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.
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.
- '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?'
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
Reproduced from Living Marxism issue 66, April 1994