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Human Fertilisation and Embryology Bill [HL]

My Lords, this has been an important discussion which has raised many difficult and serious ethical issues. I am grateful to all noble Lords who have contributed to it. The HFEA currently licenses, on a case-by-case basis, the screening of embryos where the intention is that the resulting baby’s umbilical cord blood stem cells, or bone marrow stem cells, will be used to treat an existing sibling who has a life-threatening or serious illness. The Bill clarifies the scope the HFEA has to make such decisions by setting out five purposes for which embryos can be tested, including one that specifically enables testing embryos for tissue type where there is a seriously sick older sibling. These amendments would prevent that happening. Amendment No. 29 removes the tissue typing purpose so that it would not be possible to license embryo testing to find out the tissue type of an embryo where the older sibling could be treated with, for example, the cord blood cells of the resulting child. Amendment No. 32 inserts a new sub-paragraph into Schedule 2 to the Bill which essentially bans the use of embryo testing where the purpose would be to establish whether the tissue of any resulting child would be compatible with that of their sibling for any purpose connected to the treatment of their sibling’s medical condition. Amendment No. 34 limits the regulation-making power that is provided in the Bill to amend the provision relating to embryo testing so that the paragraph inserted by Amendment No. 32 could not be altered; thus ensuring that the ban on tissue typing is maintained. To date the HFEA has licensed tissue typing for three conditions. If we were to accept this amendment we would be taking a backward step. In practice, tissue typing is only ever considered when all other options for successful treatment are exhausted; in other words, when there are no matched donors on the worldwide bone marrow registry or within the family. Understandably, many noble Lords have expressed concerns about creating embryos for the purpose of removing tissue to treat another child. We acknowledge these concerns. However, we should remember that parents making this decision are often in a difficult situation with one very sick child and no other option. It is highly unlikely that any further child who happened to be born to such parents as a result of treatment would be anything other than loved and cherished. The noble Baroness, Lady O’Cathain, spoke of the health risks to the mother and the potential implications to the family as a whole. I am sure that the parents would have reflected long and hard on such a difficult decision, and they will certainly be aware of all the risks involved. Following the creation of tissue-matched embryos and the birth of the resulting child, most frequently cord blood or bone marrow would be used in the treatment of the seriously ill older sibling. Cord blood can be collected at the time of birth with minimal impact on the child born. The noble Baroness asked what the Government are doing to encourage cord blood donation. I believe that we are encouraging a cord blood bank, but I will write to the noble Baroness with further information. If bone marrow is used, the Human Tissue Authority would oversee the transplants from children. The Human Tissue Authority and an independent assessor would have to be satisfied that the child’s best interests have been properly considered and that the regulations and the Human Tissue Authority’s codes of practice have been properly followed. Where a child donor is involved, the courts may also be involved to authorise what is in the donor child’s best interests. The Government decided on balance that the creation of embryos where the intention was to collect bone marrow for the treatment of a seriously sick sibling was appropriate, subject to these safeguards. Protection is in place by two regulatory authorities—the HFEA to license the creation of embryos for this purpose and the HTA to oversee transplants of bone marrow taken from children. Many noble Lords have asked what ““other tissue”” means. I must emphasise that ““other tissue”” is intended to capture regenerative tissue other than whole organs. An example of such tissue would be the actual cells of the umbilical cord. Research has shown that the cells may have potential for future treatment. The noble Baroness asked what effect the removal of two cells from the embryo might have. From thousands of children born worldwide following PGD there has been no evidence of harm to date. The noble Lord, Lord Patten, and others, raised the issue of the child’s human rights. It would not be lawful to remove any tissue from a child if that would be incompatible with the rights of the child under the European Convention on Human Rights. A parent could consent on behalf of a child, but only where that would be in their best interests, subject to final determination by the courts. Any decision in a child’s best interests would have to comply with the convention. I acknowledge and understand the concerns that have been raised about the use of embryo-testing technology for the purposes of tissue typing, but the provisions in the Bill allow the treatment of seriously sick children where there really are no alternatives for successful treatment. We think on balance that this is appropriate.