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I would like to correct what is, I think, a misapprehension of the noble Lord, Lord Alton. I declare an interest as a member of the UK Stem Cell Foundation, which is the main funding body purely for research into stem cells in this country, and which works in a close relationship with the Medical Research Council. Therefore, it is the leading body funding medical research in this field. The noble Lords comments about the professor of regenerative medicine are surprising to me. He claims that, in this country, we are not doing anything other than prioritising embryonic stem cells. I have to tell the noble Lord that the UK Stem Cell Foundation has not so far funded a single grant towards embryonic stem cells, nor have we ever had a grant application from this particular professor. I do not think it is unreasonable for me to say that in this Chamber. It is difficult to assess his work, so I do not know why he is leaving this country, but it is certainly not because he has had a grant application turned down because of the prioritisation suggested by the noble Lord, Lord Alton. It is important to put that on the record at the start.
The noble Lord kindly referred to my television programme on the hype surrounding embryonic stem cells, with the extraordinarily sad death of the child of 10 who was hawked around the world. I simplified the story; not only did that child go to Argentina and the Dominican Republic, but also to China and Siberia for treatment. Some people are unfortunately misguided enough to do that because of their desperation. That is another reason why we must be extremely moderate in presenting the work that we do.
It is important, in that context, to make clear that I showed on that television programme that none of the adult stem cell treatments worked either. As far as I am aware, the only adult stem cell treatment that really works and has been shown to work is where we replace bone marrow cells, usually in children with leukaemia. It is a relatively uncommon disease. A few exceptional other diseases can be treated with bone marrow, but we must make it clear that adult stem cell treatments have been equally unsuccessful. The area is still under development. That is the crucial issue for the amendment of the noble Lord, Lord Alton.
The problem is that we can never be certain in any kind of research. The beauty of the Large Hadron Collider is that we do not know whether we will find the Higgs particle, or what other particles we might discover; nor have we any serious idea of what future applications there might be for physics or engineering. To some extent, that is always true in biological experiments. We cannot say absolutely that embryonic stem cells will definitely provide cures for the range of diseases that the noble Lord has listed; it is simply not true. Nor could we say so for adult stem cells.
We must be quite cautious and make judgments about how this research is directed. Therefore, we accept that a regulatory authority has to make the best assessment of that research. We cannot absolutely say that it will definitely work but the current expert opinion, which may change, strongly suggests that it is the case.
Incidentally but remarkably, the professor of regenerative medicine to whom the noble Lord referred has not been working with adult stem cells. According to his publication record, which I checked only this week, virtually all of this work has been on foetal stem cells, mostly in umbilical cord blood. Again, that is a different area of science which is still extremely vague, and has largely been rather unsuccessful in helping treatment of patients so far. Equally, however, it holds hope, as we hope that it will do in the future.
Lord Patten: My Lords, I am pleased to follow the noble Lord, Lord Winston. I am particularly interested by his suggestion that things are interesting in science and must therefore always be pursued, looking specifically at the CERN experiment. I wish it well; I hope that it is back on the roador, rather, underground and rotatingduring next year. However, whether it is successful or not, as far as I know it does not raise any great ethical issues. Physics has in the past raised ethical issues, such as nuclear and other related matters, but CERN does not. I do not doubt that, for many scientists, work on embryonic stem cells is extremely interesting, but it comes up quite hard against some difficult ethical questions. I know that the noble Lord recognises that, and I agree with him that we must be moderate in how we discuss these issues.
That is why I strongly support the noble Lord, Lord Alton, in his amendment for two reasons that I shall state briefly, as befits us at this stage of the consideration of the Bill. First, it is reasonable and proper to ask science to demonstrate that there are no alternatives before using admixed cells in this way. To the best of my knowledge, no one has been able to stand up and say that there are no alternatives. That phrase often
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The second reason is that I am toldperhaps the Minister, with his characteristic courtesy, will confirm this point or correct methat there is nowhere in the world any existing cure, properly approved by the relevant regulatory authorities in that territory, which uses embryonic stem cells, whether admixed or not. There is nothing that is actually working so far.
Baroness Tonge: My Lords, I cannot possibly support the amendment of the noble Lord, Lord Alton. That is not because I do not respect the noble LordI always have done. He used the word repugnance about this sort of research, but he should remember that a lot of us feel repugnanceI certainly doat not doing research that may help people with terrible chronic illnesses that they have no way of curing. It is repugnant to me that we are denying people the chance of a better life.
The noble Lord referred to the mass manufacture and use of human embryos. I do not really think such a sentence is terribly helpful. By no stretch of the imagination could this research be termed mass manufacture, and it is not helpful to the general public to use such words.
The noble Lord and I are founder members of the all-party group on cord blood. It is very clearly stated that we want to encourage the collection of cord blood but definitely not for exclusive research on stem cells from cord blood. We believe that all forms of research should be pursued. We cannot possibly know where research will go or whether it will be any good until we have pursued it. That is the major pointwe must follow all lines in the interest of ultimately curing human diseases.
Lord Patel: My Lords, I was hoping that we would not have to rehearse all the lengthy discussions we had in Committee and on Report, but it looks as if we might have to. I support all that has been said by my noble friend Lord Walton of Detchant and others who have spoken, although, with all due respect, I do not agree with the amendment.
The noble Lord, Lord Alton, said several things about alternatives. Alternatives for what? Alternatives for research? Alternatives for therapy? In the United States, Professor Yamanaka and James Thomson have done research on induced pluripotent cells, taking an adult somatic cell nucleus and reprogramming it so that it behaves like an embryonic stem cell. The advances in matters of direct reprogramming of human somatic cells, without the use of oocytes or early embryos, is an exciting and welcome development. However, this work is at a very early preliminary stage. The current technology involves engineering the cells in a way that raises a number of safety issues that will need further refinement before these cells can be used in the clinic. It is only by studying the human embryonic stem cells and their behaviour that we know that the induced pluripotent cells behave in exactly the same way. Even Professor Yamanaka, who now does some of his work in California, is continuing to work in embryonic stem cells.
The really important point of any application of these so-called induced pluripotent cells must depend on the understanding of basic human biology, and that demands comparative work with both embryonic stem cells and IPS cells. One can only conclude that we should work with IPS cells only if we are interested in direct application, but if that is pursued without an understanding of the basic biology, it is like, to use the analogy I gave last time, comparing gold with material that looks like gold, but we cannot be sure until we have understood that the properties are exactly the same. Yes, IPS cells may be the future but we cannot work with them until we better understand how human embryonic stem cells behave.
In the debate last time I said it is important at this stage to allow research to continue on all types of stem cellsadult, umbilical cord, cord blood, amniotic and embryonic stem cells, and admixed embryos. Why do we need research with admixed embryos? My noble friend Lord Winston and the noble Lord, Lord Alton, briefly mentioned the availability of human oocytes. Obtaining human oocytes is not without risk and they are also in short supply. To get good stem cell lines you need fresh oocytes, which makes it even more difficult. Just now we are trying to understand the path of physiology and the biology of embryonic stem cells derived from human tissues that carry the genes of a particular disease, so that we are better able to understand how that disease develops from an early stage, are able to modify that and to develop and test drugs in vitro, and so on. Without embryonic stem cells derived through admixed embryos, we will not be able to do this research. It is necessary for research purposes. There are no alternatives but to do research on all types of stem cells.
On therapy, my noble friend Lord Winston mentioned that we have tremendous therapy in bone marrow stem cells for treating leukaemia. I agree with the noble Lord, Lord Alton, that there are other therapies using adult stem cells but they are few and far between. They are mostly autologous therapiescells taken from one person used for the treatment of that person. Adult stem cells will never be the answer for mass treatment of people with degenerative diseases. Where are we with embryonic stem cells? In research terms we are at a very early stage. In understanding the biology through using embryonic stem cells, the pace has been accelerating quite a bit. We only managed to understand and do induced pluripotent cells because we understood how embryonic cells behave. If we had not, that work would never have come to fruition.
On treatment, there is no treatment today using embryonic stem cells but there are treatments using them at an early stage of trial on animals. There have been some early human trials and it is likelyI hope it will happenthat by the end of next year or early 2010 in the United Kingdom there will be first-phase trials using human embryonic stem cells for age-related macular regeneration. Some 3 million people in this country suffer from, and 30 per cent of people aged over 65 develop, some degree of age-related macular degeneration. I hope that research will come to fruition. None of the stem cell research is likely to have an overnight success. It may not ever happen but we will not know unless we study every type of stem cell.
On funding, I declare an interest. I have declared several interests before, being not only a member of several professional organisations but also a chairman of the United Kingdom National Stem Cell Network. I am also a member of the Medical Research Council. In 2007, 424 grants were awardedat a rough estimate some £56 billion, excluding charity funding. The majority of grant applications were from the MRC, the Wellcome Foundation and the Biotechnology and Biological Sciences Research Council. The MRCs awards were 50:50 adult stem cell research to embryonic stem cell research. Some 90 per cent of the Wellcome grants were for adult stem cell research. The trend is towards adult stem cell research and towards more research on induced pluripotent stem cells. Grants are awarded to people who submit the best science; that is how it should be. They should not be awarded for poor science that is not judged good by peers. If there is any evidence that grants are awarded for poor embryological science, let us hear about it. In my view, it does not happen.
Lord May of Oxford: My Lords, I declare an interest as a member of the UK Stem Cell Foundation. Like the noble Lord, Lord Winston, I pay respect to the noble Lord, Lord Alton, for his admirable restraint and honourable declaration of his own interests: abhorrence of stem cell research.
Lord May of Oxford: I am sorry, my Lordsembryonic stem cell research. I agree with the noble Lord that, on occasion, the medical benefits and their immediacy are oversold in excesses of enthusiasm. That is nowhere plainer than in some excessively enthusiastic claims made for non-embryonic stem cell research, which, the noble Lord must agree in all fairness, he tends, understandably, to accept more uncritically than he does other things.
I will not go over the ground covered by the noble Lords, Lord Walton and Lord Winston, and the previous speaker, but I re-emphasise that we have legislation; we have a committee on human fertilisation and embryology; we have procedures that look very carefully at these matters; and we have research grants and a process for choosing the best that works well. Ultimately, to put it bluntly, the purpose of this amendment is to impede a certain class of research within that, and that is why I oppose it.
Lord Turnberg: My Lords, the case against the amendment moved by the noble Lord, Lord Alton, has been well discussed. I want to focus on the implications of its wording. It concerns human admixed embryos alone. The purpose of admixed embryos has been driven largely by the difficulty of obtaining human eggs. The implication of the amendment is that there should be no other available method of achieving the
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Lord Bates: My Lords, I humbly address the House as a new Member and a non-scientist. I suppose one might ask, then, what I have to add to this debate. It seems to me that, whereas science has a role in saying whether we can, Parliament has a role in determining whether we should. That seems a pretty simple role, and on that basis I rise to support the noble Lord, Lord Alton, in his amendment. Characteristically, he is asking the House and those in the parliamentary process to think again, to pause for thought. That is wise. As I have gone through this Bill, as well as the excellent briefing papers that are available in the Library, I have tried to absorb the materialbut the complexity of the issues at stake is bewildering. For that reason, considering matters again more carefully is very important.
As well as giving due consideration, another protection in this process is the use of language. It is critical that we say what we mean. When we use terms that are euphemistic, such as admixed embryos when we are talking about human-animal mixes, clearly that can lead people to draw different conclusions to those they would come to if we were more explicit about what they meant.
Baroness Hollis of Heigham: My Lords, as one of many non-scientists who have taken part in the extensive debates on this issue, I assure the noble Lord, Lord Bates, that we do not need extra time to think again because we have not thought; I have to say that we spent a lot of time at a detailed Committee stage and on Report in this House discussing this very issue.
Like other noble Lords, I commend the noble Lord, Lord Alton, on the very temperate way in which he introduced his amendment on an issue on which he feels very strongly. It helps the quality of debate if he is able to move amendments as he has today. However, he has not answered the query that some of us addressed to the noble Baroness, Lady Williams, who is unfortunately not here today, when she raised a very similar issue at an earlier stage.
by purposes he means outcomes. In that case, my question remains how you know until you have done it. You will know the outcomes of this procedure only when you can compare it with a result by some other means. Unless you follow all avenues, only then do you know which is the more fruitful; what you cannot do is a series of linear experiments, because at that point you cannot know what hurdle you seek to address.
This amendment presents a post hoc ergo propter hoc argument. You already have to know the outcome you would have achieved without doing it so that you therefore know you can get to the same outcome by some other way that you can take. Forgive me, but that is no way in which to conduct research, and certainly not scientific research.
Lord Tombs: My Lords, I begin by reminding noble Lords that this amendment is about the use of human-animal embryos, and the proposal is that they should not be used if reasonable alternatives are available. The debate has rather turned into a conception of the amendment as an attack on all embryonic research, which plainly it is not. It does not seek to make the world rotate in the reverse direction.
The noble Lords, Lord Walton and Lord Patel, have both described the amendment as unnecessarythe noble Lord, Lord Patel, because scientists are so fixated on purity that they would not do anything other than what the amendment suggests. I have to say that that is not my experience. The noble Lord, Lord May, thinks that acceptance of the amendment would somehow inhibit research, which was a point not agreed on by his colleagues. I want to broaden the debate and talk about what the amendment seeks to do and what effects it might have.
We have been toldand, therefore, most journalists and members of the public believethat most future cures lie with embryonic stem cell research, that there is a shortage of human eggs necessary for such research and that, therefore, we should use animal eggs to create admixed human embryos. There are still big doubts about whether these cells will yield any treatment at all and it is my contention, which I hope to demonstrate, that the proposals are unproven, unnecessary and unethical.
First, they are unproven. Embryonic stem cells are difficult to obtain, develop and maintain. They are unstable, and mutate in culture. The fact that they produce cancerous tumours when transplanted into animals has led to an understandable reticence in using them in any human therapeutic trials. It is clear that clone cells, used to address the problem of immune rejection, are not normal cells. That is why it took 277 attempts to produce Dolly the sheep and why no one has yet grown a human clone to a stage mature enough to harvest stem cells from it.
Secondly, embryonic stem cells obtained from animals are unnecessary. The ethical alternative of adult stem cells is already used to treat more than 70 diseases and, similarly, umbilical cord stem cells are being used in treatments and are easily and cheaply harvested. The website of the National Institutes of Health this month shows 2,170 clinical trials involving adult stem cells, 125 of which involved cord blood stem cells, but not one clinical trial in humans involving embryonic stem cells. That says volumes and it is not an exceptional month. Adult stem cells require limited, if any, manipulation and are readily available from a number of sources, comparatively at least. They are already providing cures in humans and there are no ethical concerns in their use, making them acceptable to virtually all patients and healthcare providers.
A number of people have referred to the factand I return to it nowthat the use of embryonic stem cells is believed to be unethical by large sections of the British community, including scientists, who regard human embryos as vulnerable human lives worthy of respect and protection. Many believe that the production of animal-human hybrids crosses a moral Rubicon and, of course, a species barrier, and that the end of providing treatments, if it were technically possible, does not justify the means of destroying human life even at its earliest stage.
The morning after the other place had voted to allow the creation of animal-human embryos, Mark Henderson, the science correspondent in the Times, who led a vigorous campaign for cloned animal-human embryos, struck a note of sober caution. He wrote that,
Those are valuable things. But if Mark Henderson, the enthusiast, is now so cautious, we may conclude that some of the claims made in this House and in another place have been somewhat overstated. In this connection, I go back to a debate held in this Chamber around 15 years ago, when the promises were extravagant and imminent.
Finally, in these uncertain economic times, but also in any good stewardship, we should be investing most heavily in those research avenues which are most likely to produce cures in the foreseeable future with fair certainty. It is not simply a matter of keeping all avenues open but of putting our money into research that is likely to yield results affecting people and not necessarily extending the boundaries of human knowledge as an end in itself. I strongly urge noble Lords to lend their support to Amendment No. 2A.
Lord Darzi of Denham: My Lords, we have spent a significant amount of time in this House debating the use of admixed embryos. The House has voted and has made its position clear, the issue has also been debated and voted on in the other place, and Members of that House agreed to the position in the Bill as it left this House. Therefore let us be clear that the current position in the Bill on this issue reflects the agreed position between the two Houses.
The amendment tabled by the noble Lord, Lord Alton of Liverpool, seeks to restrict the use of human admixed embryos for purposes of research. The effect would be that embryonic stem cell research using human admixed embryos could be carried out only as a last resort. Before any research project involving the creation or use of human admixed embryos could be licensed by the HFEA, it would have to be satisfied that the use of human admixed embryos is necessary. This means that if there were any other way of carrying out the research without using a human admixed embryo, or human embryo, the project could not be licensed.
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