Fellowship

Nearly 50 people gathered in the Clinical School at Addenbrooke's Hospital, Cambridge on Saturday 8 March to consider the government's HFE Bill. After a welcome and prayer from the Chairman and conference organiser, Peter Phillips, a consultant geriatrician in Ipswich, CMF Head of Communications Andrew Fergusson gave an overview.

He began with the birth of Louise Brown, the world's first 'test tube baby', in 1978 and moved through the Warnock Committee with its 1984 report to the 1990 Human Fertilisation and Embryology legislation. This had enacted the Warnock recommendations to 'respect' embryos but allow destructive research up to 14 days after fertilisation, had set up the HFE Authority, and had amended the 1967 Abortion Act by reducing the upper limit for most abortions from 28 to 24 weeks, at the same time permitting abortion to term for 'substantial risk' of 'serious handicap'.

The science subsequently moved fast with the birth of Dolly the sheep, the first mammalian clone, reported in 1997, and with 'therapeutic cloning' of humans being legalised in 2001. These developments meant the law needed revising, and while an initial proposal in 2007 to merge the HFEA with the Human Tissue Authority had been rejected on the grounds the merged body would be too big and unworkable, there were areas of serious concern to CMF.

He highlighted these by reporting the outcome of amendments CMF would have wanted passed in the Lords' debates, but all of which had been lost:

• Banning all animal-human hybrids – lost by 96 to 268
• Banning all 'saviour siblings' – lost by 62 to 180
• Restricting the use of saviour siblings to life-threatening diseases – lost by 121 to 162
• Maintaining recognition of the need for a father for children created by IVF – lost by 93 to 164
• Ending abortion after 24 weeks (ie discriminatory abortion for disability) – lost by 22 to 89

Before later speakers expanded in these specific areas, CMF General Secretary Peter Saunders spoke on What does it mean to be human? He described the massive shift in Western worldviews from Christian beliefs that we are created by God but fallen, that temporal help for our problems requires God's wisdom as we apply science and technology, and that the resurrection gives us hope for immortality, to the dominant secular beliefs that we are here by chance and evolution, that science and technology alone are the answers, and that they will one day give us immortality. Theism had become deism, which had become atheism, and existentialism had followed.

He saw Darwinism and Higher Criticism (where there was no faith in the authority of Scripture) as the two chief agents, and commented that human intuition had replaced divine inspiration. He traced the consequences of this in medicine from the Hippocratic Oath to the post-war Declaration of Geneva, whose statement to protect life 'from conception' was later watered down to 'from its beginning'.

Consumerism says 'We want it!' Technology says 'We can do it!' Relativism says 'Why not?' The healer has become the technologist, the caregiver the needs-meeter, and the servant the businessman. He contrasted the great Christian physician Sydenham (the 'English Hippocrates') with the animal rights guru and philosopher Peter Singer. We had moved from sanctity of life to speciesism.

He emphasised five broad Christian principles in response:

• Genesis 1 tells us that God created differences ('their kinds') and that humans alone are made 'in the image of God'.
• Genesis 1 also makes us stewards of creation, with authority and accountability. We serve without exploiting, recognise the ethics of ends and means, 'restore the masterpiece', and do God's work God's way.
• Genesis 2:24 sets the basis for marriage and family and raises questions about donor gametes. We are 'begotten not made'. Children need protection, nurture and discipline, and lineage and heredity are important to identity in the family.
• The concept of the sanctity of life arises from the image of God, and is expressed in Genesis 9:5-6 and Exodus 20:13. The intentional killing of the legally innocent is prohibited, and the strong discriminate for the weak.
• The status of the embryo was reviewed from philosophical defences and biblical references. Justice and impartiality were emphasised, and objections to conservative views were considered.

Dr Phil Jones works for the MRC Cancer Cell Unit in Cambridge and is a Fellow of Clare College. He spoke on Stem cells: crossing boundaries? As an expert in stem cell technology he reported that most of the science debated in the Bill is already out of date. The proposal to use animal eggs because of a shortage of human eggs was rendered obsolete after the November 2007-reported successes with iPS – induced pluripotent stem cells (adult fibroblasts reprogrammed back to behave with all the potential of embryonic stem cells). He described iPS as 'the most important advance in cell biology in the last 30 years'.

Reflecting ethically on 'what makes us human?' he said that it was not the 1-2% difference in DNA from the animals, nor the Warnock attribute of abilities, but was in the gift of personhood – God knows us. He commented on the attitudes of most of his scientific colleagues towards Christians – they had not forgotten the Inquisition and Galileo – and made a plea for constructive dialogue.

A helpful explanation of stem cells followed, and he pointed out that since this year, embryo destruction was no longer required to make ESCs – a single cell could be removed. The history of using rabbit eggs (China 2003) was reviewed and 'cybrids' were considered. He said that the rabbit cell became human within a few days and that the human genome was not altered, although he recognised that there was animal DNA in the mitochondria.

However, the HFE Bill did not just propose cybrids, but also chimeras and true hybrids (50% human and 50% animal). He could see no reason scientifically for ever considering this. After commenting on interspecies consequences apparently approved in the Bible (kings riding on mules!) he mentioned the $120 million mice that produced human antibodies.

He ended by repeating that iPS were the way ahead, and that just in the last four weeks work on them had been done without any risk of cancer. He hoped that the demands for cybrids would disappear, redundant, and reminded us that in his specialty '2006 was the Stone Age'.

The next hour concentrated on the threats to the family contained in the Bill. Dr Rhona Knight is a GP and academic who sits on the Nuffield Council on Bioethics, and she spoke on PGD and slippery slopes (introducing us to the new term 'function creep' which some find more acceptable than the language of 'slippery slopes'!)

Having described the origin of the technology of pre-implantation genetic diagnosis in 1989 with its intention to produce 'saviour siblings', and noting that 49/50 embryos perish for every live birth, she mentioned the Nash case in the USA and the Hashmi case in the UK. The HFEA gives permission for PGD and is becoming more liberal in policy, now approving PGD for 'risk' of illness.

Relevant issues include the degree of penetrance of the abnormal gene, the large numbers of eggs needed, the absence of long term data on the safety aspects for a child who has had a cell removed at an early stage for testing, epigenetic factors, the psychological effect on the 'saviour', and the psychological effect on the mother. This last point was illustrated by a video clip, and we then broke into pairs to consider:

• What does PGD say about people with disability?
• What are we saying about how life is valued?
• Whose choice is it?

This last point was further illustrated with another video clip, from Daniel Deronda: 'I chose for you what I would have chosen for myself'.

The HFE Bill was breaking new ground in that none of this had ever been legislated for before; the HFEA had issued licences. The slippery slope issues now were that more tissues were being proposed for removal, and for a much wider range of conditions than hitherto licensed.

In closing, she commented on 'lives unworthy of living' (words of Leo Alexander at the Nuremburg war crimes trial) and quoted the scriptures Galatians 3:28, Proverbs 24:11-12, and Matthew 22:37-39. How do I love my unborn neighbour? How do I love my embryo neighbour?

Philippa Taylor consults with CARE on bioethics and family issues, and she spoke on fathers and the family. She pointed out that family composition was changing and parenthood was being redefined. 'Husband' and 'wife' had become 'partner'. There was conflict between the concepts of genetic parents and legal (social) parents. The language of 'discrimination' was driving the debate and the law was determinant. The Bill sought to make equal any two person arrangement for having and raising children. But what rights did the children have?

In the 1990 HFE Act the requirement for those providing IVF to consider the need of the child for a father was an important principle, but the equality and discrimination agenda, and possibly the European Convention on Human Rights had affected understandings. How are the rights of children and adults to be balanced? While those conceiving naturally are unregulated, the state is assuming responsibility in IVF, and the ECHR is not clear. A recent public opinion poll had shown that 77% of the population thought the need for a father should be retained, rising to 84% in those aged 18-24. Further, the unique role of fatherhood was distinctive; it was not just about having another figure present.

The Bill proposes removing from some children any chance of ever having a father. If both persons in the parenting arrangement are to be women, then 'no man is to be treated' as a father. While there were parallels with gay adoption, and while not all children have a parent or parents, here the law was setting out to create children without fathers.

Thirdly, 'parenting certificates' were to make no mention of donor conception. If two females were recorded on the birth certificate, this was not an accurate record. CARE's position was that the state should not deny people knowledge of genetic identity, for medical reasons and reasons of rights and identity. The birth certificate should record 'by donation' and there should be a separate adoption certificate. Adopted children have two certificates and IVF children born after 3rd party donation should too. 'Who am I?' was an important question for everyone.

So, should the law be changed to redefine parenthood? Could a male be 'mother' and a female be 'father'? Philippa hoped that amendments to retain fathers would be successful in the Commons.

The afternoon sessions were much more pragmatic and practical, concentrating on action we could take, but first the question of abortion was considered. Abortion does not feature on the face of the Bill at all but, as in 1990, there will be amendments added by both sides.

Peter Saunders briefly reviewed How did we get here? by summarising the 1967 Act and the 1990 amendments, by giving some current statistics, and by quoting from the Abortion Choice website.

Regarding likely amendments in the Commons in 2008, Andrew Fergusson amplified What liberalisers want:

• Abortion on demand in the first trimester, with abolition of the need for two doctors' signatures
• Nurses and midwives to perform medical (and later surgical) abortions
• Abortions to be carried out in premises not currently licensed (with the eventual goal of the second stage of medical abortions taking place in women's homes)
• Extension of the 1967 Act to Northern Ireland
• Those with conservative views on abortion being prevented even from seeing women with crisis pregnancies

By contrast, the Alive and Kicking Alliance wants:

• None of the above
• An immediate substantial reduction in the upper gestational age limit for abortion
• An end to discriminatory abortion for disability
• A charter for informed consent – comprehensive balanced information provision with the offer of counseling, and a compulsory short cooling-off period

Rhona and Philippa joined the afternoon speakers for a question and answer panel, which dealt with factual queries as well as the often difficult management questions.

After tea, practical suggestions were given for contacting MPs about the Bill, and for petitioning the Prime Minister and the government Chief Whip to allow a free vote (no whipping) on all the 'conscience' matters within the Bill. The day ended with a time of prayer in small groups.