HFEA up for the axe?

The inaugural meeting of CORE in 1994 was entitled, 'Human Reproduction  - Who Decides?' and the key speech was by an ex-HFEA (Human Fertilisation and Embryology Authority) committee member, Professor Robert Snowden. Focus was specifically on assisted reproduction and the controversial issue of whether or not human embryos should be created using eggs from dead adults or aborted fetuses. The HFEA was engaging in one of what has turned into a long series of consultations of this kind, and not surprisingly given the controversial nature of this issue, the response was colossal.

Not even the recent HFEA exercise to canvas public opinion on the equally controversial issue of creating embryos combining animal and human gamete elicited such a response. 

Most respondents to the 1994 consultation were not in favour of creating embryos from cadavers, either at the adult or fetal stage, whether for research or pregnancy. But undeterred, the HFEA refused to bow to public opinion and did approve the creation of embryos in this way. With the proviso that the public was not quite ready for using such embryos for full reproduction, so that particular proposal was put on temporary hold. With the current human egg shortage that horror will possibly be revisited.

CORE is not in favour of creating embryos from cadavers, aborted fetuses or other animal gametes, but what must be obvious to even the most utilitarian or libertarian observer is that these are very controversial proposals raising issues of great ethical and moral concern. And the question 'Who Decides?' is as acute as it was in 1994, and CORE's answer remains unchanged - 'Definitely not the HFEA'.

It is an unelected body set up to implement the regulations of the 1990 Human Fertilisation and Embryology Act, and no more than that. When the then Chair of the HFEA, Baroness Deech, in May 2002 suggested to the Science and Technology Committee that the HFEA was making ethical decisions to save Parliament any direct involvement, an almost apoplectic Bob Spink MP rebuked her stating that it is for 'Members of Parliament who are elected to make difficult decisions on behalf of society as a whole', and CORE believes certainly not the HFEA.

News that the HFEA is up for the chop is most welcome and was not unexpected. At the 7 July public meeting of the Authority, it was intimated that there were major changes ahead, and there was a sense of deflation amongst the usually ebullient members.

This did not, however, distract from the business to hand and CORE marveled at the Committee's surreal discussion of how many foreign languages HFEA patients' guides should be translated into.  Budgetary constraints ensure that such debates are probably now academic, but it was certainly more enlivening than business projections, licence application directions, standing order revisions and the like that followed.

Over the years the HFEA has followed the trajectory of most 'quangos', with staff increases, more meetings and sub-committees, glossy publications, literature thick with management-speak, and a fashionable commitment to transparency, accountability, and trends such as Twitter.

It is more than time to ask if this is necessary, particularly in these penny- pinching times. With a Government so committed to economic cuts, who could possibly complain if the HFEA were to go?

Certainly not Professor Robert Winston, who argued in a recent letter to The Times that there was no justification for singling out one medical treatment 'for unique regulation', and that IVF should not be accorded any special status.

CORE is not often in accord with Professor Winston, but in this instance we agree that much of what goes regarding the technical practicalities of IVF could be dealt with easily by a body such as the proposed Care Quality Commission.

Where we part company with Professor Winston, however, is in his dismissal of IVF's need for special status. The human embryo can never be considered as just another organ or tissue of the human body. UK Human Fertilisation & Embryology legislation in principle rightly acknowledges this, even if the nature of this status has never been adequately defined or upheld.

Decisions on complex ethical issues in the field of assisted reproduction should ultimately be taken by Parliament, but in the first instance should be deliberated by a democratic 'National Bioethics Committee', acting in a purely advisory capacity. This would have the standing of an independent statutory body, with a membership encompassing professionals, patient groups, major religious and ethical groups, fairly representing the diverse positions within society. Core believes that the creation of such a committee would bring the UK into line with most of the democratic world.

Absolutely no CORE tears for the demise of the HFEA.