§ 3.4 p.m.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur) rose to move, That this House takes note of the report of the Committee of inquiry into Human Fertilisation and Embryology (the Warnock Report) (Cmnd. 9314).
§ The noble Lord said: My Lords, 1978 saw the birth in this county of a child described as the world's first test-tube baby. For some couples this was a major breakthrough because it offered the only method by which they might have a child which would be genetically their own. Alongside the wonder this caused and the hopes it raised, there grew understandable concern and some disquiet about where this new technology might lead. There then also grew a belief that the issues were wider than those of medical ethics; so wide, in fact, that they should be subject to the scrutiny of society as a whole. So it was that in 1982 the Government established this inquiry whose report is before us today. The Official Report for 9th July 1982 reports a request for such a measure from the noble Lady, Lady Saltoun. I am glad to see that she is in her place today.
§ Let me say a few words about the committee of inquiry. It was chaired by Dame Mary Warnock, and its membership reflected a wide range of lay, professional and religious interests. The terms of reference given to it were to consider what policies and safeguards should be applied to recent and potential developments in human fertilisation and embryology, and to make recommendations. This the inquiry has now done. The Government welcome the clarity of the report, as I think do most who have read it, and the balanced way in which the challenges posed by the new treatments and associated research have been presented. I should like to record the Government's sincere appreciation to Dame Mary and to her team for the care and concern which they brought to this formidable task. They produced a report of major importance.
The Warnock report concerns the social, ethical and legal implications of developments in human reproduction. These are complex and sensitive matters. As the foreword to the report says:
it would be idle to pretend that there is not a wide diversity in moral feelings, whether these arise from religious, philosophical or humanist beliefs. What is common … is that people generally want some principles or other to govern the development and use of the new techniques. There must be some barriers that are not to be crossed, some limits fixed, beyond which people must not be allowed to go".
The foreword goes on to say:
We realise that some people may think that we have set the limits, or have suggested that the barriers be erected, in the wrong places. But at least we hope that we have stated clearly what we think should be done, and exposed, as far as possible, the reasoning that lay behind our recommendations".
§ The Government published the committee's report without delay because we considered it of the utmost importance to make the discussion it contains, and its recommendations, widely available. At the same time, we sent it to a wide range of interested organisations 525 for comment by the end of the year. We hope all those organisations, and members of the general public, who wish to comment will make their views known to us.
§ We believe it would have been wrong to rush ahead with hasty decisions about how to take forward the recommendations contained in the report. We felt that a period of consultation was required in order to consider it fully. In moving this Motion, your Lordships will understand that it is not my purpose to announce decisions today. But it is appropriate that the views of your Lordships should be taken account of in this consultative process. The list of speakers is impressive, and we shall all benefit from the wise counsels which will be given from the Bishops' Benches and from noble Lords experienced in law, in medicine and the sciences, and in the many other matters which bear deeply on our society. At the end of the debate I shall of course respond where I can to points that will have been raised.
§ We have been presented with more than 60 recommendations for legislative or administrative change. I will highlight only the key proposals. These are, that there should be a statutory body to license and inspect all infertility services where the new techniques are used, and the use of human embryos in research. This body would also provide on-going advice to Government about future developments and ensure that criteria for good practice in infertility services were implemented. Secondly, that in addition to control by the proposed statutory body the use of human embryos in research must be strictly regulated by law. In particular, there should be an absolute limit of 14 days after fertilisation after which embryos may not be further developed; and it should be made a criminal offence to undertake certain types of research and procedures; for example, the transfer of a human embryo to the uterus of another species. Then that surrogate motherhood treatment, whether provided by agencies or individual doctors, should be banned; and that the legal status and interests of the children born as a result of AID or IVF should be secured. In particular, the AID child should be legitimised.
§ There is no doubt that many of the issues in this report will arouse strong and widely differing opinions. Indeed, among the public at large they are already doing so. There will not be a consensus view on all recommendations. The members of the committee were divided in their view on certain aspects of research and on surrogacy. It is for this reason that the Government have set a period for public debate and for consultation with interested organisations, which will continue until the end of this year. We are already considering the report very closely. We shall take careful account of all the views expressed, including those of your Lordships, before we reach decisions. My Lords, I beg to move.
§ Moved, That this House takes note of the Report of the Committee of Inquiry into Human Fertilisation and Embryology (the Warnock Report) (Cmnd. 9314).—(Lord Glenarthur.)
§ 3.10 p.m.
§ Lord Ennals
My Lords, at the start of this very important debate, let me make it quite clear that though I am speaking from the Opposition Front Bench, nothing that I say is other than my own 526 personal view. There is no party line, nor should there be at this stage of the debate on a subject raising such profound moral and ethical issues, and I am sure that the noble Lord the Minister was quite right to say that his task is to listen and that he will do so. The number of Members of your Lordships' House who are to speak today is an indication of the very widespread interest. However, we cannot escape the fact—and the committee presided over the Dame Mary Warnock believes this—that some decisions are urgently needed; of course after careful consideration. The Government themselves will have to make up their minds and introduce legislation for consideration by both Houses.
Before coming to the report, I want to say that the subject is one that has interested me personally over a number of years as a result of continuing involvement with the National Association for the Childless. Those who are fortunate enough to know the joys of having the presence of children in the home, and of seeing their children grow into mature, and in my case—and I am certain that it applies to many other noble Lords—outstandingly able adults, should not ignore for one moment the frustration and sense of deprivation of those couples who want to have children, but who, through reasons of infertility, are unable to do so.
In fact, the right to bear children is one of those human rights written into the United Nations Declaration of Human Rights. Some people do not realise that about 10 per cent. of marriages in the United Kingdom are still childless after 10 years and only a small proportion of those are childless by their own wish. The vast majority of childless couples long for a child or children and are denied them through no fault of their own. It is for them a source of profound sadness, often carrying with it the implications of inadequacy. It is not surprising therefore that, as a result of the remarkable medical skills of Mr. Patrick Steptoe and Dr. Robert Edwards, the birth of the first test-tube baby in July 1978, as referred to by the noble Lord, Lord Glenarthur, was not only hailed as a truly remarkable achievement but it held out new hope to infertile couples.
As the Warnock report on human fertilisation states in its very first paragraph:The technique, long sought, at last successful, opened up new horizons in the alleviation of infertility and in the science of embryology. It was now possible to observe the very earliest stages of human development, and with these discoveries came the hope of remedying defects at this very early stage. However there were also anxieties. There was a sense that events were moving too fast for their implications to be assimilated. Society's views on the new techniques were divided between pride in the technological achievement, pleasure at the new-found means to relieve, at least for some, the unhappiness of infertility, and unease at the apparently uncontrolled advance of science, bringing with it new possibilities for manipulating the early stages of human development".I had an opportunity of discussing these issues with Mr. Steptoe and Dr. Edwards at a conference of the National Association for the Childless, and subsequently with Dame Mary Warnock after the report was published. I should like to pay a very warm tribute to Dame Mary, as chairman of the committee, and to the laymen, doctors, scientists and theologians who served on the committee. In general, and repeating that I am speaking personally, I find the arguments persuasive and the conclusions sound.
527 It is of more than passing interest that the Central Ethical Committee of the BMA in their report in 1983 reached almost identical conclusions. Of the Warnock Committee's report, they said on 18th July this year:This is a brilliant report which records the anxieties many people feel about the work carried out by doctors at the frontiers of medicine. The conclusions will provide sensible and compassionate guidance for the introduction of laws so that we can achieve the greatest benefits from the techniques available with as few of the undesirable consequences as possible.So after careful thought and weighing up the natural concerns, such as those that will undoubtedly be expressed by a number of your Lordships today, but conscious also of the great joy that may be provided for some eager and loving couples now denied the God-given gift of children, I conclude that a statutory authority to license test-tube baby research and treatment, to control research on human embryos and to licence other treatment for infertility should be set up as soon as is reasonably possible. Research on human embryos should be limited to 14 days after fertilisation, and beyond that should be a criminal offence. The sale or purchase of human embryos, semen and eggs should be permitted only under licence from the authority. Research would have to be licensed, project by project, and legal changes should be introduced to make children bom by artificial insemination or by egg or embryo donation legitimate. Remarkably, the committee agreed unanimously on 63 recommendations, with all of which I personally—and I repeat again, personally—also agree.
Perhaps the most controversial issue is that of surrogate motherhood, on which I also share the doubts expressed not only by the committee itself but by the founder of the National Association for the Childless, Mr. Peter Houghton. It poses many problems. The first is whether it is right for one woman to donate her baby to another. If a money transaction takes place, then a sale has effectively taken place and the surrogate womb has been used for gain. I suspect that most people will feel that there is something deeply wrong about a process of this kind, particularly if money is involved. It appears to be to do with the kind of value that we place on human life; for example, not treating it as a mere commodity. Others argue that for the surrogate to expose herself to the experience of loss after a successful pregnancy is deeply unwise. Still others accuse the childless couple of selfish exploitation of other women just to have a baby of their own. In other words, what is required to obtain the baby by this means is too great when measured against the prospect of childlessness.
Have the childless couple understood that they themselves will be exposed to grief, loss and humiliation in the quite natural and possible event that the experience of pregnancy and child birth may persuade the mother to retain the child? If a money transaction is involved, do they realise that they would have no enforceable contract and could not recover it? Moreover, the surrogate mother might die during the pregnancy, or the child might be born disabled and be rejected by the couple. On this issue, too, I support strongly the conclusion of the majority of the committee—there was of course a minority 528 report—that surrogate motherhood agencies should be banned. As the Warnock Committee says:There must be some barriers that are not to be crossed, some limits fixed".The report has attempted to produce a coherent set of proposals for how public policy rather than individual conscience should respond to a range of developments in which many people will not wish to participate but which others find entirely acceptable. For a balanced approach, upon which there will be deep debate not only in your Lordships' House but in another place and throughout the country, certainly among those of religious belief, I believe that this report has provided the basis for precisely the kind of ethical, moral and legal discussion which needs to take place. For this we are greatly in debt to Dame Mary Warnock and her committee.
§ 3.22 p.m.
My Lords, as has already been said, we are debating a matter which raises questions of immense moral, ethical, religious and philosophical significance but not, I hope, for the moment at least, of party political significance. It therefore follows that, like the noble Lord, Lord Ennals, in what I say today in this debate I am not expressing a party line. My noble friends are entirely free to hold their own opinions and to express them, if they so choose.
In general terms, we on these Benches have always believed that the search for knowledge—of ourselves and of the world in which we live—should, where possible, be assisted and should not needlessly be obstructed. We also believe that people should be free to do anything that they wish to do, provided that what they do does not impinge on the safety, rights or freedom of others. But in the context of this report, who are the "others"? Is the human embryo before implantation to rank as one of the others, with the entitlement to rights and protection which legal recognition would necessarily imply? That is the kind of question which Dame Mary Warnock and her colleagues invite us to consider, though not necessarily to answer.
In our House we are not obliged to answer unanswerable questions, nor are we obliged here and now to judge between the merits of two extreme and opposing groups who believe that they already know the answers with absolute certainty: the one group which says, and will continue to say, that anything goes and the other group which insists, and will doubtless go on insisting, that nothing at all should be done.
Judging from the admirable and wholly appropriately brief speech of the noble Lord, Lord Glenarthur, this debate is not for the purpose of coming to finite conclusions. It is an occasion for careful thought, for ventilating our thoughts and for listening carefully to, and considering the thoughts of, others. In my opinion, both professionally and as a doctor, I believe that we would be very unwise to try to legislate precipitately in an area in which the rate of technological change is now so very rapid that any new legislation, by the time it reaches the statute book, might inevitably become out of date and even be overtaken by events.
529 Just think, as we have already been reminded by the noble Lord, Lord Ennals, and the noble Lord, Lord Glenarthur, for a moment of the complexity of the matters which Dame Mary asks us to consider: AIH, which is now fairly generally regarded as acceptable; AID, which is much more controversial; egg donation, which is highly controversial, and embryo donation and surrogacy which are rather more than controversial. The right of a human being born by these means to have some ultimate right to a knowledge of his or her genetic inheritance is a very important matter which needs to be considered, as is the use of human embryos in research.
The remote and, to me, alarming possibility of parthenogenesis and of the virgin birth, which is what parthenogenesis really is, may take place naturally, but we have to consider whether it should be artificially assisted to take place. There is the possibility of cloning and even the horrifying possibility of trans-species fertilisation and the gestation of human embryos in other species—matters which no one in his right mind would regard as acceptable and which should be forbidden.
All that I have said is not merely to demonstrate that I have read and studied the report with immense care, but to illustrate, as others have already illustrated, the immense complexity of the subject with which we have to deal.
Briefly, why do we have to deal with it at all? What is the point of work of this kind and what benefits could possibly flow to mankind from all this work? Let me spend a moment upon giving my answers to those questions. First, the relief of infertility and subfertility is a very important matter, but in a world in which the human population, in global terms, is now growing at a rate of 8,000 an hour—perhaps another Wolverhampton by the time this debate is over—surely we should think carefully before adding needlessly to that population.
I am bound to say that while I recognise the burden of childlessness and the right of a couple to be assisted to have a child, I am not enamoured of a technology which can now give six or seven children to a couple at one fell swoop. The incidental and accidental production of multiple pregnancies needs to be very carefully watched. On the other hand, some of the research into human fertilisation which is now being carried out and which is referred to in the report may later prove helpful in preventing pregnancy for those couples who wish to prevent it but who are opposed, on religious grounds or other kinds of fastidiousness, to mechanical or other methods and who now rely upon the so-called safe period. I am sure your Lordships know what some doctors call those who prefer to use the safe period method of contraception. We call them parents. We believe that this research could prove beneficial in that particular direction.
Let me turn briefly to the increasing prevalence in our society of genetically transmitted diseases. In a sense, modern civilisation has taken evolution, Darwinism—the survival of the fittest—by the scruff of the neck and put it into reverse. We rightly make sure not only that the least fit survive, but that they grow up and multiply. The net result is a steady increase in the incidence of a number of genetically transmitted 530 diseases. Genetic counselling can, and indeed does, assist considerably, but we need more knowledge. It is in part to gain more knowledge that this work is taking place. If we had more knowledge of this kind, genetic counselling could do a great deal more. It should, in my view, be allowed and assisted to continue.
Looking for a moment at the more grotesque possibilities in the remote future of eugenic techniques to improve the innate quality of mankind, which depends rather more upon genetic than upon environmental factors, we are on very dangerous ground indeed. But it cannot be denied that upon any impartial examination of the world today the human experiment does not seem to have been an outstanding success.
There is a widespread and rather naive assumption that as long as time keeps passing, humanity will inevitably get better and better. In my view, that assumption is not wholly supported by the facts. Personally, I entertain hopes that some day we may even be superseded and replaced by a better and more agreeable species—but I have no doubt that some would regard that as a form of heresy. If a genetically-transmitted quality such as aggression could be bred out of us, that might be no bad thing—but we must not start trying to behave or think as if we were God. We are a very long way indeed from that stage of development.
Let us proceed rapidly to set up the recommended statutory authority to regulate and watch over all these worrying matters, and let us restrict work in this field to those licensed by the authority to undertake such work and to do so within the very sensible guidelines laid down in the report. In other words, I am endorsing the view already expressed by the noble Lord, Lord Ennals. All that would require minimal legislation.
On certain of the other matters, let us proceed cautiously and without haste. The law in this field is already in something of a muddle. We have a legal point of viability of a human foetus and all the consequences that flow therefrom. We now have a measure of legal protection for the human embryo in vivo, and we must now proceed in some way to protect the human embryo which is not in vivo. In addition, we must consider very carefully the legal rights of the child that is born as a result of these new techniques. I am less concerned about the rights of fully consenting adults—be they husbands or wives, fathers or mothers, or third parties. I believe that the majority report has got those things just about right.
Finally, some words of thanks from all noble Lords on these Benches to Dame Mary Warnock and all her colleagues and helpers for an invaluable, wise, and very perceptive review of a field of medical science about which opinions differ widely and will continue to differ widely. I grow a little tired of the fact that whenever a Royal Commission or a committee of inquiry, which may have sat for something like five years, publishes its report, the leader writers of the press—and sometimes, Front Bench spokesmen on both sides of both Houses of Parliament—are able to offer us all the answers instantaneously. One wonders why anyone bothered to appoint a Royal Commission or a committee of inquiry at all. The answer is that we must think a great deal more.
531 I personally can see no prospect of total unanimity in Parliament or outside it on these many matters. For the moment therefore let us proceed slowly, think further and more deeply, and refrain from jumping in with legislation to ban things until we are much more sure of what we are doing.