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I shall comment briefly on the amendment. Many of the suggestions made by the noble Lord, Lord Northbourne, are extremely sensible and are certainly worthy of full discussion. However, I cannot help wondering whether a national bioethics committee of the kind that he envisages would carry far wider issues than the rather narrow issues that we are discussing in this Bill. A much more important matter that has come before this House repeatedly is death and euthanasia. That seems to me to be far more serious in many ways. Therefore, one cannot help wondering whether this matter is deserving of completely separate legislation and more thorough discussion than may be possible within the context of a Bill on in vitro fertilisation and reproductive medicine.
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Baroness Williams of Crosby: I listened with great attention to what the noble Lord, Lord Turnberg, and the noble Baroness, Lady Deech, said. It seems to me that there is an important gap in the present structure which a committee of this kind—possibly a parliamentary committee—would fill very successfully. In saying that, I bear in mind the distinctive contribution of groups such as the Nuffield Council on Bioethics and so on.
Members of the Committee will know that when we come to discuss an issue in a Bill which is concerned with scientific material, we often talk in terms of hypotheses—for example, about the effect of embryonic stem cell research versus adult stem cell research. They are hypotheses of the kind that the noble Lord, Lord Winston, mentioned a few moments ago with regard to the impact of long-term freezing on embryos, and other hypotheses relate to other areas of science. That is often the way in which we necessarily discuss many issues because the question of how particular proposals will work out lies in the future. By definition, that must be the case when we consider advanced research on the horizon of scientific knowledge.
I am concerned that in this House we almost never assess the impact of what we decide to go ahead with, and that applies not only to scientific Bills but Bills in general. We make decisions on the basis of the best information that we can get and the best projections that people can make, but necessarily we do not know what the effects will be, and I am struck by how rarely we look later at what they are. I repeat that that is not only true of Bills with a scientific element. As an example, back in 2001, I believed that there was huge potential in adult stem cells, but at that time that view was largely dismissed. It is not enough for me or anyone else simply to assert that embryonic stem cells provide a more effective form of research than adult stem cells; we need to know over time which of the two—or perhaps it will be both—prove to be effective forms of therapy and research. In other words, I want to know more than I do at the point at which I take part in a debate.
One thing that could effectively be done by the kind of bioethics commission that the noble Lord, Lord Alton, talked about and to which the noble Lord, Lord Turnberg, referred would be to see precisely how far the predictions that we make in our debates, and which are embodied in Bills that become Acts of Parliament, are borne out by subsequent evidence. I use the word “evidence” advisedly because I believe that we need to rely heavily on facts and not simply on an exchange of opinion. I should like to see a committee—such as the noble Lord, Lord Brennan, gave evidence on to the Joint Committee but which, by the nature of things, he has not been able to speak to again on this occasion—pursuing the statements made in this debate to find out how far they are borne out by the findings of research over the subsequent few years. We would all be able to base our conclusions and our witness on much sounder ground if we knew that that follow-up would take place. That is exactly the purpose for which I should like to see such a committee established.
Long ago, I was Minister for Science and I remember, in that capacity, being on the Turing committee of Strathclyde University, which was concerned with artificial intelligence. We made various predictions about artificial
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I hope that we might look more closely at this proposal in terms of following through the research being done to see how far it establishes the hypotheses we have been discussing. Such a committee should have the duty of reporting to Parliament on the discoveries made, how those have affected legislation that we have already passed and how they ought to guide legislation that we propose in future. The wider approach of countries such as Denmark and France—which is not exactly a unitary religious country—has great advantages because it raises issues on a much wider plane than we have done so far in the United Kingdom. That plane goes beyond the life sciences. I hope that we can consider this issue further and consider how we can keep pace with the blinding speed at which science is advancing, while at the same time not only learning from what we have already done in legislation but seeing how we should create and advance legislation in future.
Lord Harries of Pentregarth: Before I come on to my main point, I shall put what the noble Baroness, Lady Williams of Crosby, said in a slightly different way. I think she said that the views of people who supported work on adult stem cells were dismissed. With due respect, I do not think that that is true. They were taken very seriously in this House and on the Select Committee that I had the privilege of chairing. Everybody recognises that a great deal of valuable work was done; the question at issue was whether it should be the only form of research permitted. Research papers on adult stem cell work and embryonic stem cell work are being published the whole time. There is no reason why the Science and Technology Committee should not ask for a report at any stage, although we have to remember that this work is going on year after year and there may not be significant results for several years in the areas in which we most hope for results.
Baroness Williams of Crosby: I was not objecting to the chairmanship of the noble and right reverend Lord or to what happened in the Joint Committee, which did a remarkable job of work. I took part in the debates on the Bill in 2000 and 2001 and, at that point, research that seemed to indicate that adult stem cells had rich potential was treated as to some extent not very scientific.
Lord Harries of Pentregarth: I shall focus on the amendments before us. I welcome the fact that we are having this discussion. It is well worth having and the issue is well worth thinking through. I shall pose two
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Secondly, what more would this national human bioethics commission add to the work already being done? For example, the noble Lord, Lord Turnberg, mentioned the Nuffield Council on Bioethics. To begin with, that council is financed independently of government by a combination of grants from the Nuffield Foundation and the Wellcome Trust. That in itself is a significant advantage. Also, appointments to the Nuffield council are made in the usual manner for public appointments, with advertisements in all the major newspapers and interviews and the usual appointments procedures being applied.
Members of the Nuffield council are unpaid, and I notice that, according to the proposed new schedule, members of the national human bioethics committee would be remunerated for their work. The Nuffield council has a wide range of expertise, from scientific and philosophical to ethical. Here I must declare an interest, which I am afraid I do rather reluctantly. This will not raise the estimate by the noble Lord, Lord Alton, of the Nuffield council, but I declare that I am a member of it. However, it would be a help if your Lordships could discount that fact and look at the other members.
As the noble Lord, Lord Turnberg, said, the reports produced by the Nuffield council are highly prestigious and authoritative and widely read. Some of our reports get something like 50,000 or 60,000 hits when we put them on to the web; they are also taken seriously by government. There is no fear of addressing controversial issues. Recent reports have, for example, been on neonates and on the use of animals, which brings out another fact—that members of the Nuffield council working parties who produce these reports are not necessarily all of the same view. For example, the group that produced the report on the testing of animals had at least one member who was totally opposed to the use of any animal in testing. The Nuffield council tries to take other views on board and meets very regularly with the national bioethics committees of France and Germany on a bilateral and sometimes trilateral basis.
I must emphasise that I am not opposed to exploring as seriously as possible the idea of a national human bioethics commission. However, we first need to ask what its roles and responsibilities would be in relation to other bodies. Perhaps even more significantly, what would it add to the work that the Nuffield council, financed independently of government, is already doing?
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The kind of commission that we might want to examine issues, if not on a permanent basis then at least occasionally, is the kind of parliamentary Select Committee, already mentioned, that was chaired by the noble and learned Lord, Lord Mackay. Such a committee can produce the kind of reports that would be welcomed by this House and the House of Commons. Because they come from its own midst, Parliament takes such reports with particular seriousness.
Baroness Knight of Collingtree: I feel impelled to make one or two brief comments. I am somewhat troubled at what I heard a moment or two ago—not in the last two speeches. When the noble Lord, Lord Northbourne, entirely reasonably pointed out that we were discussing matters that could have certain dangers and drawbacks and that we ought to look at them, the answer from the noble Lord, Lord Winston, who is unfortunately not in his place at this precise moment, seemed to be: “Never mind; we will have another Bill to deal with that”. I cannot accept that. The noble Baroness shakes her head, but I think that she will see the statement in tomorrow’s Hansard.
Baroness Jay of Paddington: I intervene only on the basis of having heard what the noble Lord, Lord Winston, said. I think that his understanding, which he had spoken of in the previous amendment, was that clinicians were always very concerned about the risks of what they were undertaking. The question was whether it was suitable to consider the clinical risks alone. I do not think that he addressed the point that the noble Baroness is raising.
5.45 pm
Baroness Knight of Collingtree: It is my belief that he did. I merely want to support the noble Lord, Lord Northbourne. When a Bill makes important changes, it has always been possible to discuss difficulties that those changes may bring about. That is all I wish to state. It is extremely dangerous to say that other people have been always concerned about a matter and therefore the Bill need not bother with it. In my experience in this House and in another place, it has always been perfectly reasonable and acceptable to discuss difficulties that may arise from the legislation discussed.
The Lord Bishop of Winchester: I align myself with the noble Lord, Lord Alton, and with the speech at Second Reading of the noble Lord, Lord Brennan, and the material he cited. I have read, too, the speech at Second Reading of my colleague and friend the right reverend Prelate the Bishop of St Albans in which he noted many of these issues.
I recognise the strength of a number of things that noble Lords have said. The noble and right reverend Lord, Lord Harries, noted questions of potentially parallel or equivalent operations, and the noble Lord, Lord Winston, noted that there were major questions about the scope and terms of what is proposed in the amendment and whether they were much larger than could appear in an amendment to the Bill. I noted, too, the comments of the noble Lord, Lord Turnberg, and the noble Baroness, Lady Deech. I shall come back to what she said in a moment.
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Let me take up the point that the noble Baroness made in her telling remarks about the pressures of Friday afternoons. It struck me—as it has struck me in the past when I have read about Friday afternoon decisions in the press—that because necessary and humane decisions are, as she suggested, made under considerable pressure on Friday afternoons or over the weekend, those decisions will go on to gain strong status as precedents in the weeks, months and years to come. The question then arises of whether a body such as the one proposed in the amendment is necessary because of the potential difficulties, if not the dangers, of Friday afternoon decisions. The material perhaps could go to the Nuffield council.
My reason for aligning myself with the proposal is this. Both in what I have been privileged to be present for in the process of the Bill so far, and in the rest of its process, which I have carefully read, a small number of remarks have been strengthened in my mind by what I have read of the activities in recent months of one parliamentary committee in particular. This has raised considerable questions in my mind which the amendment seems to pick up. I do not want to suggest or to be heard saying, because it is not what I want to say, that any noble Lords with particular clinical or research brilliance and experience are not serious about ethical considerations—they clearly are and have expressed that awareness—but there has been in my reading and hearing a subordinate thread running through which has asked at particular points, but also once or twice as a generalisation, for regulation that is less rather than more stringent and lighter rather than heavier.
More seriously, that raises the question which has been raised in the process of this Bill of the status of ethical questions—and indeed of ethical questions out of Christian and other religious frameworks—in relation to the status of the actual, experienced, potential or perceived needs of patients and of the needs, responsibilities, intelligence and energies of clinicians and researchers, either in the present time or in years to come.
This proposal is of fundamental importance. I declare an interest in relation to paragraph 1(4)(c) of the proposed new schedule. Were these amendments to be carried, or in considering alternatives to them, it is extremely important that the content if not the wording of sub-paragraph (4)(c) should appear crystal clearly on the face of the Bill as an equal participant and not, as it has appeared occasionally in the past months, and not only in the passage of the Bill so far, as a kind of poor or suffered relation. That is very important not only in this society, with its particular intellectual, political and legal history, but at this time—when, to many people’s surprise, there is a fresh bubbling-up of a whole range of religious, non-religious and philosophical/ethical questions.
I shall give two examples. I remember from my reading the striking speech made on Second Reading by the noble Lord, Lord Ahmed, and the frequency with which noble Lords have aligned themselves with a range of others raising specifically ethical questions while disclaiming that they are led to do so from any religious tradition. That leads me to think how important this matter is—so important that I was
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- “remains a runner at Report I shall suggest an amendment to insert a new clause before Clause 1 so the debate on that will set the scene for the rest of our discussions”.
That is an extremely important proposal. I hope that this amendment will be there in that position at Report and that we shall therefore be able then to have the debate that we have been having this afternoon, in a position that will colour the whole subsequent passage of the Bill at Report.
Baroness Carnegy of Lour: My experience, from when I chaired a research ethics committee locally in Scotland some time ago, is that when a philosopher, a theologian and several consultants—I forget who the others on the committee were—get together to discuss a specific research proposal, there is an amazing degree of agreement. I discovered that consultants think very hard about the ethics of what they do, and that they listen hard to theologians and philosophers because they know that society has to be behind them when they do these things, otherwise they will have to stop doing them. In a practical way, I have learnt not to fail to listen to the noble Lords who are consultants, as well as to the theologians and philosophers.
The reason for wanting such a committee is an important one. I, too, have felt throughout my years in this House when we have been legislating that perhaps we have not listened carefully enough or at sufficient leisure to the various arguments for and against what was being suggested and the issues underlying them. The question is: how do you achieve that? Frankly, the fact that the theologians, philosophers and ethics experts who are going to meet will be appointed by the Secretary of State slightly spoils the suggestion. There might be a better argument for this committee if the House of Lords were elected, by the way. I am quite sure that we could not have this discussion if we were elected.
When we are discussing legislation in the House of Lords, the problem is always politics. It is when the politics comes in that we often spoil the deep quality of a proposal. That is natural. All of us in this House understand a good deal about politics just from seeing what happens in here. I learnt about it in local government in Dundee, and it helped me very much when I was chairing the research ethics committee to know how politics worked. However, if what is proposed could be done outside Parliament, that would be much better. I do not know enough about the Nuffield council to know about its quality, but I suspect it is probably well equipped to do that.
I am in favour of such discussion happening and being taken seriously in Parliament, but I do not feel that this is the best way of doing it. I say so to the noble Lord, Lord Alton, who himself knows politics very well, and probably understands what I am saying even if he disagrees with me. In moving his amendment he is making an important point about politics, but I am not sure he has the best idea for achieving depth in what we do in Parliament on these difficult issues.
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Baroness Jay of Paddington: I follow the noble Baroness, Lady Carnegy, on her practical experience of local ethics issues. I am not sure I follow her so generally on the path of her political observations, but what she had to say was very helpful. In listening to the Committee today, I find that there is wide agreement that people would like to see a broad ethical context for some of the discussions we have on these very important issues. As several noble Lords have said, the question comes down to how that is best expressed, both in legislation and in our general consideration in society.
I was rather surprised that the noble Baroness, Lady Williams, spoke about the need for such a committee retrospectively to assess legislation—I think I am right in taking her point in that way—because presumably that would be only if it were a parliamentary committee, which is what I would personally support. That could be a legitimate role in government. The commission suggested in the amendment of the noble Lord, Lord Alton, would not have any value in that respect. I say to the noble Baroness that something of the kind she wants to see would be best done through a parliamentary committee.
I support the points that were well made by the noble Lord, Lord Turnberg, and the noble and right reverend Lord, Lord Harries. My feeling about this issue was informed by the report of the pre-legislative scrutiny of the Bill, which, as we know, was done by the authoritative and representative body of Members of both Houses. They specifically said, after dealing with a great deal of evidence on this in paragraph 48:
“We are unable to support proposals for a national bioethics committee. Ultimately it must be for Parliament to set the ethical framework, taking the widest range of advice. We consider that an ethical input should be found from within Parliament and we recommend that Parliament should establish a joint bioethics committee of both Houses to provide ethical input to legislation raising significant issues in bioethics, such as the current draft Bill.”
That would be the appropriate way forward and would enable some of the broader points raised by, for example, the noble Lord, Lord Winston, about other issues to be considered.
Baroness Finlay of Llandaff: I hesitate to rise because so many noble Lords have already spoken and time is moving on. I have listened to the debate and it struck me that there might be a degree of confusion. The law is asked to give absolute answers, yes or no. Indeed research ethics committees are asked either to approve or reject applications before them. However, one difficulty with ethics is encapsulated in Professor Raanan Gillon’s concept of scope and the broader implications of decisions that are made.
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