Mark Henderson, Science Editor
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Once the House of Commons has voted on the Human Fertilisation and Embryology Bill, the task of implementing the legislation will fall in large part to Lisa Jardine.
On April 1 the Professor of Renaissance Studies at Queen Mary, University of London, started work as head of the Human Fertilisation and Embryology Authority (HFEA), which oversees IVF clinics and embryo research.
She has had something of a baptism of fire. On her first day it emerged that scientists at the University of Newcastle upon Tyne had created Britain’s first human-animal embryos, under the terms of a licence granted by the regulator in January.
And on Tuesday a Christian group announced that it was seeking judicial review of the authority’s decision to approve the Newcastle experiments, and those planned by a second team at King’s College London.
In her first interview since starting the job, Professor Jardine told The Times that while she could not comment on details of the pending legislation, she felt some religious opponents had been less than open about the root of their objections.
Senior Roman Catholics, such as Cardinal Keith O’Brien, who has described hybrid embryos as “experiments of Frankenstein proportion”, are theologically opposed to all areas of medicine and research in which embryos are destroyed, she said.
“The elephant in the room of the current discussion in — let’s call it the vocal Catholic constituency — is that they don’t approve of IVF because embryos are destroyed,” she said. “So when I’m listening to the strenuous and very concerned expressions of anxiety around hybrid embryos, an important element is missing.”
She was equally critical, however, of the Newcastle researchers’ decision to discuss their early experiments with the BBC, before the results had been published or peer-reviewed. “Scientists are a trusted community because they use peer-review, ethics committees, publication in journals and repeatability of outcomes in a way that is exemplary for all areas of intellectual life,” she said. “The regulator stands side by side with scientists, in a dialogue between them from which each learns. However, priority is such a big issue in this area that there’s a huge temptation to jump the gun, which is not very helpful.
“I do think last week’s events have really shown that elegantly. We were proceeding very nicely with where we’d got to, with an enormous amount of discussion, consultation, taking of ethical soundings, leading towards the new Act. But when researchers are in a hurry, then you lose that moral advantage. It’s a bit like somebody bursting a paper bag behind your head.”
Her approach to the broader aspects of the job, Professor Jardine said, will be informed by her growing realisation about the impact infertility has on society.
A few days after her appointment was announced in January, she went on holiday and fell into conversation with three women around a hotel swimming pool. “To my astonishment, all three had had fertility problems,” Professor Jardine said. “One had not had IVF because her husband wouldn’t agree, but two had had it, one successfully and one unsuccessfully. I was completely stunned. There was nothing special about those three women.”
It underlined to her how many lives are affected by infertility, IVF and donor insemination, the areas she is now in charge of regulating.
“Fertility touches everybody, absolutely everybody in the land,” she said. “One in seven couples has fertility problems. It is something people need to know about, a bit like everybody needs to know how to wire a plug.”
She considers building this knowledge to be a critical part of her role at the HFEA, quite as important as its statutory responsibilities to oversee fertility clinics and embryo research.
Though Professor Jardine is a historian of science who thought herself quite well versed in modern medical procedures, she said the limits of her own understanding had been exposed. “Until I was inside the authority, I don’t think I fully understood the process of IVF itself,” she said. “The invasiveness, the duration, the use of drugs, the complexity of combining attempts to reproduce under those circumstances with a normal life.
“It is absolutely a part of my brief to communicate that, to enable people to make informed decisions. People may not be informed, but the HFEA’s regulation touches everybody.”
One thing that surprised her was that so little fertility treatment is performed on the NHS in Britain — about 80 per cent is private. But, despite her strong views on the importance of fertility issues to everyday life, she is unconvinced by the case for much wider NHS provision. “What you’re asking me is about entitlement, and we live in a world in which there are very few things you’re entitled to,” she said.
“I think we know that immediately life-threatening conditions entitle you to treatment, but I can’t get much beyond that. If it were available there would be less heartbreak. But there’s heartbreak in lots of areas of medicine that aren’t available on the NHS. I don’t have a view.”
Professor Jardine is herself in remission from breast cancer, which has made her acutely aware of how NHS services have to be rationed. “I’ve come out of one NHS resource-guzzling area. This is quite serious: when people around me are wanting Herceptin at a cost of £20,000 a year, what can I say about competition between areas of health-related treatment?”
She also questioned the claim, often made by fertility specialists such as Lord Winston who campaign for wider NHS access, that infertility is a disease. “I understand where those clinicians are coming from. Personally, I don’t think it’s helpful.
“Infertility is not for most people life-threatening. I don’t want to call pregnancy a disease, I do want to call cancer a disease, but I’m not sure what to do with infertility.”
The in-tray
— To oversee the introduction of changes to IVF and research law included in the Human Fertilisation and Embryology Bill. These include the proposed end of the “need for a father” in fertility treatment, new rules for embryo screening, and regulation of human-animal embryos
— To reduce the rate of multiple births, through measures to encourage single-embryo transfers
— To restore firm leadership and doctors’ confidence in the HFEA, which has been run by an interim chairman and chief executive for the past few months
— To manage patient information, so that data on clinics’ success and error rates is better presented
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