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4.17 pm
Lord Alton of Liverpool: My Lords, the topicality of today's debate was underlined in the headlines in the weekend newspapers, saying that the stem cell revolution has ended the need to use human embryos. I should like to turn back to that question in the substantive part of my remarks, but before doing so I should like also to touch briefly on one point just alluded to by the noble Baroness, that of the prospect that this Bill might be extended to include abortion provision, and to refer to the issue of the welfare of children.
Like the noble Baroness, I do not believe that it would be appropriate for this Bill, which gave no opportunity in committee to consider the abortion question, to extend the Abortion Act 1967. As the author of that Act, the noble Lord, Lord Steel of Aikwood, said recently, 200,000 abortions a year are too many. We have laws that have allowed 7 million abortions in the past 40 years, some 600 every day, and thus 200,000 every year. We have laws that allow abortion up to and even during birth on the disabled. Many noble Lords will have seen a recent newspaper story from the south-west region of the country indicating that over a three-year period, some of the babies aborted with disabilities included those with cleft palate, club foot, hare-lip, webbed fingers and webbed feet. They numbered some 100.
These are contentious questions, but even more contentious is the proposal being put forward by Members of another place that this Bill should be used like a Trojan horse to introduce the abolition of the requirement for two doctors to certify an abortion and the extension of the Act to Northern Ireland. Attacks have also been made on the conscience clause, as well as reports that nurses and midwives are being required to carry out abortions. Without considering those issues in great depth and detail, rather as the right reverend Prelate the Bishop of St Albans indicated to the House a few moments ago, it would be wholly inappropriate to be rushed pell-mell into them.
I think that all noble Lords had great confidence in the way that the Select Committee, chaired so ably by the noble and learned Lord, Lord Mackay of Clashfern, looked at the equally contentious issue of assisted dying.
Lord Mackay of Clashfern: My Lords, I should point out that the chair was taken by Mr Phil Willis of another place.
Lord Alton of Liverpool: My Lords, the noble and learned Lord may have misheard me. I was talking about the equally contentious issue of assisted dying in order to make the point that that Select Committee, which inevitably did not reach a conclusion, was nonetheless able to inform the debate by producing weighty documents based not entirely on taking soundings on public opinion, as the noble Baroness just said, but also on taking huge amounts of evidence. It thus informed the debate in your Lordships' House, and I would argue that before we proceed to any changes in abortion law, the right way
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to proceed would be by the creation of a similar Select Committee so that we can look in detail at those contentious questions.
I turn next to the welfare of children. As my noble friend Lady Deech has said, there are serious concerns about the issue of "saviour siblings" and about the need for a father. The Bill extends the creation of saviour siblings to the treatment of serious disease rather than just life-threatening disease. To deliberately leave it open for children apparently to be created for the sole and explicit purpose of being available to provide any type of tissue at all for an existing sibling is appalling. This is truly dehumanising society, and is a serious development. I am currently awaiting an answer to the Parliamentary Question I tabled to the Minister on this subject, but will he say today where the Bill uses the words,
"umbilical cord blood stem cells, bone marrow or other tissue",
what "other tissue" means? The phrase in the Bill does not seem to exclude anything specifically. I was deeply concerned to hear these words from Dr Simon Fishel, the managing director of the CARE Fertility Group, who is also an inspector, peer reviewer and external adviser to the HFEA:
"You might start looking at organs".
Given that the chairman of the Joint Committee, Mr Phil Willis, bewilderingly suggested that autism was also a condition that a saviour sibling might in future be created for, Parliament surely deserves to know what the Government have in mind in extending the definitions from "life-threatening" to "serious". Also, precisely what in the Bill itself would unequivocally ban the creation of a child to be a kidney donor, for instance? Instead of creating saviour siblings for umbilical cord, how much better it would be if we were routinely collecting umbilical cord and cord blood. Only four National Health Service facilities do this at present, while 98 per cent is routinely destroyed. That would save lives immediately.
I intend to ask your Lordships to amend the Bill in Committee to ensure that harvesting causes no harm to the donor. I would also like all references in the Bill that seek to create a legal fiction around parenthood to be deleted. As the Joint Committee rightly said, to deny to a child that he or she had a real biological father would be nothing short of the state colluding in a deception. An estimated 800,000 children in Britain already have no contact with their father. To deliberately add to that number is downright irresponsible. One of the deepest questions that we ask ourselves is, "Who am I?". The right to lineage affects us all, and uncertainty over parentage can profoundly unsettle people. The popularity of television programmes such as "Who Do You Think You Are?" illustrates the natural desire to know one's family history. The guidance of the Oracle of Delphi to the Lydian King Croesus was that to be happy, he must know himself. That is true for us too.
The Government's decision to remove the reference to the "need for a father" from law and social policy is a huge error. Women should not be interrogated at IVF clinics about their sexual orientation or their marital status and many single women are loving and exceptionally good mothers, but the need for a father,
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and the right to know who he is, are the issues. I agree with the noble Lord, Lord Warner, in the debate last week on the Queen's Speech, when he said,
"children are not accessories to adults' preferences".-[Official Report, 8/11/07; col. 157.]
Like my noble friend Lady Deech, I urge the Government to delete those references from the Bill.
I turn to the issue of embryology. I want to challenge the provisions in the Bill that will add to the 2 million human embryos that since 1990 have been destroyed or experimented upon. The new Bill goes even further, permitting the creation of hybrid animal-human embryos. Many of us have previously pointed to the futility and lack of progress of embryonic stem cell research, but the argument has now shifted to the new methods for producing stem cells with the same potential as embryonic stem cells. Those committed to human embryonic stem cells now have no excuse to work with-that is, to destroy-embryos for the purpose of deriving new or patient-matched pluripotent cell lines. Last Saturday Professor Ian Wilmut, who famously cloned Dolly the sheep, declared cloning work with human embryos needless. He said:
"The work which was described from Japan of using a technique to change cells from a patient directly into stem cells without making an embryo has got so much more potential".
However, the justification given for this new Bill in the recent Queen's Speech was that we have to,
"ensure that Britain remains at the forefront of medical research".
It is clear from what Professor Wilmut said that interspecies cloning is not the way ahead.
As yet, no therapies anywhere in the world use embryonic stem cells. Strikingly, an editorial in NatureBiotechnologyin 2005 stated:
"Meanwhile, forward steps continue to be made in the field of adult stem cell therapy",
for which there are no moral hazards. It continued:
"One estimate is that there are currently over 80 therapies and around 300 clinical trials underway using such cells".
When I divided the House on this issue in 2001, many of those who voted for embryonic cloning, and who will vote for animal-human hybrids, did so out of a genuine humanitarian desire to help those who suffer from disabling diseases. The state of stem cell research led them to believe that they had to choose between the ideal of helping to cure disease and the equally cherished belief of many that it is unconscionable to destroy nascent human lives in experimentation. Six years on from the hype of 2001, not only is it clear how the hopes of the desperate have often been cruelly and falsely raised, not least by the scandal of fraudulent cloning claims, but it is apparent that the supposed ethical dilemma may have been rendered redundant. In June 2007, three separate publications heralded the successful creation of embryonic-like cells from adult stem cells. This allows for the creation of a middle ground in the debate. Ethically uncontroversial stem cell techniques are where the future lies.
In the House of Lords debate in 2001, the noble Lord, Lord Hunt, the then government Minister, said that,
"the 1990 Act already provides the answer to the question of what happens if and when research into adult cells overtakes research using embryos: embryonic research would have to stop because the use of embryos would no longer be necessary for that research".-[Official Report, 22/1/01; col. 120.]
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It is no longer necessary. I hope that, instead of ending the unnecessary destruction of human embryos and advocating the creation of animal-human hybrid embryos, we will agree to that simple test-let us call it the Hunt test-which I will seek to move as an amendment in Committee; that is, licences will not be granted unless applicants can prove that no alternative is available, and applicants should have to demonstrate that embryos from no other species could be used for the same purpose and that their proposals are well founded and based on prior work from other species. In these controversial areas of embryology, child welfare and abortion, the House should proceed with great care and be prepared, if significant improvements are not made, to reject this Bill outright at Third Reading.
4.27 pm
Subject: Committee Stage Day One interventions
Lord Alton of Liverpool: It would be surprising if Members of the Committee were not dazzled by the scientific acumen of noble Lords such as the noble Lord, Lord Winston, and my noble friends Lord Walton and Lord Patel. The noble Lord, Lord Elton, put the matter well; I have no difficulties with some of what my noble friend Lord Patel said earlier, and I
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believe that there is scope for common ground on the use of adult stem cells, a matter he alluded to. Nevertheless, issues have been raised in some of noble Lords' remarks, and indeed in the remarks on mitochondria, which no doubt we will come to later when my noble friend Lord Walton of Detchant speaks to his Amendment No. 4 in the group.
We are being asked to do different things. The amendment of my noble friend Lord Walton asks us to remove all regulation and to allow what he would like to do to proceed in a wholly unregulated way. On the other hand, my noble friend Lord Patel suggests a form of regulation. I suggest in my Amendment No. 2A that we should reserve to Parliament the right to decide on these complex and sometimes controversial issues.
The amendments in the group deal not only with the questions already alluded to but with reproductive cloning, mitochondrial DNA, and immature human and animal gametes, expanding their use into interspecies embryos. That is a phenomenally wide group of issues to consider in one group of amendments. It is also a phenomenally complex group of issues for any lay person to deal with.
We are having a rather back-to-front debate very late in our proceedings. Probably tomorrow or perhaps next week, we come to Amendments Nos. 66 and 67, tabled by the noble Lord, Lord Brennan, which urge on us the creation of a national bioethics committee that is outside Parliament and capable of giving informed opinion to Members of both Houses before decisions such as this are taken. In many ways, I wish we could have had that debate at the head of our consideration of the Bill in Committee.
My noble friend Lord Walton seeks in Amendment No. 4 to remove the need for regulation. The practical effect would be to allow licence holders to modify an egg or embryo for mitochondrial reasons without further regulatory requirement. If that were to permit reproductive cloning to prevent the transmission of mitochondrial disease without having to go through the affirmative procedure, we would have entered a brave new world without so much as a parliamentary grunt. Many of us who admire scientists and science nevertheless believe that Parliament has a right and a duty to insist that good science and good ethics march hand in hand. I doubt that I am alone in wearying of the political mantra, "We will follow the science". Parliament's job is surely to inform itself; arrive at wise and just judgments; and to lead, not to follow. We should be deeply suspicious of any attempt to remove regulation and simply place that power in the hands of the Secretary of State, however esteemed they may be.
To sleep-walk into provisions that might have irreversible effects, and to do so in the absence of a legislative, ethical and regulatory framework, would be a dereliction of our duty. So, too, would the failure to close a route to reproductive cloning. As we are seduced and subverted by the dazzle of these various proposals, I am reminded of CS Lewis's prophetic polemic, The Abolition of Man, published in 1943, and of his futuristic work, That Hideous Strength, published in 1945. He foresaw what he described as
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technological brutalism, just as Huxley foresaw a world populated from vast hatcheries and peopled with entities with intelligences ranging from alpha to epsilon. Even before Lewis and Huxley, in 1896, HG Wells published The Island of Dr Moreau. Dr Moreau, who specialised in creating animal-human hybrids, says:
"I went on with this research just the way it led me ... I have never troubled about the ethics of the matter".
He was not subject to regulation.
Instructively, Lord Feverstone, the creator of the National Institute for Coordinated Experiments in That Hideous Strength and a fictional Member of your Lordships' House, says that his aim is:
"Quite simple and obvious things, at first-sterilization of the unfit, liquidation of backward races ... selective breeding".
Ultimately, he will create:
"A new type of man".
All this was futuristic, speculative writing, but it is fast becoming reality because of the extremely permissive flexibility of provisions in Bills such as this. It is clear that the desire of the scientific lobby, to which my noble friend Lord Patel referred earlier, and evidenced in arguments for deregulation, is that the Bill embrace all future technological developments without wasting time coming back to Parliament for approval. Even when specific restrictions are stated in the Bill, they are usually accompanied by provisions to permit further change, with a minimum of scrutiny or accountability. I hope that when the Minister replies, he will reiterate that the provision of the conscience clause in the 1990 Act will continue to apply, thus protecting those scientists who do not wish to be corralled into work that in other European jurisdictions would carry a prison sentence.
It may be very unfashionable to say this, but there are tens of thousands of desperately unhappy children who are orphans and who would desperately love to be in a loving home. Adoption has gone out of favour, and I noticed in a reply to a Parliamentary Question which I tabled recently that, in the whole of last year, only 165 babies were available in this country for adoption. Of course couples who wish to prevent the transmission of disease to their children should, as the noble Lord, Lord Winston, has said, be given every support possible if they want to adopt an orphaned child, instead of going to extraordinary lengths and using cell nuclear replacement procedures to create children who may turn out to have some other unexpected disorder resulting from the very artificial procedure used to create the embryo.
Adoption would also be better than creating three genetic parents. At Second Reading my noble friend Lord Walton said that to be able to prevent the transmission of mitochondrial disease:
"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 partner's sperm, thus allowing these women to have normal children".-[Official Report, 19/11/07; col. 709.]
This means that you can carry out a technique to insert the nucleus of an egg from the woman with mitochondrial disease into the egg of an egg donor
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who has healthy mitochondria where the nucleus of that egg has been removed, and that would be followed by IVF.
I ask the Minister, if we simply insert an adult somatic cell from the woman with unhealthy mitochondria into the enucleated egg instead of inserting the nucleus from her egg, would that not be reproductive cloning after activation instead of IVF? What precisely in the Bill would prevent this, as permitted eggs and embryos are allowed to have alterations in their mitochondrial and nuclear genes if it is for the treatment of mitochondrial disease, and do not have to have been created by fertilisation as new Section 3ZA(5) can override the prohibitions in new Section 3ZA(2) and (4) which would otherwise have prohibited implanting embryos created by altering DNA and embryos that had not been created by fertilisation?
Paragraph 2(3) of Schedule 2 on page 54 also specifies that licences can be given where the nuclear and mitochondrial DNA of embryos to be implanted has been altered for the purpose of mitochondrial disease. These eggs and embryos are also specifically permitted to have material from two women according to new Section 35A on page 30. All this would seem again to permit reproductive cloning as one of several possible ways to prevent transmission of mitochondrial disease.
With the Bill as it stands in new Section 3ZA(5), both this and the procedure suggested by the noble Lord, Lord Walton, would be subject only to affirmative resolution. However, if the noble Lord's Amendment No. 4 is approved, then neither procedure would be required to go through Parliament for affirmation. This means that reproductive cloning would be legal as one method to prevent transmission of mitochondrial disease without ever having come back to Parliament. We must not allow this law of unintended consequences to happen.
Baroness O'Cathain: I agree with the noble Lord, Lord Alton, in showing concern about the groupings in the Bill. I feel the groupings are far too wide. For example, in the first grouping, it may appear as though the amendments have a great deal in common but, in reality, there are basic differences which lead to various different outcomes. Unless it is properly understood, we are in danger of passing the Bill to the House of Commons without proper scrutiny of the possible-or, indeed, probable-unintended consequences to which the noble Lord, Lord Alton, has referred. After all, the danger of any new legislation is unintended consequences, and we have had a long history of looking at this over the years.
As has already been said, the science involved is dazzling, and for a lay person to get involved in this might seem like utter stupidity. On the other hand, there are underlying issues in the Bill to which I referred at Second Reading. The Bill concerns an enormous number of people who have no idea of the basic science. When we hear people stating that the great public out there have no problem with the issues, of course they have no problem because they do not
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understand the issues. When you are asked a question about something which you do not understand and you just say, "Oh yes" or whatever, that really is a problem. I am deeply concerned about this.
We are now determined that we are going to be so leading edge in this area, where there is no guarantee of therapeutic success. In case noble Lords are not aware of the issues that were raised at Second Reading-I have not read them-I repeat that over a period of some 17 years there have been attempts to undertake this type of research and, during that period, there have been no positive results, whereas we have more than 70 proven therapeutic treatments directly attributed to the ethical adult stem cell research.
I shall address Amendment No. 1, in the name of the noble Lord, Lord Patel, in particular. Will the Minister-or indeed the noble Lord himself, if he wishes to come back-give me some satisfaction on some of the issues the amendment raises? Does it necessarily mean that no licence under Clause 4(1)(a) will any longer be needed to store or use immature eggs? Will no consent be required any more under Schedule 3 for the use of immature eggs? Immature eggs derived from adult ovarian tissue could be used without consent for cloning experimentation and so on. Immature foetal eggs derived from abortion could be stored and used without any need for a licence, while no restrictions would exist any longer on the use of immature eggs derived from born persons for treatment purposes. A licence-free environment in which immature eggs could be used for experimentation without any control is, I suggest, not the right way to go.
3.45 pm
The Deputy Chairman of Committees: As the noble Lord, Lord Alton, will also be speaking to Amendment No. 6A, I should draw the Committee's attention to an error in the Marshalled List. It says "leave out from ‘authorise' to the end of line 19"; it should say "to end of line 18".
Lord Alton of Liverpool moved Amendment No. 6:
Clause 4, page 4, leave out line 11
The noble Lord said: I am grateful for that clarification. It saves me having to make it later. In moving Amendment No. 6, I shall speak also to Amendments Nos. 6A, 16, 28, 42, 43, 45, 47, 48, 65A and 65B, which are grouped together. I am sure that the Committee will bear with me as I try to speak to this large group of amendments.
The cumulative effect of the amendments will be to ban the creation of inter-species embryos. I welcome Amendments Nos. 19, 20 and 61 in the name of the noble Earl, Lord Howe, which have been grouped with my amendments. Amendments Nos. 19 and 20 would prevent tetraploid complementation, giving rise to a substantially human foetus.
Lord Jenkin of Roding: Amendments Nos. 8, 19 and 20 are now in a separate group.
4.45 pm
Lord Alton of Liverpool: My apologies. They are not ungrouped on the list that I have been given. I am grateful for that clarification, and I will come to those amendments in due course.
Following the BSE crisis, and after the saga of genetic crops, the Science and Technology Committee of your Lordships' House said that,
"many are deeply uneasy about the huge opportunities presented by areas of science including biotechnology and information technology, which seem to be advancing far ahead of their
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awareness and assent. In turn, public unease, mistrust and outright hostility are breeding a climate of deep anxiety among scientists themselves ... Science's relationship with United Kingdom society is under strain".
Do we seriously believe that the creation of animal-human hybrid embryos, about which there is deep unease, will heal that fractured relationship? The main argument for using hybrids is for medical cures. Interspecies cloning is particularly in highlight in this regard. However, the Japanese procedure, which was referred to at Second Reading, to produce cells that resemble embryonic stem cells directly from skin, producing multipotent stem cells that were identical immunologically to the patient without using an embryo, was recently found to work with human cells by two groups, as several noble Lords mentioned in our debate on 19 November. That is a major advance. The two groups were led by Professor Yamanaka in Japan and by Professor James Thomson in America, who originally isolated human embryonic stem cells.
My noble friend Lord Patel spoke powerfully against the Japanese procedure in that debate. He questioned the ability of the production of embryonic stem cells directly from skin, and pointed to some of the issues that might arise. He emphasised that the mouse produced from these cells had tumours, owing to a particular gene that had been inserted to induce the cells to become multipotent. I am delighted to be able to tell your Lordships' House that the same research group published a further article on 30 November in Nature Biotechnology in which it described research in which it did not use that gene and none of the mice developed tumours. The cells are likely to be much more biologically relevant than cells produced by interspecies cloning, as cloning produces numerous biological flaws and carrying out interspecies cloning would simply magnify those problems. On 30 November, The Daily Telegraph reported:
"Now the Japanese team led by Prof Shinya Yamanaka and colleagues at Kyoto University show in the journal Nature Biotechnology how to convert adult human skin cells into cells that resemble embryonic stem cells without using the tumour-causing gene".
These genes will be an immune match to the patient, so pursuing this avenue of research would negate the need to pursue therapeutic cloning and interspecies cloning.
What is the precise purpose of what we are being asked to approve, should the amendments not be made to the Bill? What did scientists speaking to the Joint Committee say on being asked their views on so-called true hybrids? Dr Lovell-Badge said:
"I cannot think of a good experiment to do now but I am sure someone will think of a good experiment".
Professor Bobrow said that,
"we are also not aware of any pressing scientific reasons at the moment for creating such entities, but who knows what tomorrow might bring?".
Professor Smith said:
"At the present time, we have not been able to identify such a particular reason"-
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to make true hybrids-
"but that does not mean that they do not already exist and that there are not people already in the scientific community who would have appropriate grounds or that they would come along in the future".
This is not exactly overwhelming, compelling evidence that true hybrids are urgently required for medical use. Furthermore, the Chief Medical Officer, Sir Liam Donaldson, said in his evidence to the Joint Committee on the draft Bill on 6 June that,
"there was no clear scientific argument as to why you would want to do it, and, secondly, a feeling that this would be a step too far as far as the public are concerned. I think we do have a responsibility to ensure that we take the public with us in the other important areas of research that we want to do, and do not lose their confidence by moving forward with something which is much further out, as far as acceptability is concerned, and where the scientific arguments for wanting to do it are not particularly strong or convincing, or even existent".
I know that many of those who voted for embryonic cloning in 2001, and who will vote for animal-human hybrids, did so out of a genuine humanitarian desire to help those who suffer from disabling diseases. I do not believe that anything divides us in this House in our determination to try to do that, but were those beliefs well founded?
It may be instructive to note the subsequent widely reported comments of the noble Lord, Lord Winston, in 2005. He said:
"I think it is unlikely that embryonic stem cells are likely to be useful in healthcare for a long time ... I was concerned that parliamentarians-particularly in the House of Commons-have been convinced that it was just a matter of a few years before we would be able to transplant stem cells and cure a lot of neurological disorders, like Alzheimer's disease, for which I think it is going to be a hugely difficult problem and probably completely insoluble by stem cells".
To pretend that the creation of hybrid embryos from animal eggs will offer a desperate patient with motor neurone disease their only hope of a cure, as was prominently asserted earlier this year, is perpetrating yet another piece of fiction which does no service to the seriously ill.
Perhaps now would be a good time to pause and similarly ask what the creation of interspecies embryos might realistically promise. In his speech on Second Reading, my noble friend Lord Walton of Detchant inform us that,
"the new technique of cloning using the interspecies embryo",
would not require suppression of the immune response. Indeed, he went on to say:
"Now, if one can use animal cells to produce the type of capsule or framework in which the nucleus from that cell can be implanted, stem cells derived from that cell will be immunologically compatible with the host into whom the subsequent stem cells will be implanted. That overcomes the difficulties arising as a result of some use of other cells such as the adult stem cells to which the noble Lord, Lord Alton, referred".-[Official Report, 19/11/07; cols. 708-09.]
In due course, I know that the Committee will greatly appreciate it if my noble friend would be willing to explain how it is that cells containing proteins from a distantly related species would not provoke an immune response, yet stem cells taken only from the same individual supposedly would. In expounding such views, I also trust that my noble friend will explain fully how one can be so sure about
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the developmental potential of such a cloned interspecies entity, especially without implanting it in a womb or crossing the 14-day limit.
In our debate in January 2001, my noble friend was sceptical about progress using adult stem cells, stating that progress would take many years of fundamental research. In his speech on Second Reading, my noble friend also commended an article by Julian Savulescu on the purported benefits of attempts at human cloning with eggs of distantly related species. I hope my noble friend will take the opportunity to dissociate himself from Professor Savulescu's previously expressed views in favour of reproductive cloning or the harvesting of tissue from cloned foetuses.
Meanwhile, Her Majesty's Government seem decidedly confused regarding whether or not the potential use of a technique known as tetraploid complementation would fall under the remit of the Human Fertilisation and Embryology Act if human embryonic stem cells were injected into a tetraploid embryo of another species tetraploid embryo complementation is already a well established technique for deriving mature mice entirely from mouse embryonic stem cells in which the cells of a tetraploid mouse embryo give rise to extra embryonic tissue, such as placenta, while the mouse's embryonic stem cells contribute directly to the developing foetus.
The Minister has stated that the reference to,
"such other things as may be specified in regulations",
as proposed to be inserted under Clause 4(2) of the Bill has the scope to cover any predominantly or substantially human organism that conceivably may be created by injecting human embryonic stem cells into an embryo of another species into which the animal cells primarily produce extra embryonic tissue.
I invite the Committee to contrast those remarks with those of the noble Baroness, Lady Royall of Blaisdon, and also with those previously made by the noble Lord, Lord Hunt of Kings Heath. He stated that an animal embryo altered for an experimental or other scientific purpose by the introduction of one or more human cells will be governed by the provisions of the Animal (Scientific Procedures) Act 1986 once it reached the half-way point of gestation or incubation. That was given to me in a Written Answer on 28 June 2007. Subsequently, the noble Baroness, Lady Royall of Blaisdon, stated that if the cells that make up an embryo contain at least a haploid set of human chromosomes and at least one sequence of animal DNA, including a tetraploid complement of animal chromosomes, then it will be regulated as an interspecies embryo, but the regulation of animal embryos that contain single or multiple human cells is not within the scope of the Bill. That was given in a Written Answer on 12 July 2007.
Under which legislation would an embryo fall if it contained a significant proportion of human embryonic stem cells, which obviously themselves contain at least a haploid set of human chromosomes that have been injected into a tetraploid primate embryo? The evident confusion displayed by the contrasting answers from Her Majesty's Government on this potential issue have not inspired much more confidence in the ability
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to regulate such research than the extensive indecision of the Human Fertilisation and Embryology Authority regarding whether or not it could regulate the so-called "cybrid" embryos. Such confusion may be especially disconcerting in the light of Dr Stephen Minger's comments to the Joint Committee on the Human Tissue and Embryos (Draft) Bill that it may be only a few years before someone will want to,
"take human embryonic stem cells and put them into a primate blastocyst and take that blastocyst to mid-gestation or maybe to birth or maybe to ten years of age".
So much, then, for the 14-day limit as applied to interspecies embryos.
In 1990, in opposing the first Human Fertilisation and Embryology Bill, I quoted in another place scientific opinion that doubted the scientific worth, let alone the ethics, of human embryo experimentation. I quoted an intervention from a debate in your Lordships' House by my noble friend Lord Walton, whom I respect enormously although we disagree fundamentally on this issue. I seem to have been arguing with him now for the past 20 years. He had been asked what significant cures or advances in treatment had been achieved. He replied,
"I agree that as yet there are none".-[Official Report, 8/2/90; col. 958.]
In 2001 when I divided your Lordships' House, when close to 1 million human embryos had been destroyed, I asked the same question. No one could point to a single cure, yet we then authorised the cloning of human embryos. Seven years later we are now being asked to permit the creation of interspecies embryos. Although some 2 million human embryos have now been destroyed or experimented upon, the answer to the question remains the same. Cures-around 80 are now documented-are coming through adult stem cells, not through interspecies manipulation.
We should be clear-sighted. We should think wisely about what we are being asked to authorise. Having done so, we should reject these proposals as a step too far. I beg to move.
6 pm
Lord Alton of Liverpool: I am very grateful to all Members of your Lordships' House who have participated in this debate. There is a fundamental disagreement between us-the noble Lord, Lord Winston, alluded to that a moment ago-and I do not suppose that we will be persuaded by the arguments today, any more than we were persuaded in 2001 or in 1990. Those who believe, as I do, in the special status of the human embryo-as my noble friend Lady Warnock put it in her report, those who believe that it is the beginning of human life-will find it deeply repellent to argue that, even up until 14 days, it should be permissible to create interspecies embryos. There is a fundamental difference between us; there can be no doubt about that. I am sure that on Report, we will want to divide to test the opinion of the House on that question.
The noble Lord, Lord Darzi, told us that the regulatory authority that has regulated these things since 1990, the Human Embryology and Fertilisation Authority, will be able to regulate the use of
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animal-human hybrids. I hope that it does a better job than it has thus far. When we come to a later group of amendments about the nature of the regulatory authority, with the permission of your Lordships, I will certainly have a lot more to say on that subject.
My noble and right reverend friend Lord Harries of Pentregarth debated with me and my noble friend Lord Winston in 1998 in the Grand Committee Room of another place, at a meeting organised by the Science and Technology Committee. We disagreed then about the advantages of carrying out therapeutic cloning. The right reverend and noble Lord said then that it would-I use his exact phrase-"be illicit" to use human embryos if alternatives exist. That has come out in the amendment tabled by the noble Earl, which is in some respect a paving amendment for the next group of amendments concerning the so-called Hunt test-the words that the Minister used in 2000 that if alternatives exist, it would not be right to use human embryos.
As an undercurrent to the debate in the Committee today, we have throughout been arguing whether those alternatives exist here and now. I cannot help thinking that when people come to read the Official Report of today's debate, many of them will wonder why we had this debate about what may well be just a footnote in history. My noble friend Lord Patel is right to say that huge advances are being made. He said that science is moving on at a dramatic pace and that those advances appear to be taking place mainly through the use of adult stem cells. My noble friend has claimed that there would eventually be a problem of cancer with induced pluripotent stem cells from Japan, despite the announcement made on Friday last. I hope that he would acknowledge that all human embryonic stem cells caused a specific type of tumour-indeed, that is how embryonic stem cell scientists find out whether they have isolated true embryonic stem cells.
Lord Patel: My noble friend is quite right but, just to be accurate, I think that he meant to say "adult cells", not "adult stem cells". It is adult cells that are being reprogrammed. He is quite right: we do not know that induced pluripotent stem cells that are embryonic-like stem cells will not behave in the same way.
Lord Alton of Liverpool: There is no difference between my noble friend and me on that point. Where there would be a difference is if we turn, for instance, to the use that stem cells can be put to. He may recall that just a few months ago, I hosted a meeting in the Moses Room and invited Professor Carlos Lima. He had been featured in a BBC television programme called "Miracle Cell". Interestingly, Professor Lima has said absolutely that he will never use an embryonic stem cell. My noble friend specifically mentioned spinal cord injuries. Professor Lima has been able to use olfactory cells from the nose in the spine. More than 100 patients have now been able to walk using crutches and aids. They are off their backs and no longer comatose. That is extraordinarily exciting. There can be agreement among all parts of
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your Lordships' House that where good science and good ethics march hand in hand, we should all get behind it. I interviewed Professor Lima when he was here and published that exchange in the HouseMagazine, in case any of your Lordships want to read more about that.
My noble friend Lord Walton referred to Professor Ian Wilmut. It is true that in 2001, it was Professor Wilmut who was demanding that we should allow therapeutic cloning to take place in this country, so that he would be able to continue with the kind of developments that had led to the cloning of Dolly the sheep. As we all know, Professor Wilmut has now abandoned those techniques because he does not believe that that is where the future lies. Although I am delighted to listen to what Professor Wilmut has to say through my noble friend, it has to be said that the advice that he gave your Lordships' House in 2001 about what he needed to do and what we needed to do to enable that progress has not turned out to be correct.
The noble Baroness, Lady Neuberger, was right to say that we should guard against the unnecessary stimulation of ovaries. I hope that I will have her support when we get to Amendment No. 62, which attempts to deal with that very question.
We are divided. I very much doubt that anything said in Committee today will change your Lordships' minds. Nevertheless, as other noble Lords have said-the noble Lord, Lord Jenkin of Roding, in particular-outside this place, there is huge public consternation among people who feel that we are going in an unnecessary direction.
Lord Jenkin of Roding: I did not say that.
Lord Alton of Liverpool: The noble Lord said that there was concern outside and that that concern had been expressed to the Joint Committee by distinguished people. He said that he did not agree with it, but that that concern was often well articulated and represented a perfectly reasonable point of view.
When we get to Report, I intend to test the opinion of your Lordships' House but, for today, I am willing not to press the amendments. I beg to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendment No. 6A not moved.]
Lord Alton of Liverpool moved Amendment No. 7:
Clause 4, page 4, line 18, at end insert-
"( ) A licence cannot be issued unless the criterion set out in paragraph 3(b) of Schedule 2 to this Act is satisfied."
The noble Lord said: In moving Amendment No. 7 and speaking to the amendments grouped with it, Amendments Nos. 44 and 46, I point out that the amendment should read-I have mentioned this to the Public Bill Office-"3(6)", not "3(b)". That is a minor point, because this is only a consequential amendment; the real issue is contained in Amendments Nos. 44 and 46.
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I return to an issue that I raised on Second Reading: what I then dubbed the Hunt test, which I hope will be incorporated into the granting of all licences. In the debate in your Lordships' House in 2001, the then Minister, the noble Lord, Lord Hunt, said that,
"the 1990 Act already provides the answer to the question of what happens if and when research into adult cells overtakes research using embryos: embryonic research would have to stop because the use of embryos would no longer be necessary for that research".-[Official Report, 22/1/01; col. 120.]
In another place, the Minister said in debate that the HFEA,
"must satisfy itself that there is no other way of doing the research, avoiding embryo use"-[Official Report, Commons, 19/12/00; col. 214.]
That point was alluded to by my noble and right reverend friend Lord Harris of Pentregarth in our previous debate.
Accordingly, I propose Amendments Nos. 44 and 46 to ensure that licences may be granted only when applicants can prove that no alternative is available and to encourage the best substantiated scientific research. They will also bring the Human Fertilisation and Embryology Act in line with paragraph 8(3) of the International Society for Stem Cell Research guidelines for human embryonic stem cell research, which states:
"The project proposal should include a discussion of alternative methods, and provide a rationale for employing the requested human materials, the proposed methodology and for performing the experiments in a human rather than an animal model system".
Although the noble Lord, Lord Darzi, has tried to offer assurances that current legislation and regulation are in accordance with the International Society for Stem Cell Research and the World Medical Association's declaration of Helsinki, I remain to be convinced that all is necessarily as it should be. Paragraph 11 of the declaration of Helsinki states:
"Medical research involving human subjects must conform to generally accepted scientific principles, be based on a thorough knowledge of the scientific literature, other relevant sources of information, and on adequate laboratory and, where appropriate, animal experimentation".
Can any Member of the Committee demonstrate how the shifting rationale underlying currently licensed human cloning research fits those criteria? By way of example, initially, Licence R0152 was stated to be for the treatment of diabetes, then for no particular disease, then again for the study of diabetes and now, apparently, for general transplantation purposes.
In a Written Answer, the noble Lord, Lord Triesman, asserted that somatic cell nuclear transfer,
"is considered to hold great promise for the development of patient-specific stem cell therapies, which may overcome the problems of immune rejection that would otherwise prove a barrier to the use of transplanted stem cells".-[Official Report, 12/11/07; col. WA 2.].
At present, there is understandable excitement about whether direct reprogramming of human skin cells might ultimately achieve the same goal, and particularly about the work of Professor Yamanaka in Japan. In June 2007, three publications heralded the successful creation of embryonic-like cells from
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adult stem cells. Within the past month, no fewer than three further publications have shown that the same approach is feasible in directly reprogramming human cells. It remains to be seen how much work might lead to specific therapies, but there are grounds for optimism as well as caution. By contrast, I was surprised to discover that no similar supporting references were provided in a reply to a subsequent Question for Written Answer in which I asked,
"which empirical studies in either humans or other species have conclusively demonstrated the benefits of human somatic cell nuclear transfer with regard to therapies that overcome the problems of immune rejection with patient-specific embryonic stem cells".-[Official Report, 26/11/07; col. WA 98.].
This question is especially pertinent when the research in question is now diverting £760,000 of public funding so that women might be persuaded to provide around 700 precious eggs that otherwise might be used for their own fertility treatment. If such research with human subjects requires financial inducements and the underlying rationale may not be unequivocally supported by scientific literature and prior animal experimentation, how does it accord with international standards? This is especially curious in the light of oral evidence given to the House of Commons Science and Technology Committee by the chief executive of the Medical Research Council on 5 February 2007, which was published as House of Commons Papers HC 272-l. He expressed doubt about support for the use of human oocytes for somatic nuclear transfer due to the virtually zero success rate. Bearing in mind the alternatives pursued in other countries, with which some of our leading scientists now hope to catch up, it seems fair to ask what could conceivably be accomplished with human cloning that could not possibly be achieved by other approaches. Perhaps the Minister will enlighten us and will say which other countries permit interspecies human embryos.
Forbes magazine, which is hardly interested in ethical objections, recommends that investors do not do what the British Government have done. It says that only dumb public money is going into embryonic stem cells. As yet, there are no therapies anywhere in the world that use embryonic stem cells. It is striking that a 2005 editorial in Nature Biotechnology, a magazine that was referred to during our earlier proceedings, says:
"Meanwhile forward steps continue to be made in the field of adult stem cell therapy. One estimate is that there are currently over 80 therapies and around 300 clinical trials under way using such cells".
I know that in 2001-
Lord Patten: I was not able to be here during the week when the Bill had its Second Reading, and this is my first intervention. I am very glad to have the opportunity to intervene, and I am grateful to the noble Lord for giving way. I have just come relatively hot-foot, by my standards, from the City of London where opinion seems to be exactly as the noble Lord sets out. At the moment, only the dumbest of dumb money is putting its resources behind such experimentation. The markets-I have chosen my moment carefully because the noble Baroness, Lady
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Thatcher, is not present-are not always right. I recognise that they can get it wrong, but at the moment they do not feel it is very sensible to put what is, alas, a diminishing amount of liquidity behind this research.
Lord Alton of Liverpool: I am grateful to the noble Lord, Lord Patten, for his intervention. He brings to our debates great expertise about the movements of attitudes in the City. I hope that at later stages he will be able to talk more about some of the economic as well as the ethical and scientific arguments.
Lord Winston: No commercial money went into the development of in vitro fertilisation, one of the technologies that have led to more than 1 million babies being produced. Unfortunately for Robert Edwards and Patrick Steptoe, they worked without any such investment. They could not get investment.
Lord Alton of Liverpool: I am grateful to the noble Lord for that intervention. There is a huge amount of altruism involved in these debates, and there is also vested interest. At Second Reading, the noble Lord, Lord Winston, rightly drew our attention to some of the charlatans who operate in this area.
As soon as laboratories were required to provide more justification for their requests to use animals in vivisection, repetitive duplication and the number of animals used were radically reduced. Is it so unreasonable to demand at least the same for human embryos? Can the Government truly say that it was necessary to destroy or experiment on 2 million human embryos? Even if they no longer believe that the human embryo has special status-perhaps the Minister will say whether they do-surely it should be necessary to demonstrate that no alternative exists. Amendments Nos. 44 and 46 would do that. I beg to move.
6.15 pm
Lord Alton of Liverpool: I am grateful to everyone who has participated in the debate this evening. I shall return to this issue on Report, because it is a fundamental question. I draw noble Lords' attention to paragraph (c) in my Amendment No. 46, which says,
"that the research specified in the licence cannot be achieved satisfactorily by any other reasonably practicable method not entailing the use of embryos or inter-species embryos".
That is the crux of the debate. If it is possible for my noble friends Lord Patel and Lord Walton, or the noble Lord, Lord Winston, to demonstrate satisfactorily to the Human Fertilisation and Embryology Authority that alternatives exist, they could proceed under the terms of the amendment.
The noble Lord, Lord Patel, reminded us of something that he said earlier when he questioned the work of Professor Yamanaka and the need for 20 vectors to expedite that work. However, compared with the more than 200 attempts that Professor Wilmut had to make to clone Dolly the sheep, that seems to be rather better and more effective. I said earlier that we should exercise caution as well as optimism. Importantly, extraordinary alternatives are emerging that do not need to use human embryos. This creates some middle ground in the debate, and I am sorry that more Members of the Committee have not attempted to stand on that middle ground.
I was struck by a comment by Professor Neil Scolding, who is professor of neuroscience at the University of Bristol at Frenchay Hospital, when he gave evidence to the Joint Committee and was asked what he thought was driving this determination to have interspecies embryos and to create more human embryos. I dispute the figure given by the Human Fertilisation and Embryology Authority. The figures that I have been using have been based on replies that I have been given in your Lordships' House about the numbers of embryos that have been destroyed or experimented on. That is the point-not the figure given by the noble Earl, which in turn was given to him by the Human Fertilisation and Embryology Authority. Professor Scolding's point was that mere
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curiosity is driving the debate, and we need to give some attention to it. If mere scientific curiosity, admirable though that may be, is really what is driving the debate, surely we have a duty to say that other factors must be held to account.
I was surprised to hear the noble Lord, Lord Patel, say that producing satisfactory results, which this amendment would require, is too high a hurdle. In the world in which I work and live, one is expected to give some evidence that the line of inquiry pursued, certainly where public resources are being used, should have to have some reasonable outcome in order to justify continuing with it. I shall return to this issue, but I have two other points to make before I conclude.
My noble friend Lord Walton of Detchant said that there would be no immunological reaction if the cells were transplanted into the patient. I refer him to an article in Methods in Enzymology, volume 260, in which it was discovered that mitochondria can cause an immune reaction. Would not the animal mitochondria that would be present in these cells therefore be likely to cause an even greater immune reaction? The noble Lord, Lord Winston, intervened on the issue of the hamster test and said, if I understood him correctly, that you do not need a licence for the hamster test if it is for treatment rather than for research. I do not understand this, and I hope that the Minister will-
Lord Walton of Detchant: I am not a biologist, but I am given to understand that if you have a sybarite embryo from which you create generations of stem cells that are subsequently reprogrammed, even if the nuclei have been inserted into an animal cell such as a rabbit cell, mitochondria are very fragile organelles, and it is likely that as those cell lines matured, the nuclei would continue to present their DNA in those cells but the mitochondrial genome would probably disappear. That is my understanding. I cannot prove it, but I believe that that is right.
Lord Alton of Liverpool: My noble friend may well be right, and if he is not a biologist I am certainly in no position to be able to say conclusively that he is right or wrong. However, I refer him to the paper by VM Dabhi and KF Lindahl, published in 1995 in Methods in Enzymology, volume 260, and entitled "Mitochondrial DNA-encoded histocompatibility antigens". It is precisely because there is difference between scientists that I passionately believe that regulatory authorities need to hear these arguments so that people better qualified than me can assess what is true and what is not.
Lord Patten: I am concerned that there is quite a statistical gap between the figure given by the noble Lord of the number of embryos destroyed, which was around 2 million, and the figure suggested by my noble friend Lord Howe on the Front Bench on information provided to him by the authority, which was about 80,000. I know that the Minister has been listening most carefully to this debate, and it occurred
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to me that the noble Lord might wish to ask him if we could have the facts and figures by the time we next debate this issue. I understand that they have come out in Parliamentary Answers given by the Minister's predecessors to the noble Lord, Lord Alton.
Lord Harries of Pentregarth: I-
Lord Alton of Liverpool: I understand that procedurally I have to give way to someone else before they can intervene. I am very happy to give way to the noble Lord, Lord Winston, and to my noble and right reverend friend after that.
Lord Winston: That is a curious piece of procedure. I think that the noble Lord, Lord Alton, was pointing out that a large number of embryos have been destroyed. He argues that the figure is possibly 2 million. I cannot contradict that. The noble Earl, Lord Howe, pointed out that 83,000 registered embryos have been used for research. However, in vitro fertilisation, as I pointed out, destroys a large number of embryos that cannot be used for fertility treatment. Sadly, they are not researched. It would be helpful if they were. I think it would be ethically justified-ethically a good thing-if we encouraged more research, but that is my personal opinion.
Lord Alton of Liverpool: I am grateful to the noble Lord, because that demonstrates that both figures are in the world of reality, although it is clear that what the HFEA is saying is entirely different from what I had already said to the Committee. I think that my noble and right reverend friend wanted to intervene, but in his absence perhaps the noble Lord, Lord Patel, will.
Lord Patel: I stand merely to comment on the statement made by my noble friend Lord Alton about mitochondria. Of course if might be possible to go further and remove the mitochondria in an interspecies embryo so that the embryo ends up being a nucleus of a somatic cell inserted into an animal egg from which the nucleus and the mitochondria are removed. You cannot of course remove the cytoplasm, because it would not divide.
Lord Alton of Liverpool: I understand that point, which demonstrates again the need for a body that can properly evaluate these issues before proceeding with further experimentation and research. That is why I will argue later in our proceedings for the appointment of an amicus curiae to the Human Fertilisation and Embryology Authority, whose job it would be to speak out on behalf of the human embryo precisely as local ethics committees do in relation to animal procedures. I will also argue that we need more balanced representation on the Human Fertilisation and Embryology Authority, and, as the noble Lord, Lord Brennan, argued earlier in our proceedings, that we should establish a national bioethics committee.
Before I conclude, I return to what the noble Lord, Lord Winston, said about the hamster test. When the
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Minister responds, perhaps he will be able to tell us the precise position. I am told that you need a licence to use the hamster test for treatment as well as for research. Paragraph 9(1)(f) of Schedule 2 to the Human Fertilisation and Embryology Act 1990 specifies that you need a licence for both research and treatment, so I wonder whether we could have clarification on that as the debate unfolds.
At this point, I beg leave to withdraw the amendment, to which I shall return on Report.
Amendment, by leave, withdrawn.
Human Fertilisation and Embryology Bill [HL]
8.42 pm
House again in Committee.
Lord Alton of Liverpool moved Amendment No. 21:
After Clause 4, insert the following new Clause-
"Reports to the Secretary of State
In section 7 of the 1990 Act (reports to the Secretary of State), after subsection (2) insert-
"(2A) A report prepared under this section shall include information on the resources used in-
(a) human embryonic stem cell research; and(b) adult stem cell research within the United Kingdom.""
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The noble Lord said: In moving Amendment No. 21, I shall also speak to Amendments Nos. 22, 23 and 62. Amendment No. 21 is in my name and that of the noble Baroness, Lady Williams of Crosby, who spoke at Second Reading and who is unavoidably absent overseas, taking part in a long-standing engagement.
The amendment would require the Human Fertilisation and Embryology Authority to report to the Secretary of State on the respective sums of money used in human embryonic stem cell research and adult stem cell research. It seeks to ensure that, as with the local ethical review process established in the case of animal experiments under the Animals (Scientific Procedures) Act 1986, an amicus curiae-in this case, someone to speak for the human embryo-would be appointed to the Human Fertilisation and Embryology Authority and would have a remit at least to challenge repetitive experimentation.
Amendment No. 23 seeks to disqualify from membership of the HFEA anyone who has a direct pecuniary interest in any of the activities governed by the Act. Amendment No. 62 seeks to establish clear record-keeping by the HFEA of ovarian stimulation, oocyte retrieval and hospitalisation.
Turning first to Amendment No. 21, it is ironic indeed that the moral justification, if it can be passed as such, for experiments on human embryos is the desire to keep Britain in the lead. This mistaken jingoism is a false patriotism at every level. While we have been diverted down the blind alley of embryonic stem cell research, the most breathtaking discoveries are being made by our competitors. Promises of a biotech El Dorado have proved illusionary, with vast sums of public money consumed in the process. How much better it would have been if those public resources have been used, as some of us have argued throughout, on the less ethically troubled pursuit of adult stem cell technologies. Amendment No. 21 seeks to require regular reportage of the respective sums of money allocated for the two approaches, a point eloquently made during the Second Reading debate by the noble Baroness.
Amendments Nos. 22 and 23 deal with the membership and the role of Human Fertilisation and Embryology Authority. There are currently 18 members of the HFEA. It has an interim chair, Walter Merricks, who was a founder member of Donor Conception Network. The chair is supposed to be a lay person and I would argue that to accord this status to Mr Merricks is stretching definitions-something about which we heard earlier in another context-beyond their intended sense. Eight other current members of the authority are working as medical or scientific professionals in the field of IVF or genetics. Apart from Mr Merricks there are two other members, Messrs Brown and Dundas, who are directly involved in patients' groups and lobbying. The other seven could generically be described as lay people, but some have publicly advocated embryonic experimentation and cloning. The academic lawyer, Emily Jackson, who has spoken out in favour of human reproductive cloning is an active participant in pro-choice abortion politics and this November delivered a speech at the London School of Economics entitled
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"Rejecting the sanctity principle and rethinking the wrongness of killing". Her perspective is contained in the title, which she argued passionately. David Archard is the token philosopher on the authority, holding entirely predictable views. The four others could be described as neutral in the absence of any information to the contrary. So, in effect, it is only possible to claim that, at the most, four of the 18 come at assisted reproduction and embryo research from a potentially neutral perspective.
I have never heard any indication of any member of the committee who has expressed serious reservations about anything which vast swathes of our population consider to be controversial at best and unethical at worst. Summing up this analysis, 11 of the 18 are involved, in one way or another, with fertility treatment and research; three others are outspoken in their position on research; leaving just four others-two with a financial background, one involved in childcare work and one ex-BBC-who could possibly be described as neutral.
As the Times reported only this morning, the Human Fertilisation and Embryology Authority, a point I put to my noble friend the right reverend Lord Harries of Pentregarth, is currently considering two licence applications from the Newcastle and King's Universities for the creation of interspecies embryos, called by them cytoplasmic hybrids, involving the cloning process, adult somatic cells and enucleated animal eggs. These applications are due to be ruled on on 5 December. Following a freedom of information request by Comment on Reproductive Ethics, it is acknowledged that the HFEA has never turned down a research licence application to the best of its knowledge. Will it grant these applications? As I asked my noble friend earlier today, what then is the purpose of the Bill which dedicates so much space to the permitted creation of interspecies embryos? It would appear that the HFEA has already assumed authority in this area of science.
So indifferent is the HFEA to widespread hostility to creating animal-human hybrids that they it has totally disregarded its own consultation which demonstrated that of more than 800 submissions, only one in eight supported the creation of hybrids. This not only ignores public consultation but it is dangerous to treat Parliament with apparent contempt to pre-empt deliberation in both Houses; it would make a total mockery of what passes as a democratic process.
This is not a new problem. In 1982 the then Government announced the terms of reference for what became known as the Warnock committee. On 18 November 1993, in a Radio 4 broadcast of the "Analysis" programme, my noble friend Lady Warnock gave an insightful response when asked how the membership of her committee was determined. I quote her directly from a transcript:
"There exists what is generally known as the Central List. The Central List is produced and combed for people who might have an interest in this kind of thing. I was then given a kind of draft list and asked whether there were any other people I thought would be obvious choices, maybe people who were not yet among the great and the good, and I was with some difficulty allowed a power of veto. There was one particular person who
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was supposed to be the Catholic, and I said I would not have him. I just knew that I couldn't work with him. We went right up to the day before publication with the civil servants saying, ‘But there's nobody else in the world'. So in the end, the night before publication, I said, ‘Well, will you please tell the Minister that it's a very, very bad way to embark on working on a committee when you know that there's somebody you're not going to find easy to work with'. The following morning two names were suggested. So I did win on that, but it was very, very hard and it took a lot of persistence".
Doubtless it would be much easier for us all if people we found it difficult to work with could be excluded from committees and public bodies. I have probably had that effect on some of your Lordships during today's proceedings. In 2002 Susie Leather, the chair of the HFEA, said:
"I don't think we need them"-
that is, people opposed to the use of human embryos-
"continually on the committee saying, ‘I'm opposed to all this'".
And the Joint Committee adumbrated a very telling new constitutional principle:
"those with such public views cannot administer the law to which they may be fundamentally opposed".
That simply is not true. Removing dissenting and questioning voices is a huge error. Many local ethical review committees-I sit on one-contain people opposed to animal experimentation, but they see their role as a questioning one, ensuring, at least in the context of the law as it stands, that the interests of the subject are not dismissed or neglected.
When I last looked, 70 per cent of the HFEA's income came in fees from the very clinics it is supposed to police-a case of the watchdog being far too closely identified with the burglar. Perhaps the Minister can tell us what the current figure is. Clearly that incestuous relationship makes it difficult to say no too often, or ever at all. My Amendments Nos. 22 and 23 seek to address those issues.
On Amendment No. 62, Her Majesty's Government have declined to follow the lead of their South Korean counterparts by restricting the type of human eggs that may be used in embryo research in order to protect women's health and welfare. Instead, appeal is made to an HFEA consultation undertaken in 2006 on the donation of eggs for research in which the publicly stated risks of side effects due to ovarian hyperstimulation-a point made today by the noble Baroness, Lady Neuberger-seems, curiously, to have been described as threefold lower than those indicated by the Royal College of Obstetricians and Gynaecologists in the same year. I refer your Lordships to two Written Answers, at cols. WA 99 on 23 October 2007 and WA 131 on 29 November, to Questions I tabled, as well as to the conflicting statements of the HFEA and the RCOG. The HFEA has said:
"Mild OHSS is relatively common (occurring in between 1-10% of treatment) and can be treated and controlled. Severe OHSS is rarer (occurring in around 1% of cases)".
The Royal College of Obstetricians and Gynaecologists, by contrast, says:
"Women should be informed that mild forms of OHSS are common, affecting up to 33% of in vitro fertilisation (IVF)
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cycles, and that 3-8% of IVF cycles are complicated by moderate or severe OHSS".
According to Written Answers by the Minister, the noble Lord, Lord Darzi of Denham, on 22 October, the Human Fertilisation and Embryology Authority appears to have incomplete records regarding ovarian hyperstimulation syndrome. This is not necessarily reported by clinics unless treatment was discontinued, and it does not hold data regarding how many in vitro fertilisation patients were at risk of hospitalisation after producing 20 or more eggs. Such appalling deficits would hopefully be rectified by the implementation of Amendment No. 62, which would lay on the HFEA a duty to keep records. Although clinics have to report OHSS if it causes an IVF cycle to be cancelled before egg collection for embryo transfer, they do not have to report all cases of women being hospitalised for OHSS. If women choose to continue with the cycle, risking their health, and end up in hospital, IVF clinics do not need to report it. The Royal College of Obstetricians and Gynaecologists, in its guidelines on the management of OHSS published in September 2006, called for auditable standards, including the percentage of women who were admitted to hospital with OHSS, the number of days as an in-patient and incidence of thrombosis.
The appalling degree of underreporting recently came to light when the journal, Human Fertility, reported in September that, in a four-year period of study, there were 53 incidents of women from an IVF clinic in Newcastle being hospitalised with OHSS, two of whom had life-threatening complications. However, the data held by the HFEA for the Newcastle clinic on the reported incidence of OHSS for six years during the same period show that only three cases of OHSS were reported to it.
Amendment No. 62 has an affinity with Amendment No. 24, in the name of my noble friend Lady Finlay, which also stresses the importance of record-keeping, in that case of IVF-success rates on the one hand, and risks of serious adverse side-effects on the other. I hope that the Committee and the Government will be convinced by the arguments for greater transparency and accountability. I beg to move.
Lord Alton of Liverpool: My Lords, I am grateful to the Minister for her reply, and especially for the fair wind she and the noble Baroness, Lady Barker, have given to the principles outlined in Amendment No. 21. If some way can be found to provide the information about the balance of resources allocated to the different kinds of stem cell technologies, everyone in the House would be better informed and grateful for that. I accept the earlier point of my noble friend Lord Patel, however, that this is not just about insisting on equity. It may well be that we should be insisting that a lot more money goes into adult stem cells if the case that I have been making all afternoon comes to pass. It is not about getting an artificial figure, but about having proper data.
On the argument about the make-up of the HFEA in my Amendments Nos. 22 and 23, my noble friend Lady Deech talked about the actress appointed to the committee. I do not know the views of the actress, but I think I know the views of both the rabbi and the bishop. My noble and right reverend friend Lord Harries will recall that, when he chaired the Select Committee of your Lordships' House that retrospectively looked at the orders we passed in 2001, 38 theologians from the reformed, Anglican, Orthodox and Catholic traditions, submitted a joint statement opposing the
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use of human embryos in cloning procedures. That appeared as a footnote to the final report, but not in the body of the report. Interestingly, one of those theologians is now the most reverend Primate the Archbishop of Canterbury.
No bishop and no rabbi who has ever spoken out against the use of human embryos has, for the reasons that my noble and right reverend friend described, ever been appointed to the HFEA. His argument was that it would be incompatible because of the contrary opinion that they would put and because that might place them in an unacceptable dilemma. I do not accept the basis of that argument.
Lord Harries of Pentregarth: I do not think that I used the word "incompatible"; I just said that it would be very difficult.
Lord Alton of Liverpool: I am grateful to my noble and right reverend friend for giving that slight nuance to the point. Nevertheless, even if it was very difficult, we should not rule it as outside the scope of the membership of the HFEA in future-the point made by the noble Lord, Lord Patten. If we are looking at future of appointments, it is not unreasonable to have members who do not themselves support the original premise on which an authority was established. Sometimes, by bringing informed arguments to the debate, they are able to convince people of the merits of looking again-especially at things such as repetitive use of human embryos, the very point that I enumerated as one of the key questions.
Lord Winston: The noble Lord mentions that no rabbi who is opposed to human embryo research has been appointed to the Human Fertilisation and Embryology Authority. As far as I am aware, there is no rabbi who is opposed to the use of embryos for research. Indeed, the London Beth Din, which is the authentic legal authority of the Jewish courts in this country, supported this research in quite strong terms-as I think that the noble Lord, Lord Alton, will remember-when, stem cells were discussed in the Select Committee.
Baroness Hollis of Heigham: I am sorry to intervene, but I have a real problem here about the issue of good faith and bad faith. It seems to me that if a body is set up by law, to seek to go on to it to undermine what it was set up to establish raises an issue of bad faith. Many years ago, I was asked as a local councillor to sit on the board of a girls' public day school trust. I said that I was committed to education, but that they should realise that I did not believe in fee-paying schools and I thought that, in that context, there was an issue of bad faith. They said, "Thank you very much. We think that, as a result, perhaps you should not sit on our board because you are at core opposed to the objectives of the organisation". They were honourable; I tried to be honourable; and that was that.
It seems to me a little odd to demand the right-when you have failed to win an argument in the parliamentary forum, which is the appropriate
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place for an array of voices to be heard-to sit on the administrative body to undermine that which Parliament has established because you do not believe in its core principles. That raises an issue of bad faith.
Lord Alton of Liverpool: I will come back to the point that the noble Baroness just made, but let me first deal with the intervention from the noble Lord, Lord Winston. I take him back to our very first debate in your Lordships' House-I instigated it on a Motion in 1998, I think. The then Chief Rabbi, Lord Jakobovits, who was a member of your Lordships' House, spoke strongly against the use of human embryos in cloning procedures. I will happily send a copy of his speech from that debate to the noble Lord, Lord Winston.
I do not think that one can say that every rabbi or every bishop shares the same opinion, but I believe, turning to the point made by the noble Baroness, that to exclude people who may take a contrary view is wrong. I told your Lordships that I serve on a local ethics committee connected with my university, looking at the animal procedures that take place there. I am very struck by the fact that, on that committee, there is one member who is opposed to vivisection. That does not compromise the way in which he participates in our debates. I like to hear what he has to say about repetitive use and duplication of use of animals. I am not always convinced by his arguments, but I think that those arguments are worth hearing. They are certainly not arguments of bad faith. To exclude people entirely from such committees because a parliamentary vote went one way or the other seems to me entirely wrong.
When we had the vote on human cloning in 2001, nearly a third of your Lordships voted against that proposition. The House was divided, but by a majority voted in favour of the 1990 legislation. A significant number of people have always been opposed to it. The precondition that my noble and right reverend friend Lord Harries put before the House that only someone with a passion should be appointed rather than someone who is neutral would mean that everybody who is appointed to the HFEA would be on the other side of the argument.
9.45 pm
Lord Patten: This point about passion is important, but would the noble Lord not agree that on this authority or some future authority that might be considering, say, licences to do with interspecies embryos, it might be quite useful to that authority's deliberations to have someone who is not passionate and who would say, "I recall the noble Lord, Lord Darzi, in his speech during the last group of amendments saying that a lot a very wise scientists are unable to define what one of these things is, so shouldn't we pause for a moment or two before we decide to license it or not"? That has nothing to do with passion or being anti-science; it is to do with the small, still voice of reason.
Lord Alton of Liverpool: I entirely agree with the point that the noble Lord, Lord Patten, has just made. People who come to these committees do not have to
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be passionate on one side of the argument, and I therefore disagree with the proposition of my noble and right reverend friend.
My noble friend Lady Deech said that the HFEA came out against sex selection. Indeed, the Bill prohibits it. I welcome that, but I think that she would also concur with what I said about the HFEA's public consultation about interspecies embryo experimentation. One in eight of the 800 responses to the consultation document was opposed, but that did not influence the HFEA's position.
Turning finally to Amendment No. 62-
Lord Elton: I think that I heard the word "finally" and I want to get in a question before the noble Lord withdraws from the field, if that is what he is going to do. The noble Lord, Lord Northbourne, raised an important point, and the noble Baroness, Lady Deech, said that it was an obvious point that had not been overlooked and that the interests of the child were written in to the law in every possible direction. Does that go beyond Section 13(5) of the 1990 Act? She spoke as if there was a great barrage of protection there. This is important, so perhaps the Minister or the noble Baroness could direct me to where else I should look.
Lord Alton of Liverpool: The Minister will want to return to that intervention by the noble Lord, Lord Elton. People from a child welfare background have been appointed to the HFEA; I welcome that, as I said in my opening remarks. I am not saying that everyone who has ever been appointed to the HFEA has a loaded, biased view that I find totally unacceptable. I am not saying that at all; in fact, my noble friend Lady Deech did a superb job during her time as chairman and was very objective and fair, even though I sometimes disagreed with the conclusions that the HFEA reached. I am arguing that the composition of the membership of the HFEA should be more balanced and that it should be more questioning of the way in which the law is being interpreted-in particular, about the tendency to pre-empt Parliament. To have a meeting of the HFEA this very week, between the sittings of this Committee of your Lordships' House, to determine applications on interspecies embryos will create a great deal of cynicism in the minds of the public, who wonder whether we have not allowed ourselves to become just a rubber stamp.
I say "finally" again-
Baroness Deech: Before my noble friend reaches a conclusion, I shall add, on the welfare of the child, that at the moment the authority is very concerned about multiple births, with all the adverse consequences that they have for the health of the children. It went very far-some said too far-in counselling of all sorts. It keeps a register of the names of donor fathers and spent a great deal of time debating the anonymity of donors and the effect that that would have on children. I could go on and on. This all springs from the statute.
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Lord Alton of Liverpool: I am grateful for that intervention. The Committee will be relieved to know that it brings me to end of what I want to say on this group of amendments. The noble Lord, Lord Winston, also touched on the importance of collecting data on other issues as well as OHSS. He said that we should have information about what happens to children born as a consequence of these procedures after their birth. On another occasion, I heard the noble Lord asking about the data that we have on children born after the freezing of human embryos and the incidence of disability arising from that. I agree that we should have that data. We need to know a lot more about all these things.
The noble Lord, Lord Patel, was right to say that patient safety and patient care should be the issues of which we take greatest consideration. Perhaps we could collect data on people who have been treated here and developed OHSS and who then go back to overseas destinations. At least we might invite them to provide self-reporting. That might be useful data to accumulate in the future. I see some of the practical difficulties that have been raised in that context.
This has been, as have the other debates that we have had today, an illuminating debate. Great expertise has been brought to the Committee. I hope that the Government will reflect on some of the points that
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have been made in the debate and that before Report it might be possible to reach some compromise and to move on some of these issues. In the mean time, I beg leave to withdraw the amendments.
Amendment, by leave, withdrawn.
Clause 5 agreed to.
Subject: Day Two committee Interventions HF and E Bill
Human Fertilisation and Embryology Bill [HL]
Committee resumed Tuesday December 4th
3.45 pm
Lord Alton of Liverpool: I, too, rise to support my noble friend Lady Finlay. I passionately believe that this area should be regulated inside the National Health Service. I thought the noble Lord, Lord Winston, made a very compelling case to us today and at Second Reading when he spoke about those who operate outside the NHS. He described some of their suspect practices and gave the impression that charlatans were operating, with some very bogus therapies being produced that were not helping patients who presented themselves. For those reasons, regulation within the National Health Service is a far better way for us to proceed than that which unravelled after the 1990 legislation.
I was struck when listening to my noble friend Lord Patel talk about the issues around twins. I hope that the Minister will accept his plea for more research to be done into those unknown causes of miscarriage . I know from our private conversations that my noble friend knows a huge amount about the subject. I hope that the House will listen carefully to him. My noble friend Lady Finlay quoted Dr Charles Kingsland earlier but she does not know, although my noble friend Lord Patel does, that 17 years ago, when the 1990 legislation was going through both Houses, my own wife miscarried a twin and Dr Kingsland was the doctor on duty that night. I have followed this issue carefully and it is one that we should spend more time trying to understand and diagnose.
We should also look more closely at the issue of prematurity. I recently chaired a meeting that was addressed by one of the leading authorities in the field, Professor Brind, who produced evidence that
4 Dec 2007 : Column 1620
where people have had a pregnancy end prematurely, there is subsequently a higher risk of prematurity leading to the very issues that the noble Lord, Lord Winston, described and the additional costs that arise from dealing with very early birth, some of which can bring disabilities with them. There are long-term issues there that we need to discuss.
I say to the noble Baroness, Lady Tonge, that there is no difference between us about people having the right to decide about the number of children they have, but it is worth pointing out that in OECD countries the population has been falling. If it were not for the very welcome arrival of Polish people and others in our country, our population would have been falling too.
The issue, surely, is one of poverty. My late mother came from the west of Ireland and, as everyone knows, in the 19th century before the Irish famine the population was 8 million but it fell to 4 million: 3 million emigrated and 1 million died. It is my passionate belief that, throughout the developing world, if we attack poverty we will see a normal reduction in family size.
I agree with many of the noble Baroness's other remarks and I hope that the Government will take these issues seriously.
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Baroness Warnock: I think that I am not alone in supposing that the extension of research into this field is agreed to and welcomed on the grounds that it will lead to therapeutic use. It seems odd, therefore, to suggest that an amendment which simply foresees it should be rejected. Whether there needs to be another regulatory body when it happens is a separate question which I hope could be settled under regulations. The idea of having to wait and go through new primary legislation, with all the endless discussion that that involves, when all that is being done is putting into practice something which we all hoped would happen all along and which was the purpose of the extension that was agreed in 2001, seems to be an unnecessary obstacle in the way of the use that we all hope that this research will have.
Lord Alton of Liverpool: Before my noble friend responds to the other inquiries that have been made of him, perhaps I may ask him whether it is intended that, within the scope of the amendment, interspecies embryos also would be used in therapies. Is it open to that interpretation?
Lord Patel: No, it is not.
Embryo testing:
Lord Alton of Liverpool: I raise a slightly different point but I agree with the remarks that have just been made. To change the emphasis, as this amendment would, from "the testing of embryos" to techniques and embryo storage puts it the wrong way round. It takes the emphasis away from the human embryo and puts it on techniques. I would be unhappy about such a change for that reason. However, the noble Baroness raised an important point about embryo storage. What is the department doing to monitor the effects of long-term storage? Is there any empirical evidence, as has been suggested by some outside this place, that that can lead in turn to impairment and disability later?
Testing for characteristics
5.30 pm
Lord Alton of Liverpool: I hope that we will think carefully before making this change. I am certain that it is not the intention of the noble Baroness or that of her noble friend who tabled the amendment to widen this debate to the area of characteristic selection, but I worry that if we change the words in the Bill, that is how it could be misrepresented outside your Lordships' House. I am glad that the Bill unequivocally prohibits sex selection. We are absolutely right to do that. We have to guard against the mentality that can sometimes lead to wanting designer babies.
A very good new book, Everything Conceivable: How Assisted Reproduction is Changing Men, Women and the World, which the Librarian in your Lordships' House made available to me, has just been published in America. Interestingly, it was written by a feminist, and I would not necessarily share all her conclusions; but she says that what she calls "yuppie eugenics" can lead to all sorts of pressures when people are tested. I fully accept that this is more likely to happen in the United States than here, but we should always guard against these things. In the book, she says, for instance, that one couple argue about what height their egg donor should be. Another provides a score list, based on looks, education, IQ and sporting interest. Clearly, none of these are abnormalities but are characteristics. I hope that the Minister will tell us whether, if we were to change the words in the Bill, it might be open to that interpretation.
5.45 pm
Lord Alton of Liverpool moved Amendment No. 32:
Schedule 2, page 55, leave out lines 27 to 34
The noble Lord said: There is a typographical error in Amendment No. 39. It says "Page 56, line 3" but should read "Page 56, line 30".
The cumulative effect of Amendments Nos. 32, 32A, 33, 34, 39, 40 and 41 would be to block tissue typing for the purposes of selecting an embryo that is an immune match to an existing child, to prevent children being used for organ donation after tissue typing for any purpose, to prevent the law being extended to allow children to be created to be organ and tissue donors, to limit the circumstances in which the creation of children as organ donors can take place, and to make the creation of children as organ donors a procedure of last resort.
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I was struck by the prescience and acuity of a comment in the 25 August edition of New Scientist. It is worth listening to an extract from the article in question:
"It is excellent news that parents in the UK will probably be allowed to have sibling saviours to save children with ‘serious' rather than merely life-threatening diseases ... Perhaps legislators should now seize the opportunity not only to permit this far-sighted approach, but also to solve the donor organ crisis.
It should be possible to ensure that all children born to a couple are immunologically compatible so that, were one of the family to suffer a catastrophic organ failure, siblings would be on hand to provide another. Naturally, the elected saviour sibling would be required to provide the organ, although since the issue of consent does not arise with saviours at present, there is no need to suppose that this will be a problem in the future.
The scheme would, of course, work best for kidneys, as the saviours could rely on their spare to see them through; half a liver could also be donated without too much worry. A heart and/or lungs would be trickier, but it does not stretch the imagination to suppose that our brave scientists and legislators will be able to see a way around this inconvenience".
Let us first dispose of the casuistry that saviour siblings are donors. There is clearly something of a contradiction in using the word "donor", as a donor has to give consent, and that is manifestly impossible in what is proposed. Personal organ donation is often a generous and altruistic act, and many Members of your Lordships' House will carry donor cards, but it is always an act freely entered into. It is an act of autonomy and personal choice but clearly a baby or a young child does not have any say in this momentous decision. Furthermore, reducing the present hurdle for permitting such an extraordinary presumption from "life-threatening" to "serious" conditions-which, as we know in another context, may mean a cleft palate or webbed fingers-should not be allowed to happen without deep and fundamental debate.
The Bill proposes that an embryo can be tested to see whether it is an immune match for an existing sibling if the existing child suffers from a serious medical condition which can be treated by,
"umbilical cord blood stem cells, bone marrow or other tissue of any resulting child".
On 21 November, I asked the noble Lord, Lord Darzi, what the words "or other tissue" meant. He left the House in no doubt that it included organs, including organs from non-consenting children who are too young to give consent. He stated:
"The Bill does not limit which tissue can be used in the treatment of a sibling ... and the Human Tissue Authority must approve any transplants involving organs from living donors and for children who are too young to give consent".-[Official Report, 21/11/07; col. 869.]
Therefore, if the embryo is found to be an immune match, it will be implanted deliberately to become a source of spare parts for an existing child-its sibling-even when it is too young to give consent.
My Amendment No. 32 goes to the heart of this matter. Many of your Lordships may not be too unhappy about permitting a child to be created to provide tissue from the umbilical cord, but the difficulty is that, once an embryo is tissue-typed and is known to be an immune match for an existing child, it will be available to provide any tissue or organ after birth, even if ostensibly it had been created only to
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provide umbilical cord blood. I shall say more about this later but I am proposing Amendment No. 32 in order to bring about a complete ban on tissue typing to produce a saviour sibling.
Amendment No. 32A deals with the issue of life-threatening conditions. The Bill proposes that a saviour sibling can be created to provide tissue and organs for diseases in an existing child that are not even life-threatening but merely serious. When the Minister was asked why the Government have changed the criterion from "life-threatening" to "serious", he replied:
"The pre-legislative scrutiny committee recommended that the Bill should not be limited to life-threatening conditions but should also include serious conditions".-[Official Report, 21/11/07; col. 869.]
As I said at Second Reading, autism has already been suggested by the chairman of the Joint Committee scrutinising the Bill as one of the disorders for which a saviour sibling could be treated to provide tissue. In an interview with the Daily Telegraph, he said that saviour siblings cannot currently be used to help children with autism but it was an example of the kind of serious condition that the committee believed should be tackled by the technique. It is hard to see what kind of tissue could help to overcome autism. However, if a child could be created to help with autism in an existing child, what else could be classified as serious? That is why I am proposing Amendment No. 32A.
In Amendments Nos. 33 and 34 I propose that saviour siblings may be created only to obtain umbilical cord blood and that the disease that these stem cells can be proposed to treat has to be capable of being treated effectively by umbilical cord blood. As the Bill stands, the term "treated by umbilical cord blood" is very open to interpretation. It would seem not to matter how effectively the cord blood, or indeed any tissue or organ, could help the existing sibling. As the Bill stands, even if there was only a small chance of success in treating the disease, the saviour sibling could be created. That also raises the issue that if a child is created ostensibly only for umbilical cord blood and if the umbilical cord blood was not effective in treating the disease, subsequently any tissue or organ could be used to treat the existing child to see whether that would be more effective. It would be known that the child was an immune match for the existing sibling, as it had undergone deliberate tissue typing as an embryo to ensure that it was an immune match. Therefore any tissue or organ would be compatible. Thus to those of your Lordships who are concerned about the use of any tissue other than umbilical cord blood, both limiting tissue typing of saviour siblings to obtain umbilical cord blood, and inserting the phrase "treated effectively", should ensure that taking other tissues or organs after birth need not occur.
Amendment No. 40 would permit a saviour sibling to be made only if there is no alternative treatment available, including umbilical cord blood from other donors. Amendment No. 41 deals with offences relating to harming saviour siblings, or taking tissue from them. The first paragraph of Amendment No. 41 proposes that it would be a criminal offence to take organs or bone marrow from a saviour sibling, or to subject it to any intrusive medical procedure in order
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to treat the existing child. Sub-paragraph (5) in Amendment No. 41 proposes that it would be a criminal offence to take organs from a saviour sibling, while permitting the taking of bone marrow. Sub-paragraph (6) of Amendment No. 41 proposes that it would be a criminal offence to cause harm to a child through any intrusive medical intervention in order to treat the existing child.
Such amendments are necessary to avoid a saviour sibling being created ostensibly for umbilical cord blood, or for cord blood and bone marrow, but then used for organs or other tissues after birth. Using other organs would be possible if there are no safeguards in place, since it would have been implanted, following tissue typing, to be an immune match. I emphasise that this is not similar to using organs from a child created normally, or by IVF, without tissue typing. Saviour siblings are the result of deliberate intervention, involving an optional stage of tissue typing following IVF, to create a child to be a tissue or even organ donor for an existing child. The saviour sibling's entire existence would be lived with the sentence of knowing that it had been created to be a tissue or organ donor.
As this Bill is currently drafted, we are being asked to legislate in favour of the creation of embryos whose tissue type is a match for a sick sibling. The intention is to carry such embryos through pregnancy in order to harvest the cord blood or bone marrow or other tissues-perhaps a liver or kidney; who knows?-later on in an attempt to cure the child already in existence.
Any parent who has had a sick child-most of us in this House will have been in that position at some time-and certainly any parent caring for a seriously ill child will understandably search desperately for cures, and nothing is more likely to evoke compassion in the hearts of the nation than a plea for help from such parents. We do have a duty as a caring society to offer the services of the very best medicine, and to continue the search for new and successful cures. Medicine, however, cannot function in a moral vacuum and many ethical considerations need to be taken on board, even when dealing with relatively simple issues, let alone a dilemma as complex as this one.
At first instance, this may well seem an heroic solution, an acceptable way to cure a seriously ill child. On the other hand, we may have a gut feeling that something is not right about this procedure. Gut feelings are absolutely valid and often represent the greatest wisdom. Our compassion for the welfare of existing sick children does not legitimise a trade off with our legal responsibilities for the welfare of children, including those created by assisted reproduction. There is no reason why criminal law prohibitions on battery or abusive behaviour towards children should not apply as much to children created by IVF as to everybody else. In the current legal realm, how could any invasive medical intervention performed on a child not for its own benefit, when it could not possibly give consent, not be argued in law to be an assault against the bodily integrity and right to autonomy of that innocent child?
No child should be created specifically for the benefit of a third party, no matter how pressing the anguish of the parents. That is the absolute principle at stake
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here, but it must also be added that the therapeutic benefits of creating tissue-matching babies have been inaccurately portrayed to the public as an easy procedure with guaranteed success. It is also usually argued that this is the only, or ideal, therapeutic route. In reality, the chances of the matching baby being created successfully are limited. IVF has a low success rate. Pregnancies do not always go to term. There is no guarantee, even in the case simply of cord blood, that there will be sufficient blood harvested, or that any subsequent transplant will be successful.
The medical team awaiting the birth of a tissue-matching child to provide therapy is placed in an unenviable position, with a significant risk that best practice in pregnancy may be hijacked by the interests of the sick sibling. Worsening of the sick child could inspire thoughts of provoking a premature delivery. Such a response has already been recorded. What if the cord is around the neck of the new baby and needs to be sacrificed in the interests of good obstetric practice? Another reality is that, in order to create the matching baby, many unwanted embryos will be discarded in the process, including those diagnosed as carrying genetic disease and those who are disease-free. It is very much a hit or miss technology and it is criticised for some of the eugenics practices associated with embryo selection in the first place.
And what happens if the donation is not successful or-a rare but real likelihood-if the donation itself causes the death of the recipient, or the recipient dies anyway? Sadly, even when the tissue matches come from uncontentious sources-cord blood banks, unrelated donors and so on-the recipient is not always cured. What burden will that place on the designed baby? It is often recorded that children feel an irrational responsibility for the death of their parents or siblings. The psychological burden put on a tissue-matching child must not be dismissed in a rose-coloured enthusiasm for the benefits that might accrue to a third party. When the Minister replies, perhaps she will say what research has been done on the psychological impact of being a saviour sibling.
Are there any other ways to provide the cures in question? Thankfully, yes, and there is a middle ground here, to which the Committee should give deep and serious consideration, especially between now and Report. The lottery of trying to design a saviour sibling is a lengthy and unreliable process at best, making it immensely impractical and never likely to be universally practised. Instead, we should explore less controversial routes to the desired cures and in particular, we should support the collection of stem cells from cord blood and invest seriously in this non-controversial and exciting source of transplant material.
Colin McGuckin, the professor of regenerative medicine at Newcastle University, in evidence submitted to the Joint Committee on the Human Tissue and Embryos (Draft) Bill, said:
"Cord blood stem cells, which we specialise in, already treat 85 clinical diseases".
But it was said in a meeting that I organised in the Moses Room of your Lordships' House by Dr Peter Hollands, a senior scientist specialising in this area, that 98 per cent of cord blood produced in this country
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is routinely destroyed. There are, I understand-no doubt the Minister will correct me if I am wrong-only four NHS facilities in this country at the moment that do that collection. Contrast that with the situation in the United States. If we were to store the cord blood from every baby born in this country, we would have a bank of stem cells of infinite value, and if this was practised internationally on the largest possible scale, the therapeutic potential would be extraordinary.
Lord Walton of Detchant: I interrupt my noble friend for one moment to say that there is now a major project under way, funded by the Wellcome Trust and the Medical Research Council and others, to produce a cord blood bank in the United Kingdom, which I think will be immensely valuable.
Lord Alton of Liverpool: I am very grateful for the intervention of my noble friend. I know that he has been personally involved in that project and I am delighted that it is under way. That is a very worthwhile step forward. Nevertheless, I think he would accept that at the moment, for us to destroy 98 per cent of cord blood, and to have only four NHS facilities routinely collecting it, is not a satisfactory situation.
It takes a speedy 24 hours to send cord blood stem cell transplant material from one country to another. That is the right way forward-not the unethical practice of designing babies as tissue donors. I beg to move.
The Deputy Chairman of Committees (Lord Brougham and Vaux): I advise the Committee that if this amendment is agreed to, I am unable to call Amendments No. 32A to 35 inclusive, or Amendments Nos. 39 to 41.
6 pm
Earl Howe: The noble Lord, Lord Alton has set out a range of concerns about these provisions. While I cannot support him on all of them, I join him in expressing a considerable degree of worry about the idea of using a saviour sibling as a source of organs for transplantation. That is the subject of Amendment No. 35.
Lord Alton of Liverpool: The Minister has done real justice to this. Along with the noble Earl, I welcome her assurance that she will look again at the issue of organs and that she will be willing to discuss some of the other anxieties and concerns that Members from all parts of your Lordships' House have raised in Committee today.
The noble Lord, Lord Jenkin of Roding, was right when he said that after scrutiny has taken place and the Joint Committees have had their deliberations, of course people in this House can change their minds on Report as they come to see in the full light of day precisely what we are being required to do. Those who sometimes talk about moving to a unicameral legislature, and would like to see the abolition of your Lordships' House, ought to see the record of yesterday's and today's parliamentary debates to see the quality of the contributions from all sides of this argument. I welcome every contribution that has been made today. This debate more than justifies the existence of this House.
I reassure the Minister that the article from New Scientist was meant to be cryptic. It was actually pointed at the provisions we are allowing for in the Bill, rather than advocating them.
Two issues have been raised during the debate. The first is the question of "serious" rather than "life-threatening". The noble and learned Lords, Lord Lloyd of Berwick and Lord Mackay of Clashfern, have two of the finest legal minds in the country and I hope that between now and Report they will have the chance to give further consideration to this. It may well be that provisions around the wardships of court, which have previously prevailed, should apply in all circumstances. Maybe that is the route we will have to go, rather than looking at whether we use "serious" or "life-threatening". We should consider other options for dealing with these questions when they arise.
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None of us wants this to become routine-that seemed to be a theme that united us. The right reverend Prelate the Bishop of Winchester said we should not go towards a society that becomes deliberately instrumentalised. I agree entirely.
The noble Baroness, Lady Tonge, raised the issue of "serious" and wondered what the problem was for people like me in the interpretation of that word. During my opening remarks I tried to allude to one instance that is a good parallel here. She will know the case of the Reverend Joanna Jepson, a young woman who challenged the law because, on reading the statistics for late abortions, she discovered that cleft palate, club foot, hare-lip, webbed fingers and webbed feet were being included in the "serious" category for abortion of a child. Clearly none of those by itself is a life-threatening disease. That is an issue my noble friend Lady Masham raised at Second Reading. It goes to the heart of how we interpret things. Therefore, we have to be careful before we change a phrase, such as from "life-threatening" to "serious", that sends a signal, intentionally or not, that somehow we want to lower the threshold of the requirement.
The other issue that has been raised is whether other tissues should be included in the scope of the Bill. I refer to some comments by Dr Simon Fishel, a senior IVF expert and an inspector, peer reviewer and external adviser for the HFEA who has already created saviour siblings to obtain umbilical cord blood, and who is the managing director of CARE Fertility Group, the United Kingdom's largest independent provider of assisted conceptions. He welcomed the new legislation and predicted, in an article entitled "Secret ruling on ‘designer babies'" by Mark Henderson in the Times, that saviour siblings would be used in future to provide organs such as kidneys to treat existing children.
"You might start looking at organs",
he has said.
There are therefore IVF experts who would take into consideration the effect on the planned child, as specified in the seventh code of practice, and would consider it a good idea to create a child to be a kidney donor. I do not believe that is the intention of the Committee, and I hope we will be able to make progress between now and Report in dealing with that matter.
I am grateful to everyone who has contributed to the debate today. We have covered some very controversial, difficult and profoundly testing issues. In the spirit of the answer the Minister has given, I am more than content to withdraw the amendment at this stage and hope it will not be necessary to test the opinion of the House on Report. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendments Nos. 32A to 48 not moved.]
Human Fertilisation and Embryology Bill [HL]
3.12 pm December 10th 2007
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My Lords, I beg to move that the House do now again resolve itself into Committee on this Bill.
Moved accordingly, and, on Question, Motion agreed to.
House in Committee accordingly.
[The LORD SPEAKER in the Chair.]
Lord Alton of Liverpool: My noble friend Lord Patel has just said that there should be the strictest safeguards. He has also said that we should not proceed to incorporate these amendments as a light undertaking. He has recognised the seriousness of what is proposed in these amendments. Like him, we all want to see cures for the sorts of diseases that he has just enumerated. However, the Committee also needs to consider whether this is the right way to do it.
These amendments in the name of my noble friend would overturn most of the current prohibitions and would enable gametes and cells of non-consenting children to be removed from their bodies and used to make interspecies embryos or human embryos for research. Proposed new paragraph 12A(1) would permit all types of hybrids specified in new Section 4A of the 1990 Act to be made from these children's gametes, including true hybrids at new Section 4A(5)(a), interspecies cloned embryos at new Section 4A(5)(b), human animal transgenic embryos at new Section 4A(5)(c), animal human chimeric embryos at new Section 4A(5)(d), and such other things as may be specified in regulations at new Section 4A(5)(e). It would also permit human embryos, including cloned human embryos, to be made from their gametes and cells. These could be made from the gametes and cells of non-consenting children for research, using them in combination with human or animal eggs. These interspecies or human embryos could also be stored and used without consent. That is the issue on which my noble friend and I will part company. It raises a number of objections on which the Committee will want to reflect.
For instance, later in life, a non-consenting child might feel considerable antagonism that their gametes and cells were taken and used to create interspecies embryos without consent. Whatever the benefits that may be cited, where is the principle of autonomy that is so frequently cited in other debates in your Lordships' House? I can imagine the anger of a young adult who felt that their very personhood had been violated and sacrificed to a supposed greater scientific good. For example, how would a teenage girl feel if a true hybrid had been made between her eggs and animal sperm? Alluring scientific possibilities should never be allowed to corrode our sensibilities.
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Seeking Patients' Consent: The Ethical Considerations, produced by the General Medical Council, describes how a young person can be treated as an adult and can be presumed to have capacity to decide at 16. My noble friend referred to that. Therefore, one must assume that Amendments Nos. 50 and 54 are intended to exploit the potential inability of young children under 16 years of age to provide informed consent. The same document provided by the GMC also states:
"Where a child under 16 years old is not competent to give or withhold their informed consent, a person with parental responsibility may authorise investigations or treatments which are in the child's best interests".
On the basis of existing empirical evidence, how can the creation of an interspecies embryo necessarily be stated to be in the best interests of a non-consenting child? Let us not forget that the purpose of these amendments is restricted solely to research rather than to clinical treatments that have already proven their worth and might be used in the interests of the child. My noble friend Lord Patel stated in our debate on 3 December how producing satisfactory results was too high a hurdle. He made those comments on Amendments Nos. 7, 44 and 46. My amendment said that,
"the research method proposed is most likely to produce satisfactory results".
My noble friend said:
"That is too high a standard for any research project".-[Official Report, 3/12/07; col. 1544.]
Again, that opens a clear difference between my noble friend and I on those previous amendments, as well as this one.
This amendment would allow human embryos to be made using gametes or cells from a child without their consent. How would the non-consenting child feel in later life once they realised that they were made a mother or father at an age too young to give consent, even if the embryo was destroyed by 14 days? Not many of us would want to know that our gametes had been taken, without our having any understanding of it, to make interspecies embryos or human embryos on our behalf and without our consent. No one has the right to take that decision on behalf of others. I feel that this is going too far.
There are echoes here also of an application made more than a decade ago by an Edinburgh scientist, Roger Gosden, who sought permission from the HFEA to use the eggs of aborted baby girls for fertility treatments. The HFEA did not demur. It embarked on a public consultation on whether a little girl would be aborted and then robbed of her eggs from her ovaries. A woman is at her most fertile at 20 weeks' gestation, when she has 5 million eggs in her womb, 4 million of which are shed naturally before birth. An aborted girl could be seen as a rich source of organs and tissues.
You can face a prison sentence for stealing the eggs of certain rare birds in Britain. Are birds to have greater protection in law than children when it comes to taking their gametes?
The noble Baroness, Lady Knight of Collingtree, and I tabled an amendment in another place to a criminal justice bill and successfully outlawed what I described as contemporary grave robbery. That a
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child should have an aborted foetus as its mother, and the aborted girl's mother as its grandmother, struck many members of the House of Commons as obscene and certainly not an auspicious start to life. However, the Human Fertilisation and Embryology Authority had a public consultation over that issue. These amendments do not seek to create life beyond 14 days and, in that sense, are obviously different from the proposal that had been placed before the HFEA by Roger Gosden-but we should not seek to create life in that manner at all.
Obtaining gametes, especially from a girl, is not like giving blood. The procedure needs to be spelt out in full and any attendant risk, present or future, should be made clear to your Lordships while we debate the matter. I hope that the Minister, when he comes to reply, will tell the Committee very clearly how exactly one would get the gametes from these infants and children, especially how one would obtain eggs or ovarian tissue from a teenage girl of reproductive age. That should be described in ordinary, everyday language so all of us can understand what the procedure would be. Furthermore, would the procedure involve a general anaesthetic, and would that involve a risk? Would there be any risk to the girl during any of the surgical procedures? My noble friend said on Amendment No. 62:
"I should like to see a greater degree of patient safety being promoted in all aspects of medicine",-[Official Report, 3/12/07; col. 1592.]
and I entirely agree with him. We need clarification on that point. The noble Lord, Lord Winston, will speak next, I think, and help to illuminate our proceedings. I want to know whether we can guarantee that there will be no possible risk of future damage to the child's own reproductive system.
On a related subject, I ask the Minister whether there is an error in new paragraph 9 in Schedule 3, in line 12 of page 63 and line 2 of page 64. Can he explain the relevance of "donor" with reference to "child donor" in that paragraph? Is that paragraph specifically related to the storage of gametes of children who may be ill or undergoing some medical procedure, such as chemotherapy, that may render them infertile, with the intention of storing their gametes to enable them to have their own genetic children later in life? That would seem perfectly reasonable. Is the purpose broader, to include donation as implied by "child donor", and if so can these other purposes be explained? Is "donor" intended to mean "patient", in which case could that be rectified, otherwise the meaning of the term could be considerably expanded in practice? If the word is intended to mean "donor", does that mean that the child is intended to be an egg or sperm donor for somebody else's fertility treatment, or to provide eggs or sperm for research without their consent?
Finally, let me return to an issue raised earlier in our Committee. Why exactly do we need to do these things? We create embryos under any number of guises when alternatives exist. Yet, even if there were no alternatives, to create interspecies embryos from non-consenting children is going too far.
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Only last week, Bob Edwards of Louise Brown fame commented at the end of the HFEA annual review about the need for welfare of the child to be the priority. In passing, he questioned the wisdom of the HFEA being involved in sanctioning the creation of hybrids.
Doubt was cast earlier on the figure I cited of 2 million human embryos destroyed or experimented on since the passage of the 1990 Act. A lesser figure of 82,955 was mentioned, but that is in connection with the number of embryos donated for research. The figures are in a parliamentary reply given to me on 28 June by the noble Lord, Lord Hunt of Kings Heath, at col. WA 159. The number of embryos created involving fresh, non-frozen embryos is 1,940,576, with just 3.4 per cent resulting in live births from a total of 66,715 treatment cycles. Since 1991, 76,462 embryos have been created in treatments involving frozen embryos, with 13 per cent resulting in live births from 10,040 treatment cycles. Therefore, more than 2 million embryos have been destroyed or experimented on since 1990.
I also asked why no data were held on embryos created using cell nuclear replacement or therapeutic cloning. The Minister replied that the HFEA,
"does not routinely collect data on the number of embryos created using cell nuclear replacement",-[Official Report, 28/6/07; col. WA 159.]
technology. Such data are kept by the local research project. Surely they should be made available to the HFEA and Parliament.
If Amendments Nos. 50 and 54 were agreed to, would we collect data on the gametes and cells taken from non-consenting children or would that, too, become so routine that we would not feel the need to do it? I hope that the Committee will not incorporate these amendments into the Bill.
3.30 pm
Baroness Carnegy of Lour: I have not joined in the proceedings before. I missed Second Reading but I have listened to the whole of the Committee stage so far. The main part of the argument of the noble Lord, Lord Alton, was that he wondered what a child would think when it grew a little older and was told by its
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parents that its body had been used for this purpose. Most young people are extremely idealistic. If a parent said to a child, "We were asked whether cells from your body could be used to save other children from dreadful diseases and I gave permission for that. I don't know whether you succeeded in your help, but perhaps some progress has been made", I would have thought that that child would be absolutely thrilled to have been able to help.
I am sorry that the church-part of the church, anyway-is being so depressing about the possibilities before us. As a church person myself I find it sad. I appreciate what the noble Lord is doing-he does it beautifully and with huge integrity, and I admire him for it-but I am sad about it and it is the church that is doing this. I am not talking about all the other issues because I am not sure that I fully understand them all, but on his point about what the child would think when told by its parent that it had helped in this way, I think he is wrong.
Lord Alton of Liverpool: I am grateful to the noble Baroness for raising that issue. First, I do not speak for the church or indeed put forward views held by the church. The church is quite capable of doing that on its own behalf. I put forward my own views. I have argued for probably 40 years for the sanctity of human life from the womb to the tomb and I will go on arguing that proposition. I am extremely grateful to the noble Baroness for the way in which she couched her remarks.
I spoke to these amendments because I want to shed light on whether gametes or cells are involved. The noble Lord will no doubt give us further illumination when he comes to describe what is actually in the amendments and what dangers there might be for the young woman from whom these gametes might be taken. That seems a perfectly proper question to ask in the context of this issue and to raise again the issue of consent and what precisely is meant by "donor". The noble Lord, Lord Patten, is right to ask about that; the point was raised in our debate last week about so-called saviour siblings and will be raised in other contexts as the Bill proceeds.
All of us need to think very carefully about what we do on behalf of others, even when parents give consent. I agree with the noble Lord, Lord Winston. I was in the position 18 years ago when my own daughter had a congenital hip displacement, of having to gave consent for general anaesthetics and for operations to be carried out, which were very painful and difficult. I am glad to say that, thanks to the skills of the doctors in