Catherine Connolly (Galway West, Independent) | Oireachtas source

Fáiltím roimh an deis a bheith páirteach sa díospóireacht seo. Tá sé thar a bheith casta. Tá sé deacair na téarmaí, agus níos mó ná sin, na hábhair a thuiscint. Tá gá le bheith i d'fhealsamh i ndáiríre.

I welcome the opportunity to take part in this debate. It is quite difficult to get one's head around all of the medical concepts, what is possible and what is not possible. In addition to being a Deputy, one would want to be a philosopher, a doctor and many other things besides. I welcome that I have adequate speaking time in regard to this matter.

I have before me a report done by the members of the commission that was set up by the current Taoiseach when Minister for Health in March 2000.

Some 22 years ago in 2000 he set up a commission, which then took five years to deliberate. It is interesting what it said. I will come back to its 40 recommendations. The chairman of the Commission on Assisted Human Reproduction said in the report:

In being asked to advise on the social, ethical and legal factors, the Commission did not attempt to act as the arbiter of public morals. The members were conscious of the strongly held and diverse feelings in the public at large. A broad interdisciplinary approach was taken that allowed recommendations to evolve as a result of informed open debate. It was evident that there exists a broad spectrum of cultural and ethical positions. [...]

The report is intended to reflect the richness and variety of the debates that took place both in the Commission itself and in the work groups. [This was back in 2005] If I may presume to attribute an overall philosophical position to the Commission I think it could be encapsulated in the form of a question: should science do everything that science can do? There was widespread recognition of the benefits of advances in this specialised area of medical science but this was tempered by a note of caution, that society as a whole and not only scientists, must take responsibility for the management of major scientific change, especially in areas that are concerned with the dignity of human life.

I am coming back to fully supporting the Bill as it relates to assisted human reproduction, but there are many other aspects to this area that really need a broad discussion. I will move from the 2005 review to Schedule 2 of this Bill, which sets out what is prohibited. This shows us where the science is at the moment and what is possible, in that we actually have to prohibit "the creation of a human-animal hybrid embryo" and many other things that are prohibited. Scientific knowledge has gone so far that many, many things are possible that are inconceivable to me, morally or in justice, but they are possible. It is not just scientists that are participating or making decisions. It is the Dáil and concerned groups too.

I am also very concerned that the broad discussion that took place between 2000 and 2005 was utterly ignored until today. That commission made 40 recommendations, one of which was very far-reaching. I do not agree with the particular recommendation myself, and it was not taken on board in relation to this Bill. It is that a presumption would be made in relation to the intended parents, that from birth on, the presumption would be that the intended parents are the parents, and that a child born through surrogacy should be presumed to be that of the commissioning parents from birth on. There was a dissenting view on that at the time, which I happen to agree with. My point is that the complexity of what is involved here was fully discussed. Unfortunately, it was ignored. When we fast forward to five years ago, the heads of the Bill were produced and were discussed with only four meetings of the committee with Deputy Harty, who had done a great job. There was only four meetings in relation to such complex matters. The committee produced a report. Some of the recommendations were taken on board in relation to this Bill and some were not. Then we had the report of the special rapporteur in 2020, when he too laid out the state of play.

I must thank the Oireachtas Library and Research Service, which produced two papers, under pressure. Again, I do not know what influence we might have but the Oireachtas Library and Research Service is under constant pressure to inform Members and educate us. The Bill was only produced last week or the week before, coincidentally, in the same week that the rapporteur produced another report, which was on illegal adoptions and the importance of identity. It is ironic that the rapporteur has emphasised the importance of the right to know one's origins and legal identity in a week where legislation is published highlighting the vacuum around the right to knowledge for children born through assisted human reproduction, and the utter fragmentation, in theory, of that identity depending on how the assisted human reproduction is done. I will come back to that point.

As was pointed out by other speakers, in 2020 Professor Conor O'Mahony, the special rapporteur on child protection produced A Review of Children's Rights and Best Interests in the Context of Donor-Assisted Human Reproduction and Surrogacy in Irish Law, in which he said that "Surrogacy is entirely unregulated in Irish law." This was 20 years after then Minister for Health, Deputy Micheál Martin, commissioned the report. So, 20 years later, surrogacy remained "entirely unregulated". Professor O'Mahony goes on: "Children are born and raised in families in which one parent is treated as legal stranger to the child." I had to read this a few times. At the committee the professor said:

Surrogacy is entirely unregulated in Irish law. The result is that children are born and raised in families in which one parent is treated as a legal stranger to the child. This fails to recognise adequately the children's right to family life and their right to identity in some cases of donor-assisted human reproduction and entirely ignores those rights in the case of surrogacy. [This is what I am zoning in on] This is contrary to both the best interests of children and the principle of non-discrimination.

Professor O'Mahony also pointed out at the committee that the Supreme Court has highlighted this issue. In his review Professor O'Mahony said: "The impact of this position on children born following surrogacy arrangements has been repeatedly highlighted, including by the Supreme Court, which has called on the Oireachtas to fill this legislative vacuum."

We are beginning to fill the legislative vacuum with this Bill, and it is a good start. It is important however to give the context on that. Up to now, successive Governments have been pushed and pushed, from the original commission to the Children and Family Relationships Act in 2015, which had some protection for children born through donated sperm or eggs. However, with that Act we had the crazy position where the relevant sections 3 and 4 never came into operation, I understand, until 2020. This was five years after the Act was passed. When those sections did come into operation there is nothing before me to show that the Act, or the operation of that Act, had been reviewed. Separately, the cross-party committee has said that this legislation currently before us is so important that when it becomes law it should be reviewed after one year. The Government has pointed out that this is not necessary because Standing Orders allows for a review. If that is the position, where is the review of the 2015 Act? Do we have it? It has not been referred to anywhere in what I have read. I think that this is very important. When the two sections of that Act came into operation in 2020 there was an obligation to register, but I have no access to information on that anywhere. It also distinguishes between children born through assisted human reproduction, prior to that legislation becoming operational, and post operational. We have a complete mess with regard to rights and identity, and this is just one tiny aspect of this area.

On top of that we have completely ignored international surrogacy. I have my own opinion on international surrogacy. I will place on the record that I believe assisted human reproduction should be publicly provided on a not-for-profit basis. This is absolutely essential and should have been done. I have no time for going down the direction of profit-led development in this area, which is particularly sensitive on so many levels. Of course, this also has not happened but I understand that the Government will look at that aspect sometime in the future. When one reads around this, however, one cannot escape the conclusion that in all of this development - outside of couples and regardless of their standing in needing help, which I fully and absolutely support - there are other aspects. We can see from what has been prohibited, that some aspects are being pushed by a certain for-profit approach in relation to health. This should be completely taken out of the area of assisted human reproduction. It should be gone.

The legal vacuum is bad enough, but we also have an information vacuum. We are utterly reliant on the clinics to tell us what procedures have been carried out and whether they have been successful. We know from the Oireachtas Library and Research Service's paper that the number of treatment cycles has increased and the trend is in an upward direction. We can get those figures but they are not from a central database. We are utterly reliant on the companies that are making a profit for the information and we do not know the outcomes of these procedures. As well as the legislation lacuna, there is an information lacuna with regard to outcomes, such as the number of pregnancies, successful pregnancies, live births and so on. None of that information is there, despite the fact that we have been on notice about this for a very long time.

Some regulation was provided by the Health Products Regulatory Authority, which was designated as the competent authority and has some oversight. However, it has no role in relation to ethics, research or looking at where we are going and in what direction. In all the reports before me, different things were asked of the Government. In a sense, the Government has tried to do its best with the legislation it has produced but this requires further discussion. We have to look at the international component and decide what we are going to do about international surrogacy. Difficult as that is, we need a full discussion on it. At what stage will that happen?

Various committees said not to make counselling mandatory. As I understand it, however, the Bill makes both counselling and legal advice mandatory. That will increase the cost. I have an open mind as to whether counselling should be mandatory. There was so much to take in here. I do my best to take things in and form an educated opinion as best I can but I wonder what the justification is on the Government's side for making counselling mandatory. My background tells me that something being mandatory is not a good way to start a process. It also increases the cost.

There are many other ethical issues around sex selection and pre-implantation genetic diagnoses. I agree with the restrictions that have been placed on these areas. They will only be allowed in very restricted circumstances. The pre-legislative scrutiny of the heads of the Bill took place so long ago, and the report of the commission was so long ago, that not only are we talking about fragmented identities but a fragmented discussion as well. Now we are waiting for the international element to be discussed by the committee. Overall, it is extremely difficult to deal with this subject in any coherent way.

It is quite clear that Ireland is an outlier in this area, having no legislation in respect of it. However, it is not entirely clear where all the other countries stand, based on the research. Some allow for certain procedures while others do not, and so on. Regulation is absolutely essential and that regulation must be kept under constant review.

It is unacceptable, morally and on every other level, that assisted human reproduction is available to rich people or those who have access to money but out of the question for people on a lower income. That is immoral on every level and should not be allowed to continue. It is urgent that we get a public model as quickly as we can. We are doing everything like a jigsaw. We are forming policy in a vacuum without information before us. It has been 22 years since we set up a commission. I am making my comments against that background. I welcome the legislation, and it is important that we begin to legislate.

It is ironic - although ironic might not capture it - that on the one hand, we have the rapporteur's report telling us about the damage caused to children and adults when the State stands by and allows their identity to be taken from them and then, on the other hand, we allow an ad hocapproach to assisted human reproduction in such a way that children born by means of it do not have access to their identity or where they came from. This Bill seeks to rectify that but I would like that to be teased out.

There is also an issue whereby cases from prior to the Children and Family Relationships Act 2015 becoming operational in 2020 are operating under a different system to the ones that arose after that. All I see is a fragmentation of the most basic human right, that is, for children to know who their biological parents are and what their genetic background is. If we are making that point in one report from the special rapporteur, the same logic applies to this. While I embrace medical science, the changes being made and what it can provide us, it must be regulated in a manner that is for the public good and the common good.

I wonder if the same scientific effort could go into making our society more equal in terms of pollution and toxins, which lead to infertility, or other things relating to health generally. What about basic housing? This is separate from assisted human reproduction but I am talking about the application of science for the common good. If such effort was put into other areas, what difference would it make to our society? How many thousands in this country do not have such a basic thing as a house? They have no security. Yet, science can go down a road which is absolutely essential for assisted human reproduction but also makes possible many other things that are now rightly prohibited by this Bill. I will go back to the basic question asked in the 2005 commission report: "should science do everything that science can do?" Should these things be left to scientists? I believe they should not. If not, where is the forum for looking at all these complex issues that we as a society must deal with?

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