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No controls on infertility treatment

The Human Fertilisation and Embryology Authority has asked for views on the use of eggs from human embryos and other ovarian tissue in research and infertility treatment. In his response to the HFEA, Living Marxism science editor John Gillott puts the case for unfettered scientific progress, and against authoritarian controls


The Human Fertilisation and Embryology Authority (HFEA) was set up by parliament to regulate the provision of certain fertility treatments and any research involving human embryos. In a public consultation document issued in January, the HFEA asks for responses to eight questions on the use of donated ovarian tissue in embryo research and assisted conception.
'a Should ways be sought of increasing the supply of eggs for use in research and infertility treatment? If so, what ways can be suggested?

b Should ovarian tissue from live donors be used in research?

c Should eggs or ovarian tissue from cadavers be used in research?

d Should eggs or ovarian tissue from fetuses be used in research?

e Should ovarian tissue from live donors be used in treatment?

f Should eggs or ovarian tissue from cadavers be used in treatment?

g Should eggs or ovarian tissue from fetuses be used in treatment?

h If you think that eggs or ovarian tissue from any of these sources should be allowed to be used in treatment or research, whose consent should be required, when should it be given, and in what form? Should there be any difference in the consents required for eggs or tissue used for research, and eggs or tissue used for treatment?'
Leaving aside for the moment the issue of consent, the answer to the first seven questions must be a resounding yes. This is the only answer consistent with human welfare and scientific advance.

There are around 600 000 infertile women in Britain, and the waiting time for fertility treatment can be as long as three years. This is a cause of much human misery and frustration. In part the delays are caused by a shortage of donated eggs for assisted conception. The use of eggs from dead bodies and fetuses would make a significant difference to many women. The donation of ovarian tissue, rather than simply eggs, would, if the graft was successful, greatly reduce the amount of treatment an infertile woman need undergo in order to have children.

Much more research is needed to improve the efficiency of fertility treatment. Success rates vary from zero to over 30 per cent. If research on eggs and ovarian tissue from any source can help to improve success rates, it would make a significant difference to many people.

Research using donated ovarian tissue could also widen knowledge of issues that directly impinge on the lives of millions of people, such as the development of congenital diseases, the causes of miscarriages, and the timing of the menopause. Research could also lead to new methods of contraception, and new methods of detecting fetal abnormalities.

Research on embryonic development and research using fetal material are central to many other areas of medicine and science - cancer research and treatments for degenerative disorders to name but two. Even complete spinal breaks may one day be repaired using fetal mate-rial. While these issues fall outside the remit of the HFEA's consultation, they need to be brought into the discussion so that the full range of benefits deriving from research using donated ovarian and fetal material becomes more widely known.

Unfortunately, little has been heard of the advantages of using donated tissue in the debate so far. Instead, critics who stress the public 'yuk factor' that the use of fetal eggs arouses have received most attention. The HFEA is in part responsible for this.

The HFEA is preoccupied with what it calls the 'ethical' issues involved in fertility treatment. For women seeking treatment, however, a whole host of other questions are crucial. Fertility treatment is a lottery. Access to it depends on where you live, how much money you have, and whether a local GP or hospital decides that you have the right 'lifestyle'. Providing decent treatment, open to all, ought to be the priority.

Before this consultation began, the HFEA chose to second guess public opinion when it declared that 'the public...may feel an instinctive repugnance to the use of ovarian tissue from these sources for research or fertility treatment'. And the HFEA's enthusiasm to highlight what it sees as 'new and difficult moral dilemmas' has only helped sow confusion. In fact, the moral issues are quite straightforward.

The HFEA's biggest worry is the effect on a child of finding out that he was born from an egg taken from a fetus. HFEA member Richard Holloway, the episcopalian Bishop of Edinburgh, and members of parliament David Alton and Dame Jill Knight argue that such a child would be psychologically disturbed.

There was a similar outcry when in vitro fertilisation (IVF) techniques were developed. Yet today, it is widely recognised that children born through IVF are generally as well-adjusted as any other children. Perhaps more so, because their parents went to such trouble to have them. The same may well hold for children born using fetal eggs.

Much more damage will be caused to a child by the reaction of society to him than by the biological facts of his birth. In the past, generations of children born outside marriage had their lives blighted by being branded as 'bastards'. If religious and conservative critics succeed in attaching similar social stigma to children born using donated eggs and tissue, they will be responsible if those children turn out to be disturbed.

Some commentators have raised broader fears about the transfer of germ cells. Apparently, such transfers threaten to undermine the human soul and put us on a slippery slope leading to a totalitarian Brave New World complete with 'designer babies'.

This is nonsense. The transfer of eggs from one woman to another has already taken place without society falling apart or soulless monsters being born. The transfer from cadaver and fetus to a woman is no different.

All that women seeking infertility treatment today want is the possibility of a healthy child. However, if in the distant future 'designer babies' become possible, society may well decide that a little design is no bad thing. After all, the blind working of chance mutation and natural selection has given us cystic fibrosis and many other diseases.

The HFEA believes the issue of consent to be especially problematic. In fact, the transfer of ovarian tissue and eggs raises no new problems as far as consent is concerned. If existing practice is followed, the family of the diseased would give consent in the case of cadavers. And, treating a fetus as a part of the body tissue of a woman, she would give consent to the use of the aborted fetus. Alternatively, consent could be handed over to the relevant authorities. Either way, the pros and cons are not specific to ovarian tissue donation.

Access to treatment is the only serious policy issue arising from the new techniques. In fertility treatment, as in many other areas today, the rights of the individual are increasingly being abrogated by a plethora of state and para-state bodies.

In France, IVF is restricted to sterile heterosexual couples in a 'stable union'. In many clinics in Britain, a couple must satisfy a whole host of 'lifestyle' conditions in order to receive treatment. Health secretary Virginia Bottomley has said that 'women do not have the right to have a child; the child has the right to a suitable home'.

All of these policies and arguments are authoritarian impositions and should be rejected. Who is to judge what 'suitable' means? The logic of these measures would be Mrs Bottomley and her health quangos taking control over the procreative activity of fertile women.

Neither doctors, fertility clinics, nor the state should be able to decide who can and cannot have children. Individuals must be free to make their own decisions.
Reproduced from Living Marxism issue 66, April 1994

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