Great Britain's Debate Over the Utilization of Fetal Ova

Angela Kennedy


Fetal Attraction

There appears to be some magical quality to fetal remains, and this quality is very much in demand. Legalisation of abortion in Western nations, and the increase in abortion that has followed, provides a steady stream of material upon which to experiment. For example, in 1991, as part of research into AIDS, scientists in the United States reportedly transplanted the internal organs of aborted human fetuses into laboratory mice. Still living tissue was introduced into mice bred without an immune system.[1] The brain cells of six-week old male fetuses have been used to try to effect a cure for Parkinson's disease, though with dubious success.[2] Naomi Wolf notes that human fetal tissue cells are sold to manufacturers of skin creams, and that pregnant women in poor countries are persuaded to abort their children, sometimes as late as seven months gestation, for 200 dollars to an undercover trade in cosmetic fetal tissue.[3]

Wolf relates this carnage to the significance of rejuvenation in sacrifice. Now we know that, in the near future, the death of a fetus by abortion could indeed give rise to a re-birth. Biologically, the fetus could herself become a mother, of sorts, even in her own death throes.

In 1993 Dr. Roger Gosden, a British fertility scientist at Edinburgh University, offered his work for scrutiny to the British governing body, the Human Fertilisation and Embryology Authority (HFEA). The HFEA, in turn, decided to offer the proposals to public scrutiny, and produced a consultative document available to the public. Those proposals were for the use of ovarian tissue, including ova, not only from live donors, but from cadavers and aborted fetuses, to treat infertile women.

The applications of these proposals with regard to the ovarian tissue of cadavers and aborted fetuses are said not to be possible at this time, or even imminent. Techniques do not yet exist for taking the thousands of ova from aborted human female fetuses, maturing them in a laboratory and implanting after fertilisation. However, this practice apparently could occur in two to three years if research were allowed to continue. Scientists in Korea have supposedly produced a child from the ova of a dead woman.[4] Yet other experts have dismissed the techniques as not being possible for another "one or two decades." This prediction was given by Professor Robert Winston of the IVF Unit at the Hammersmith Hospital at a symposium held on 25 April 1994 on Donated Ovarian Tissue held by the Catholic newspaper The Universe. He insisted, "There is absolutely no evidence that fetal ovarian tissue will be used by the time the technique is possible, as there will be better technology to mature ova from adult ovaries by then."[5]

This begs the question: why were the proposals offered up for public scrutiny? This is not a usual occurrence. It has long been a criticism of bioethics that scientific advances and new techniques are kept hidden from the public. Professor John McClean, an embryologist at Manchester University, had his own theories as to the reasons for the public consultation, which he offered at the same Symposium on Donated Ovarian Tissue: "The freedom, given in the 1990 Act for embryos to be used for scientific purposes, has been seriously curtailed by a lack of availability--hence this document. The intended objective is to increase the supply of eggs."[6]

Thus, a hornet's nest of debate was stirred up in Great Britain in the first half of 1994, over a technique that may become possible, or may not.

The Legal Background

To understand the background to this debate, it is necessary to understand some of the British legal background to the issue of reproductive technology, particularly recent developments. The 1967 Abortion Act clarified that doctors cannot be prosecuted if abortions are performed for "medical" reasons, including social or psychological ones, or if the fetus is "severely disabled." The 1929 Infant Life Preservation Act held that a fetus over 28 weeks was capable of independent life, and this led to the practice of restricting abortion after that time.

In 1990, a pro-life Liberal Democrat Member of Parliament, David Alton, introduced a Private Members Bill which declared 18 weeks the maximum age of gestation in which a fetus could be aborted. This bill was defeated, and instead an upper limit of 24 weeks was allowed, except for suspected fetal handicap, for which there is no upper limit. Practically, this means that a baby can be aborted up to birth, leading to a very hazy distinction between abortion and infanticide. These guidelines were incorporated in the Human Fertilisation and Embryology Act of 1990, which came about as a result of the findings of the 1984 Warnock Committee Report, which was commissioned by the Government after the birth of the world's first test-tube baby, Louise Brown, in 1978.

The 1990 Act regulates and monitors In Vitro Fertilisation (IVF) treatment centres and purports to ensure that research carried out using human embryos is conducted in a "responsible" way by means of a licensing system.[7] The three areas covered by the Act are:

  1. any fertilisation treatment involving the use of donated eggs or sperm (donor insemination), or embryos created outside the body (IVF);
  2. storage of ova, sperm and embryos;
  3. research on human embryos.

Parliament set up the Human Fertilisation and Embryology Authority (HFEA) to carry out the work required by law. It claims to be an independent body, though this assertion is questionable. It is funded partly by the taxpayer, and partly by the licensed centres it controls.

The Authority inspects and monitors licensed centres. It has other duties related to giving information and advice to centres and to the public, including people who may wish to use the techniques covered by the Act, and it keeps a confidential register of information about donors, patients, and treatments. In time it will have a legal duty to tell adults who ask whether they were born as a result of treatment using donated eggs or sperm, and whether they are related to someone they wish to marry. The register with this information was set up on 1 August 1991. No information about patients, offspring, and donors will be divulged by the Authority. Adults will not be able to find out the circumstances of the treatment, or how they might be related, but it is apparently possible that they will be told the donor's skin colour, eye colour, job, or hobbies. This of course would not be possible if the ova donor were a fetus.

Under the Act, it is currently illegal to:

  1. do research on embryos over 14 days old (this leads us to question whether the aborted fetus is an embryo over 14 days old. There has been no deliberation over this issue to date)
  2. attempt to clone human embryos
  3. attempt human-animal hybridization.

Broad Cross-Section of Views?

The HFEA is comprised of 21 members, appointed by the Secretary of State "to represent a broad range of views and experience, medical, scientific, social, legal, lay and religious." However, broad range of views has not been achieved. During the consideration of the Act, the Government stated that only those who approved of techniques that involve the use of an embryo, including its destruction, would be appointed to the HFEA. Baroness Warnock, whose bioethics committee helped shape the Act, herself rejected a Catholic from the committee because "I just knew that I couldn't work with him." Members include an actress, a Church of England bishop, a member of the equal-opportunities commission, the managing director of BBC Radio, a banker, a rabbi, a nurse, a child psychiatrist, an obstetrician, a geneticist, an embryologist, a management consultant, and a Health Care trust manager. Since its inception, pro-life Labour and Liberal MPs have campaigned for a more representative selection of HFEA members, to include people who would firmly call themselves pro-life.

In 1989 "A Review of the Guidance on the Research Use of Fetuses and Fetal Material" was published, now known as the Polkinghorne Report. This report is used as a guideline for the use of fetuses in research and therapy. It accepts the seriousness of abortion and the "dignity" of the fetus, but does not accept that abortions under the 1967 Abortion Act are performed for any reasons except for "serious" moral issues, such as the health of the mother.

As far as moral deliberation goes, this report presents as a fait accompli. There cannot be an argument that the use of fetal tissue following abortion is morally disqualified, because no legal abortion performed is morally wrong. In practice, any reason for abortion--sex-selection, inconvenience, poverty, rejection, unsupportive male partners--can be covered by "social and psychological" reasons. This report can, therefore, be fairly described as not particularly rigourous in its exploration of moral issues.

"The Yuk Factor"

With an acceptance of abortion as morally right and legal, the public was invited to comment on the proposals to use ova from live donors, cadavers and fetuses. As live ova donors have been used for some time, as with sperm donors, the real issues to be explored were the proposals regarding cadavers and fetuses. Reactions were varied. Predictably, perhaps, prominent pro-life commentators described the processes as "womb-robbing," "cannibalising," "robbing a dead soldier" and "plunder." If perhaps metaphorically relevant, these descriptions were described as emotive by others. Nevertheless, a new phrase was coined to describe the response of the public that was becoming apparent: the "Yuk factor." It appeared that even to a public resigned to abortion, these proposals were going just too far. Even members of the HFEA admitted to feeling distaste for the ideas.

The Reverend Dr. John Polkinghorne himself, President of Queen's College Cambridge and Chairman of the Polkinghorne Committee, said that bringing children into the world whose mothers had never lived and had been prevented from living by their grandmothers could be very psychologically damaging to them.[8]

The Medical Ethics Committee of the British Medical Association (BMA) decided that ovarian tissue from human fetuses should not be used to provide eggs for infertile women, although it had no objections to experimenting on fetal tissue, or to the use of eggs donated by a dead woman or girl who had previously given specific consent. This would presumably mean that they would not want toddlers or pre-pubescent girls to donate ova, even with the consent of parents.[9]

However, the decision on the ethics of using fetal ova must now go to the BMA Council and five other BMA committees. According to Stuart Horner, the committee's chairman, there has been a change in opinion from the Committee because there have been impressions gained from other people. "There may be no logical reason," but they believe there was a limit to be defined.

Predictably, again, the "scientists," "ratmionalists," and other moral intelligentsia, who prided themselves on their reasoned rather than emotive responses, labelled objections as "anti-science"[10] or "an irrational response to scientific advance."[11] The geneticist Steve Jones accused those who disagreed of glorying in the pursuance of "a triumphalist New Ignorance."[12]

Writer Brian Appleyard recognised that any objections to scientific research can always be labelled Luddite, irrational or even barbaric, and he feared that the scientists will have their way eventually. Nevertheless, he maintained, "The Enlightenment answered science with this simple statement: the human self is an end to itself and can never be a means to an end."[13]

Colin Campbell, Chairman of the HFEA, attempted to divorce the issues of using fetal ova from that of abortion itself. Like the Polkinghorne Committee, he endeavored to convince the public that abortion was legal and moral per se.[14] This was a fundamental misrepresentation of the issues, although this was not necessarily of deliberate intent.

Other issues of fertility became confused with the fetal and cadaver ova donation debate when a woman was apparently given the ova of a white donor to produce a child of mixed race since her husband was of mixed race,[15] and a number of post-menopausal women apparently gave birth to children following ova donation.[16]

Vivisection

The comparison of reproductive technology with vivisection was made succinctly by Malcolm Eames of the British Union for the Abolition of Vivisection, who reminded us that the techniques involved have all been developed in laboratory animals, and that in effect what we do to animals is a dress rehearsal for what we do to humans.[17]

This premise is borne out by current practice. In Japan a 120-day-old goat fetus was kept alive in a rubber uterus for 17 days, after being removed from its mother's womb. Japanese scientists have also been experimenting with parthogenesis, the production of offspring from unfertilised ova. Cloning of farm animals has been going on for some years. The debate about fetal ova donation directly results from successful techniques of transplanting ova from fetal mice.[18]

Carol Adams has written about the sexual politics of meat-eating, and has identified the use of "feminised protein," i.e eggs and milk.[19] The products of female animal reproduction are taken over and used, consumed by men. It is not difficult to detect the analogy with the use of the products of female human reproduction, especially as it illustrates the exploitation of the powerless (animals, fetuses, women) by the powerful (males).

Feminist Response

In view of the fact that reproductive technology is clearly a feminist issue, it was all the more surprising that feminists appeared to have so little to contribute to the debate on this new use of our bodies. While many men entered the public debate, the feminist (at least the pro-choice feminist) response was muted. Very little was said in any of the feminist journals. In the public arena, the voices of groups like the Feminist International Network of Resistance to Reproductive and Genetic Engineering (FINNRAGE) were conspicuous by their absence. The anti-abortion group LIFE asked why feminists were not protesting the exploitation of their unborn sisters.

To be fair, the occasional comment was voiced by women writers. Rosalind Coward conceded that "to abort involves not seeing the fetal mass as human, but taking its [her] eggs means it is human enough to have its potential raided...."[20] Linda Grant, an advocate of abortion, unwittingly humanised the fetus by describing the transfer of ova from an aborted fetus to "the uterus of another woman."[21] She asked some pertinent questions as to why morally sound, low-tech ways of controlling fertility could not be found, about childlessness itself, and about the male desire to control reproduction through reproductive technology. National Abortion Campaign chairwoman Leonora Lloyd asked why no money was being spent on helping women come to terms with childlessness, a very relevant point, though her views on the issue of fetal ova donation itself are not recorded.[22]

Bearing in mind that it was female bodies at stake here, and bearing in mind some of the burning issues related to women's rights, it was remarkable that so much of the debate was led by men, and so little by women. This may have been because the opportunity was not given to women in a largely male-controlled media, but this does not explain the dearth of discussion in feminist journals.

Hidden Issues

Thus, in an atmosphere of inaccuracies, omissions, name-calling and opinion-ridden sound-bites, it became increasingly difficult to follow a path of moral truth, or even of scientific accuracy. It is a testimony to the "public's" integrity that so many people did make their views known to the HFEA. Outlined below are some of the issues that were not made public knowledge by the HFEA, but that had direct and critical bearing on the moral points in question.

The methods that would need to be used to obtain fetal ovarian tissue were never made known to the public. It is known that there would have to be an optimum time for "harvesting" ovarian tissue at about twenty weeks gestation. It is obvious that methods of abortion necessary to obtain ovarian tissue could not:

(a) dismember the fetus;
(b) leave a long period between the death of the fetus and "harvesting." As in other organ donations, a "live" body is the optimum condition.

It can therefore be concluded that the only suitable methods of abortion would be hysterotomy and removal of an intact fetus, or a vaginal delivery of an infant not killed in utero by saline beforehand. (This was not denied by the HFEA when I postulated the points to them). Therefore:

(a) late abortions might be carried out to obtain ova;
(b) invasive procedures might be carried out to obtain ova;
(c) live infants could be born.

These methods raise serious questions as to the issue of consent to these late abortions. Usually, late abortions are carried out on fetuses who have genetic or other "defects." It is illegal in Britain to carry out abortions routinely on healthy fetuses after 24 weeks. The current practice is to carry out abortions that are for "social and psychological reasons" as soon as possible, as late abortions are considered traumatic for women (as any pro-life feminist could have told them). If scientists want "healthy" fetal material, material from fetuses that are not genetically "defective" (for obvious eugenic reasons), they would have to time the latter types of abortion to a later stage than is usual. This could quite easily, therefore, lead to more late abortions, with their associated traumas. The issue of consent is raised because Polkinghorne states that fetal tissue must not be obtained from women for specific uses. How would a doctor persuade a pregnant woman to undergo a late abortion for no personal or medical reason, without breaching Polkinghorne guidelines? How ethical would it be for doctors to time abortions to the "needs" of the research scientists, as opposed to the welfare of the woman undergoing abortion?

Another issue of consent is raised because in Britain, although the Polkinghorne guidelines state that a woman's consent should be sought before her fetal child is used for other purposes, there is no way at present to enforce these guidelines. This is a unique situation. All other organ donation or use of a body for research purposes is preceded by the personal consent of the involved individuals or their relatives. It is a blatant example of discrimination to neglect that basic right of consent to mothers of fetuses, even where the mothers have chosen to abort, and certainly if the death of the fetus is due to accident -- i.e., miscarriage. Whether the fetus is considered part of a woman's body, or a being in her own right, as a woman who has miscarried a "wanted" child would consider, the issue of consent must be the same as in all other cases.

There is a third issue of consent that relates to that of the father of the aborted fetus. His consent is not required for abortion, nor for other treatments using aborted fetuses. Whether his consent should be obtained for the use of his genetic offspring to propagate new life is an issue that has not been resolved.

The fourth issue of consent relates to the fetus herself. (It is perfectly in order, and not emotive, to use the words "she," "her," and "herself." The fact that scientists wish to use ovarian tissue is an obvious reference to the fact that the fetus is a known female at the time of abortion.) It was postulated by some during the debate on ovarian tissue donation that a fetus may, if she could communicate, be in favour of giving life to offspring while she herself had been denied life.[23] This is a preposterous assertion. There is no rational and logical way that this assumption can be justified. What such a notion implies is that the fetus, who has no rights in British Law, nevertheless has such a highly developed sense of altruism in utero that she would die happy knowing she had propagated "new life." While denied any humanity in order to justify abortion, the fetus is suddenly ascribed the qualities of a willing martyr when she possesses a quality that scientists want, in this case her dormant reproductive ability.

Other attempts to justify the proposed research included the assertion that the denial of her life but creation of other life from her body parts could be "positive use for material from a fetus that would otherwise be discarded" (from the HFEA Consultation Document)[24]. This inconsistent and hypocritical supposition was echoed by many bioethicists. A number of analogies can be made here, such as the Nazi plundering of the personal belongings of gassed concentration-camp victims, and the suggestions that the Brazilian street children, considered vermin in Brazilian society, should have their body organs "harvested" to allow "valued" children -- i.e, the offspring of rich people -- to benefit. Even if not yet considered a "person" under the value judgements of Lockeans, the fetus, if allowed to follow her destiny, has every chance of reaching the hallowed status of personhood. Polkinghorne guidelines take account of this potential.

The most positive use of a fetus is to let her live her own life.

A Lasting Legacy

There are other considerations to be examined regarding the issues of ova/ovarian tissue from the dead, whether the donors are fetuses or cadavers.

The mothers of the aborted fetuses, who may come to regret the abortion in later years, may not be able to come to terms with the fact that another woman may be bearing a child conceived from the body of her own dead fetus. This may be particularly difficult if the mother of the aborted fetus is herself unable to conceive following the abortion.

The fathers of aborted fetuses will have to try to come to terms with the possibility that someone has borne their genetic grandchild, conceived from their dead genetic daughter. This may be particularly difficult if the father did not want the mother to abort.

The grandparents of aborted fetuses, and the parents of dead female donors of ovarian tissue, will have to come to terms with the possibility that their daughters or genetic granddaughters have biologically mothered other children. This would be particularly difficult for parents of "cadavers" who may wish to establish a bond with the genetic offspring of their dead daughters. This also raises the issue of consent to ovarian tissue donation from the parents of dead women or girls. At such a harrowing time, would it be ethical to approach grieving parents for consent and expect them to grasp the complexities of their daughter's death giving rise to a genetic grandchild? Could we blame parents who might try to track down their genetic grandchild in the future?

People have an apparently universal need to know about their origins. Unlike adopted children, who usually have access to their birth history and parentage and may trace these if they wish, the genetic offspring of aborted fetuses and cadavers will be denied their history. This is a sad example of the breach of a fundamental principle in health care, "truth-telling." However, this has probably been proposed because to know the truth -- that one's genetic mother was dead before one's conception -- would be too horrifying. So the genetic offspring of such origin would not only have a tragic history, they would also be denied their history.

The parents who receive the ova from an aborted fetus or cadaver would know that, genetically, the child concerned would be the offspring of the father and an anonymous dead being. If this is not acknowledged or communicated to the child, the parenting process would be continued on an untruth. This could very well lead to tensions between the parents themselves and the child, especially as they may eventually have to try and come to terms with the grisly circumstances of the conception of this child. Could this lead to a horror that could be transferred to the child, a resentment of that child's origins? This would be bad for the relationship between parents and children.

Feminist Discomfort

Why were feminists, those who advocate abortion at least, so averse to discussion of this issue? Perhaps it was because the issue itself highlighted so many inconsistencies and problems with the current blanket acceptance of abortion as a good thing for women. Despite all efforts to disassociate the use of fetal ova from the issue of abortion itself, there were some horribly relevant points that kept surfacing regarding consent and medical trauma to women.

The humanity of the fetus, and her femaleness, were revealed. At 20 weeks, a pre-born girl has 5 million ova. She is sentient and reacts to light and sound. She can feel pain. Knowing that at this, and even earlier stages, a female fetus possesses even more than the external signs of her gender might make a woman feel that she is, after all, carrying a human being. She is not carrying that erroneous and unscientific description, "a clump of cells" -- she is carrying a "sister," so to speak.

The assertion that a woman has a right not to become a mother rings hollow when we realise that by aborting a girl, and letting her ova be used, we are first killing our unborn children, and then turning them into parents. This irony would probably not be lost on intelligent women.

Finally, after years of maintaining that being childless must not mean the end of the world for a woman, that she has the right to be defined by other achievements, that being childless is not a failure, women are then confronted with new and terrible reproductive technology, which scientists insist is for our own good, to help treat childlessness. The question must have occurred to feminists: Is childlessness so awful that we would go to this length to avoid it?

These burning issues continually bring up one constant, and that constant is abortion. This issue like no other illustrates the way in which abortion keeps women oppressed. Because abortion is the sacred cow of the feminist movement, feminists have been instructed not to make any criticism of abortion because to do so would place abortion "in a bad light."[25] It has come to the situation where abortion is seen as more important than bodily, emotional, or intellectual integrity. Abortion is becoming more important than women's welfare.

Abortion advocates continue to do women a great injustice by refusing to reflect on these issues.

Which Way the Moral Pathway?

After six months of controversy and debate, the HFEA decided, for the time being at least, not to license the proposals to use the ova of fetuses or cadavers in research or therapy. This may change in the future, if the bioethicists who favour such proposals can convince the public that it should.

The role of bioethicists has been criticised by such philosophers as Anne MacKlean.[26] She challenges the bioethicists' claim to possess the moral expertise to deliberate on moral issues, and criticises as inadequate and destructive the almost universal utilitarianism of moral philosophers in the field of bioethics.

It is essential that more women be consulted concerning the moral issues that arise from science, particularly those involving reproductive technology. It is also vital that pro-life feminists be included in the debates. In our critical analyses of abortion, we counter the destructiveness of utilitarianism. If utilitarianism, selective idealism, relativism, and other sliding-scale approaches to reproductive technology continue to dominate ethical decisions, science's capacity for advance will override its capacity for good.