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I welcome the periodic review by Parliament of this area of the law. I note that in the Bill there is confirmation in every respect of decisions taken by the authority. All the scientific provisions in the Bill, which I regard as excellent, confirm decisions already taken by the authority. There is evident respect for the way in which the authority has approached its job and I hope that noble Lords are pleased that the HFEA is not to be amalgamated with another body.
It is where the Bill crosses over into the organisation of family life that I have more concerns. There is a risk in the unfolding of IVF and the consequent science that our humanity and the respective roles of men and women are ignored. It would be extraordinary if this House were to ignore the contribution made by half of
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There would be fewer concerns if the NHS provided more IVF and if such provision as there is were spread more evenly across the country. It is important to note that the public do not take IVF for granted. Treatment rolls on into new areas and blurs into research. I hope that the House will resist the siren voices that say that IVF has become commonplace and there is no need to regulate it. Clause 7 requires regulation to be proportionate. However, I should tell your Lordships that, speaking from experience, the pressure from politics and the media are such that, whenever a relatively small but unavoidable human error occursfor example, a lost embryothere is a hue and cry and a call for more regulation, and it would be wise to err on the side of safety. Furthermore, private doctors in this field are among the wealthiest clinicians in the country. It is of course in their interests to ensure that, by using many embryos, the woman becomes pregnant, but the costs of multiple births fall on the National Health Service. This is unfair and I look forward to the day when no more than one embryo at a time may be used.
In this field, the law is paramount but we should not forget the need for moneyproper resources to enforce, to register and to fight casesbecause all the time judicial review is being used to challenge interpretations, no matter how watertight the definitions may seem. Then of course there are ethics. The authority has indeed worked out ethical principles: autonomy, safety, welfare, respect for the embryo and the saving of life.
In the scientific field, the Bill confirms the wider use of pre-implantation genetic diagnosis. That is good. I hope that your Lordships will be pleased that the deliberate choice of an embryo that is, for example, likely to be deaf will be prevented by Clause 14. The Bill confirms saviour siblings, no selection of sex for social reasons, and extended purposes for research in embryology, first allowed in the 2001 regulations. That research, once legitimated, put the UK at the forefront of world stem cell research. Interspecies embryos will be legitimated and I think that that is right. The Bill reaffirms the importance of consent. There is to be no use of gametes taken from comatose or dead persons without their prior consent, as set out in paragraphs 5, 9 and 10 of Schedule 3. I also welcome the cooling-off period of one year when consent is withdrawn to avoid further sad cases such as that of Natallie Evans, which went to the European Court of Human Rights.
However, I feel that I should take issue with two clauses. Clause 14 would omit a childs need for a father as a consideration in the assessment of welfare that has to be carried out by the doctor proposing to treat a woman. I hope that this new clause can be removed so that we revert to the law as it standsthe careful and sensitive compromise worked out in 1990, as described by the noble and learned Lord, Lord Mackay, which has held firm for all that period. The requirement is, after all, only to consider the need; it is not an absolute ban on treatment by any means,
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Does a child really not need a father? Clearly, the need for a mother remains unchallengedit is implicit in the way that the law works. I think that a child needs a father. First, we are where we are. To remove the requirement that a child needs a father is to make a fresh statement to the effect that a child does not need a father. It sends a message to men, at a time when many of them feel undermined as providers and parents, contrary to government policy in this field. Government policy is that men should pay for their children after divorce and separation and that they should take responsibility. Divorce law judges hold that contact with a father after divorce is a good thing. Recently, the Government have sought to encourage single women to name the father of their babies on the birth certificates. We are told that children who find out that they are adopted or created by donor insemination need to know their fathers. The United Nations Convention on the Rights of the Child says that every child has the right to know and to be cared for by both parents and of course anonymity has been removed from sperm donors, which must mean that they are important.
The current law does no more than require that a doctor checks whether there is a male in the social circlefor example, a grandfatherand causes parents to reflect on how to cope with the situation. Indeed the requirements have been much watered down by the HFEA code which has done its utmost to ensure that there is no discrimination without good reason. I would argue that the present law is not discriminatory. It applies to men and women: heterosexual couples, homosexual couples, married, cohabiting and others. Even if it were discriminatory, it is justified on the ground that the welfare of the child is paramount.
There is a wealth of research showing that children need fathers, not just a parent. Children need to see complementary roles, the relationship between the sexes, a microcosm of society as they grow up. There is also research showing that children born to lesbian parents do well, but it is limited research, mostly carried out by one researcher in this country and of necessity the children are very young. Some research shows that those children suffer from the inevitably confused and secretive family relationships that occur.
Recent reports have placed Britain at the bottom of the international league tables for the welfare of children and we know that boys without parents fail at school, that they turn to worse role models and that fathers play a great part in the upbringing of their children as well. A survey reported this morning shows that 77 per cent of the public would keep the law the way it is. After all, if a woman is pregnant and her husband dies during the pregnancy, do we not say that is a tragedy?
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Finally, I put in a plea. It takes courage to stand up for what is right for children; women have won respect for their bodies and their roles in the past few years; but it is time to take care of and to support men in this enterprise as well.
The Lord Bishop of St Albans: My Lords, I have the very considerable privilege of being a member of the Joint Committee which met for a few weeks in the early summer of this year. I too want to put on record not only my appreciation of the chairmanship of Mr Phillip Willis but also the work of the Clerk to the committee. We were all working under great pressure and they were outstanding. To meet the deadlines we had to put to one side some of the ethical issues that underlie the Bill, although in the time available we were able to consider briefly just a few.
It is relatively easy to expose the ethical issues by asking a simple question: does the kind of scientific endeavour and therapeutic treatment which this Bill allows need regulation at all and why not let scientific and therapeutic market forces rip? As soon as one asks the question one begins to realise what some of the ethical issues are. Unregulated research and treatment could jeopardise our common understanding of what it means to be human; it could jeopardise our understanding of what we believe to be the meaning and purpose of human life; it could jeopardise our understanding of human relationships; and an unregulated free-for-all could and might lead to the unscrupulous treatment of the most vulnerable and could and might lead to some appalling abuses of power.
I outline again the four major philosophical ethical areas: first, the meaning of our humanity; secondly, the meaning and purpose of our lives; thirdly, the meaning, purpose and value of human relationships; and, fourthly, the right use of power. Those four ethical issues are accompanied by othersfor example, because we have the ability to carry out research and treatment, how do we decide whether we should, and what criteria should we use to determine this? How are we to decide whether the kind of research and treatment outlined by the Bill is likely to harm or enhance individuals in society? And, conversely, what might be the effects on individuals in society if we fail to carry out the proposed research and treatment? In my view the moral questions inherent in the Bill tumble over each other in rapid succession.
I again remind noble Lords that our ability in the Joint Committee to tackle some of those questions was hampered by two thingsfirst, as I have said, lack of time, and, secondly, having to spend time on whether the HFEA and the HTA should be coalesced into RATE. That proposal has wisely been abandoned, but the time the Joint Committee spent on that could have been spent on some of the ethical questions. In that committee some of us became aware of both the significance and the accuracy of what Sir Liam Donaldson described as the,
Our lack of time as a committee also meant that we were unable to explore in as much depth as some of us would have liked not only the questions I have outlined, but the one that is key to this whole enterprise: what is the moral status of the human embryo? Does every embryo from the moment of fertilisation have a unique indelible moral status or does the moral status of the embryo change as the embryo develops? I recognise that the Warnock reportand many philosophers and theologians have before and sincedebated this question, but ethically that question lies at the heart of this Bill, and, because of changes in science and technology and changes in public attitudes, it needs to be debated again.
I have read something about the science involved in human fertility research and treatment. I found much of that science breathtakingly interesting. I recognise that it is carried out in some instances with remarkable humilityit is very movingbut I am among those who believe that this Bill is of such fundamental importance that greater and further consideration of the ethical issues should and must be given.
I share the view of the Joint Committee that a joint bioethics committee of Parliament should be set up. If noble Lords want the details they should look at paragraph 295 on page 77 of the Joint Committee's report. I hope that that recommendation will be acted on as a matter of urgency. Such a committee should be appointed not to provide retrospective reflection on legislation but to provide a lot of prospective thinking.
We hear mucheven today we have heard muchabout impact assessments. What is the point of impact assessments if they do not include the ethical dimensions of the issues before us? Of course I recognise the beauty and humanity of much of the science, but it would be tragic if that beauty and humanity were to be damaged by any deficit in ethical thinking in this Parliament. It would be even more appalling if those who might be brought to birth as a result of the proposals outlined asked of us: Why? Why were they in such a rush? Why didnt they have the courage or the wisdom to give deep and long consideration to the morality of the proposals before rushing into law?.
The Bill is not only about us in our generation. It is not only about our place in the world scientifically and technologically. It is also potentially about generations of people yet to come. It seems to me that we owe it to them to ensure that we give as much attention to the ethics as we do to the science and to the regulatory mechanisms. It is for their sake that we must get the ethics, and therefore the legislation, right.
Baroness Jay of Paddington: My Lords, the House will be very grateful to the right reverend Prelate for raising the basic moral issues that lie behind this important legislation. I rise, in this debate of experts, as a lay person who has none the less followed the issues closely for 20 years, to say that I very much welcome the Bill as the latest and most sensible step in a process that has been exemplary of good governance since the 1980s. After all, in an era when Parliament, the Executive and even independent regulators are often under fire for various inadequacies, it is good that we can be confident that in this very complex area of IVF and embryo research, we have been extraordinarily well guided and organised, both in policy and in practice.
As the Minister said in his introduction to the Bill, we are now a world leader in this field. Importantly, the strength of the relationship that has grown up between scientists, policymakers and regulators has meant that as technology has developed, the ethical debate has continued and the Government have notas is so often the caselagged behind advances in science or changes in public opinion, but have been able to keep pace with and reflect exciting new opportunities and differences in people's views.
That is obviously the purpose of the Bill. I must congratulate the Government, as other speakers have done, on the process of extensive consultation and pre-legislative scrutiny that has produced these very thoughtful proposals. Particular thanks are obviously due to those Members of your Lordships' House and Members of another place who took part in the Joint Scrutiny Committee on the draft Bill, most of whose substantive recommendations I agree with and, much more importantly, the Government have accepted. Noble Lords who were members of the scrutiny committee have spoken and will speak about the specific changes from the draft Bill that they welcome. I simply say that I am delighted to see the disappearance of RATE. It is my very strong view that the right architecture for providing a clear statutory framework based on the principles of devolved regulation is now the backbone of the Bill.
In the context of both clinical practice and research, I have always personally supported the flexibility of permissive legislation plus, needless to say, very firm regulatory boundaries, with the boundaries derivedhere I perhaps part company with the right reverend Prelatefrom the gradualist approach to the developing moral status of the embryo, which I was first convinced of by the report produced by the noble Baroness, Lady Warnock. I appreciate of course that others prefer a more explicit, absolutist approach, but I am happy to continue with the way in which we have satisfactorily reached the position that we have during the past 17 years. None the less, I would agree with the right reverend Prelate that the suggestion made by the scrutiny committee of the joint standing bioethics committee in Parliament has attractions, which I hope we can debate further at later stages of the Bill.
It is the pure research questions which will continue to throw up the most tricky problems for both those concerned with ethics and the regulators. We have all
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However, clinical advantages of being able to use stored embryos in many social situations quickly became obvious. On the medical research side, the possibilities of using spare frozen embryos were already opening up. Today, freezing and storing are common practice. This Bill, in dealing with todays realities, expands the definitions of so-called permitted embryos to include, as we have heard, interspecies embryos, which were unthought of at least by this lay person in the 1980s.
I was very appreciative of the strictures that the noble and learned Lord, Lord Mackay of Clashfern, addressed in his contribution about the definitions of those interspecies embryos and I hope that we will return to that at a later stage. I clearly understand that the very existence of interspecies embryos can create the sort of apprehensions that I felt when I first saw those steaming vats of frozen embryos two decades ago.
However, I believe that some of the same arguments about offering better solutions to the infertile, as well as significantly improving disease research, apply here at least as strongly to the new technologies as they did to some of the older ones. As I understand it, the most convincing argument for using specially created interspecies embryos is that there is a shortage of specially created human embryos donated for research. The research potential is simply too valuable to be limited in this way. After all, we have already seen early progress in understanding such complex conditions as Parkinsons disease and Alzheimers disease. I am particularly impressed by the valuable insights from pre-implantation genetic diagnosis. If assisted reproduction techniques can help to diminish the appalling burden of inherited genetic diseases, such as Duchenne muscular dystrophy or Huntingtons Chorea, it will rightly seem a medical and social triumph. I am grateful to those members of the Medical Research Council and other scientists who have given me very detailed briefing on this, to which again I hope we will return in detail when we consider some of these possibilities.
It is interesting that the general public appear broadlyas we all know, this does not always happen in todays worldto support the work of scientists and doctors in this field. Tolerance, presumably, is based on the appreciation of the practical help given by IVF to infertile couples and hope for a breakthrough in some of the familiar, intractable diseases. I suspect that public confidence is also based on the record of good governance in this field.
None the less, the scrutiny committee was right to look critically at the way in which evidence of public
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I was pleased that the committee also noted that those of us who served on the earlier committee on the assisted dying Bill introduced by the noble Lord, Lord Joffe, had similar problems when trying to assess the weight of public opinion on relevant questions. It is a very important issue, particularly in sensitive policy areas where stakeholders and interest groups may be loudly vociferous and appear to be numerically strong but do not necessarily represent the broad democratic position. I agree with the scrutiny committee that the Government should take a more proactive approach in supporting public awareness and understanding of these issues, and look, too, closely at how public opinion is sampled and reported in this and other areas of bioethical interest.
On practical service provision, I follow the noble Baroness, Lady Deech, in saying that I would like to see IVF provided by the National Health Service to many more people. It would mean not only an improvement in service equity, but it might also, as the noble Baroness suggested, lead to regulatory advantage. In the past and no doubt in the future, I understand that the activities to have caused the HFEA the greatest problems have usually been found at the margins of the commercial sector where services are offered to women who are desperate for any form of treatment. I have no doubt that as the technology develops, it will be here that the ethical horror stories, such as cloning and inappropriate implantation, will be found. The more that can be done by the NHS, the easier it will be to squeeze out dubious commercial practice and regulate more thoroughly.
The question of the role of fathers has already arisen this afternoon, and for myself I take an unusually agnostic position. I listened with great interest to the contribution of the noble Baroness, Lady Deech, and I look forward to the speech of my noble friend Lady Hollis of Heigham, who I believe is to speak in the gap. She, too, was a member of the committee on this Bill.
In conclusion, the process which led to this Bill was rightly described by the noble and right reverend Lord, Lord Harries of Pentregarthwho has also been closely involved in this fieldin the Queens Speech debate as a model of good practice. The principles of permissive statute backed by tight regulation have brought us very successfully from the early days of IVF technology to today. Now I hope that those same principles can take us forward to the next stages, both in clinical practice and in scientific discovery. In my view, it would be a very great pity if this model of good practice was diverted or distorted by attempts to introduce other matters such as abortion into our consideration of the Bill. I was glad that it appeared that all Front Benches were agreed on this. I look forward to further discussion on these very complex issues, and to the Committee stage.
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