Baroness Mary Warnock interview: on the 14-day rule, philosophers as committee chairs, and the next report
Almost 34 years ago, Baroness Mary Warnock headed up a committee whose report was to form the basis for the legislation and regulation of IVF and embryo research the world over. The 'Warnock Report', commissioned by the UK government in 1982 following the birth of the world's first IVF baby Louise Brown in July 1978, laid down the basis for the 14-day time limit on the laboratory research of human embryos, and the foundations of the UK's regulator the HFEA (Human Fertilisation and Embryology Authority).
Next week, Baroness Warnock – also patron of the Progress Educational Trust (PET), which publishes BioNews – will receive the major international Dan David Award from the Dan David Foundation, headquartered at Tel Aviv University in Israel (see BioNews 937). It is the first time in its 17-year history that the prize has been awarded for bioethics. The foundation said it is 'for her leading role in the development of practical bioethics and specifically for her progressive and unparalleled contribution to the ethics of embryology and genetics and their ethical and philosophical implication, reproductive technologies, and disability studies'.
Baroness Warnock spoke to BioNews about the seminal 1984 report, current issues in embryology, and regulation.
Your 1984 report has been described as the most influential analysis of this area in the world - how do you feel about that? Do think this has been for the good?
I have to say, I feel rather pleased. Every time the Human Fertilisation and Embryology Act was amended or changed, or another act brought in to supplement it – I always felt a sort of delight that I'd done something.
I think from the point of view of remedying infertility, which is a condition I feel very strongly about, I think it has done good. It was a start. The beginning. But of course an enormous lot has happened since then.
How important a role do you think philosophers should have in shaping policy in science and medicine?
I think it's quite useful to be a philosopher because philosophers don't have the expertise of a subject matter of their own. Their profession is analysing what people say and teasing out what they mean. They are quite useful as chairmen of committees.
I think in this case [for the 1984 report] people would not have been very happy if the committee had been chaired by a doctor or scientist, because the people who disapproved of research in human embryos were the sort that felt that scientists and doctors would have no regard for morality. They wouldn't have trusted the findings of the committee if it had been a scientist or doctor chairing it. I think a lawyer would have been a bit suspect too.
With the benefit of hindsight what would you have done differently?
It's a difficult question because so much has come up since. I think we had all the information that we could possibly have had at that time. We spent a whole year really listening to people, taking evidence and reading their submissions. We took a good deal of evidence from all kinds of people – medical [professionals], gynaecologists, research teams working in the field. We also heard from people who thought that any intervention (what used to be called the 'artificial family') in the process of starting a family was wrong. There were a lot of extreme views.
...would you have reached a different conclusion in your report?
Rather on the contrary – I think the most important thing really, and the only reason it managed to get through Parliament, was that we had the 14-day cut-off rule. If we hadn't had a definite number of days beyond which it would be a criminal offence to keep an embryo alive in the lab – that was immensely important [in getting through].
I personally wouldn't want it to change. There's talk now to extend it, but I hope that won't happen. It's only very recently that the embryo has been kept alive longer than five days [in the lab]. There's no reason to change it at the moment.
I'm perfectly sure that if we had tried to describe a stage of development of the embryo which would be the cut-off that would not have worked. Everybody can count up to 14, and everybody can keep a record. It was the simplicity of that rule that made it successful.
What was the most difficult ethical issue you had to tackle in the report?
It was difficult in the sense that we were dealing with something completely new. There had never been an embryo alive outside the uterus in the lab before. There were absolutely no precedents.
The research had to go on but the process was very precarious at the beginning, finding a way to keep the embryo alive [in the lab]. If an embryo was used to carry out this research it would have been quite immoral to use the embryo to implant in a uterus – you wouldn't know if it had been damaged. This was an ethical issue that divided the committee itself, and the public.
There we were recommending that embryos should be created and deliberately used for research and then destroyed – this is what people described as murder.
Some say that as IVF is now routine it no longer needs so much specialised legislation and regulation, nor does it need its own special regulator. What do you think of this argument?
I think it's a very dangerous argument. The first recommendation in our report was to set up the HFEA to inspect and monitor infertility treatment. I believe that is very important because it has more or less ruled out rogue practitioners.
People who are infertile and want to start a family are very desperate and therefore very vulnerable. I wouldn't want that [protection] changed for anything. People say it's over-regulated – I think that's a fault on the right side.
Given the advances we may be seeing in this area with genome editing, the ability to grow embryos in vitro for longer and the creation of in vitro derived gametes is it time for a new Warnock Report?
I don't think so. It would be quite good to have a sort of readable summary of where we've got to and what the issues are. But I don't think that amounts to a whole new committee being set up.
It might be that the government might commission someone to write a kind of history of where we have got to. As far as I know there are people doing that at this moment. 'The Making of British Bioethics' by Duncan Wilson and published by Manchester University has a chapter on it [the field].
Are there any other issues in the field on your mind?
I think the whole field of genetic intervention and the possibilities of performing therapeutic interventions on embryos – either when they have been implanted, or in the lab – is still developing and is extremely exciting.
The one thing I do deplore is the attitude of what I think of as the disability lobby who think it's wrong to try and eliminate hereditary diseases because it is suggesting that they are unworthy of life. That is an absolutely terrible argument. The disability lobby is very vocal on this subject and it does form a real obstacle on progress.
You have been involved with landmark reports in two areas – embryology and your 1978 report in education. Is there a report in another area you would like to be commissioned to produce?
No. But I'd like to write another report on education. I think that so much has happened in the way of education, and the government has tinkered with education in one way or another. I think there's a real need for another full-blown investigation.
If Andrew Adonis had had longer as minister for education, I thought he would have performed some miracles. Unfortunately, he got moved on. If I had my way I'd set up a Royal Commission on education with Andrew Adonis as its chairman.