but the answerwhatever it may beignored, so it is irrelevant, or a question that is asked and is meaningful, is acted on and in consequence denies treatment in a discriminatory way? I suggest to the House that if we go down that path we will end up in an unnecessary legislative mess. However much we personally may prefer conventional families for children, these words do not belong in the Bill, and I hope that the House will not seek to insert them.
Baroness O'Neill of Bengarve: My Lords, with the leave of the House, I would like to speak briefly in the gap. I scrubbed my name from the speaking list on Monday because I was not sure that I could be here for the winding-up speeches. I will not say all that I had it in mind to say there because many others have said it very well. I want to suggest one thing: there may be more room for compromise than has yet been apparent in the contentious question of the need for a father.
We are all clear that this legislation does not in any way abolish the biological reality of fathers. Cloning remains and in my view should remain illegal. The question arises about the social need for a father. Many noble Lords have spoken eloquently about the importance of fathers in the lives of their children. I wholeheartedly agree. If the views of the noble Baroness, Lady Hollis, about the family are conservative, mine must be ultra-conservative, because I think that children need about five parents. That is based on the experience of being a parent on my own and of living most of my life in some way or another in the extended family.
Fathers are needed. Biological fathers are not touched by this legislation but we must face the reality that the social father is very often not the biological father. The social father may indeed be a stepfather, close friend of the family or an uncle. The role of the father is indisputably essential and it must be fulfilled for every child and, I would contend, while especially so for young boys, also for young girls.
We must protect that, but in doing so we may be unwise to leave the need for a father in the legislation. It is a highly ambiguous phrase which has not proved practical in the way in which IVF clinics operate. I also believe that we may have reason to remove the phrase agreed fatherhood. Being a father is a deeply understood notion in our and every culture. Fatherhood is not something that is up for legislative redefinition. We would do much better to put the emphasis on the notion of the agreed parent and the second agreed parent and, if I had my way, even the third agreed parent. We need not challenge in a way that many of our fellow citizens find offensive the importance of fathers in fixing with legal certainty the parental rights of those who actually bring children up.
Baroness Barker: My Lords, I also wish to convey to the family of the noble Lord, Lord Brennan, our best wishes for a speedy recovery. I would also like to say to the noble Lord, Lord Darzi, that when his fitness to practice review occurs, my noble friend Lady Tonge would like to be there to give a testimonial.
My noble friends Lord Carlile and Lady Williams of Crosby cannot be here today for different reasons although at different stages they will take part in the Bill. It is always a difficult job to be a Front-Bencher summing up on a debate of this kind, but I am glad to do so for two reasons. It allows me to set forward the
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In the Liberal Democrats, we have a deliberative and inclusive policy-making process and it is open to all members. It is our party's policy to support the use of embryos for research designed to improve reproductive medicine and to find cures for disease. However, in recognition of conflicting and very deeply held religious and moral views, we, like the Conservatives, believe that this should be open to a free vote. It is also our party's policy that individual women and lesbian and gay couples should not face discrimination when they seek fertility treatment. I will explain why later.
My school bus used to go past an old Victorian building every day. Nobody paid it very much attention until 25 July 1978 when Louise Brown was born there. I remember thinking that the world had changed radically on that daythere were new and interesting complexities and an overwhelming sense of joy and hope. Not until five years later did the groundbreaking report of the noble Baroness, Lady Warnock, set the ethical and moral principles which took on board the enormity of those changes. Those five main principles continue to inform democratic debate and legislation on assisted reproductive medicine. The principle of the developing moral status of the embryo has not been accepted universally but I believe that it forms the cornerstone of good governance, appropriate legislation and ethical practice in this most difficult of areas.
This House with its scientific, ethical and religious expertise of the highest order has an unrivalled opportunity to go behind some of the simplistic and pejorative headlines to look at the legal and social evidenceI stress the word evidencewhich should enable us to set the ethical boundaries for these matters. Since 1984, legislation in this area has followed in the wake of scientific discovery and on each occasion it has been the responsibility of politicians to set the boundaries within which research is deemed necessary and acceptable. As we do so we should recognise the increasing rapidity with which scientific knowledge is being developed.
I listened to the many noble Lords who invited us to consider a standing national committee on bioethics. I would be happy to do that. However, it is important that it should not duplicate the work of local research ethics committees nor the Nuffield Council on Bioethics, and that it should work closely with the Science and Technology Committee of this House to look towards developing technologies and to consider their ethical implications.
If only one message goes out clearly from our debate, I hope that it will be that the creation of interspecies embryos is solely for the purpose of research and that such embryos cannot be used for reproduction and will not exist beyond 14 days. I hope that the Government will agree with the suggestion made by my noble friend Lady Williams the other day that there is a need for them to press for a similar ban around the world so that the high standards in this country to which many noble Lords alluded are universal.
In the time available to me I shall not attempt to replicate the speeches of the noble Lords, Lord Walton and Lord Patel. I simply thank them for the way in which they cast light and clarity on some extremely complex areas. However, the noble and learned Lord, Lord Mackay, voiced the concern of many of us that the Bill should have absolute clarity with regard to terminology. Exactly what does the term permitted embryo mean and how can it be used? The right reverend Prelate the Bishop of Newcastle was absolutely right to ask for clarification of the terms cytoplasmic and true hybrid embryos. We will support him in that.
Much has been said about the development of adult stem cells. As we have heard increasingly over the past few days, it is a very promising and hopeful line of research which holds out the possibility of developing immunologically compatible cells with the host. That is a truly exciting development. However, I do not think that any speaker in this debate has made it clear that the technology still involves harvesting human female eggs, a procedure that is not without its dangers.
I listened very carefully to the exposition of the noble Lord, Lord Walton, about the necessity for continuing cell line research for the foreseeable future if we are to find cures for dreadful diseases. But more than anything I noted the statement made by Professor Wilmut yesterday, and repeated on the Today programme, that, notwithstanding his decision, we are years away from finding research answers and cures. Therefore it is of the utmost importance that all lines of research continue. I invite the Minister to address another of the questions posed by my noble friend Lady Williams about research funding. Will he confirm that there will be no bias in the research funding for the different types of research?
I was tempted to say that this is a reflection of modern life, but perhaps it is more a reflection of family life, which is, and always has been, complex and messy. I believe that Clause 28 of the 1990 Act talks about how the husband of a woman who receives fertility treatment shall be treated as the father of the resulting child, not the donor of the sperm with which the child was created. To use the phrase used by some noble Lords during the debate, that is a lie. It is not true. But we saw and understood in 1990 the concept of social parenthood; it was expressed in that way too.
Since the report of the noble Baroness, Lady Warnock, not only science and scientific knowledge but families have changed. It was the considered view of Parliament and this House that there should be legal recognition of civil partnerships. I say to those noble Lords who have said throughout the debate that they do not wish to be discriminatory in any way that some of the statements that have been made about fatherhood and parenthood can only be that.
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