Science and Technology report opens debate on assisted reproduction laws

When we announced that we were going to undertake a review of the Human Fertilisation and Embryology Act 1990, a lot of people said we were mad. They were absolutely right, of course, but someone had to do it. It was clear to us that the Act and the Human Fertilisation and Embryology Authority (HFEA) were struggling to come to terms with advances in technology and had not kept pace with changes in medical practice and social attitudes.

The 1990 Act was underpinned by the report of the Warnock Committee published in 1984. We found that its foundations were still sound. It was right that the embryo had some protection under the law but not human rights. This means that IVF is acceptable and that research on embryos was ethical provided that its value was compelling and the results could not be achieved without using embryos.

Critics of our report have described it as ultra-libertarian, which sounds as if it should be an insult. Why belief in liberty should be seen as extreme is beyond me. The issue should really be how we go about resolving those areas where there are conflicts between the liberty of different people and how the state goes about resolving these.

An easy area to resolve is the welfare of the child. When Suzi Leather (chair of the HFEA) came to give evidence to us, she described it as a central part of the HFE Act. It has certainly become a central part of the HFEA's policy, which is why we need to strip this provision from the HFE Act and stop the state making subjective judgements about people's private lives. The HFEA agonise over how welfare of the child should be interpreted but it doesn't matter what they do; it will still fail to provide any protection for potential children and it will still discriminate against the infertile and non-traditional families.

In contrast, embryo selection was much more difficult. While we were uneasy about a Government regulator making decisions on the criteria for PGD(preimplantation genetic diagnosis), there were good reasons for imposing some boundaries. For most applications of PGD, it seemed that the limitations in the technology would ensure that the choice of desirable characteristics was not realistic - except sex selection. In the end we were torn between legitimising cultural biases and the current absence of evidence of societal impacts. In the end, the lack of compelling reasons not to permit it, at least for family balancing, was persuasive. This principle, that evidence should be the cornerstone of policy in assisted reproduction, has been applied throughout our conclusions.

Our proposals on the regulation of research have been portrayed as being less stringent. This is not necessarily the case. We have said that all forms of embryo could be created for research provided that they were destroyed at 14 days. But this is coupled with a demand that proposals pass ethical scrutiny and rigorous scientific review. What we have taken out are the stipulations for research purposes in the legislation and the deliberations of the HFEA, which add nothing to the process of determining whether a research application is a valid scientific proposal. Our proposed change would reduce bureaucracy and eliminate inflexible rules on what constitutes valid ethical research.

Some people saw our inquiry as a scrutiny of the HFEA (not least the HFEA). While we found it necessary to comment on its performance in places, our principle concern was whether its statutory role was still appropriate. We concluded that the HFEA has performed a valuable role over the last 14 years but its had its day. The Spitfire is a cherished part of our heritage but we wouldn't press it into service to defend our shores now. We have proposed a regulator that sticks to ensuring that the highest quality of treatment is provided by enforcing high technical standards. If the Government needs an advisory body it should expand the remit of the Human Genetics Commission, as we suggested.

It doesn't mean that doctors and scientists can do what ever they like. Our proposals mean greater responsibility for health care professionals to inform the decisions made by patients and to collaborate to share best practice and data. Fifteen years ago assisted reproduction was a new profession but it now needs to mature.

During our inquiry (and especially in its latter stages), we had some heated discussions on the Committee. Now that we have finished, it is your turn to engage in debate, tackle taboos and tell the Department of Health what you think.

BioNews Editor's note: For your comments on the report email Department of Health at review-hfe-act@dh.gsi.gov.uk