Wisdom from the Lords

The Human Fertilisation and Embryology Bill was scrutinised so thoroughly that at times during the last three months the House of Lords felt like a forensic lab. Such was the level of expertise available to the House that a new term was coined, ‘noble and scientific lords’. Inevitably, in a House which includes religious representatives, ethicists and lawyers the social aspects of the Bill were debated extensively. No doubt similar debates will occur in the Commons. Any MP preparing to address the social aspects of the Bill will find it useful to read, and contrast, the speeches of Baroness Deech and Lord Carlile.

One of the most interesting aspects of the passage of this Bill through the Lords was that it gave rise to genuine debate in which people changed their minds and unforeseen issues came to the fore. Five significant issues were raised in the Lords, four of which the government undertook to address in the Commons.

The most important issue, as those who read the letter in The Times from the leading research scientists in the UK will know, is the continued use of existing stem cell lines. There is a bank of stem cells which have been derived from donors over many years, and which have been worked on to the point that they can now be used for research into particular conditions.

Many of the patients who donated cells did so when evidence of consent did not have to meet the standards of Human Rights Act compliance. Furthermore, many of the patients, whose identity is now not known because tissues are anonymised, simply gave general consent for research not for specific forms of research.

Some Peers argued that donors may have refused to allow their cells to be used in research which involves human admixed embryos. Others argued that the loss of this cell bank will be so devastating to research that an exemption, for these cells only, should be permitted.

Lord Patel raised the issue of use of cells from children. Scientists state that this is necessary in order to study life-limiting conditions, such as Batten’s Disease, which are so severe that those affected do not survive to adulthood. Many Peers believe that removal of cells from someone who cannot give consent is wholly unethical. Others believe that the potential to research cures is a compelling reason to permit such research within clear ethical boundaries. The government has agreed to consider proposals to align this Bill with the existing provisions of the Mental Capacity Act.

Recent advances in research have given rise to the possibility that at some stage in the future it may be possible, using somatic cells, to create artificial gametes. It might be possible to take cells from a man, say one who is about to undergo chemotherapy, and develop artificial gametes which would enable him to have a child. The government’s reason for rejecting amendments proposed in the Lords is that, if it were possible, same sex couples could ask to be given the same right to this treatment as heterosexual couples. Futuristic it may seem, but as this legislation is likely to govern the ethics of reproductive medicine for some years this issue requires serious consideration.

Several Peers addressed the existing gap between licensing for research and licensing for therapy. The government’s stated view of what is possible under existing regulatory arrangements altered hugely between the committee and report stages. Given the potential for therapies to be developed soon, this issue should be clarified in the Commons.

The Lords spent an undue amount of time considering a proposal for a standing national bioethics commission. The most substantial argument in favour is dissatisfaction with the composition of existing bodies such as the Nuffield Council on Bioethics. That is hardly a reason to set up a duplicate body. MPs could usefully consider whether the establishment of a parliamentary select committee of both houses with a remit to advise on the ethical and legal implications of developments in biomedical research and medicine would be worthwhile.

Finally, the best advice for those about to debate this contentious, fascinating subject is to read the speeches of Lord Walton, Lord Patel, Baroness Warnock and Baroness Williams, which provide insight and wisdom in a way which no amount of briefing can convey. I hope that the above mentioned issues will be settled before the Bill returns to the Lords later in the year.

Baroness Barker is Liberal Democrat spokesperson on health in the House of Lords.