I join with Baroness Murphy in welcoming the legalisation of clinical procedures to overcome the transmission of the dreadful mitochondrial disease. The Lords voted by a huge majority to allow the HFEA to consider treatment on a case-by-case basis, as envisaged in the 2008 Human Fertilisation & Embryology Act, and even by the wise Baroness Warnock, in her groundbreaking 1984 report on the new technology of IVF and its consequences (http://www.hfea.gov.uk/docs/Warnock_Report_of_the_Committee_of_Inquiry_into_Human_Fertilisation_and_Embryology_1984.pdf)
I also agree with Baroness Murphy about what underlies the opposition. As former chair of the HFEA, bearing the scars, I saw it every time science made progress and a new technique for the prevention of disease and the improvement of fertility became available – the opponents argued “the law isn’t clear; we don’t have enough information; why should Britain be first; the research isn’t fully available; it will stimulate the demand for donor eggs; it will be dangerous for women; the resulting babies will grow into infertile adults; embryos will be wasted; nasty commercialism will prevail; it’s a slippery slope to designer babies and the end of the human race as we know it; we need more time; of course we want to alleviate suffering” etc etc. Weasel words, which the Lords fairly patiently brushed aside last night. The contribution from a Bishop was particularly inconclusive and lacking in scientific or moral leadership. At the HFEA we were discussing mitochondria as far back as the 1990s: nothing sudden in it. It was perverse to coin the phrase “3-parent babies” in the recent debate . We don’t call kidney or heart transplant patients “4-parent adults”, a designation with a slightly greater claim to accuracy.
Other opponents said they were merely concerned that the law on mitochondria was not clear, and that the Lords should reach a consensus on it before proceeding further. Well, first of all, the law is crystal clear in the 2008 Act, and second, it is not for the Lords to reach a binding determination on the meaning of legislation. We make it, but if it is challenged, the only settled interpretation can come from a court of law. European law is not binding on us in this respect, or detailed enough. If we took any notice of European treaties, we would have no embryo research and no stem cell developments.
The further south you go in Europe the more restrictive they are in research and treatment. I was amused to read an open letter from a group of Italians asking our Parliament to refrain from legalising mitochondria treatment. Before 2004 there was no IVF regulation in Italy at all, and it was to Rome that patients travelled from the UK and other European states to obtain procedures forbidden here as unethical, for example to choose a baby’s sex or colour for social reasons, or to seek IVF for women over 60. Finally the Italians faced up to the need for regulation, and enacted some of the most restrictive laws in Europe, forbidding inter alia embryo freezing. The law was challenged in their top court and partly overturned, but the result is that Italy has lower IVF success rates than the European average, and Italian women travel abroad for good treatment. Which is what would happen in reverse if mitochondria treatment had not been allowed here – British women would travel to whatever countries did permit it, with some risk. So let’s not look to Italy for moral compass.
The opponents sought the moral high ground. Well, I’m a believer too – it is no moral high ground to condemn would-be mothers and sick children to suffer when a cure is in sight. I believe we were given our intelligence to work with nature to alleviate suffering and improve human life. Were it not so, we would all be dying at 40, avoiding penicillin, not wearing glasses and hearing aids and so on, ludicrous!
There have always been those who oppose medical advances, especially those that benefit women, on “moral”, “natural law” grounds – pain relief in childbirth, contraception, vaccination, transplants. Their fellow believers at various times tried to block IVF, the freezing of embryos and eggs, intracytoplasmic sperm injection and stem cell research through cloning. Who can now reasonably regret any of that? and I for one look forward to great results in the cure of disease by way of stem cells.
We all want healthy children. The opponents of reform said they were concerned about damage to the human genome, implying that supporters did not care. Let me point out to them a bigger danger. The very distinguished American geneticist James Crow has explained that the greatest mutational health hazard to the human genome is fertile older males. Sperm degrades as men age and the poor results can then be passed along to the children they father in old age (over 55) in permanently degraded and irreparable form which transmits to later generations. That means older fatherhood risks children and grandchildren with schizophrenia, hypochondroplasia, hydrocephalus, polycystic kidney disease and a host of other unpleasant illnesses. Will the MPs and Lords so worried about the effects of mitochondria treatment also do their bit to warn of the dangers of fatherhood in older age? or is that asking too much?
Good luck and congratulations to the researchers, clinicians and patients, and well done our legislators.