1. The Catholic Bishops’ Joint BioethicsCommittee represents the three Bishops’ Conferences of England and Wales,Scotland, and Ireland. It is composed of Bishops from all three Conferences,together with priests and laypeople with relevant expertise. We welcome the opportunity to contribute to the Department of Health Review ofthe Human Fertilisation and Embryology Act, as the area of assisted conceptionraises fundamental issues in regard to human rights.(1) These include therights of children to protection from physical and emotional harm, and therights of women and men to protection from reproductiveexploitation. So numerous are the moral problems arising in thearea of assisted conception that we are unable in this submission to do morethan highlight some of the most urgent of these for the Department’sconsideration.
2. While it is not, of course, the purpose of law toprohibit every moral wrong, legal intervention is called for in areas involvingserious unjust harm. Our preferred model is not, however, regulation(Question 2), insofar as this means the granting of licenses for practices suchas destructive research on human embryos under certain conditions. Rather, we favour an outright prohibition of embryo research and all researchinvolving a lethal, unjust assault on a living human individual. We alsosupport a prohibition of particular forms of embryo research, such as cloning,even if other forms of embryo research, no less unjust, will regrettably remainlawful. In the same way, while we do not support the grantingof licenses to internet services which provide gametes, we do support theprohibition of such services (Question 9) or, failing that, the prohibition ofsuch services where gametes are anonymously provided. Our aim is toprotect children from at least some forms of serious injustice which assistedconception can involve.
Use of embryos inresearch/treatment
3. There is general agreement among human embryologists thathuman life begins at fertilisation, at least for those not conceived in otherways, such as twinning or cloning. Most embryos are created when thesperm and ovum combine, though it is certainly possible for embryos to becreated from other cells or parts of cells.
4. Where the main disagreement arises is in the status to beattributed to the human organism at the embryo stage. If, however,moral status is linked to the objective interests of the subject, it should beclear that these interests begin as soon as that individual comes intoexistence. It is not necessary to be conscious or self-aware to haveobjective interests in one’s own future, or rights protecting thoseinterests. Just as newborn babies have rights and interests ofwhich they are unaware, the same is true of the human individual at an earlierstage of life. Each human individual has rights and interests concerninghis or her welfare: there is no such thing as a human being/organism withsubhuman moral status.
5. It is for this reason that we are opposed to alldestructive research on human embryos: such research, like all harmfulhuman experimentation, should be prohibited by law. In the words of theDeclaration of Helsinki (revised 1975) ‘In research on man, the interestof science and society should never take precedence over considerations relatedto the wellbeing of the subject’.
6. As mentioned earlier, we support, above all, a totalban on destructive embryo research. If it is decided that thisfundamentally unjust practice will continue we believe that it should berestricted as far as possible by a ban on particular forms of embryoresearch. For example, we would support continuing the current banon research involving replacing the nucleus of a cell of an embryo (Question 59),and would urge that a similar ban be applied to research involving the transferof pronuclei from the cell of a pre-syngamy embryo into an ovum or embryo, orreplacement of the nucleus of an ovum before it is fertilised (Question58). Indeed, all research involving alterations to thegenetic structure of an embryo should be prohibited (Question 60), not leastbecause this paves the way for widespread germ-line genetic engineering, withall the hazards this would pose.
7. We strongly oppose legalising the creation/destruction ofembryos for the treatment of serious diseases (Question 65). Not only isit offensive to the embryo’s dignity to be created as a pharmaceuticalingredient, but allowing this would put women under pressure to conceivechildren whose cells could be harvested to treat sick relatives. Women’s eggs would be collected - at some risk to their own lives and health -purely to create embryos to be killed and used to benefit thirdparties. This would further alienate women from their rights andresponsibilities as parents/potential parents. It is hard to thinkof a practice more removed from what, in our view, is the only proper settingfor conceiving new life: an act of love between thoseunconditionally committed to each other, and to any future child.
8. We wish to emphasise that, in anycase, no treatments currently exist using early embryonic stem cells, incontrast to no less than 65 treatments already in existence using adult stemcells.(2) There should be further investment in treatments of this kind,which are morally acceptable to all, as opposed to treatments which, were theyever developed, would pose serious dilemmas of conscience for many patients andclinicians.
Embryoselection/discarding
9. We support a prohibition of all deliberatediscarding or destruction of human embryos, whether on the basis of disabilityor on some other basis. We regret that this dehumanizing practice has notbeen seriously questioned in the consultation, at least in regard to those subjectedto such discrimination on the ground described above.
Having said that, we would certainly not favour addingdiscrimination on the ground of sex (Question 37) to discrimination on theground of disability. Nor would we favour adding positive selectionfor disability to the list of discriminatory tests permitted (Question32); we are also strongly opposed to the current permission forpre-implantation genetic diagnosis (PGD) to be practised for tissue typing(Question 35). Children have a right to their parents’ unconditionalacceptance, at every stage of life.
10. Not only PGD, but all deliberate creation ofembryos who will not or may not be transferred to the mother should beprohibited by law. We would urge that a far preferable way ofpreventing the dangers posed by multiple births would be to prohibit not thetransfer of multiple embryos (Question 10), but the creation of embryos ingreater numbers than will be immediately transferred. While our ownposition is that all non-sexual reproduction is against human dignity, we verymuch support legislation to prohibit the worst abuses such productionbrings. In practice, embryos ‘produced’ like products are all toolikely to be treated like products - for example, subjected to qualitycontrol, and discarded if ‘surplus’ or unwanted. For that veryreason, embryos conceived in this way need to be stringently protected, ifprohibiting their manufacture is – whether rightly or wrongly – seen asimpossible or undesirable.
Welfare of the child
11. The minority of children conceived by assistedreproduction who will survive to birth also need the serious protection of thelaw. We very much support retaining the requirement that notreatment be given unless account has been taken of the welfare of any childborn, including that child’s need for a father (Questions 13, 17). We do not favour amending this requirement so that it relates to medicalwelfare alone (Question 15) or reformulating it to refer to situations where‘the clinician believes’ there is a risk of ‘significant harm’ (Question16). The fertility industry is, most would agree, consumer-centredin its approach: the protection of children does not figure highlyon the agenda of practitioners. No encouragement ought to begiven to those who would subordinate children’s rights and interests to theperceived rights, interests or desires of potential parents. Infertility is a very painful experience for couples, and sympathy for theirsituation is appropriate; however, this does not legitimiseany and every treatment which might be provided.
12. The ‘welfare of the child’ provision shouldcertainly include a reference to the need of the child for both a father and amother (Question 17); thus to use gametes derived from unconsentingpeople, including born or unborn children, should remain prohibited (Question21). People should not be made parents without their consent, andwillingness to care for the child. However, where an embryo alreadyexists in storage, the genetic mother has a right and (normally) a duty togestate her own child, whether or not the genetic father and/or the woman’spartner has withdrawn consent. As an absolute minimum, eithergenetic parent should be permitted to veto the removal from storage and‘allowing to perish’ of his or her own embryo (Question 22). Having saidthis, we do not accept the imposition of arbitrary time-limits beyond whichstorage of embryos may not continue (Question 23). One of the mostserious injustices involved in IVF is the production of multiple embryos, whoare subsequently allowed - perhaps, indeed, intended - to perish, assurplus to requirements. As mentioned earlier, instead of prohibiting thetransfer of multiple embryos (Question 10), the law should prohibit thecreation of embryos in greater numbers than will be immediately transferred.
Donor conception
13. Children have an interest in astable family environment, and in knowledge of, and rearing by, their owngenetic parents. Research on offspring conceived through donorinsemination has shown that many of these offspring are acutely conscious ofthe fact they have been deprived in advance of conception of half their geneticfamily.(3) We would urge that this serious injustice be remedied as faras possible, by the provision of information on their genetic relatives todonor-conceived people from the age of 16 (Question 40). A centralregister of donor treatment should be kept, so that donor-conceived people maybe given identifying information on relatives, including, but not limited to,those they intend to marry, or with whom they intend to form a civilpartnership (Questions 39, 41). Donor-conceived people should becontacted on reaching 16 by the registrar concerning their rights in this area(Question 45). They should have access to identifying informationon both donor-conceived (Question 43) and naturally conceived siblings(Question 44). In the latter case, such access should be reciprocalonly after a certain period - for example, ten years, to give donor-conceivedpeople time to come to terms with the truth about their conception before theyare approached by social children of their donor father, who may reveal to himthe whereabouts of his donor offspring. We would urge that thoseconceived before 1 April 2005, when anonymity was removed, be given similarrights to those conceived after this date.
Surrogacy
14. Surrogate motherhoodinvolves a further fragmentation and trivialisation of parenthood, in that awoman deliberately becomes a gestational mother with no intention of committingherself to caring for the child she gestates. This practice isexploitative of both the woman and the child, and damages the way conceptionand gestation are regarded in society as a whole. If surrogacycannot be prohibited altogether (the option we would prefer), commercialsurrogacy, at very least, should continue to be prohibited (Question50). We do not believe that agencies should be registered with theDepartment of Health, as the Brazier Committee recommends (Question 51), asthis would constitute official endorsement of such agencies. (An analogymight be with the case of prostitution: those opposed to prostitution arerightly unwilling to accept the official registering of brothels, as thiseffectively legitimises their existence.)
15. It is, however,necessary to provide as best we can for any children born as a result of asurrogacy arrangement, assuming that the surrogate mother does not wish to keepthe child. For reasons concerned with the child’s sense ofidentity, and right to know - and be cared for by - his or her geneticparents, we recommend that genetic parents involved in surrogacy proceduresremain eligible for ‘fast track adoption’. In the case ofmarried couples, the court order should be made in favour of the couple, undercertain conditions, whereas in the case of unmarried or same-sex couples, theorder should simply be made in favour of the genetic parent (again, undercertain conditions).
16. To give a courtorder in favour of unmarried heterosexual couples (Question 54) would be todownplay the proven significance of marriage in providing a stable (orrelatively stable) environment for children. In the case of same-sexcouples (Questions 55-56) such a court order would send out a further messagethat such couples – despite the fact they cannot offer role models of bothsexes – are regarded as no less suitable by virtue of that fact to raise achild. Further, making orders in favour of same-sex couples wouldencourage the provision of fertility ‘treatment’ to those who are not infertileand/or will not be made more fertile by the surrogacy arrangement.
Conclusion
17. The area of assistedconception concerns the rights of children, and the law in this area shouldtherefore be particularly robust. It is vital to protectchildren from being treated as ‘consumer choices’ of adults, rather than as newhuman beings to be accepted unconditionally. Most urgent of all isthe need to protect children from being literally envisaged as raw material –as when embryos are used, and even conceived, simply as providers ofcells. Society needs to rediscover a profound respect, first,for the child at the beginning of his or her life, and then for the meanswhereby life is passed on by couples to the next generation. In anarea where life is produced in a way very similar to the manufacture of aproduct, it is all the more important to protect the child resulting to thedegree that we can.
Notes
[1] Whilesome of the points made in this submission reflect (though our arguments do notrely on) established teaching of the Catholic Church, other points simplyreflect our own judgment of the best way of protecting the rights the Churchrecognises, and are not attributable to the Church as such.
[2] Fordetails, see the website www.stemcellresearch.org.
[3] See e.g. A.J. Turner and A. Coyle, ‘What does it mean tobe a donor offspring? The identity experiences of adults conceivedby donor insemination and the implications for counselling and therapy’, HumanReproduction 15 (2000): 2041-2051; A.W. Cordray, ‘A survey ofpeople conceived through donor insemination’, DI Network News 14(1999/2000): 4-5; A. McWhinnie, ‘Gamete donation andanonymity: Should offspring from donated gametes continue to be deniedknowledge of their origins and antecedents?’ Human Reproduction 16(2001): 807-817.
Article published by http://www.linacre.org/HFEA Review 2005.html
