| Previous Section | Back to Table of Contents | Lords Hansard Home Page |
First, this is a government Bill, based on proper parliamentary procedures of pre-legislative scrutiny and taking independent evidence, and the Government have the right, and can expect, to get their legislation
28 Jan 2008 : Column 487
Secondly, I want to pick up the implied point that the results would somehow be different if there were no government Whip—in other words, that those who are being whipped are in some sense voting against their natural inclination, conscience and compassion. Would the noble Lord say to Members of his own side who have been in the government Lobbies that they were exercising conscience while those of us on the government Benches who went in those same Lobbies were not? I am sure that the noble Lord would not wish to suggest for a moment that only one side has the monopoly on compassion or conscience in this argument. I therefore wish that he would not continue to insist that those of us who believe in this Bill and have voted to support the Government are, as a result, under the sway of a juggernaut that informs our decision-making.
Baroness Royall of Blaisdon: My Lords, I was rising to mention the point about order, but I will now sit down.
Lord Patten: My Lords, I have been speaking succinctly, as I am sure the Chief Whip recognises, and I shall respond succinctly to the noble Baroness’s lengthy two-question exposé by saying that she might have fallen foul of putting words into my mouth. At no stage did I suggest that the result would be different; I have no idea whether it would have been, had a three-line Whip been applied or not. However, I know that I think it wrong for a three-line Whip to be applied on such matters of conscientious issue. It is not a satisfactory get-out to say that someone can go to the last Chief Whip—or the present, new and smiling Chief Whip—and say, “Look, I am having conscientious trouble and prefer not to go though the Lobbies tonight”. What happened back in 1990 was much better; we did not have three-line Whips on such issues, as my noble and learned friend Lord Mackay of Clashfern pointed out.
I conclude on this point, as I attempted to do a moment or two ago. The scientific community has nothing at all to fear from this, as it would benefit greatly from having outside advice made under a dispassionate and formidable chairman. The Government have nothing to fear either.
Lord Harries of Pentregarth: My Lords, there is initially something attractive about the idea of a national bioethics committee, and nobody could put its case more powerfully than the noble Baroness, Lady Williams. She has advanced the argument way beyond where it went in Committee and I would like to address some of her points fairly directly.
First, the noble Baroness emphasised that almost every other country in the world has a national bioethics committee. However, she mentioned the United States
28 Jan 2008 : Column 488
Secondly, the noble Baroness mentioned the advantage of a national bioethics committee being financed by the state, in contrast to other bodies that might be financed by industry and, therefore, have a vested interest. As I think she knows, the Nuffield Council on Bioethics is financed by two great charitable foundations, the Wellcome Trust and the Nuffield Foundation, and there is no question of the recommendation of the council being in any way skewed by vested commercial interests.
Another aspect of the work of national bioethics committees shows that there is often tension between long-term research or thinking about major issues and the short-term advice that the Government need. Those do not sit easily together. The fact is that long-term work is certainly needed; some reports from the Nuffield council take, perhaps, three years and cannot be provided quickly. If short-term advice is needed by the Government, Parliament is surely the place to look for it—either in one of our Select Committees especially set up for that purpose, or in a standing committee to which recourse can quickly be made. The noble Baroness should agree about that inherent tension. We would have to ask whether such a national bioethics committee would be expected to provide advice in the short term for the Government on particular issues that came up or whether we would want long-term work to be done.
The noble Baroness mentioned the reality of what she called fragile boundaries. It is good to have the 14-day rule and the possibility of reproductive cloning, for example, brought to our attention. Yet would a national bioethics committee really be any greater safeguard to crossing those boundaries than what is already in place? After all, one could imagine a situation in which a national bioethics committee had been highly politicised by a Government who actually wanted to break one of those boundaries—sex selection is an obvious instance. I argue that a national bioethics committee would be no guarantee that some boundaries would not be stepped across.
Finally, the noble Baroness mentioned the advantage of a national bioethics committee being accountable to Parliament. However, we really need to ask to whom it is appropriate that a think tank on bioethics should be accountable. Surely it should be accountable to those whose opinion it respects. The Nuffield council, for example, regards itself as accountable to experts in the field—to scientists, ethicists and any other experts appropriate to thinking about bioethics. In other words, we hope to be judged on the quality of the work. A national bioethics committee, if it was really doing its work, would surely be looking to its work quality and would hope to gain the respect of those best qualified to judge that work. Accountability to Parliament would be neither here nor there as far as that was concerned. Therefore, while I hugely respect what the noble Baroness says, if those four or five issues that I have mentioned are looked at seriously, the advantages of a national bioethics committee are by no means clear.
28 Jan 2008 : Column 489
Baroness Kennedy of The Shaws: My Lords, might I bring some information to this debate? For eight years, I chaired the Human Genetics Commission; I stepped down only last November. It is now chaired by Sir John Sulston, who was my vice-chair. He was the head of the British end of the genome project and you could not meet a more ethical scientist. I remind your Lordships that the commission has on it the very kinds of people whom the noble Baroness, Lady Williams, spoke of; we had medical practitioners, research scientists, genetic counsellors, ethicists, moral philosophers, members from the Consumers’ Association and people suffering from a disability. We had a consultative panel of 100 persons, all of whom had genetic disease or genetic propensities within their families. The whole business of bioethics therefore stretches beyond the issues that we have been debating on this Bill.
Your Lordships should understand the ecology of the advice given to the Government on ethics. What is interesting is that, while the ground is rather divided in this country, it is covered. The HFEA, for example, deals with the issue of gender selection, whereas the Human Genetics Commission advises on issues such as the ethical oversight of the police DNA database. Our commission has been advising the Government on the improper use of genetic information; because of that, a criminal offence was created to prevent people from stealing DNA and misusing it. We produced many of the kinds of papers that the noble Baroness, Lady Williams, spoke of. For example we produced a paper on over-the-counter testing, where there are real issues of ethical implication. We also produced work on genetics and reproductive choice, and the possible overuse of testing without parents having an opportunity to refuse some of the tests on offer. I mentioned that there are ethical issues beyond those being debated here. Bodies exist to advise the Government, after considerable debate and consultation with the public. Indeed, we travel around the country so that our meetings are not confined to London.
6 pm
I had the experience of going to the United States to visit, at its invitation, the White House committee on bioethics. I went with the then chair of the HFEA, Suzi Leather. It was interesting because together we had basically covered the same ground as that committee. However, the experience was most depressing because, to some extent, that committee could not get beyond the primary debate. In the end, the right-to-life debate was the only debate, which hampered the opportunity to have the kind of debate that we have seen taking place in this House over these past weeks.
Given my background, that whole debate reaches deeply into my heart. I feel that issues about life and those fragile boundaries that the noble Baroness mentioned need to be decided in the public domain, ultimately by elected representatives in Parliament. In visiting and meeting bioethics committees, I was concerned at the way in which almost inevitably those issues became politicised. So let us have our politics out in the open. I am unhappy about subcontracting ethics to a group of ethicists. That forgets the fact that franchising out ethics to a set of eminent personages
28 Jan 2008 : Column 490
Watching the bioethics committee in the White House at work was seriously depressing. All groupings want to be represented; you end up with all the major churches and many other groups insisting on representation. I am sure that everyone involved is profoundly moral, but in that situation, ultimately, the debates become privatised. It is important that we try to find better ways of having these debates publicly.
That may mean putting more money into the Human Genetics Commission. When I stepped down, I had my sort of debriefing meeting as a former chair, who had been asked to stay on time after time until it became a bit too long. I said that it might be better to bring in some of the ethical issues that had been with the HFEA. I felt that there was a discomfort in some of those issues being with the HFEA, which is seen by the public as a regulatory body. It is confusing to have the regulatory function and an advisory function on ethics combined. Perhaps one body could do that, in the form of the Human Genetics Commission. However, to start setting up a bioethics commission and to have a contention as to who should be on it and who might be represented on it will inevitably lead to a politicisation that I think we should avoid. I return to my submission to this House, which is that we are all ethicists.
Baroness O'Neill of Bengarve: My Lords, we have an opportunity here, but I hope that we do not take it. Let me try to explain why. I have some interests to declare. I was a founder member of the Nuffield Council on Bioethics and later its chair. I stood down when I started to chair the Nuffield Foundation. So, for more than 15 years, I have been looking at what it really takes to enable a body to achieve independence. I do not say that that has been perfectly achieved, but it is very difficult to achieve, and that is one of the aims spoken about by the noble Baroness, Lady Williams.
We need to think about structures much more carefully than we can today in an amendment to an already complex Bill. Six to eight people is a very small number. Is the whole of human bioethics to be separated from other parts of bioethics? Constantly one finds overlap between human issues and concerns of animal welfare: let us think of xenotransplantation. One continually finds overlaps between human issues and environmental issues and one now finds issues of bioethics that stray into public health. In the broader—perhaps I should say the narrower—academic world where I come from, people now talk about broad bioethics; that is, uniting human, environmental and public health issues.
The remit of such a committee is important. In the mean time, a large range of bodies in this country address particular parts of this remit. Some are publicly funded and some are charitably funded. Between them, they cover the waterfront moderately well. However, there are some things that they cannot do. One of the main things that they cannot do is to have influence, whereas perhaps the US and German bioethics
28 Jan 2008 : Column 491
We need to think much harder before we launch into a national committee. We need to think about what areas of bioethics such a committee should consider. Where are the boundaries? How should it be staffed? Who are the people who should be there? How many would be needed to do a serious job? Could they really then be expected to carry the many additional functions that this amendment would assign to them? If they took on these public engagement and education functions, could they be expected to preserve that form of neutrality that is initially described? As the noble Baroness, Lady Warnock, has said, would it not in the end come back to Parliament—I hope with a free vote—to make decisions on these matters? I believe that it would. Although I am not wholly hostile to this proposal, I am open to being convinced. We need to think far more seriously about what you have to do to secure independence, which I do not think is easy, how one achieves that across time and how one achieves proper connection with the public.
Lord Warner: My Lords, perhaps I may share with the House my experience as a Health Minister who commissioned a paper on whether we should move towards a bioethics commission. I shall not divulge the personal views that were offered to me. However, I received a paper on the proposal, I considered it and I discussed it with the Nuffield Council on Bioethics. It might be worth sharing some of the reasons why I decided that it was not a good idea to proceed with the proposal. I have to acknowledge that if you are a busy Minister and wrestling with some of the difficult issues around ethics in NHS research and development, in the Human Tissue Bill, in genetics et cetera, then there is something extremely attractive in the idea of being able to outsource some of those issues. I do not dismiss that attraction. However, when it comes to grappling with the specific points in taking that forward, you have to confront some rather uncomfortable issues.
If this commission were to be set up, what range and diversity of membership would make it an authoritative body that carries credence with the public, has a wide diversity of opinion and would be authoritative enough to be useful to Governments of all and varied persuasions? The truth is that you need a very large body indeed to produce that kind of authoritative body. The idea that you could do that with between six and eight members, I say to the noble Baroness, just does not stand up to detailed scrutiny. You also have to look, as I did, at the experience of other countries that have gone down this route. I say to the noble Baroness, for whom I have the highest regard, that I thought she was a bit selective about the virtues of some of those other
28 Jan 2008 : Column 492
We therefore have the problem of whether such a body, particularly if it were a small body, could be captured. As the noble Baroness may know, we in the Labour Party are rather expert in entryism; we have quite a lot of experience in that area. There is therefore an issue—dare I say it to some of my colleagues in other parts of the House—about whether faith-based organisations would seek to capture some of these bodies. Uncomfortable stuff though it is, I have to say, based on the experience of other organisations overseas, there is a risk.
Scientists themselves are extremely diverse. A membership of between six and eight would not allow much capacity for a wide range of scientific views, opinions and expertise to be incorporated in such a body. Moreover, the noble Baroness, Lady O’Neill, makes a very important point, as does my noble friend Lady Kennedy of The Shaws: the ground is already quite well covered by quite a lot of bodies. If you are a Minister, you are not short of people offering you advice in these areas. I agree that the advice sometimes conflicts, but nevertheless there is no shortage of people coming to you with expert advice in many of these areas. The Human Genetics Commission has done remarkably good work in this area. The regulators, even though they are regulators, do themselves bring something to bear in these areas because of their experience in dealing with the regulatory issues. The Nuffield Council produces very measured reports after a lot of consultation and research. That is all available, both in the public arena and to Parliament.
One of the issues that I thought was overwhelmingly important was that we did not try to escape from the fact that elected politicians and appointed politicians need to wrestle with these issues. Parliament needs to wrestle with them. Sometimes it is uncomfortable for many elected politicians to wrestle with these issues. They would prefer that things should go away. In a sense, however, that is the important part of a democracy—that we have these issues out in the open and bring them to Parliament. If we are to go down the path of a new body, it should be something that is enshrined in Parliament. It should be a parliamentary debating capability rather than something off-shored to help us out with difficult issues. We need to wrestle with them as parliamentarians.
6.15 pm
The Lord Bishop of St Albans: My Lords, I should like to begin this brief speech by reminding the House of some words of Professor Sir Liam Donaldson, which he gave at the pre-legislative scrutiny committee:
“We have had, generally, in this country a deficit in medical ethics, both in the input to some of our decisions over the years and, also, in medical ethicists”.
That is a statement we should take seriously. Why is there such a dearth? Because we do not take the teaching of philosophy in schools with the seriousness we should or treat it with the seriousness we should at university level or in medical schools.
28 Jan 2008 : Column 493
The normal response in the context of this Bill when anyone suggests there is a need for a national committee is to say, as has been said today: “We already have such groups—the HFEA ethics and law advisory group, the Nuffield Council on Bioethics, and so on”. None of them, to the best of my knowledge, has any statutory authority. Quite rightly, noble Lords have raised questions of membership should a national body be set up. Can we be absolutely certain that those ethical groups which already exist include, with full voting rights, those who for significant ethical or religious reasons cannot and do not share the presuppositions of other ethicists in those bodies? My information is that that does not happen.
There is not time in a debate of this kind to look at the current stage of ethical thinking in our country. In general, over the past few decades, it seems that it has become increasingly utilitarian and pragmatic. However, within the history of philosophical and ethical thinking in western Europe there have been two significant strands. The first strand is based on the powers of human reason and the capacity for logical thought. I cherish that strand. The second strand is based on the possibility, only the possibility, that the words revelation, epiphany, theophany and disclosure—the kind of words used in the Judaeo-Christian tradition—have a basis in reality, in personal experience and in social experience.
It seems to me that the danger facing ethical thinking in the United Kingdom is that this second strand is treated these days as a lifestyle choice and dismissed as having no more significance than, say, the choice of a gym or a fitness regime. I think that it is slightly unjust to suggest that churches and faith groups might be involved in entryism. What seems to happen most of the time is that, because those of us who have a faith are treated as though we were lifestyle idiots, or the last of the witch doctors, the doors are not opened. Quite the opposite—they are bolted shut. For some reason it is assumed that we are unable to think logically or reasonably and have nothing to contribute. That is very sad.
Suppose for a moment that ethics are not simply about practical and utilitarian behaviour but are also concerned with what is or should be or may be actually true. If that is the case, it seems only fair and just that the significant strand of Judaeo-Christian ethical thinking to which I alluded should be a foundational part of ethical thinking in our country and not treated as though we are somehow bigoted entryists. To exclude that kind of thinking seems discriminatory.
If what I have said is at all accurate, then to ensure that we have in our country a national committee concerned with human bioethics seems a reasonably wise step. The challenges facing those in research and treatment procedures in medicine are massive, and we are all indebted to the scrupulous care which the best medical practitioners and research scientists bring to their work. Having served on the pre-legislative scrutiny committee, I recognised that I was in the presence of such practitioners and such scientists. It was an enormous privilege simply to listen to what they are doing and to try to understand it.
28 Jan 2008 : Column 494
| Next Section | Back to Table of Contents | Lords Hansard Home Page |