The Submission by Affinity to the Department of Health’s Public Consultation on the Review of the Human Fertilisation and Embryology Act 1990.
To understand the questions and proposals to which this submission refers, you will need to read it in conjunction with the Department of Health’s electronic response template at www.dh.gov.uk/assetRoot/04/11/78/73/04117873.doc and maybe even with the document entitled, Review of the Human Fertilisation and Embryology Act: A Public Consultation at www.dh.gov.uk/assetRoot/04/11/78/72/04117872.pdf
AFFINITY (formerly the British Evangelical Council, which was founded in 1952) is a network of evangelical Christian denominations, church groupings and independent causes. It is probably the largest association of exclusively Bible-centred churches in the United Kingdom, representing approximately 1,200 congregations.
This submission has been produced by Affinity’s Social Issues Team, composed of those with expertise in bioethics, law, social trends, theology, politics and education.
We note that the Department prefers responses to the 74 detailed questions of this Consultation via the electronic response template. Our submission is not in this format. Instead, we have responded to groups of questions and proposals using the 10 given general headings. We apologise in advance if this creates problems in analysing our answers.
Affinity’s bioethical position
Affinity has always sought to develop and maintain a consistently biblical approach to bioethical issues. This has resulted in what some may consider to be a conservative stance. Nevertheless, our position is robust, yet simple – a unique human life is created at fertilisation. Because all human life is made in the image of God, it is inherently valuable and must never be the subject of deliberate destruction. Since destruction is inevitable in IVF and embryo research, we are opposed to such reproductive treatments and such experimentation.
What is more, we are increasingly dismayed by the escalating numbers of embryos deliberately destroyed. When human embryos are regarded as mere biological material, means to an end, and expendable, then human life is manifestly downgraded and we all become significantly diminished.
However, our opposition to current practices does not mean that we are uninterested in the subject matter of this Consultation. On the contrary, we are especially keen, as good citizens, to engage with Government in this unique opportunity to shape future legislation and draw ethical boundaries in areas that are of fundamental importance to all sections of society. After all, what could be more important than influencing these matters of life, death, family and society?
The model and scope of regulation (1-12)
Affinity is, of course, adamant that the use of all human embryos, whether in assisted reproductive technologies or in research experiments, must be subject to the most strict legal framework.
However, we do not consider that the current model has worked well. We have no objection to Parliament setting that legal framework, but on many occasions we have despaired at some of the decisions and attitudes of the Human Fertilisation and Embryology Authority (HFEA). That Authority has repeatedly ridden roughshod over public opinion, it has often not consulted, and hence its pronouncements have too often been both unrepresentative and substandard, which have resulted in embarrassing backtracking or rapid modification.
To state that the HFEA has consistently been composed of members who are ‘poachers turned gamekeepers’ may be too strong, though, at the very least, conflicts of interest over licensing, regulating, inspecting and research proposals must have arisen frequently. Certainly their decisions and declarations have been generally non-interventionist and typically unprincipled.
Because of these basic problems, Affinity would not oppose the dissolution of the HFEA. Furthermore, we would recommend that Parliament grasps this opportunity and insists that major policymaking decisions are its remit, and not those of an unelected body. Although some form of licensing body is required to implement Parliamentary decisions, now is the time to review its responsibilities, powers, and especially, its composition and accountability. A clear demarcation between policymaking and day-to-day regulation is required.
To facilitate this separation of powers, Affinity would support the creation of a permanent bioethics commission. Such a commission, unencumbered by any regulatory role, could promote widespread debate, explore ethical principles, consider future directions and assess their biological, social, moral, economic and spiritual implications, and then advise Parliament. The operation of such a commission would undoubtedly improve the current ad hoc approach to these vital issues.
Affinity would welcome changes to the current legislation so that all human embryos, created outside the body, by whatever means and for whatever purpose, are subject to regulation. Similarly, all ova intended for the creation of embryos should be subject to regulation.
We support the prohibition of the use of artificial gametes. There is no need to include a ‘flexibility’ clause in the Act – any such fundamental changes must be returned to Parliament to be the subject of primary legislation.
We support the prohibition of internet services that supply sperm and ova – human gametes must never be allowed to become mere commodities.
Since the transfer of a single embryo during assisted reproductive techniques should result in fewer ‘spare’ embryos being created, we would support such a move within Parliament.
Our opposition to assisted reproductive techniques includes, albeit in a minor way, their high costs, but we are also aware that market forces largely determine the prices that consumers will pay, rather than those set by any regulator.
We are very wary of extending the powers of any regulatory body.
Welfare of the child (13-17)
The welfare of the child should remain a paramount consideration. It is because of the artificial nature of IVF that clinicians have the unique opportunity to assess some aspects of the child’s welfare and therefore it should remain their obligation. Since this matter should be retained within the Act, it should also be the subject of evaluation by any regulatory body.
And ‘welfare’ consists of more than just ‘medical welfare’, or the risk of ‘serious harm’. Proper judgements of welfare must include clinical, familial, psychological and social aspects, and these will, from time to time, inevitably result in the pronouncement of ‘No’.
Further to the above, we do not support the removal of the ‘need of the child for a father’. Children need both fathers and mothers and we cannot support moves to either discourage parental responsibility or discriminate against, or denigrate the role of either parent. The damaging effects caused by these moves to children, and to society, are becoming all too obvious – those in the assisted reproductive industry must not be allowed to become intentional contributors.
The use and storage of gametes and embryos (18-30)
The issue of written consent serves again to highlight the artificiality of assisted reproductive techniques. While we cannot condone such techniques, we concede that written permission probably safeguards, at least to some extent, the future use of stored gametes and embryos. And if the use of gametes requires written permission, then why not their storage? After all, the intention of storage is solely for their use. Nevertheless, such proposals confirm our uneasiness about all these endeavours – once a bad practice is permitted, other dubious practices are bound to follow.
Hence, our consternation at the ethical tangles created by withdrawal of consent and the fate of stored embryos. We can never support procedures that deliberately allow human embryos to perish. It would be best if they were never created, and it would be better if they were offered and transferred to other infertile women. Similarly, embryo storage, a miserable by-product of IVF, is such a bioethical nightmare, we would prefer not to comment.
The whole assisted reproductive industry needs to be entirely accountable and transparent. This is the way to reduce mix-ups, scandals, malpractice and unrealistic expectations. Therefore, more, not less, information about treatments and more appropriate counselling should be the legal requirements.
The payment of gamete donors is an unpalatable topic. If Parliament wishes to maintain an altruistic edge to the IVF industry rather than risk increased exploitation, then payments should be within the levels of compensation rather than ‘what the market will bear’.
Reproductive choices: screening and selection (31-38)
Affinity is opposed in principle to screening, both for and against disability. It is the road to eugenics because those embryos which ‘fail’ such screening criteria will be destroyed. We reject the thinking that one human life is more valuable than another – this is at the root of shabby discrimination and it is unworthy of the support of any Christian organisation.
Since we consider that embryo screening and selection are invidious procedures, we are opposed to the use of PGD for so-called family balancing, the production of donor siblings and sex selection for non-medical reasons. The HFEA has, in the recent past, shown itself to be quite incapable of formulating principled policy in these areas. These issues are so serious that they demand the attention and legislation of Parliament.
Information and the HFEA Register (39-49)
We find it very difficult, no, impossible, to comment on the proposals in this section of the Consultation. We are so sorry that this and previous Governments have allowed such bioethical dilemmas to accumulate. Not only has the commodification of children been allowed, but now ‘new’ problems, such as, the identity of these donor-conceived children, to what family do they belong, and who can they marry, have surfaced. We feel our society has become like those of whom it was said, ‘They sow the wind and reap the whirlwind’ [Hosea 8:7].
We have consistently opposed the practice of surrogacy because it is clearly condemned by the Bible. Though we would wish to see a decrease in this dubious practice, we would recommend that no changes be made to current surrogacy law, certainly nothing that would encourage it.
Status and legal parenthood (53-56)
Practices such as IVF and surrogacy bring with them a trail of problems.
We will not support a further belittling of marriage by this or any other Government. While married and unmarried men can share the same paternal status, they cannot be equal in marital status, nor can those who opt for civil partnerships. Unless a condition of assisted reproductive treatment for a man and a woman is that they are a married couple, then such intractable problems will remain, and increase.
We have never recognised any basis for the 14-day rule – it has always been entirely arbitrary and lacking in any biological or bioethical principle. However, we would support a reduction in this time limit only because it would decrease embryo abuse.
Furthermore, since we are opposed to any research on human embryos that results in their destruction, we do not support their use in studying mitochondrial diseases, nuclear replacement, other genetic alterations, human-animal hybrids, or chimera embryos.
If such research is permitted, it must be controlled by the most strict legal framework and safeguards. Such research projects need to be rigorously assessed as to their safety, timeliness and appropriateness. We, and many others, fear that some such research is too often driven merely by the scientific imperative. The application of stem cell technology and the debate over the use of adult versus embryonic stem cells is a current example of such apparent inappropriateness. The work of a widely-respected, permanent bioethics commission should help allay fears in this and other areas.
The Regulatory Authority for Tissues and Embryos (66-72)
Since we consider that the HFEA has failed in many aspects of its duty, we are happy to see it disbanded. However, we see no reason to think that the RATE will be an improvement – its membership, fund-raising, inspection policies and so on, appear to be no different from those of the HFEA.
The great need is for a more accountable body, taking direct instructions and decisions from the constituency of Parliament. The other issues raised in this section of the Consultation, such as, sanctions and maximum penalties are, by comparison, minor.
Affinity welcomes the opportunity to review the 1990 Act. Though we cannot support many of the practices outlined in that Act, we can see that, in some areas, it is outdated. In particular, the linkage between legislative (Parliament) and regulatory (HFEA) functions needs serious attention.
It is clear that the HFEA has proved itself to be largely incapable of performing its duty, whether as an unelected body, or in overstepping its remit. It is therefore time that Parliament regained the oversight of the issues relating to assisted reproduction and embryo research.
A regulatory body is required, but it must act as the servant of Parliament, not its master. In addition, we would support the formation of a bioethics commission. This could, among other projects, undertake long-term reviews of current and future trends, devise robust frameworks of ethics and practice, in order that it would be the advisory body to Parliament. This should, in turn, produce a better understanding of, and a greater confidence in the ethics and practice of these bioethical issues.
Dr John R. Ling
PO Box 2119
Reading RG1 7WS.