An Ethics Competition

Baroness Deech

The Human Fertilisation and Embryology Act 2008 was largely the work of the House of Lords.  It built on and extended the provisions about IVF and embryo research in the 1990 law, which had established in Britain the first comprehensive regulatory authority in this field, the Human Fertilisation and Embryology Authority.  The HFEA arouses great interest all over the world, and is sometimes emulated abroad. The Lords contains some internationally recognised experts in this field; indeed, I said at the time that if one were to put together a national committee on the subject, you would find nearly all of those names in the House of Lords, and they made substantial contributions to the enactment of the new law. Intensive Lords debates in 2000-2001 also led to the legalisation of stem cell research and hope for cures in the future.

I was invited to lecture on it at the Centre for British Studies (is there such a centre here?) at Humboldt University, Berlin.  I told the audience about our stem cell work, advances in IVF, research on animal/human hybrid embryos and how it was all scrutinised by Parliament.  The German audience had very different views about the ethics involved in this field.  Remembering the terrible experiences with experimentation and eugenics in the Nazi period, German law forbids research on and the keeping of embryos, although work on adult stem cells is fostered.  Feminist thinking, Catholicism, the disabled and the influence of the Green movement in Germany also contribute to the decision to prohibit some infertility treatments and diagnoses that are allowed in the UK.

The discussion showed me that it is impossible to get all European states to agree on these issues or sign up to one treaty, because they have different cultural, religious and historical attitudes.  On the other hand, European law allows a citizen of one state to travel to another to get the treatment, or do the research, that is not allowed in the home state, so there is a risk that the most permissive standards will come to prevail.  But who is the most ethical nation in this situation?

9 comments for “An Ethics Competition

  1. Carl Holbrough
    27/11/2009 at 6:39 pm

    Ethics / moral philosophy. Which nation has the best ?

    Let`s rule the Germans out for starters, they`re still suffering WWII guilt syndrome and are unable at present to get beyond that even if they weren`t born at that time. I do so try to tell them I don`t blame them, the ones under 60 but they love languishing in it. We have to rule them out because they`re frightened of upsetting anyone.

    The French, hmmmm. Laws that take into account emotional feeling when you commit a crime. No mention ever of black, white, asian etc., allowed even by the Police in discrimination statute, everyone is the same. Seems ethical to me.

    The Americans. A nation split in two or more, a schizophrenic land. The biggest anti-war, anti-porn and the biggest porn production and warring nation.

    Really I do not know enough about any other nation than our own. Are we ethical ? Well our prisons are full.

    Ok, so the real underlying question is. Is our Government ethical ? Er …expenses…

    OK so the real, real question is. Is our stance on Embryo and stem cell research ethical ?

    I saw a wonderful program recently about three disabled people searching for a cure. One with a broken back, one leg amputee and one arm amputee. The research shown was fascinating and looked really promising, the magic pixie dust used by the American Military, made from peoples own stem cells was brilliant. I don`t think you`ll hear one argument about using peoples own stem cells.

    Where the problem lies is in Embryonics and this will split man and wife, as it does where I am concerned. So who is most ethical, my wife or me ? Neither will ever admit being wrong and it`s like a decision on a child problem, there is no book that tells right from wrong. There is no solution.

    If you tell people the truth about how products and medicines are tested on animals who DO suffer, you mess with their minds. They know they need the medicines but at the same time love the cuddly wuddly bunnies.

    An embryo for some will still be a living thing, no matter the stage/how big. To use it will remain unethical in their view but they won`t ask questions when you`re keeping their child alive by a certain treatment(most of the time).

    If you want to frighten people then please carry on using the word “hybrid”, it brings visions of monsters, experiments that have gone wrong and ties in nicely with “genetically modified”.

    But are we ethical ?

    Oh my goodness! We cannot even sort out the law on prostitution.

    It depends if you cure cancer or create Frankenstein in which case the peasants will let you know.

    The answer at present can only lie with individuals and Governments who make hard decisions for us. Nobody wanted seatbelt law, but we`re glad of it now.

    You choose but keep it quiet so the wife don`t find out. 😉

  2. Gareth Howell
    28/11/2009 at 10:15 am

    Baroness Deech makes a salient observation about the Germans, and my view is that they are very wise to have the approach that they do have. After the Lisbon treaty all things are possible regarding treaties and European directives.

    Cost would be the only factor in allowing the status quo of the most permissive state to prevail.

    It would inhibit even more than it does already, and that is just about enough for me.

    My own recent observations are that the NHS, like all organizations, is corrupt in its own way, and for the state to pay for surgery, or operations, of very dubious value, is part of that corruption, whatever an eminent surgeon may think on the day.

    If the NHS patient is then confronted by
    paying half a cent, then she makes the decision she should have made, regarding the cost to the state, in the first place.

    The Germans are very wise. They must have been making a comparison of what passes now in UK, with what passed then as Nazi experimentation, and I am not making a trivial, or inflammatory, remark in saying so.

    It is the Free NHS which is the main driver of the so called ethics that we do hold.
    If it cost, it would be very different.

    • baronessdeech
      28/11/2009 at 9:55 pm

      Indeed, if more IVF was on the NHS there would be less need for separate ethics codes and regulation. But there are many reasons put forward for the NHS not to spend too much on IVF; not when there are demands for more treatment for cancer and other serious diseases. It will be interesting to see whether the further integration of Europe leads to any more uniform codes of practice in this field.

  3. Chris K
    28/11/2009 at 12:30 pm

    I attended an ethics in Synthetic Biology talk/debate on Thursday night. The main topic of conversation, apart from what exactly it is, was how it is regulated. When it comes to engineering organisms, people feel very uneasy. Especially as, according to the scientists running the event, there are people who try and do this “in their garage”.

    When I asked about regulation the reply was that it’s a hodgepodge, with various bodies getting involved. The European Commission, naturally, produces hundred-page long documents every so often. More important though is self-regulation by fellow scientists through the funding committees themselves. One lady I spoke to said that the ethical committee she sat on had never rejected funding for something for being unethical, only for being rubbish.

    There are only a few labs capable of producing genetic code, and there are certain ones which ring alarm bells and they refuse to create (eg Smallpox). However a Guardian journalist a couple of years ago managed to get round this by ordering different parts of genetic code from different labs, though I was reassured he could never have actually managed to reach the crucial next step of doing anything with them.

    I did feel happy leaving the event that there were safeguards in place, although ultimately any one nation or group of nations is powerless to stop any particular research or activity. At the same time I was very impressed that scientists come from all over the world to do their research here.

    Your question is an interesting one. I would say the country providing more freedom is more ethical, but I probably wouldn’t say that if the country was offering a treatment I didn’t approve of!

  4. Gareth Howell
    28/11/2009 at 2:48 pm

    “the country providing more freedom is more ethical, but I probably wouldn’t say that if the country was offering a treatment I didn’t approve of”

    …and it would not matter because the patient determined to get the treatment ,in whichever state it would be necessary to go to, would have to pay for the travel, and the treatment.

    If you are referring to the “freedom” of treatment, which you might be, ie a National health service, then the ethics are probably worth what you pay for them!

  5. Gareth Howell
    30/11/2009 at 3:21 pm

    ” European law allows a citizen of one state to travel to another to get the treatment, or do the research, that is not allowed in the home state, so there is a risk that the most permissive standards will come to prevail. But who is the most ethical nation in this situation?”

    The most ethical state might be the one whose
    legislators recognize the value of the treatment but do not recognize the cost of it
    as being worthwhile for the patient.

    Since the other state may well not have the same measure of State health services, or be prepared to accept nationals from those other states as non-paying patients, the patient’s financial commitment to the procedure, would be the only test.

    Unfortunately we can not make law for the NHS and different law for the Private sector
    except by default.

    Somebody who can not obtain treatment from the state, and who goes to a Private consultant, would immediately be referred to
    a hospital in the private group in another state, where the procedure is allowed.

    What usually happens is that the NHS consultant would persuade the patient that
    the hoped-for treatment is actually not available at all, thereby maintaining the monopoly power of the NHS over the patient.

    The acronym NHS should actually be changed to reflect the fact that we are now one state
    out of 27, and that other states in the same union have different law.

    I doubt whether European Law will become a factor in deciding on such issues, unless there are ways of appealing against state law
    in European courts so that Case law would begin to have an effect.

    New courts… and new bio-technology too.

    If somebody considered European courts they would also consider other European and private health services, and take the train
    or plane …….

    You can scarcely complain about not getting a procedure which would otherwise be “free”, and which you are advised against on account of the Law, and even told that there is NO such possibility anywhere.

  6. Gareth Howell
    30/11/2009 at 4:22 pm

    The case of Natalie Evans against her former partner Mr Johnston was the recent case in point.

    It would be a guide to judgements in future similar cases, that if the permission of the
    partner is withdrawn before the clinical surgery insemination, then it may not be done.

    That would apply to five minutes before
    as well as five days.

    The observation by the Judges in the case that there is no standard practice to go by in the different states, makes a judgement no easier.

    You might say that once Mr Johnstone had made his donation, then it was entirely up to Natalie Evans as to what to do with it, but she had no such luck in persuading either
    the judges or the UK Supreme court, as it is now, of her rights according to Article 8 (right to family Life) of Human rights law.

    That judgement will now be taken in to account with all other similar cases.

    European human fertilization and embryology
    ethics, case law.

  7. Gareth Howell
    30/11/2009 at 4:57 pm

    “The couple consented to the treatment and subsequently six embryos were created and placed in storage. ”

    It was the moment of implantation that the ECHR was concerned with. Ms Evans did not consider the Court of Appeal(Supreme court)
    decision to be an adequate one, so took it to them.

    They STILL decided that it was the moment of implantation that was decisive and not the moment of insemination, but who is to say that the psychological mood of Ms Evans at the moments between insemination and implantation would not have been the critical factor in the success of a pregnancy?

    The judges evidently found that Ms Evans mood would have had nothing to do with it!

    Article 2 of the Convention was also considered, whilst Article 8, right to family life was not considered relevant.

    Such case law is probably the only unified law that the Baroness will get.

    If you look to the Law and ethics, before you do anything, and not to what is naturally right or wrong, even though human nature has been manipulated, then the Law is happy to make decisions for you that would have been far better made by yourselves.

    • Gar Hywel
      13/12/2009 at 4:04 pm

      Noble Baroness Deech seemed to suggest that it was only/mainly the Private sector that needed the Law, that the NHS is capable of regulating itself?

      I contend that the opposite is true, but also that the notion of Consumerism in public health services should be conscientiously avoided that it a actually creates disease,
      as the Hon Member HofC for Newport Paul Flynn remarked this week, that we do not really know that the big pharmaceuticals are not actually inventing things like Swine flu for the sake of their fancy profits!

      I don’t agree with that either, but it is certainly an example of the possibility!

      All these dastardly hard selling sickness charities are other cases in point.

      They all make diseases and sickness a very desirable thing for many people to have, and the name of the game is crass CONSUMERISM!

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