[Paleopsych] spiked-liberties: Regulating reproductive technology - less is more

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Sat Apr 2 16:08:17 UTC 2005

Regulating reproductive technology - less is more 

[Discusses sex selection in Britain, among other things.]

    A UK government committee has concluded that more trust should be put
    in parents, doctors and scientists. And this is an 'extreme
    libertarian' position?
    by Jennie Bristow

    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
    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 stressesthe
    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.'
    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
    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
    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.'
    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:
    [2]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) [3]Ethics row as choosing baby's sex splits MPs, Guardian, 24
    March 2005
    (3) [4]Ethics row as choosing baby's sex splits MPs, Guardian, 24
    March 2005
    (4) [5]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


    2. http://www.instituteofideas.com/transcripts/policywatch1.pdf
    3. http://www.guardian.co.uk/uk_news/story/0,,1444427,00.html
    4. http://www.guardian.co.uk/uk_news/story/0,,1444427,00.html
    5. http://www.hfea.gov.uk/PressOffice/Archive/1111664473

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