[Recorded by Electronic Apparatus]
Thursday, March 13, 1997
.0909 
[English]
The Chair (Mrs. Bonnie Hickey (St. John's East, Lib.)): Good morning, everybody. Welcome to our committee.
André, please introduce your people. We'll have questions for you after you're finished your presentation, if that's okay.
Mr. André Juneau (Assistant Deputy Minister, Policy and Consultant Branch, Department of Health): Thank you, Madam Chair.
.0910
I have with me Phyllis Colvin, director of health policy in our department, and Susan Zimmerman, who is with the Justice Department, more specifically with legal services at Health Canada.
I have some comments I'd like to make and then if you like, we could take the committee briefly through the bill and then take questions. We're in your hands.
Bill C-47, an act respecting human reproduction and genetic technologies, prohibits uses of reproductive and genetic technologies that are ethically and socially unacceptable to Canadians. Our overriding goal at Health Canada is to protect the health and safety of Canadians. We also seek to ensure the appropriate treatment of human reproductive materials and to protect the dignity and security of all persons, especially women and children.
The bill ensures that unsafe and unethical uses of reproductive and genetic technologies are prohibited, but it opens the way for regulation of acceptable uses of these technologies. In the absence of legislation, these technologies are proliferating in a regulatory vacuum, thus placing the health and well-being of individuals and families and future generations at risk.
Canadians have told the government, as they told the Royal Commission on New Reproductive Technologies, that they want the federal government to manage new reproductive technologies in a way that protects those most affected, that reflects our collective values, and that prepares us to meet the challenges of the 21st century. Canadians want unethical practices prohibited by law and so does the government.
The Constitution divides jurisdiction over health matters between the federal and the provincial governments. The federal government has the power to make laws when issues relate to public health and safety or to the maintenance of peace, order, security, and morality. This legislation lies squarely within the Canadian tradition of using the criminal law to protect the health of Canadians, their safety, and their values. Most federal health law, such as the Tobacco Products Control Act and the Narcotic Control Act, is based on this use of the criminal law, and the courts have recognized these as valid exercises of the federal government's authority.
The federal government believes it has a duty to establish the basic parameters of public health, safety, and morality on which Canadians may rely from coast to coast to coast. To ensure adequate protection for all Canadians in the area of reproductive and genetic technologies, there must be uniformity across the country with respect to what practices are prohibited, what practices are allowed, and what safeguards apply.
As with all criminal legislation, provinces will be free to take as active a role as they choose in prosecuting the offences set out in this bill. In fact, parallel provincial legislation in this field would be welcome. Even if several provinces were to enact such legislation, however, it would not diminish the need for a federal law to provide that no region of Canada become a haven for the unregulated practice of these technologies. In any case, this is a hypothetical scenario, as to date no province has comprehensive legislation dealing with such technologies.
[Translation]
Federal legislation on the new reproductive and genetic technologies is valid from a constitutional and ethical point of view. These new technologies may have an impact on all Canadians, today and in the future, from coast to coast to coast. Creating human life raises social, moral, ethical, economic and legal issues which are fundamental. These issues are too serious to be resolved only in a fragmented way, at the provincial level. We do not want interprovincial tourism to turn into reproductive tourism.
Canada is not the only state to resort to criminal law to prohibit unacceptable uses of the new reproductive and genetic technologies. The United Kingdom, Germany and France have similar laws. Bill C-47 reflects a global trend, that is the will of society to drive technology and not be driven by it. This piece of legislation concerns unique and interrelated crimes bringing into play some technologies which set them apart from all other crimes. This is why the government has decided to enact a separate piece of legislation rather than add prohibitions to existing ones. When this Act comes into force, is passed by Parliament, Canadians can rest assured that they are protected against uses of these technologies which are neither safe nor ethical.
Practices which have the effect of using women, children and human reproductive materials as mere objects will be illegal everywhere in Canada. Then, the government will be in a position to follow-up, as planned, with a regulatory regime ensuring that technologies acceptable from an ethical standpoint are applied safely and efficiently.
.0915
[English]
We do not have the luxury of ignoring the profound dilemmas that accompany new reproductive and genetic technologies. The speed with which technological development can take place is illustrated by the recent cloning of an adult sheep, which produced a sheep popularly known as Dolly, a development that has focused world attention on the possibility of the cloning of humans.
For reasons that are obvious to the vast majority of Canadians, the cloning of human beings is unacceptable from an ethical standpoint, and this bill addresses the issue directly by banning the creation of human clones.
In July 1995 the federal government called for a moratorium on activity in this area and President Clinton has just recently called for a similar ban in the United States. The Canadian government is now proceeding to a legislative ban. Some said that such protection under the law was unnecessary. The birth of Dolly illustrates exactly why legislation of this kind is needed.
In response, however, to the Dolly development and other concerns that exist in the area of research on the human embryo, the deputy minister is writing to the chair of Health Canada's advisory committee on the interim moratorium and asking them, the committee, to focus specifically on issues arising from research on the human embryo. This way the advisory committee will assist the deputy minister and the department, and through them the minister, in formulating policy in this area.
Tremendous thought has gone into this proposed legislation, with input from experts in all fields associated with the technologies. The Royal Commission on New Reproductive Technologies began the task with wide-ranging consultations involving more than 40,000 Canadians, 13 volumes of research studies and 293 recommendations in its final report.
The federal government reviewed the commission's work, continued consultations in this area with some 50 stakeholder groups and with all 12 provincial and territorial governments. The Advisory Committee on New Reproductive and Genetic Technologies and the embryo research group have provided valuable input to our work.
We know, as you do, that unanimity is impossible given the emotional resonance of these issues. But with the weight of evidence that has accumulated through the initiatives I've outlined it is possible - indeed necessary, we think - to proceed with action based on common ground, common ground identified through extensive soundings of Canadian and international expertise and viewpoints.
In conclusion, I know the honourable members of the committee will examine the bill with great care and diligence. As officials at Health Canada we will attempt to assist you as best we can.
Thank you.
If you would like, Madam Chair, my colleagues could take you briefly through the structure of the bill and its main provisions.
The Chair: If that's okay with everybody, I would agree.
Ms Phyllis Colvin (Acting Director, Health Policy and Information Directorate, Policy and Consultation Branch, Department of Health): Perhaps as a guide to the legislation you might refer to the end table of the bill itself, called ``Table of Provisions''. It's the last page of the official copy of the legislation and it gives a very short guide to the legislation, including, obviously, the title.
Ms Susan Zimmerman (Counsel, Department of Health): Our hope of course would be that during the transition regime the practice would change so that donors would be accustomed to not being paid.
The bill establishes definitions for the various technologies in play and for the various actors and aspects of the technologies it deals with. In terms of the objects of the bill, one of the things that's very important to clarify in this respect is that there are roughly two categories of technologies, those that are prohibited as unacceptable under this legislation and those that are deemed to be acceptable within a regulatory context.
Bill C-47 deals with the former, and of course we're going to be proceeding with actions in the latter area as was set out in the discussion paper on the regulatory regime the government recently published.
In the context of prohibiting certain unacceptable technologies, the bill proceeds then to outline what the prohibitive procedures would be. It focuses specifically on payment of surrogate mothers; purchase and sale especially with respect to gametes; and the use of the ovum without consent. Then it moves on to various enforcement provisions: offence and punishment, notice to interested authorities, court orders, consent of the Attorney General, inspectors and analysts who would be involved in the enforcement process and the regulations that may be developed under the legislation.
.0920
In terms of the main prohibited procedures, in no particular order, this legislation deals with such procedures as sex selection, cloning, animal-human hybrids, the treatment of gametes with respect to, for example, their commercial aspects, and research elements, in which there are a number of provisions that deal with the research dynamic. Embryo research past 14 days is a particular area of focus, and creation of embryos for research only, bans on the selling of eggs, sperm and embryos and offers to provide or pay for prohibited services. In addition, it deals with more unusual aspects of the technologies: ectogenesis, and germ line genetic alteration. A very important element that is dealt with as well in the bill is the question of informed consent, so that we're in a position to be able to ensure that the technologies, and in particular the materials used in those technologies, are treated with respect and informed by a consent procedure.
So that's the overall gist of the bill. I suppose at this stage we should entertain questions.
The Chair: Madam, do you have any questions?
[Translation]
Mrs. Pauline Picard (Drummond, BQ): Mr. Juneau, Bill C-47 comes together with another bill which is supposed to complete it and establish a regulatory framework for other technologies which cannot be simply prohibited. Where are we at in this regard? Are you working on this document at the moment?
Mr. Juneau: Yes, we are.
Mrs. Pauline Picard: What would happen to Bill C-47 if an election was called by the end of April, to be held at the beginning of June? Would the bill be shelved? Would we start anew?
Mr. Juneau: Mrs. Picard, it's not necessarily appropriate for a government official to comment on whether or not an election will be called and what will happen to the bill.
Mrs. Pauline Picard: You just said that you were currently working on this other bill. I think it is urgent to act in the coming weeks. We are perfectly aware of the political situation we are in, and this is the kind of bill which usually dies on the Order Paper when Parliament is dissolved. It's because of the urgency of the matter that I ask you about the regulatory document and whether you're working on it at the moment. Are we going to have something about that shortly?
Mr. Juneau: As you know, the government believes that it is urgent to pass Bill C-47 which is now being discussed by the Sub-Committee. Regarding the regulatory bill, and taking into account our knowledge of the issues involved, it would of course be desirable to get this legislation passed as soon as possible. The government, not I, takes the decisions leading to the tabling of a bill. So, I'm not the one who is going to announce what will happen in this regard. If you're asking me whether it's desirable for the other bill to be quickly passed after this one, I would say yes.
Mrs. Pauline Picard: We recently heard about Dolly. Do you know whether this kind of research on cloning is currently being conducted in Canada? Are our scientists in a position to perform that type of cloning and can it happen in our scientific laboratories? Is this being monitored? Is there any follow-up among our scientists regarding this type of genetic engineering?
Mr. Juneau: This is a very good question and I would ask Ms Colvin to answer it in more detail. You raised a number of issues. To our knowledge, this type of research is not being conducted here at the moment.
.0925
However, your question also deals with the future, since you've asked whether we monitor this type of activity. In our mind, all this justifies the importance of the bill which is examined presently, as well as the next one. I give the floor to Ms Colvin so that she can clarify the matter further.
[English]
Ms Colvin: Yes, we have been in constant contact in the course of developing the legislation, in particular with respect to cloning, with the Medical Research Council, which is essentially the medical research arm of the federal government. They have assured us that as far as they are aware, in terms of medical research in Canada, there is nothing of that nature ongoing.
Clearly there is an issue here associated with the Dolly development that bears on animal research as well as human research, but if your question is directed at human research that assurance is in place. Indeed, we have been working with them not simply on the cloning issue but also with respect to all 13 of the practices covered by the legislation. They have been taking soundings of the research field and assure us that the 13 practices dealt with in the legislation are being respected at this moment.
[Translation]
Mrs. Pauline Picard: I noticed that in the bill which was tabled, there is no mention of research on women's infertility. Rather, the action is driven by the fact that we need to legislate some practices which are entirely unacceptable. At the medical level, instead of focusing on assisted reproduction, research could have been concerned with ways to correct women's infertility and find out its origin. Can we expect that, at one point or other, someone is going to suggest that research be undertaken to discover the origin of infertility, which is more and more common, particularly in young women of this generation?
Mr. Juneau: As the Royal Commission lead by Dr. Patricia Baird has done, we have thought a lot about this issue. Clearly, the bill doesn't deal with those matters since its purpose is to prohibit and ban some practices. It would not have been the right instrument to deal with the kind of very important research you mentioned.
We gave it a lot of thought and worked on documents which Phyllis is going to talk about.
[English]
Ms Colvin: There are several components to the policy on new reproductive and genetic technologies, and you're quite right, one of the main focuses of the effort the government is making is the issue of infertility. There are a number of ways, obviously, to address the infertility question.
The government has chosen to take a non-legislative approach in that area. It indeed is working with the provinces at the present time on the development of a framework for sexual and reproductive health and indeed anticipates that this framework will shortly be available to Canadians in the form of either a published document or other announcements.
The development of that framework is obviously a very complex task, because we are involving the provinces at every stage in addressing this particular question and there is a need to educate Canadians and give them more information about the various options they have with respect to infertility.
With respect to the technologies, clearly those that are effective and useful will be handled in the regulatory regime, corrections to infertility issues that lend themselves to technological solutions. But there are many infertility issues that can be dealt with in other ways and in particular through basic public health. That's the scope and purpose of the framework we're developing with the provinces at the present time.
The Chair: Mrs. Parrish.
Mrs. Carolyn Parrish (Mississauga West, Lib.): Thank you.
I don't know if I've missed it, if it's not addressed in this, or if it comes through in the regulations, but...and first of all, I think this is a very well-balanced bill. I think it protects people who still want to use some of the technologies that have been used for quite some time without allowing us to go into the really scary new stuff that frightened a lot of the church groups and a lot of the people in Canada.
.0930
I've had delegations visit me, and they've talked about the fact that we have adoption registries in this country. If you adopt a child you can get the medical history and the family history. I noticed that you addressed the fact that a sperm donor has to give consent to have his sperm used, but there doesn't seem to be any registry or any information that's automatically given to the mother when she has a sperm donation. Is this going to be addressed in regulations or is this something we don't touch?
Ms Colvin: It's going to be addressed in regulations. As part of the discussion paper we put out on the regulatory regime, we made it explicit that indeed the issue of registries will be dealt with. There are a number of types of registries in this area.
Clearly there could be advantages in having registries to capture the degree of exposures involved in these technologies. A good example of this would be to ensure that with those people who use the technologies and have drug exposures, for example, this exposure and its outcomes can be followed through a registry. That would be particularly useful from the point of view of gauging outcomes and self-correcting the system if it were necessary.
In addition to that, obviously there is a requirement and indeed a demand in the country for more information concerning the source of the gamete. This is a very complex question as to whether or not you would have identifying or non-identifying information in such registries, and we are working out those details at the present time.
Mrs. Carolyn Parrish: Second, close to my home I notice clinics popping up all over the place, particularly now that doctors are being regulated as to how much they can bill OHIP. Many of them are going off into these types of technologies. I don't mean to be critical, but it's an excellent way of making money above OHIP. There is a clinic right on the corner near my street where they actually are licensed to do surgical procedures. I assume that includes implanting of fertilized eggs.
I know we can use all these regulations in hospitals, but how do we regulate a clinic like that? I know it has to be properly licensed, but how are you going to regulate a clinic like that and know what's going on in there?
Ms Colvin: The regulatory regime as proposed will indeed license these clinics in terms of the way in which they conduct their procedures from a health and safety perspective. There are many ways in which the apparatus of the health care system, as it were, can be managed and controlled. We're not stepping into provincial jurisdiction on that score, so the degree to which infrastructure is in place, numbers of clinics, etc., will be something that provinces will deal with.
From the point of view of the health and safety of the procedures those clinics will offer, the regulatory regime will address that explicitly.
Mrs. Carolyn Parrish: We would expect the provinces to supervise our regulations in this case?
Ms Colvin: The way in which the regulatory apparatus unfolds actually is to come. There will be discussions with the provinces as we move forward. There may be the potential for shared infrastructure in terms of how we implement the regulatory regime, but suffice it to say that at the present moment, that's something we can't really predict.
Mrs. Carolyn Parrish: Given that we are actually making giant steps in regulating all of this, do you think such private clinics are in jeopardy in any way and that this type of technology should be moved back into major hospitals?
Ms Colvin: That's not my impression. No, I don't believe the clinic activity present in Canada is jeopardized by the type of regulation that may be in place in months or years.
This is a growth area, and it's a growth area around the world. We can expect more activity in this area as time goes on. Just as in Canada a few years ago this was almost unknown as a major part of medical activity, we expect it to grow at quite a pace, in part because of the demand that infertility creates for this type of service, but also in part because of technological push. There's a new technology virtually every day and something becomes available that may be of benefit to Canadians.
.0935
Mrs. Carolyn Parrish: Am I understanding this clearly, that the old idea of putting sperm in a centrifuge and having the female ones go to the top and the male ones go to the bottom is outlawed by you?
Ms Colvin: There are a number of ways in which sex selection can take place, but you've identified the preconception sex collection technique of preference. Yes, for a straight situation where you want to differentiate between boys and girls and make a choice, that's prohibited in the legislation for reasons of the stress we've placed on the equality between men and women and obviously their precursors.
Mrs. Carolyn Parrish: Good. Thank you very much.
The Chair: I have a question. If this bill is passed, will this result in us losing our scientists to other countries? Will we lose the best medical research people we have through this bill?
Ms Colvin: My hope certainly would be no. One of the reasons I believe that this is not likely to be the case is that the most responsible countries in this area - by that I mean most of the industrialized countries - are taking similar kinds of measures.
There are extraordinary numbers of international precedents in this field. As we get into the discussion of this type of technology, I can indicate which countries in the industrialized world are involved in those precedents.
They are developing the same kinds of prohibitions and regulatory regimes we've just been talking about. The reason of course, is to protect their populations from a health and safety perspective. Responsible practitioners and scientists recognize some of the risks associated with these technologies.
In fact, Canada, if anything, could be said to be somewhat behind other countries in terms of the legislative frameworks available in this area. I think we need to move, in order to make sure that we're as protected as some other countries that already have regimes in place.
The Chair: I have one other question before we finish up here. Say the bill is passed. I've heard some concern that people are worried that people who are being paid to donate their sperm will be fined or sentenced to four years in prison. It could be a heavy fine of $500,000.
Is there any way we can, through this bill, make sure that something like that doesn't happen? We're paying them now I think $20 or $25 to maybe help them pay their parking ticket while they go in and do their thing. Is there any way we can protect the people from making this a criminal act that they participate in?
Ms Colvin: The situation with respect to donor sperm is that the government recognizes that the commercialization of this practice is a pre-established aspect of Canadian life. As a result, there's been a decision taken that in this particular case only in terms of the prohibitions there will be a transition regime of likely approximately three years in order to allow the individuals involved in the donor sperm system and sperm banking to adjust to the regime, which is non-commerical as specified in the act.
As for the implications for individuals, Susan?
Ms Susan Zimmerman (Counsel, Department of Health): Our hope of course would be that during the transition regime the practice would change so that donors would be accustomed to not being paid.
If, however, at the end of that regime, when that section comes into force, would people be liable for penalties? Yes, they would. Would they be liable for the penalties in the act? I would point out the maximum penalties. It would be extremely unlikely that people would be in fact fined or imprisoned to the maximum extent for the sale of sperm. Don't forget that the penalty provisions in this act are there for all the prohibited activities, from the least serious to the most serious, if you like.
The Chair: I know right now they're getting paid for their sperm. So say we take it that they have to donate it the way we donate our blood, which we don't get paid to donate. If we do something like this, do you see it as maybe being a pilot project? Because we don't want to take the risk that we're going to lose donors coming in because they're not getting their $25, or $20, or whatever the case may be. So do you see maybe a pilot project to see if the level of people that donate this sperm...?
.0940
Ms Colvin: That's exactly what the government is contemplating, a pilot project to establish the context in and around a completely non-commercial, voluntary, altruistic system.
At the present time, most of the international community is tending to go towards more non-commercial systems, but what is necessary is to get a better fix on what the precise implications of that are for sperm donation.
One of the commitments the government has made is with respect to availability of sperm, that we don't want to have any untoward transition effects from moving from a commercial to a non-commercial system. So the notion of a pilot has been floated with the appropriate medical authorities, in particular the Society of Obstetricians and Gynaecologists and the Canadian Fertility and Andrology Society. We've made them aware that we're interested in piloting in this area.
The Chair: Thank you very much.
Are there any other questions? Colleen.
Ms Colleen Beaumier (Brampton, Lib.): I'd like to discuss the payment as well. When you're looking at retrieval of an ovum, I think it's probably a great deal more complicated and takes a great deal more commitment. I'm not sure what you expect to achieve by totally removing what we might call commercialization, some form of reimbursement for time lost, for expenses. I don't really understand the purpose of saying absolutely no payment for this. We're not talking about it being a great deal of profit. I think this is what concerns a number of people.
Ms Colvin: This is an area that is quite complex, but in fact the amounts of money that can flow to someone who is involved in a donor sperm situation can be significant. There's a range. At the top of the range is about $120 per donation. At the bottom of the range, as far as our intelligence gives us to believe, it would be around $20 per donation.
In that range, it's hard to know exactly what constitutes expense and inducement, and since this is a repetitive procedure - in other words, sperm donation often involves not just one visit, but subsequent visits - there is the capacity within the system for individuals to be into a situation where inducement is certainly there.
In terms of the precedents vis-à-vis other tissues, in Canada, as you know, we have, by and large, non-commercial systems for the donation of other tissues, such as blood, etc., and when we went across the country asking Canadians what they felt about this issue, there was a large degree of consensus, common ground, whatever the terminology, with respect to the need to have essentially a non-commercial system with respect to gamete donation, because these are the building blocks of life.
They're not even in the same order as other tissues. They are of a different order. They are contributing to the creation of life. In fact, you will likely hear in this committee from people who will put the argument to you that in fact the moratorium was sufficient notice to the industry, shall we say, that non-commercialization is something that Canadians would like to see, and that it should be proceeded upon immediately.
In the case of donor eggs, there is a great deal of information about the impact that the donation of eggs has on the women who are involved, and so that is prohibited in the legislation, and the commercialization of that aspect is prohibited in the legislation. But as I said before, we have a pre-established donation system in respect to sperm. We have acknowledged that there is probably a need for a transition regime, and we'll be moving on that.
.0945
One of the things that I think is very important to recognize in this whole area is the health and safety aspect. While screening can accomplish a great deal and while we have indeed put a priority on health and safety with respect to the screening of sperm, for example, it cannot guarantee everything. When you are in a situation where gametes are being given in a set of circumstances where inducements are in place, there is every indication from the literature on a variety of tissues that you're not going to get information that is as complete about the health history, genetic history, etc., of the donor.
We are taking a precautionary stance in this respect in the interests of the health of the women who are recipients and in the interests of the children who will be born of these technologies.
Ms Colleen Beaumier: When you talk about asking Canadians how they feel about this and the commercialization, are you talking about asking infertile Canadians? I'm sure I feel much differently about it, having had no problems at all, than someone who is faced with this problem. I'm not sure all Canadians really understand it. I'm certainly getting a different view of this situation from the beginning of agreeing to be on this committee until today, and I'm sure it will turn right around again by the time the committee is over. That's one question.
Second, you were talking about the regulatory aspect. Are you saying that the province will also set up the regulatory board or the watchdog to ensure that one donor doesn't happen to be the main supplier for one region or the main supplier for anywhere? That's potentially a very frightening situation. I'm sure it's frightening for the parents of these children. When they meet other parents with children, they could be concerned about the relationship among these children. They could think, ``Oh, my God, I wonder if our children are related.''
Ms Colvin: Those are two very good questions. With respect to the infertility groups, the consultation we undertook included infertility groups. I'm not going to deny that there are different viewpoints within the infertility community or among those affected by infertility. Suffice it to say that we have taken soundings of the opinions of the infertile and we have an infertility representative on our advisory committee who has been very active on this particular issue. The question is how to find the balance. I think the transition regime is a step in the right direction in terms of ensuring that the transition and transaction aspects associated with going from commercial to non-commercial are handled.
In terms of the regulation of aspects of donation and the question of linkages in terms of supply, yes, that issue has come up quite a few times. There are concerns, I know, in the infertility community about the degree to which the supply of sperm is not regulated to encourage the diversity that should be there. In terms of the channels, as it were, by which the tissues flow into our medical practice, there probably are some issues that ought to be addressed. We will be moving forward on that in the regulatory regime.
Ms Colleen Beaumier: Thank you.
The Chair: We'll start our rounds again with Pauline, and then Carolyn.
[Translation]
Mrs. Pauline Picard: Bioethics research is an ever-changing area and we even come to the point where none of us can really keep up. Recently, we have seen a surrogate mother carrying two embryos for two different couples. Will there be a committee or a strategy so that we can react immediately to that type of situation which, in fact, raises all the issues we were talking about earlier, social, moral and ethical?
.0950
Canadians and Quebeckers want to know where we are headed. Are women going to become experimental labs? This is my concern.
There is a bill which we all agree on and which everybody wants. We have to legislate on some practices which are totally unacceptable. But other things are coming fast on the horizon. We are almost beyond that. Will there be committees or people to explore these new issues, as they are raised, so that we can be prepared to react?
Mr. Juneau: This is, again, a very good question. As I said in my preliminary remarks, we shall ask an existing committee - the membership of which includes experts in various disciplines, such as ethics and genetics - to study those new issues. This committee had been set up originally to advise us on the moratorium and we shall ask that it focuses its work on more recent as well as future developments.
Furthermore, even if this is not directly related to your discussions, as was indicated in the document which was published recently, there will be a possibility, at the second stage of the process, trough the regulatory bill, to define even more precise approaches to enable us to keep abreast of the issues you are concerned about.
[English]
Ms Colvin: Based on my experience, I regard this as the most participatory health issue I have ever dealt with, and that includes a lot of issues. It includes tobacco and a lot of other things that have come across my desk. More Canadians want to participate actively in the discussion of this area precisely because it is about life, about the reproduction of the species, and because, I think, they want a greater sense of control over the process.
This is one of the things the royal commission made a recommendation for. The commission essentially recommended the creation of some kind of an authority, a body or whatever, where that type of discussion would be ongoing and where there would be a building of a social consensus about how these technologies are to operate - indeed, about how some of the very fundamental issues associated with protecting women and with using these technologies appropriately should be resolved.
We are in the process as part of the regulatory regime to deal with the question of infrastructure. There will probably need to be some transitional infrastructures from where we are now through to the creation of whatever body emerges from the regulatory authorities' discussion. There many options in that respect. We are going to be dealing with the provinces to get a better feel for how they see that issue as we move forward on regulation.
Suffice it to say that we are very conscious of the need to keep the discussion going, as it were, and to make sure that as many Canadians as possible are brought into that discussion, because in the last analysis, this is about the way in which society evolves into the 21st century.
The Chair: Thank you. Carolyn.
Mrs. Carolyn Parrish: In these regulations that are being constructed, is there still an opportunity for one sister to give another sister an ovum, or is that going to be eliminated?
Ms Colvin: The surrogacy provision or the preconception provision that's in the act covers the issue of commercial surrogacy, i.e., situations where there is brokerage or situations where one couple is prepared to pay a woman to act as a surrogate on their behalf. It does not include what we have often referred to as ``non-commercial'' surrogacy arrangements.
There are clearly limits to what the state can accomplish in this area. There are regimes around the world that do address this issue, and in fact there are some who have said that non-commercial surrogacy should per se be dealt with in legislation. But for the time being, the focus of this legislation is on commercial aspects of surrogacy, in particular what you might call surrogacy that involves for-profit aspects and brokerage.
.0955
Mrs. Carolyn Parrish: If we are going to eliminate paying for sperm, which, by the way, I agree with... I think it's like the blood system in the States. It was always more questionable because people could go and give a pint every couple of hours if they needed money for something.
I'm hoping, though, that two things my colleagues have addressed...one, the fact that a prolific donor who has very viable sperm could have 7,000 little offspring running around, which is not good for the population. That's an exaggeration, of course.
The other thing I'm concerned about is what we are going to do about foster donors, medical students in universities, people who are truly interested in reproductive technology - those doing it as a gesture to help people. There has to be some education done, and I assume we're working in that direction.
Ms Colvin: That's correct. We will be working on the education side as well, obviously, such as the piloting I mentioned earlier.
Typically, what happens internationally is that as you move to a more non-commercial - and as designated in the discussion paper, more open - system, you get a different type of donor. You get an older donor, perhaps a more mature donor, a donor who has thought through the implications of the donation, not just for the medical practice system but also for the individuals he's connected with, for his own family, for what might be involved down the line, and in terms of responsibilities, should the child that's born ever connect with the person who gave the donation, and so forth. These are very complicated questions.
In France, for example, there's a requirement that married men engaged in donation actually bring their wives into the discussion of this because of the implication for family formation, both through the technology and also with respect to their own families.
Typically, what happens is that you develop a different kind of system, one where the donors are more focused on the implications and therefore more cognizant of what the long-term impacts are going to be, and certainly, it is to be hoped, more cognizant of their responsibilities with respect to donation.
Mrs. Carolyn Parrish: And the aspect of the 7,000 little tow-headed kids running around.
Ms Colvin: That's less a question of the individual donor and the composition of the donor community and more a question of how the system organizes itself to ensure the maximum diversity of donor straws, as it were, into a community. This has been a concern, for example, for small communities in rural areas, where there may be only one source of donor sperm, say, and one practitioner engaged in this kind of procedure. It's quite well known in the sperm-banking industry that in certain instances the donor pools being drawn on are quite limited. A sperm bank may have only a few hundred donors that it ever accesses, and less that are really quite active.
So there are selection procedures in this area that have to be paid attention to. This is an ongoing issue.
Mrs. Carolyn Parrish: So I can be assured that this is something that's being addressed and is being watched carefully.
Thank you.
The Chair: I'd like to go back to the carrier surrogate mother for a minute. I guess it's not so much a question as a statement. We need to be careful that we don't make this a rich person's gift, that a person in a lower class who wants to have a child can't afford to have a surrogate mother. So when we're talking of compensation, it has to be equal for the rich and for the poor alike. I would like everybody to keep that in mind.
It is something you should keep in mind when you're doing the legal part of this - that we don't go out and fight for only one area, the rich.
André and your team, thank you for being here today.
Thank you, colleagues.
We are adjourned.