Current Bioethics Issues – Winter 2024

This report first appeared in our Social Issues Bulletin – Issue 57 which is available to download here.

New Assisted Suicide Bill in Westminster Parliament

On 16 October 2024, Ms Kim Leadbeater MP introduced the Terminally Ill Adults (End of Life) Bill for England and Wales in the House of Commons, which would allow terminally ill adults to request assistance to prematurely end their lives, subject to suggested safeguards. Interestingly, this Bill follows the decision of the Welsh Senedd on 23 October 2024 to reject, by 26 votes to 19, a motion supporting assisted suicide.

If the Westminster Bill is accepted, it would imply that the value of a human life is determined by certain subjective quality standards, allowing some lives to be deemed unworthy. Indeed, the UK Parliament would no longer be able to affirm and defend the lives of all its members, as well as the principle that every human life is full of value and meaning, even in cases where individuals are elderly, dependent on others, have lost autonomy, or are receiving palliative care.

The Westminster Bill’s Second Reading will be held on Friday, 29 November 2024, where the main principles of the Bill will be debated and put to a vote. Regardless of the outcome, the vote will carry significant consequences for related legislation in Scotland and Northern Ireland.

Number of Stored Human Embryos Reaches 500,000 in the UK

An Open Access article published in June 2024 indicated that about 500,000 embryos are currently stored in a frozen state in the UK, with a significant proportion likely to be discarded eventually. The findings used data from 1991 to 2019 provided by the UK Human Fertilisation and Embryology Authority.^[1]

In light of these trends, the principal author, Zishang Yue, highlighted that any destruction of human embryos creates a moral dilemma. This is because UK legislation is based on the Government’s 1984 Report of the Committee of Inquiry into Human Fertilisation and Embryology (Warnock Report),^[2] which acknowledges that human embryos hold a special (though undefined) moral status. Since human embryos retain this moral status in the UK, it is essential to address ethical concerns around the creation and destruction of vast numbers of embryos in fertility clinics. On this point, Lord Alton of the House of Lords remarked in The Daily Mail in 2012 that embryos were being created and discarded on an ‘industrial’ scale in the UK, adding: ‘It happens on a day-by-day basis with casual indifference’.^[3]

The article suggests several proposals to manage the growing number of embryos in storage in the UK. These include amending the law to resemble Germany’s 1990 Embryo Protection Act, which explicitly forbids the creation of surplus embryos during an IVF cycle.^[4] The German Act also states that an embryo only exists after fusion of the pronuclei (containing the chromosomes) of the sperm and egg cells, which occurs around 10–24 hours after the sperm cell first penetrates the egg. This definition excludes newly fertilised eggs from being classed as embryos until the fusion stage, allowing them to be stored in Germany before this stage is reached.

‘Compensation’ for Individuals ‘Donating’ Their Sperm and Eggs Raised in the UK

From 1 October 2024, ‘compensation’ for men to ‘donate’ their sperm has risen to £45 per clinic visit, while for women, it has increased from £750 to £986. The Human Fertilisation and Embryology Authority, which sets the ‘compensation’ amount, cited a shortage of egg and sperm donors among other reasons. However, it emphasised that ‘donating’ is a ‘complex decision’ and should not be driven purely by monetary motives, as payment for donation is illegal in the UK. This means that the money must be viewed as ‘compensation’, though the term is not clearly defined.^[5] It is worth noting that egg donation carries inherent risks.^[6]

Interestingly, in the UK, women can still legally ‘barter’ their eggs. This arrangement allows them to receive free or significantly discounted IVF treatment (typically costing up to £5,000 per cycle) in exchange for donating eggs to other patients or researchers.^[7]

However, this practice raises ethical concerns regarding the potential exploitation of vulnerable individuals who may not afford the full cost of IVF and are ineligible for free treatment in the UK. Wealthier women are unlikely to be motivated by such a ‘bartering’ scheme. Additionally, this practice appears to contradict the Council of Europe (of which the UK remains a member) Convention on Human Rights and Biomedicine (1999, which the UK has not signed), which states in Article 21 (Prohibition of financial gain) that ‘the human body and its parts shall not, as such, give rise to financial gain.’

New UK Guidelines for Developing Synthetic Human Embryo Models

In July 2024, a new UK code of practice was announced to guide the creation of synthetic human embryo models. These are three-dimensional embryonic structures created in laboratories to mimic early human embryos. The technology became ethically controversial in 2023 when researchers created an embryo model with a heartbeat and features resembling those found in the third or fourth week of pregnancy, without using eggs or sperm.

The previous lack of specific guidelines left scientists uncertain about the legal and ethical limits of their work. Under existing UK law, researchers can grow ‘real’ human embryos for research purposes for up to 14 days, after which they must be destroyed. However, if synthetic embryo models are not classified as ‘real’ human embryos, they are not bound by this restriction.

The new voluntary code of practice will establish an oversight committee to decide how long specific embryo models may be developed, though it does not rule out experiments exceeding the 14-day limit.^[8] This raises concerns regarding whether members of the oversight committee would be willing to safeguard certain embryo models if they do not even consider ‘real’ human embryos as warranting protection.

Footnotes:

^[1]  Yue, Z., & MacKellar, C. (2024). A quantitative analysis of stored frozen surplus embryos in the UK. The New Bioethics, 1–18.

^[2]  Warnock Report, Report of the Committee of Inquiry into Human Fertilisation and Embryology (London: Her Majesty’s Stationery Office, 1984).

^[3]  Steve Doughty, ‘1.7 million embryos created for IVF have been thrown away, and just 7 per cent lead to pregnancy’. Mail Online. 31 December 2012

^[4]  German 1990 Embryo Protection Act, (1990 §1.1.2-1.1.5) https://www.rki.de/SharedDocs/Gesetzestexte/Embryonenschutzgesetz_englisch.pdf?__blob=publicationFile

^[5]  Charlotte Edwards, ‘Sperm donor cash rises by £10 as UK faces shortage’, BBC News, 1 October 2024 https://www.bbc.co.uk/news/articles/cm24vd6ldypo

^[6]  Charlotte Edwards, ‘Egg donors warned not to do it for the £986 cash’, BBC News, 8 August 2024, https://www.bbc.co.uk/news/articles/clyl34qdzjxo

^[7]  See Egg Sharing from the Human Fertilisation and Embryology Authority:  https://www.hfea.gov.uk/donation/donors/egg-sharing/

^[8]  Ian Sample, ‘Work on synthetic human embryos to get code of practice in UK’, The Guardian, 4 July 2024, https://www.theguardian.com/science/article/2024/jul/04/work-on-synthetic-human-embryos-to-get-code-of-practice-in-uk