Conscientious Objection (Medical Activities) Bill [HL]

Debate between Lord Alton of Liverpool and Lord Winston

Committee: 1st sitting (Hansard): House of Lords
Friday 23rd March 2018 Lords Chamber

[Lord Alton of Liverpool]

Does the noble and learned Lord therefore think it is a good situation for us to be in that, for instance, people who have religious views or who are atheists and are opposed to taking the life of an unborn child in the womb are by and large pretty well excluded now from gynaecology and obstetrics? The noble Lord, Lord Winston, says from a sedentary position that that is not true. If he can give an example to me of, for instance, people who hold deeply committed Christian evangelical views or who are committed Roman Catholics or, for instance, Orthodox Jews who would support, for instance, the taking of life up to birth, as the law now allows since 1990 in the case of Down’s syndrome, I would be surprised, but I would be interested to hear those names.

[Lord Winston]

I would like to correct that impression, if I may. I hope it might be useful if I might still be able to speak in due course about the amendments that I tabled, but not at this stage.

I cite as an example my own unit, and this situation was not because I was the head of it. There were a number of people with very orthodox religious views from three or four different faiths, including Jews and Catholics, some of whom were involved with in vitro fertilisation at different levels. We could accommodate those because we had the staff to do so. I am not convinced that, in the field of obstetrics and gynaecology, the health service has been inimical to people who are orthodox Catholics.

Immigration Bill

Debate between Lord Alton of Liverpool and Lord Winston

Tuesday 10th May 2016 Lords Chamber

[Lord Winston (Lab)]

My Lords, I shall detail the House only briefly. I am most concerned about this issue. I fear that the Government have completely overlooked a very important point. You are not just detaining a pregnant woman, you are detaining the foetus inside that pregnant woman. The effect on that foetus is something about which science is increasingly concerned. The recent science of epigenetics tells us clearly that the foetus at certain stages during pregnancy is extremely vulnerable to the environment of the mother. Indeed, I have been involved in this area of research at Imperial College, and I shall refer briefly to research going on not only at Imperial but at the University of Singapore, which I shall visit later this week, and McGill University in Canada, among other places.

It turns out that at a certain stage in pregnancy, if a woman’s stress hormones, particularly cortisol, are raised, the effect on the foetus may be profound. Working after the ice storm in Ontario some years ago, Michael Meaney undertook cognitive tests on infants aged five, who had effectively been interned within their own houses because of the darkness and lack of electricity over a period of time. He found significant cognitive impairment. There is also some evidence that after massive stress to the mother, some children may behave aberrantly when they grow up —particularly, for example, being more aggressive.

Unfortunately, at this stage the science is not absolutely clear but there is a massive amount of evidence from work on rodents and some other animals. The evidence from human work is increasingly that certain stages of pregnancy—for example, once the foetus is identifiable in the uterus, usually at around 22 to 26 weeks—are a particularly vulnerable time. That is when stressing a woman may have a severely adverse effect.

For that reason, the Government need to recognise that they may be responsible for a heritable effect on that child and possibly even on the grandchildren of the mother. Until that is firmly worked out, I beg the Government to consider that internment, if it must be done at all, must be done only under the most serious circumstances. We cannot go back for women who have previously been detained in prison and other places, but in future we must make sure that we make law which is humane and amendable, so that we cause the minimum amount of damage to future generations.

[Lord Alton of Liverpool (CB)]

My Lords, I will speak very briefly to support the amendment moved so well by the noble Baroness, Lady Lister, this afternoon. I supported her on earlier occasions when we debated these issues. I am particularly pleased to follow the noble Lord, Lord Winston, who has returned us to an aspect of the debate which we discussed at earlier stages.

Members of your Lordships’ House may recall the remarks of the noble Baroness, Lady Neuberger, during our earlier debates. She focused on the effects on the unborn child of being detained in these stressful circumstances. I referred to work by the late, eminent psychiatrist, Professor Kenneth McCall, who described the effects later in life on children who had been affected by traumatic events that they had experienced in the womb. On the other side of that coin, of course, the world-famous violinist Yehudi Menuhin said that he believed that he learned his love of music during the time that he was in his mother’s womb. So it may be that the empirical evidence needs to be extended and much more work needs to be done around these things—but our own common sense and knowledge of our own human development probably take us in that direction.

But this is not just about concern for the unborn child. The noble Baroness quite rightly reminded us of the recommendations of Stephen Shaw, which were at the very heart of the debate when we looked at this earlier in our proceedings. He of course recommended that there should be an absolute ban—so this falls a long way short of his recommendations. The noble Baroness, Lady Lister, in her phrase, “very exceptional”, is reminding the Government that it cannot be right for us to have pregnant women held in detention in these ways.

I was particularly pleased, like the noble Baroness and the noble Baroness, Lady Hamwee, to read the remarks of the Conservative Member of Parliament for Enfield, Southgate, David Burrowes, who spoke so well in the other place yesterday. I hope that when the noble and learned Lord comes to reply, he will respond to the concerns that David Burrowes raised and to the remarks of the Royal College of Midwives—referred to earlier by the noble Baroness—which were quite categorical in saying that we should never keep women in these circumstances.

I have one or two questions to put to the noble and learned Lord. What kind of pre-departure accommodation will be made available when a pregnant woman is being held? Will he say a word about that and will he talk about how those particular needs will be met? Will he also assure us that pregnant women will not, for instance, as has happened in the past, be picked up in dawn raids, put in the back of vans and taken miles away to accommodation, with appalling consequences for the women in those circumstances? There are accounts of nauseous experiences, of vomiting and of people being incredibly distressed by those kinds of experiences. This should be in very exceptional circumstances, as the noble Baroness said.

Finally, I underline the point made by the noble Baronesses, Lady Hamwee and Lady Lister, about the second part of Amendment 85E. An odd phrase has been included at this late stage to say that,

“a person who, apart from this section, has power to authorise the detention must have regard to the woman’s welfare”.

Those words—“apart from this section”—are, at the very best, ambiguous, and I really cannot see what point they have. Could the noble and learned Lord enlighten us when he comes to reply?

Animals (Scientific Procedures) Act 1986 Amendment Regulations 2012

Debate between Lord Alton of Liverpool and Lord Winston

Thursday 13th December 2012 Grand Committee

[Lord Winston]

My Lords, first, I declare an interest as animal licence-holder for more than 40 years; I think I am almost the longest holder of a licence in London. I work at Imperial College where animal research is conducted. I am a member of a research council which from time to time may need to support the use of animal research for specific validation in engineering, and I am also chairman of a spin-out biotech company, although I do not take any income from that company. Clearly all companies are aiming eventually to make a profit, although I doubt that this one will, but it is still exploring various patents that involve techniques that will be tested on animals.

I am grateful for the clarity of the Minister’s assessment of the directive, which was very helpful. I want to add a personal note of thanks to the Home Office, which has been exemplary in the way it has helped me from time to time with licence applications. In recent years, we have seen a much greater recognition of the need to collaborate and care for the way that we ensure that the law is properly enforced, and I feel very confident in the officials with whom I have dealt.

With that preamble, I express some concerns about this directive and about how we might go ahead. In particular, I am concerned about the three Rs. The three Rs have been around for a very long time. When they were first considered, nobody appreciated where the limitations of the reductions or replacements might be. For example, when the three Rs were first proposed, nobody considered that cell culture is a very limited model for many needs in medicine. Cells in culture do not always perform or behave in the same way as cells do inside an intact organ or, even more importantly, an intact total person or being. A rodent that is alive and well, in which the cells are functioning without changes altering how the genes express or how the cells are growing normally in that organ, is fundamental to medicine. To some extent replacement, reduction and refinement are a bit of problem in cell culture.

When one looks at organ culture, human organs unquestionably do not react completely normally. The classic example is the isolated liver. It was hoped that it might replace the liver of people in liver failure, but those livers do not react in the same way. They cannot because they are not subject to all the homeostatic control mechanisms that go on inside an intact organ.

When computer modelling was first envisaged, it was also thought to be a very good way of replacing animals in research. It has become apparent in the past three or four years that computer models fall way short of what is needed. They cannot predict how animals in the intact state would behave. Many of the invertebrate species, in which we can work, are not always ideal models either.

We have to accept that there is going to be a need to continue, particularly in rodents. In my view, there are some reasons for considering that not only should that work continue but it may need some degree of amplification. The reason why I say that is as follows. First, I am very concerned about the issue of the backbone of British science, which, as every research council will tell you, is the PhD student. That is the person who does the mainstream experimental work that we hope will lead to our understanding of medicine and our improvements of treatment, and of course contributes to the British economy with novel and innovative ideas. There is no question, from my experience and that of many other people, that PhD students are increasingly reluctant to go into important areas of medicine and biology where animal research is being used, not because they disapprove of that research but because they are concerned increasingly about the delay, when they have a finite time—now rigidly defined because of fees and so on—of three years to complete their PhD. For a PhD student to delay starting experimental work is a massive problem.

Many PhD students do not see this work as anything other than laudable. It is worth bearing in mind, since we sometimes forget, that most scientists are actually very altruistic people; they go into an area of work because they believe that they are going to do some good. They certainly do not want to harm animals, or indeed people. However, there is concern. I have one person in my own lab who refused an area of research because she felt that it was seen publicly as being disreputable; it was felt to be not very acceptable to the public as it involved mice. That individual ended up doing work, which was actually very good science, in a different area of biology that did not involve animals, but it took a long time. That was a typical switch that we often see in young scientists, and I am a bit concerned about that.

Further, as noble Lords will appreciate well, there is the issue of the fear among experimentalists about their risk of being attacked. Unfortunately, not enough of the community are prepared to put their head above the parapet, and we need to do more to encourage my colleagues to stand up and be accountable.

The second issue, apart from the PhD students, is the real issue that it is an important aspect of our economy. I have no doubt that we have to be stringent and careful about how we use animals, and we have to be utterly humane. That is an essential component of any work; certainly, as a doctor, I feel that that is important, just as it would be in treating a patient. As I think my noble friend on this side will say, we in Britain feel that our regulations are probably more stringent than most of Europe, and we are probably far further down the road of being sure that we are running a proper shop in our universities and other laboratories. However, 11% of our GDP comes from manufacturing. Although we are losing some of our great pharmaceutical companies, big pharma and biotech is an important area where we still lead the world, and those companies need animal work. It is fair to say that there is hardly a single drug that any of this in this Room have taken that does not depend on some animal research. The exception would be aspirin and, I think, digitalis, but I cannot think of any others; all the rest will at some stage have had animal research to prove their efficacy, their safety and that their long-term effects were not a problem.

That is one reason why this has to continue, and another is vaccinology. People may say that with modern genetics, reverse vaccinology, where you tailor a vaccine descending on the genome of what you are trying to combat, is the answer, but the modern techniques of making vaccines all use intact animals at some stage, so that also needs to be factored in.

I do not want to go on for too long because it would be wrong to do so, but I just want to draw attention to a couple of other points. First, one of the great areas of medicine which is really advancing and offers hope for better treatment is genetics. There, the greatest single model probably is the modified mouse. That has been a massive advance in the past few years—of course, since the three Rs. Increasingly, we are needing to look at mice whose genes are not working in the way that they would normally work because of cancer or other issues. They are absolutely essential to animal research. While we have to make certain that these animals do not suffer undue pain and are humanely treated, it would be unthinkable to allow more patients to die because we are not prepared to look for new drugs that might combat a condition which will kill one-third of the human population of the United Kingdom eventually.

On transplantable organs, I note the directive and its issue on transplantation but we also have to bear it in mind that every 15 minutes around the world someone is put on a transplant list. Most people on a transplant list will not get an organ. For every one person put on a list, there are probably five others who do not even get there. One of the great hopes is still xenotransplantation. The idea that we might not be able to engineer pigs for their organs when they are killed absolutely humanely, and much more humanely than, for example, in farming, is something we need to bear in mind.

We need to be clear in Europe as regards this technology, in which we lead in this country and may want to continue to produce. I have to admit that my company is involved in that technology, so I have a vested interest. I am not speaking because of that vested interest: I believe passionately that it is worth doing.

Let me conclude by arguing that one of the things that we need to do is to get a sense of reality about the three Rs. We need to recognise, for example, that every research university is doing animal research and that we need to have more people putting their heads above the parapet. It would be really helpful if the Government could encourage more public engagement. We note that they had many responses from the public but I suspect that even those came from people with a very narrow view of animal research—either very pro or very opposed to it.

From various polls, including a fairly recent MORI poll, it is clear that most people still do not really understand, first, how stringent and well conducted our regulations are and, secondly, the value of the research that is going on. We should be trying to focus more of our attention on that.

[Lord Alton of Liverpool]

My Lords, as the noble Lord, Lord Taylor of Holbeach, has told us, these draft regulations are intended to tighten the regulations on the use of animals in scientific research in the less well regulated European Union countries, particularly to improve animal welfare. I declare an interest as I serve on my university’s ethics committee, which oversees any Home Office licences required for such research, which, I might add, is undertaken for all the ethical reasons described by the noble Lord, Lord Winston.

Let me begin by welcoming the tightening of animal welfare legislation that the EU directive requires. I also welcome the instances of more stringent protection of animals in these regulations than is required by the EU directive, particularly the retention of the UK special protection for cats, dogs and horses; I find it surprising that that is not required in the directive.

Before turning to my concerns, perhaps I may pick up on a point mentioned by the Minister when he talked about three Rs—replace, reduce and refine. Perhaps when he comes to respond, he will amplify slightly on the question of replacement and to tell us what it is that he thinks that animals, such as the rodents described by the noble Lord, Lord Winston, should be replaced with. The Committee will not be surprised to know that I am particularly concerned about the use of human embryos.

However, during the proceedings on the Human Fertilisation and Embryology Act 2008, the noble Lord, Lord Hunt of Kings Heath, who spoke several times during those proceedings, made abundantly clear what became known almost in shorthand as the Hunt test. If alternatives existed to the use of human embryos, they should always be used. There is potential here for conflict: if they were to be used for replacement for animals, how does that accord with the so-called Hunt test that was used during those proceedings.

My concerns in this legislation to improve animal welfare centre on the importance of ensuring that other areas of legislation therefore do not suffer. There are a number of major concerns about this on which I will ask the Minister for reassurance. I return to some of the questions raised during the passage of the HFE Act, and in subsequent Questions I asked of the noble Earl, Lord Howe, on 20 July 2011. In a Written Answer he confirmed that some 3.1 million human embryos had been created since the passage of the 1990 legislation, and that 1.4 million of those had been discarded. To put it another way, for every baby born by IVF, 30 human embryos are destroyed. In a further reply that day, the noble Earl said that 150 animal/human hybrids had been created over the three years up to July 2011; that is obviously the question that I will centre on in my remarks today. I will also partly focus on replacement, which I referred to. I hope that as he comes to reply today, the noble Lord, Lord Taylor of Holbeach, will be able to tell us what the numbers of animal/human hybrids created in the United Kingdom have been since that was authorised; and also the total number of human embryos that have been destroyed or experimented upon since the passage of the 1990 legislation.