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Human Fertilisation and Embryology Bill [HL]

My Lords, I suppose I never thought 22 years ago when I had a conversation with Alan Handyside on a wet Sunday afternoon on the theoretical possibility of pre-implantation genetic diagnosis that I would end up in a debate like this in the House of Lords. The first children from this treatment of recognising a specific gene in an embryo diagnosed after a biopsy of that embryo are coming up to their 17th birthday. It will be 17 years next April. I feel I ought to put in an interjection simply because my lab pioneered this technology. I am really sorry that I was not in my place when the noble Baroness, Lady O’Cathain, spoke but I imagine that she will find me a surprising supporter of some of the things that she has been saying. One of my concerns is something that has been in the news very recently. When you biopsy an embryo, you effectively take away one or at most two cells containing one or two molecules of DNA. What you are effectively doing is something which has been in the courts recently in Northern Ireland and is currently under scrutiny in the courts generally in the British—a form of low copy number DNA. Essentially, you are trying to establish the genetics of an embryo based on the tiniest possible amount of tissue in very controlled circumstances, unlike in criminal circumstances or where the courts are looking at age DNA, but none the less subject to all sorts of problems regarding the gene amplification and the risk of contamination of that DNA. At present, that technology is by no means entirely safe. There are risks of making a wrong diagnosis—thinking that you have a particular tissue type when you have not, or getting a gene defect right when you have not. The history of PGD shows that from time to time mistakes have been made and an embryo affected by a disease for which there has been screening has been transferred to the uterus. Here we have a particular case in point. Most of these cases will be in families where there is a gene defect already and therefore the scientists involved will not just be screening for one specific gene but for the gene which causes the defect and the series of genes which make up the tissue type of that embryo. Therefore, there is a very real risk of not making a correct diagnosis. I listened very carefully to the noble Baroness, Lady Deech, who says that the chances of getting it right are about one in 16. I am not sure what the mathematics are, but I imagine that the chances of getting it right every time are really quite low and even if it is correct, you still have the recognition that if that child grows up, its stem cells will be capable of being taken up by that embryo. So the problem for me is, first, the serious risk of unreasonably raising the hopes of couples by a technology which at the moment is very rare. I think the noble Baroness would agree with me from her experience as chairman of the HFEA that these requests are exceptional. They are very unusual and it is interesting to notice that over the years they have not increased. So whatever your Lordships decide—I am not sure which way I would vote if there were a vote—I do not think it will make a huge difference to the practice of in vitro fertilisation in actual issues. As a clinician—and I agree very strongly with the right reverend Prelate the Bishop of Winchester on this—it seems to me that we are at risk of being on a kind of slippery slope. In general I am not a great believer in the slippery slope, but even if we do establish a child who is compatible with its elder sibling and free of the gene defect, the problem is that if the initial stem cell transplant does not work, there is then the increasing pressure to consider what you might do next as the child grows up. If there is organ failure, do you consider a renal transplant from that child, which is quite a feasible proposition? That gives rise to huge difficulties. I hear what the noble Lord, Lord Jenkin, is saying about regenerative organs, but I remind the House that a number of organs are regenerative that are solid tissues. The liver is one such organ that regenerates. This definition is not very clear, and it gives rise to a medical problem. There is a real risk that children might be used, and therefore abused, with this technology, so we must consider this very carefully. I know that the noble Baroness, Lady Deech, has argued that the courts can protect such a child. She is right in theory, but in practice such children who are at risk cannot be protected, because even if the courts decide against a particular procedure for that child as a donor, there is still the family pressure and the notion that that child has in some way failed its elder sibling and therefore its parents. That is a real problem, which the House must consider this evening.