TY - JOUR
AU - Waxman, Sacha
AB - In this edited collection, Kirsty Horsey brings together a range of experts in law and ethics who offer a critical evaluation of recent developments relating to the UK’s laws on human-assisted conception. Despite the title’s use of the term revisiting, the contributors have, in fact, focused on current topics in the field rather than a general re-exploration of the chronological development of regulation in human fertilisation and embryology. Horsey demonstrates the overarching purpose of the book by asking, in the preface, ‘whether the Human Fertilisation and Embryology Act 2008 has achieved the stated aim of being “fit for purpose” or, if not, what could or should be done to improve it’ (p x) . Correspondingly, what follows in the next thirteen chapters is an examination of the law and ethics of human fertilisation and embryology with topics including changing conceptualisations of child welfare and the parenting provisions,1 problems with DIY-assisted conception,2 prisoners’ access to fertility services,3 attribution of legal parenthood in surrogacy,4 mitochondrial DNA transfer,5 as well as chapters which offer a comparative perspective on the UK’s regulation with that in Canada and Australia.6 The book assumes a prior understanding of the legislative development of the law and related ethical issues leading up to the passage of the 2008 Act.7 Wide-ranging topics mean that although the critical depth of the book is sufficient to achieve its stated aim, it does not purport to be anything other than a snapshot of opinions on the 2008 Act. Each chapter seeks in its own right to evaluate the fresh risks and challenges that have emerged from established and existing technologies and techniques in the field of assisted human reproduction. The contributors individually set their scene and immediately delve into their critique of their chosen topic. The advantage to this format is that the content is factual, targeted, and relatively concise, so the book ought to appeal to a wide cohort of readers from multiple disciplines. While some chapters appear to revisit ground previously explored in the literature (for example, those by Eric Blyth and Helen Codd),8 all chapters offer a new analytical twist on the specific aspect of regulation explored, following the enactment of the 2008 Act, and provide valuable insights into the social and regulatory challenges that lie ahead. In their chapters, Blyth and Codd engage with different problems arising from the child welfare clause and prisoners’ access to treatments. To some extent, the content of these chapters intertwine on issues relating to a person’s reproductive liberty and a right to procreate. In both chapters, the authors’ analytical approach causes the reader to step away from what are broadly construed as familiar subjects and conduct a more rounded assessment of the UK law as it currently stands. By the end of these chapters, for entirely different reasons, the reader is left asking restructured questions surrounding access to treatment, prohibition on treatment and the detrimental force of current political climates on access to fertility services. Therefore, in these opening chapters alone the book achieves its stated aim of offering valuable insights into the social and regulatory challenges that lie ahead. Similar issues are taken further in Emily Jackson’s chapter where she explores a relatively untouched area of regulation—DIY-assisted conception.9 Jackson discusses the dangers of such conception both within the UK and outside this jurisdiction. True to form, her critique is particularly interesting as it alludes to the growing presence of reproductive tourism. She proposes reasons for its growth and assesses the potentially negative effect this growth has for our system of regulation, given the paradoxical relationship between systems of regulation both home and abroad. More, arguably, controversial aspects of law’s involvement in assisted conception are covered in Chapters 5–8. The benefits of egg-sharing schemes are offset against what is framed by Karen Devine as a potential risk for some less affluent women being ‘doubly disadvantaged’ by such sharing arrangements (p 71).10 Interestingly, she highlights broader provocative debate insofar as a risk that a woman might be unable to access reciprocal reproductive schemes due to her lower financial status or reproductive physiology, and convincingly argues that umbilical cord blood stem cells could be utilised in the egg-share model while circumventing the criticisms that current benefits-in-kind arrangements attract (p 76). In the following chapter, Jennifer Snelling and Colin Gavaghan articulate a forceful argument against the comprehensive nature of pre-implantation genetic diagnosis (PGD) regulation in the UK,11 as compared to that proposed by Isabel Karpin in Chapter 12 where the Australian model of regulation is explored.12 Snelling and Gavaghan draw an interesting and refreshing example of the inconsistent approach in UK regulation by comparing the use of PGD for autism and rhesus antibody status. In that respect, this chapter is particularly novel and it seamlessly leads onto the debate surrounding the creation of a ‘three parent baby’ (explored by Laura Riley in Chapter 7),13 and the unfavourable way in which the 2008 Act addresses the concept of surrogacy (discussed by Horsey and Katia Neofytou in Chapter 8).14 The latter is a more interesting read because Horsey and Neofytou examine some alternative regulatory models (Israel and Greece) in an attempt to propose a ‘better’ system of regulation in place of the UK’s current model. Their discussion usefully links back to aspects of reproductive tourism, which was discussed by Jackson in Chapter 3. Horsey and Neofytou conclude that while ‘there will never be universal agreement about surrogacy’, the law regulating it in the UK remains unfit for purpose even after the 2008 Act (p 132). The only disappointing feature of their chapter is that they do not set out a different regulatory system, despite articulating such a convincing case that it is imperative to review the UK’s laws regulating surrogacy. Although Horsey and Neofytou succinctly describe important aspects of what might be contained in a different regulatory system in the UK, such as transparency in payments and parenthood provisions which might avoid the temptation to seek surrogacy abroad, it would have been beneficial to understand their views as to how the system would be improved with a clear proposal of amended regulation. There are some aspects of law’s involvement in human-assisted conception that are not covered in this edited collection, including reproductive cloning and human-admixed embryos. Nor are the prospects of regulating emerging or future procedures, such as womb transplants or ectogenesis, considered. Furthermore, contributors do not engage with the ethical wrestling surrounding who should get access to such treatment services, whether privately funded or NHS commissioned, which would have provided something of a binary chapter central to the overarching theme of the book as a ‘review’. Nevertheless, the contributors to this collection provide a clear and concise overview of the main relevant dilemmas currently faced in the field of available reproductive technologies, as opposed to those which are still at the research stage. As a lawyer and medical law researcher, my engagement with assisted reproductive technologies frequently causes me to question many of the central themes addressed within this collection. As a review of the status of assisted reproduction legislation, this book will undoubtedly be of great use and interest to students, researchers, and practitioners in medical law, bioethics, medicine, and child welfare. It gives the reader a solid basis to begin an in-depth exploration of issues relating to assisted reproductive technologies and for that reason I would recommend it. Indeed, for any reader interested in biomedicine, bioethics, or related law, this book represents the perfect reference for an examination of the current state of play in the regulation of assisted reproductive technologies. 1 E Blyth, ‘From Need “For a Father” to Need “For Supportive Parenting”: Changing Conceptualisations of the Welfare of the Child Following Assisted Reproductive Technology in the United Kingdom’, ch 2. 2 E Jackson, ‘The Law and DIY Assisted Conception’, ch 3. 3 H Codd, ‘“Prisoners” Access to Fertility Services’, ch 4. 4 K Horsey and K Neofytou, ‘The Fertility Treatment Time Forgot: What Should be Done About Surrogacy in the UK?’, ch 8. 5 L Riley, ‘The ‘Two-Mother’ Misnomer: Mitochondrial DNA Transfer under the HFE Act’, ch 7. 6 P White, ‘A Less than Perfect Law’: The Unfulfilled Promise of Canada’s Assisted Human Reproduction Act’, ch 11; I Karpin, ‘The Regulation of PGD for Medical Sex Selection and the Gendering of Disability in the UK and Australia’, ch 12; A Stuhmcke, ‘New Wine in Old Bottles and Old Wine in New Bottles: The Judicial Response to International Commercial Surrogacy in the United Kingdom and Australia’, ch 13. 7 Save for Blyth in ch 2, where a relatively full account of the legislative development of the child welfare principle is discussed. 8 See n 1 and n 3. 9 See n 2. 10 ‘Thinking Outside the (Egg) Box: Egg-Share Agreements, Cord Blood and ‘Benefits-in-Kind’, ch 5. 11 J Snelling and C Gavaghan, ‘PGD Past, Present and Future: Is the HFE Act ‘Fit for Purpose’?’, ch 6. 12 Karpin (n 6). 13 See n 5. 14 See n 4. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com
TI - Kirsty Horsey (ed.), Revisiting the Regulation of Human Fertilisation and Embryology
JF - Medical Law Review
DO - 10.1093/medlaw/fww024
DA - 2016-10-01
UR - https://www.deepdyve.com/lp/oxford-university-press/kirsty-horsey-ed-revisiting-the-regulation-of-human-fertilisation-and-Uqn3tmp0iP
SP - 652
EP - 654
VL - 24
IS - 4
DP - DeepDyve
ER -