Aims of the HFEA: past and future

Public reaction to breakthroughs in fertility treatment and embryo research tends to be extremely mixed, revealing an often ambivalent attitude to science itself. After 12 years of intense public debate about the ethics of IVF and human embryo research, Parliament passed the Human Fertilisation and Embryology Act 1990, which established the Human Fertilisation and Embryology Authority (HFEA). The aims of the HFEA are to regulate licensed clinics in a rigorous but sensitive way; to protect patients who may be vulnerable to exploitation, whether intended or inadvertent; to enable this sensitive area of science and medicine to progress in a responsible way; and to reassure the public that the possible excesses are guarded against. The HFEA is an arbiter over several balancing acts: especially the balance between the practitioner's right to clinical freedom and scientific progress against protection of patients, future offspring and the limits of public acceptability; or the right of access to treatment against the need to maintain acceptability, respectability and safety. In the last 8 years several issues have arisen that challenge society's view of what is 'normal' or 'acceptable' in human reproduction, and this will undoubtedly continue to happen in the future. These issues have been difficult for society to accommodate, and have presented serious challenges to conventional ideas. However, the HFEA has been able to assure both public and legislators that clinics are acting reasonably and that there are adequate controls in place.