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Friday, 24 November, 2000, 15:56 GMT
Lord Winston answered your questions

Professor Lord Winston is Europe's foremost fertility treatment pioneer.

He trained as a doctor at London Hospital Medical College and London University and specialised in gynaecology and later fertility.

He has attracted his fair share of controversy throughout his career. In a New Statesman interview he famously remarked that the funding of Britain's health service was the worst in Europe.

And recently he has begun to question his own research over IVF. "We are obsessed with IVF. Everyone thinks they really need IVF when the evidence for that need is not that good."

To watch coverage of the forum, select the link below:



Tony B, UK:

Your programmes for television have been excellent and have enlightened many people. In all of the work you have done, what is it that has fascinated you the most?

Lord Winston:
I don't think I can answer that question. I think that they each have different elements to them which are important. I think that the notion of being able to regenerate tissue is one that is of growing importance and I think the use of stem cells; cells which are immature which might be directed into growing into a particular tissue is one of the most profoundly important areas of medical science at the moment and one that I think we will see progressing providing the law allows us to continue to research with stem cells.

What sort of things do you think will be the areas where stem cells will have the greatest impact?

Lord Winston:
I think they will have a fairly early impact in some neurological disorders like Parkinson's, which is a very common disease. They may have a benefit for people with diseases such as diabetes, where you might be able to get cells which start to produce insulin in the pancreas. But nearly every tissue potentially could be benefited from stem cell technology, including skin, bone, brain and liver. There are many life-saving disorders, including heart disease which might be benefited from stem cell technology.

Can you see a lot of that happening within the next one or two decades, given the right conditions?

Lord Winston:
Providing there isn't a ban on stem cell technology, which at the moment is at least a possibility, I think it certainly will be something which will be valuable within the next decade.

Benjamin, Wolverhampton:
You're on record as saying you dislike the term "designer babies" but this may be the way we can prevent inherited disease?

I think he is keen to know where you draw the line between necessary and unnecessary screenings or modifications.

Lord Winston:
I don't really know what is meant by the term "designer baby" - I mean you are not designing anything. When you get married and have a baby with a particular partner, that is a designer baby in so far as it has got the genes that only you and your partner have. If that means designer babies then we all have designer babies and we are all designer babies probably in turn - unless, of course, the pregnancy is not planned and with a partner that you are not expecting.

All we do with the genetics of embryo selection is in families where there is a very, very serious disease, which is caused by a single gene defect, try to select the random number of embryos which will not have that particular gene. I don't that is designer babies and I don't think there is any risk of it going beyond disease processes.

Do you think there is a limit to the diseases which ought to be screened out at that level?

Lord Winston:
Most single gene defects are actually caused by very serious disorders - there are very few exceptions. Most single gene defects actually kill young children - mostly babies or cripple them so severely that their life is really seriously impaired and shortened. There are a few single gene defects which are not in that category; one of which is colour-blindness in some people - well I don't think anyone is going to select for colour-blindness - that would be a trivial use of a very difficult technology.

Harry Yuruten, Perth, Australia:
For ethical and moral reasons, do you think that only couples unable to have children should be given IVF treatment? Should IVF be available to single and lesbian woman?

Lord Winston:
Why not? I don't think it is an issue. I know it has been an issue in Australia where the Catholic Church has come out, I think rather foolishly, and condemned the use of infertility treatments in lesbian couples.

I think it is singularly unwise for any church or government to make statements about general moral issues that are not shared in a pluralistic society. Nobody is suggesting to Catholics what they should do, nobody is suggesting to Jews what they should do, nobody is suggesting to Christians what they should do. Different people who have high moral values, including lesbians - who may well have just as high moral values as you and I - may decide that they want to have a child and why shouldn't they? The only reason why you would want to prevent that from happening was if you had some definite evidence that the child might be a considerable disadvantage.

So it should never be the doctor's place to make any value judgement?

Lord Winston:
I think doctors have a place, yes, because if a doctor thinks there is a serious risk of a child being damaged as a result of the treatment that he might be doing to produce a child, then I think he has a moral and a political responsibility, but certainly a moral responsibility to try to dissuade that couple from having that treatment.

But I have never seen any serious evidence which shows that children that are produced in the context of a loving lesbian relationship are actually disadvantaged. What the studies seem to show is that they are better off and better adjusted and that they get on better with other children in school and that their sexuality is completely unaffected. This notion that you need to have a father-figure is all very well but it does not have much substance with regard to lesbian couples.

Lisa Hawkins, Melton Mowbray, UK:
What are your thoughts on the recent case of the lady who has successfully prosecuted the Sheffield Fertility Centre, regarding the replacement of three embryos instead of two?

Lord Winston:
If she didn't give approval for three embryos to be transferred to her uterus then she is within her rights to sue for negligence because she had something done to her without informed consent. In my view, the damages should be nothing because it seems to me that to have the gift of an extra child is a very great gift that literally thousands of people would want.

There are certain things which cannot be compensated for - how can you be compensated for a healthy child and it seems to me to be a complete nonsense and misuse of the law. Whilst this woman has a right to sue, because there technically negligence, she should not be rewarded.

Do you see it as a sign of the increasing commercialism of the technology you use?

Lord Winston:
No, I think it is more worrying than that. It is more the increasing use of the law to try and "put right" every minor wrong that people have, which is sometimes quite mischievous. Unfortunately, there is an increase of lawsuits against doctors, for example, which are very difficult to justify and result in doctors being very defensive about how they treat patients - it is very undesirable in the long-term that there should be so much litigation, so much of which is mischievous.

Tim Edwards:
Professor Stephen Hawking has recently stated his belief that genetic scientists in the future will 'create' super intelligent humans outside the womb. Hawking's rationale for this is that a humans intelligence is limited by the fact that the head must be of a particular size in order to pass through the birth canal and by engineering humans outside of the womb there could be , in effect, no limitation to intelligence. Have you given this any thought and do you think this is a possibility?

Lord Winston:
I would suggest that Stephen Hawking hasn't given it much thought either - it seems complete nonsense to me. Just because Stephen Hawking is a tremendous individual with a huge intelligence it does not mean to say he is automatically right.

I don't think he has the slightest understanding of the biology that would be involved and it seems inordinately foolish. I very much doubt whether we will be engendering humans of super intelligence in that sort of way, certainly not in anybody's lifetime watching this on-line programme or in my children or grandchildren's time. Not least because it seems absolutely impossible to grow mammals permanently outside the womb, right through pregnancy, because you need a placenta.

I have a great respect for Stephen Hawking who I know personally, and if he really did say this statement, then think that he needs to make sure that it is said in the right context because out of context it is a ludicrous statement. We scientists are not masters of society, we don't control the universe, we are servants of our society, we are paid through public funds and we have a responsibility to do and say things that are responsible.

Tony Lawson, Catania, Italy:
Why are more resources not being directed at discovering and eliminating the causes of infertility instead of curing the symptoms (especially the alarming rise in male fertility)?

Lord Winston:
I think there is quite a lot of research that has gone into male infertility over a long period of years. When you look at any disease process more research tends to go into trying to treated it rather than prevent it. You can look at the history of preventative medicine which doesn't have a particularly good track record in any field. There is only one area of preventative medicine which has worked and that is persuading people to stop smoking.

I am sceptical that finding the causes of infertility would fundamentally make much difference to people who are infertile. Human beings are by their very inherent nature amongst the most infertile animals on the planet and it is very easy for that balance to be tipped over to make them seriously sub-fertile. So there will be a focus on treatment rather than prevention in the future as well as there has been in the past.

Georgia Bootiman, St. Albans, UK:
Have you ever wanted to go abroad to work in other European countries where there is a substantial amount of money invested in the Health Service, e.g. Germany, or do you prefer to work in the UK, and why?

Lord Winston:
I have done. I worked for a year in Belgium where I was paid a very handsome salary years ago. I have worked in France. I go to California once a month. I have worked in the United States on a regular basis, permanently. However, I have always wanted to come back to the UK because it is the best place to live for me, because I am English.

Obviously if you are Australian you would feel Australia was the best place to live. I feel part of British culture. I miss the city where I live, which is London, that has the most phenomenal possibilities, not only for my own work, but also for my own entertainment. My family feel comfortable here. Just because money may be more available elsewhere - it certainly is in the United States - that is a pretty poor reason I think for wanting to go there. I have everything I need in Britain.

Michael Beckwith, Blackpool, UK:
You need good scientific minds to create the new marvels of today, but you also need political visionaries who can see what the new science for what it is. Do you think that most ministers concentrate too much on short-term political events?

Lord Winston:
I think that in this country we are very lucky at the moment. We have one of the best ministers for science that we have ever had in David Sainsbury who I think is an exemplary minister who thinks in the short-term and in the long-term. He is not a scientist himself but he has gained a huge understanding and a feel for science in an amazingly quick time. He has been of real benefit to British science.

Scientists have to recognise where the "hot spots" are for society's development but science cannot be entirely goal-orientated - it has to be directed towards basic areas because it is only by uncovering the basic areas that you start to find out where the applications might be.

Adam Atkinson, London, UK:
There is concern about some areas of medical research operating in a value-free environment, particularly where the debate centres on issues such as the sanctity of life. Instead of a polarised "public debate" that we often have at present, do you think there is a role for ethicists and scientists to work together even if it might mean forgoing some avenues of possible research?

Lord Winston:
Well I have to say to Adam Atkinson that I think he is talking complete nonsense. I don't think science does work ever in a value-free area. What he says completely misrepresents and undervalues what scientists are about.

The truth is that scientists think very deeply about the ethical issues and have done always. If you look at the history of science, the ethical issues have always troubled scientists. The scientists were discussing the issue of embryo research back in the 1960s, well before the public or governments. It was the scientists who asked again and again for legislation and regulation and asked for dialogue and ethical debate. So I think it is not true to say that we work in a moral-free area, I believe we think very deeply about the morals.

Yes of course scientists should be involved with ethical debates and with philosophers but they are already. There were scientists and ethicists working on the Warnock Report for example. There are major issues about the sanctity of life and I think that people who don't understand that are not doing themselves a proper service.

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