Ethics

Contents:

1. Evidence-base and public opinion
2. Monitoring, regulation and licensing
3. Animal-human hybrids
4. Stem cells
5. Saviour siblings
6. Need for a father
7. Abortion:-
• Current opinion
• Current evidence:
• Fetal survival
• Fetal pain
• Mental health risks of abortion
• Reports - Science and Technology Committee
• Organisations - BMA, RCOG etc

1. Evidence-base and public opinion

Here is the 2006 report on the 2005 public consultation. Much of the evidence and opinion given in the public consultation was overlooked or even blatantly disregarded:

- Opinion ignored on the need for a father

Paragraph 2.25 states: Responses to the Government's consultation from individual members of the public generally favoured retention of a reference to the child's need for a father…

However, the government ignored this evidence and is now advocating fatherless families by removing from the Act the current stated requirement to consider the IVF child's need for a father.

- Opinion ignored on hybrid embryos

Paragraph 2.83 states: The Government recognises that there is considerable public unease with the possible creation of embryos combining human and animal material, and particularly to the prospect that such entities could be brought to term. This view was strongly represented in responses to the Department of Health's consultation.

However, the HFE Bill now proposes to create entities combining animal and human genetic material.

CMF opinion

You can read CMF's submission to the joint parliamentary scrutiny committee.

Recent public opinion

A poll of the general public carried out in late March 2008 showed:

• 79% think it is important to consider the child's need for a father in IVF
• 60% think it is wrong to create animal-human embryos (only 33% think it is right)
• 51% agree creation of 'saviour siblings' denies the child a choice in how their body is used

The extensively quoted Populus poll purporting to show 50% support for animal-human hybrids contained a highly loaded question.

2. Monitoring, regulation and licensing

Agree licensing should remain but stricter regulation is required, which should be done in an open and accountable manner. The Human Fertilisation Embryology Authority has consistently and repeatedly gone beyond its mandate. For example, the HFEA has already granted licences for animal-human hybrids, before it has been considered in Parliament.

This led recently to protests from a cross-party group of over 40 MPs who have varying perspectives on issues in the bill but share the view that the granting of licences was an abuse of the democratic process. Their letter to the Telegraph should be widely quoted in correspondence to MPs.

It was this granting of licences even before Parliament had ruled on the issue that led to the production of animal-human hybrids in Newcastle, announced in the media on 1 April.

It needs to be ensured this 'active monitoring' is implemented in reality.

Britain is regarded as a rogue state in many countries and has amongst the most liberal laws in the world in this area of research.

3. Animal-human hybrids

Evidence and opinion from the public consultation about creating animal-human hybrids were ignored. Creating animal-human hybrids opens a can of worms, striking at the core of our identity and humanity. It is not merely a scientific question to be decided on by a group of select people; it is a profound moral and philosophical decision that should not be taken lightly. No consideration of possible consequences appears to have been considered in this.

No one has yet demonstrated what therapeutic use chimeras or true hybrids might be put to, yet the government is trying to legalise them anyway – we should question their motives, which have no evidence base.

Leaving aside the ethical issues, the only hybrids that might conceivably be of use are cybrids (cytoplasmic hybrids) but these are produced by cell nuclear replacement (ie. cloning by the Dolly method). This method of cloning human embryos is so inefficient that no one has yet grown a cloned human embryo beyond the blastocyst stage. It does not work. In the meantime the cost and risk to women of producing eggs in the numbers necessary has led scientists to turn to placing human DNA into animal eggs by using the Dolly method – creating animal human cytoplasmic hybrids or 'cybrids'.

The production of animal-human cybrids was first announced in China in 2003 but there has been virtually nothing published about them for five years since, suggesting there have been huge difficulties in finding any new scientific applications.

You may find it useful to quote Dr David King, a secular scientist from Human Genetics Alert, commenting on the recent news that scientists in Newcastle had created hybrid embryos. There are 3 good paragraphs from him in a recent Telegraph article:

For anyone who understands basic biology, it is no surprise that these embryos died at such an early stage. Cloning is inefficient precisely because it is so unnatural, and by mixing species it becomes even more unnatural and unlikely to succeed.

The public has been grossly misled by the hype that this is vital medical research. Even if stem cells were ever to be produced, like cloned animals, they would have so many errors of their metabolism that they would produce completely misleading data. This research is a complete waste of taxpayers' money.

The timing of the announcement of this non-result, just as Parliament is about to debate legislation on hybrid embryos is typical of the Newcastle lab's tendency to manipulate the media and politicians. The BBC has been duped into making this a news story, which will then be used to persuade politicians that animal-human hybrids are promising science. This is 'science-by-press-release' which breaks all the scientific community's ethical guidelines.

Most MPs will not have heard these arguments – it is really crucial to make the point that not only is this technology unethical but the indications are that it will not work.

Response

Licences for this unproven therapy have already been given even before Parliament has made these techniques legal.

Ethical alternatives

There are ethical alternatives that we need to invest in, such as adult stem cells, umbilical cord blood stem cells, and induced pluripotent stem cells (iPS) – we should not be embarking on this research unless it is both necessary and desirable. MPs seem to be pushing for research to be desirable or necessary – being desirable only would give scientists a free rein to do whatever they desire!

4. Stem cells

Why not? Scientists themselves recognise that it is adult and umbilical cord blood stem cells that are going to provide future therapies, because of the difficulties in culturing embryonic stem cells and the dangers of implanting them. Embryonic stem cell research is now only being looked at to increase understanding of how abnormal diseased cells function, and this can be examined in other ways now using iPS.

Leading scientists in Japan and the US (Yamanaka and Thomson) have recently produced embryonic like stem cells (iPS) by reprogramming adult stem cells. Ian Wilmut, the Edinburgh scientist who cloned Dolly the sheep, has now abandoned embryonic stem cell research because using reprogrammed adult stem cells (iPS) is far more likely to yield research results. Newspaper links:

• Dolly the sheep creator
• The Japanese scientist Yamanaka

This method of reprogramming adult skin cells (fibroblasts) into iPS by injection of just four genes is much more efficient. The Medical Research Council has recognised this and is now channelling £600,000 of funding to develop iPS (induced pluripotent stem cells).

Adult stem cells have provided clinical benefits in over 70 diseases and there have been none from embryonic research.

The government based its current policy with regard to embryonic stem cells on the Donaldson Report (1999). This promised a cure for degenerative diseases such as Parkinson's, diabetes and Alzheimer's. However, embryonic stem cells have yet to provide a single therapy for any human disease. Embryonic stem cell research is not the answer.

Further links to CMF pieces on stem cells:

• www.cmf.org.uk/literature/content.asp?context=article&id=1913
• www.cmf.org.uk/literature/content.asp?context=article&id=1556

5. Saviour siblings

Links to helpful articles from CMF and others:

• CMF briefing paper on saviour siblings
• CMF File (2005) on saviour siblings
• All Party Parliamentary Pro-life Group on saviour siblings
• CMF briefing paper on pre-implantation genetic diagnosis

6. Need for a father

A poll carried out in late March 2008 showed 79% of the general public think it is important to consider the child's need for a father in IVF.

Much of the evidence given in the public consultation was overlooked or even blatantly disregarded. Paragraph 2.25 even states: Responses to the Government's consultation from individual members of the public generally favoured retention of a reference to the child's need for a father…

However, the government ignored this evidence and is now advocating fatherless families by removing from the Act the current stated need for a father for IVF children.

Links to helpful articles from CMF and others:

• CMF briefing paper on fatherless families
• All Party Parliamentary Pro-life Group on need for a father

7. Abortion

Although abortion is not currently mentioned on the face of the HFE Bill, it opens up the opportunity for the current law on abortion to be amended – tightened, or further liberalised.

This is just incorrect. Does the government really believe that almost 7 million abortions since 1967, now 200,000 a year, and one in four pregnancies ending in abortion, is what Parliament intended? Even Lord Steel who introduced the 1967 bill says the limit should be set to 12 weeks .

This goes against public opinion. A 2007 survey showed 68% of people, including 72% of women, want a substantial reduction in the upper time limit to around 13 weeks.

The Chief Executive of Marie Stopes (the largest abortion provider in the UK outside the NHS) said 'We do feel that in the light of medical developments the upper limit should come down' (Tim Black, Chief Executive, Marie Stopes International, Sunday Times, 3 April 2005). Marie Stopes have since retracted this statement after being pressured by pro-choice groups.

This goes against current evidence. See following pages on fetal survival and fetal pain.

Current evidence: fetal survival

There are a number of peer reviewed studies which demonstrate the significant improvement in survival rates of babies born pre-term if neonatal intensive care is provided at birth.

This exposes the weakness of the EPICure study (currently the basis for the government's stance) which averaged out all births at all hospitals across the UK and took no account of the postcode lottery of neonatal care which exists in the UK. Outcomes for mother and baby will depend very much on the quality of care available in the hospital at which the mother presents.

The current abortion time limit was set in 1990. Neonatal care has progressed since then and premature babies now survive below the 24-week time limit. This means that in one part of the hospital doctors will be giving the benefit of full neonatal care to a baby born prematurely at 23-weeks' gestation whilst in another part of the hospital a baby of the same gestational age is being aborted. In the best-resourced units survival has improved steadily year-on-year for extremely preterm infants born at 24-weeks' gestation or less.

Abortions continue to be performed at a stage in pregnancy when babies are capable of being born alive. A paper published by the West Midlands Perinatal Institute in 2007 revealed that in that region 3.2% of babies aborted for abnormality were born alive, with aborted babies showing signs of life from as early as 17 weeks' gestation.

See: Newspaper article on 66 babies being left to die after botched abortions. Arguments for lowering the 24 week upper limit are summarised in a recent Triple Helix Editorial

Current evidence: fetal pain

Response:

• This research is over 10 years old
• More recent research, such as Prof KJ Anand's (see below) suggests that the foetus is capable of experiencing pain from at least 20 weeks' gestation and possibly as early as 17 weeks' gestation. This means that babies aborted in these later stages of pregnancy may suffer excruciating pain. This evidence was recently ignored by the House of Commons Science and Technology Committee.

Read this newspaper article

Journal article: Lowery C, Hardman M, Manning N, Hall R, Anand K. Neurodevelopmental Changes of Fetal Pain. Seminars in Perinatology 2007; 31:5: 275-282

Current evidence: mental health risks of abortion

Practice has been based on the 1994 statement from the Royal College of Psychiatrists that there is 'no evidence… of an increased risk of major psychiatric disorder or of long-lasting psychological distress'.

In March 2008 the RCPsych released new guidance and it recommends that 'adequate and appropriate information regarding the possible risks and benefits to physical and mental health' are given to the woman. The RCPsych are now undertaking a full systematic review of the evidence.

Reports

Science and Technology Committee's report on abortion: In October 2007 the Commons Science and Technology Committee produced a report on abortion. This will be used to form parliamentary opinion relating to the HFE Bill. The committee was not balanced and did not listen to both sides; for example, of 18 witnesses chosen to give evidence 13 were for the abortion law to be liberalised.

Fundamental evidence was ignored in this report. CMF regards this report as 'deeply flawed'.

At the time it was published two MPs on the committee produced a minority report, which gives a more balanced and objective view of the evidence. This minority report includes more information on the following issues:

• Requirement for two doctors' signatures – no current evidence it delays procedure.
• Involvement of nurses – evidence was not submitted on this topic even though conclusions were given.
• Places where abortion can be carried out – recommendations of Science and Technology Committee's majority report are unsafe.

Organisations

Comment from the minority report: 'Since 1997, the RCOG has consistently denied that foetuses can feel pain earlier than 26 weeks, without acknowledging that amongst experts in this field there is no consensus. Professor Anand is a world authority on the management of neonatal pain and has put forward a cogent argument suggesting that the RCOG position is based on a number of false or uncertain presuppositions. The RCOG in response to comments by Anand in a Channel Four Dispatches programme has issued a press release claiming they keep a 'watching brief on new scientific developments and advancements in foetal medicine, and continue to examine emerging evidence from the international scientific community about foetal awareness and foetal pain' but are 'unaware of the work of Dr Anand or any other work that contradicts the basic findings of (their) review.'

'For the RCOG to report the studies of researchers who share their own official position, whilst ignoring research published by other leading researchers with contrary views, is at the very least misleading and at worst a serious abuse of power. It seems bizarre that the RCOG has not made more of an effort to find out more about contrary evidence before making such a bold public statement.'

Representation at these organisations should be called in to question: For example, Evan Harris MP, who is the Secretary of the All Party ProChoice Group, was crucial as a member of the BMA Ethics Committee in determining the BMA's official line, and was also very influential in the Science and Technology Committee, tabling over 100 amendments to their draft report. These committees comprise prominent pro-choice advocates.

More information on aspects related to abortion:

• CMF briefing papers
• Updates on news and recent articles