Regulating reproductive technology – less is more

Hurrah for the Science and Technology Committee. For once, a House of Commons select committee has reviewed the law surrounding a contentious area of science and social life – in this instance, the use of human reproductive technologies – and argued for less regulation, not more.

No wonder it’s controversial.

The report, Human Reproductive Technologies and the Law, puts a powerful case for putting key decisions about IVF treatment and embryo researchers in the hands of the people best qualified to make them: scientists, doctors and patients (1). It calls for the abolition of the legal requirement, in the Human Fertilisation and Embryology (HFE) Act 1990, that couples seeking IVF treatment should be officially assessed regarding the welfare of the child that could be born as a result. This requirement, states the committee, is ‘impossible to implement and unjustifiably discriminates against the infertile and some other sections of the population’.

On the question of selecting and screening embryos, the report states bluntly that ‘the spectre of eugenics should not be used to obscure rational discussion’. So in the face of cod-ethical media panics about ‘designer babies’, the select committee cautiously argues, in relation to sex selection, that ‘we have not heard compelling evidence to prohibit its use for family balancing at least’. In relation to decisions about preimplanation genetic diagnosis (PGD) and tissue typing, which can be used to create ‘saviour siblings’ whose birth gives the potential to treat an existing child suffering from a genetic disease, the committee says that it sees ‘no role for a regulator’ and ‘this should be a matter for patients, in consultation with their doctors, as long as they operate within legislation, and within ethical practice’.

The Science and Technology Committee attacks the change in the law surrounding anonymity for donors of eggs and sperm, claiming that ‘the evidence that supported this decision by the Department of Health [is] inadequate and misleading’. Rather, it suggests retaining the option of anonymity alongside non-anonymous donation, which would enable ‘donors and patients to make choices that reflect their circumstances’. And it even argues that a total prohibition on reproductive cloning – one of the most contentious aspects of embryo research – is not necessarily justified. This issue ‘raises many serious safety and ethical issues’, the committee claims; but ‘several of the prohibitions within the Human Fertilisation and Embryology (HFE) Act 1990 reflect an unwillingness to tackle taboos rather than coherent argument’.

Having robustly criticised so many aspects of the regulation of human reproductive technologies in the UK, it comes as little surprise that one of the committee’s key recommendations is to get rid of the regulator. The Human Fertilisation and Embryology Authority (HFEA), the government body that for the past decade has been charged with regulating fertility treatment and embryo research, has, according to the committee, tried its best under difficult circumstances but it has ’employed an excessive use of the precautionary principle’.

So the Science and Technology Committee suggests that ‘the current regulatory model, which provides the HFEA with a large amount of policymaking flexibility, should be replaced with a system which devolves clinical decision-making and technical standards down to patients and professionals while at the same time strengthening parliamentary and ethical oversight’. Another body should take over the other aspect of the HFEA’s remit: the regulation of embryo reasearch.

The committee has not shied away from the hard arguments, or adopted easy recommendations: which in this day and age generally call for greater precaution, and more regulation. But in refusing to take the easy route, it has not won many immediate friends. Indeed, the committee itself was split down the middle, and five members issued a statement publicly disagreeing with the report.

‘We believe this report is unbalanced, light on ethics, goes too far in the direction of deregulation and is too dismissive of public opinion and much of the evidence’, they said. ‘This report was always going to be controversial but to adopt an extreme libertarian approach from the start, on the basis that there was never going to be unanimity, was wrong…. As a result, we have a report which stresses…the importance of regulation. But then it goes on to recommend creation of hybrid animal-human embryos, unregulated creation of embryos for research and unregulated screening out of disorders in embryos for reproduction. Half the committee simply could not sign up to this.’ (2)

Geraldine Smith, Labour MP for Morecambe and Lunesdale, put it more succinctly. She termed it ‘the Frankenstein report’, and added: ‘It seems like anything goes as long as it’s science.’ Many news headlines have predictably followed the Frankenstein line, with one claiming ‘MPs call for sex selection’. And self-styled ethics groups are, also predictably, up in arms. ‘The kind of ethics we see in this report, which is incapable of saying a clear no to anything, is no ethics at all’, says David King, director of Human Genetics Alert (3). One wonders what the reaction would have been had the report recommended anything really outlandish.

For really, what has this select committee concluded? That people should be trusted to make their own fertility decisions, that doctors should be trusted with decisions about clinical procedures, and that the course of scientific research is better determined by scientists than government committees. Furthermore, the way the Science and Technology Committee presents its recommendations is self-consciously responsible – the need for an ‘evidence-driven’ approach to regulation, and the emphasis on ethical decision-making, is a constant theme.

In different times, this would hardly be a radical outlook. Indeed, in different times the very notion that the government should play an intimate role in deciding who should be allowed fertility treatment and precisely what sort of treatment doctors could give them, and in setting official limits on scientific enquiry, would cause an outcry. That a group of MPs should be pilloried as irresponsible mavericks (or ‘libertarians’, which today seems to amount to the same thing) by their colleagues simply for suggesting that reproductive decisions should be made by those best qualified to make them, indicates the strength of suspicion and risk-aversion that governs such discussions today.

Suzi Leather, chair of the HFEA, has called the report ‘radical’, and said that it makes ‘ a number of bold and challenging recommendations’ (4). But the spirit of these recommendations is shared by many of those directly involved with reproductive technologies – patients, who do feel unfairly discriminated against by the requirement to prove that they are suitable for parenthood while those who fall pregnant naturally do not have to justify themselves in this way; clinicians, who find their ability to treat patients in the best way they see fit compromised; and scientists, who find their work limited by over-cautious legislation.

In a statement to BioNews, a news and comment service published by the UK charity Progress Educational Trust, Ian Gibson, chair of the Science and Technology Committee, said: ‘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.’ (5)

Unfortunately, the climate that we live in does view ideas of liberty as dangerous and extreme – particularly in such areas of life as parenting, where it is assumed that people need greater official monitoring and support to make the right choices about how they raise their child, and particularly in areas of scientific progress, where the precautionary principle reigns supreme. The Science and Technology Committee’s report is very welcome for putting these issues back on the political agenda. Whether it will hold any sway with a government hell-bent on more regulation of science, medicine and parenting remains to be seen.

Read on:

Submission to the Science and Technology Committee’s Inquiry, by Tony Gilland, science and society director at the Institute of Ideas

(1) Informal Summary of House of Commons Science and Technology Select Committee Report, 24 March 2005

(2) Ethics row as choosing baby’s sex splits MPs, Guardian, 24 March 2005

(3) Ethics row as choosing baby’s sex splits MPs, Guardian, 24 March 2005

(4) HFEA Statement following the House of Commons Science & Technology Select Committee report, 24 March 2005

(5) Exclusive response from Dr Ian Gibson MP to BioNews on the Human Reproductive Technologies and the Law report, BioNews, 29 March 2005