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ss nucleus - autumn 2005,  Fertility review - getting involved

Fertility review - getting involved

Rhona Knight lays down a challenge

I boarded the train, laptop in rucksack, ready to start this article on the public consultation by the Department of Health (DoH) on a review of the Human Fertilisation and Embryology Act (HFE Act). As I got on, a wry smile came to my lips. The train was called Charles Darwin. My mind turned to the church’s original responses to Darwin’s theories on the origin of species, or at least the responses we hear and read of today. The picture painted of Christians at that time is of people blinded by faith who were unwilling to open their eyes to the wonders of science and the theory of evolution. Even today this view of Christians finds media material to support such a perspective: ‘Religious right evolves tactics to fight Darwin’ ran a Times headline on 30 August this year.

Elijah or Esther?

Today, it seems, Christians are still suffering the consequences of how they are perceived to react to ‘scientific progress’. In public consultations on ethical issues particularly, admission of religious faith seems somehow to negate what we contribute into the public arena. Ad hominem arguments are put forward: ‘She’s only saying that because she’s a Christian’. Religious and faith submissions are grouped together, often with pro-life submissions, and on reading the final publications, there is a feeling that arguments based on faith perspectives are somehow of less value in a society in which much of moral philosophy is based on the worldview of secular humanism.

The relevance of this? Well, if you are going to respond to the public consultation document I am about to describe, pray about the approach you will take. Are you going to be an Elijah, speaking God’s word to the people and writing from a faith-based perspective? Or are you going to be an Esther, blending into palace life for the most part, speaking God’s word to the people but using a language that is accepted by all? That common language at the moment is the language of reason, logic and evidence based medicine.

HFE Act review

And so to the review of the HFE Act. The government announced its decision to review this on 21 January 2004. It published its consultation document on 16 August 2005 and the public have until 25 November to respond.

On 23 March 2004 the government’s Science and Technology Committee published a very relevant and contentious report,[1] which took a liberal approach to reproductive technologies. The minutes of this committee’s meeting make interesting reading,[2] indicating that the final document does not reflect the views of the committee as a whole. The report itself comments on the role of public consultation indicating that ‘they made no efforts to quantify the views submitted’.[3]

In the report a gradualist approach to the status of the human embryo is adopted,[4] and yet when an embryo actually becomes human is not defined. The report indicates that it believes that in the light of technological advances, trying to define what an embryo is should be resisted,[5] and yet at the same time it acknowledges that the embryo does have special status and value due to the nature of its humanity. That value and status is again not defined. The report also looks at the HFE Act and the Human Fertilisation and Embryology Authority (HFEA) itself, leading one to believe that in some way this report will inform the HFE Act review.   The consultation document on the review of the HFE Act is in itself a reasonably easy to read document. It is 90 pages in all and can be easily downloaded.[6] It is divided into ten sections, which look at topics such as:

  • The welfare of the child eg the need for a father)
  • The use and storage of gametes and embryos 
  • Screening and selection (including sex selection)
  • Surrogacy

Caroline Flint, the Parliamentary Undersecretary of State for Public Health, sets the scene in the foreword by describing the UK as a world leader in human reproductive technologies. She continues by citing the perceived benefits of both the HFE Act and the HFEA, indicating that the combination of these have instilled public confidence.[7] However, due to the fact that technologies have developed further, and society’s attitudes have changed, the question of whether the law should be changed, and if so how, needs to be debated. The aim of the public consultation is to help them tackle these issues: ‘The government’s aim in reviewing the act is to ensure that the law remains effective and fit for purpose in the early 21st century.’[8]

Asking awkward questions

When one looks at the topics covered there are some obvious questions. Why has the DoH chosen to look again at sex screening and the welfare of the child? This has been done recently by HFEA, sex selection being rejected except for good medical reasons, and the welfare of the child being deemed as paramount. The cynic might think that it is because the ‘right’ answers have not yet been given, and that the questions will just be asked again and again until they are. Also why does the document suggest disbanding HFEA and forming instead a Regulatory Authority of Tissues and Embryos? The title of this proposed organisation itself seems to devalue the status of an embryo to that of a kidney. One cannot help but feeling on reading the document, that the only way will be ‘forward’ and the technological imperative will have its way. Science says we can, so why not?

We are also told: ‘The Government does not intend that the review of the HFE Act will open up those fundamental aspects of the legislation which are widely accepted in our society or which have been recently debated and conclusively resolved in Parliament. These include the creation and use of embryos for research, the prohibition on human reproductive cloning, and the removal of donor anonymity.’[9] One must question the wisdom of being unwilling to review the past before looking to the future. Even the liberal Science and Technology Committee report indicates that it wants to review the consequences of the loss of donor anonymity in sperm donation.

The impression I get from reading this document is that a very open legislation, allowing science to go where it will, is very likely. John Paul Maytum, of the HFEA, indicated that any new legislation would need to have scope for amendment, which ‘would mean we could tweak legislation when new developments came along, and we would not have to go back to primary legislation’.[10] Such comments do not give much comfort. The public ‘yuk’ factor, as we know from experience, gets eroded, so that things which once seemed unthinkable can now be proposed by respected scientists and politicians.

How should we respond?

So where does this leave us if we are going to respond to the document? There is still a place for faith-based arguments. The post-modern, multi-faith society in which we live does allow for a challenge to the assumption of secularism being the predominant approach today, and it is important that the good news of the intrinsic value of the individual in God’s eyes continues to be heard. There is also scope for non-faith based arguments. We could push to have the status and value of the embryo defined. We might look at the logical conclusions of some of the outcomes of these new technologies.

If you haven’t yet watched the film ‘Gattaca’ (about a world where genetic selection and enhancement is the norm), nor read the book My Sister’s Keeper[11] (about a girl conceived as a ‘saviour sibling’ to help an older sister with leukaemia), try and put them high on your ‘to do’ list - they will give you some ideas. There is also scope for looking at real examples of genetic engineering and their not so good outcomes in plants.[12] One could also comment on lessons to be learned from the Science and Technology Report, which appeared to ignore public consultation, and overrule more conservative members of the committee. Finally, one could ask what are the boundaries that should never be crossed?

Finishing this article, and reflecting on the name of the train that I had been sitting in earlier, I wondered if instead it should have been called ‘Francis Galton’. Francis, Darwin’s cousin, was also known as the father of eugenics. Eugenics has occurred throughout history from ancient Sparta to Nazi Germany. It now continues through the embryo selection already occurring in the UK. There is, after all, nothing new under the sun. The question is: what are we going to do about it?[13]

References
  1. House of Commons Science and Technology Committee. Inquiry into Human Reproductive Technologies and the Law. Fifth Report of Session 2004-05. HC 7-1 
  2. House of Commons Science and Technology Committee. Inquiry into Human Reproductive Technologies and the Law. Eighth Special Report of Session 2004-05. HC 491 
  3. House of Commons Science and Technology Committee. Inquiry into Human Reproductive Technologies and the Law. Fifth Report of Session 2004-05. HC 7-1, para 361 
  4. Ibid, para 28 
  5. Ibid, para 53 
  6. www.dh.gov.uk/Consultations/ClosedConsultations/fs/en
  7. Review of the Human Fertilisation and Embryology Act. London: Department of Health, 2005:3 
  8. Op cit, para 1:5 
  9. Op cit, para 1:13 
  10. newsvote.bbc.co.uk 2005: 16 August 
  11. Picoult J. My sister’s keeper. London: Hodder & Stoughton, 2005 
  12. Nottingham S. Eat your genes. New York: Zed, 2003 
  13. Pr 24:11,12
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