Madam Speaker, I rise today to speak to Bill C-47-
-an act respecting human reproductive and genetic technologies.
This government is committed to a regime that protects the health of Canadian women and children, reflects Canadian social values and ethical standards and recognizes the needs of infertile Canadians.
It is our view that a caring society demonstrates its concern by using science and technology to aid those who would otherwise be denied the joy of parenthood, while protecting those who risk being harmed both now and in the future.
Probably the most difficult question most of our parents and indeed some of us in this Chamber faced was how to name their new baby. The choices confronting those who want to become parents today are often much more vast, more technologically complex and have greater repercussions for generations to come than we have ever as individuals and as a society had to deal with.
Couples having difficulty conceiving a child have to decide to seek outside intervention, or not to seek it, as the case may be. They have to make decisions about drugs and treatment regimes. They have to balance their desire to have a child against the potential risks involved. Sometimes these would be parents have to decide whether to involve a third individual, an anonymous donor, in their search for parenthood, whether they are willing to undergo invasive and difficult procedures such as in vitro fertilization and what to do with the embryos that may be created as a result of this procedure.
Women who are already pregnant, whether through natural or assisted means, have to decide together with their partners whether to undergo prenatal diagnosis and what to do with the information once they have it. It is our opinion that we have to develop a two pronged approach to deal with many of these issues.
First, through the legislation before us today, we are proposing to prohibit certain unacceptable technologies. Second, we are developing a regulatory regime to manage safe and effective technologies that are permissible.
The technologies and practices that would be prohibited under today's legislation are ethically and socially questionable. They pose significant threats to the health of those who use them and to the children who are born as a result of their implementation. They have significant adverse effects on the physical and emotional well-being of children and they pose significant threats to the health of the population.
This legislation I believe is valuable in its own right, an important first step in addressing public concerns. But this is yet not enough. That is why the government has also released a position paper outlining a proposed regulatory framework for those technologies that, while acceptable, still require regulation to ensure the safety and well-being of women who depend on them, the children who emanate from their use and families that are created from them in Canada.
What we are proposing is not, as one can imagine, an easy task. Its complexity has required us to consult the status of women, heritage, finance, treasury board, industry, human resources devel-
opment, citizenship and immigration, the solicitor general, agriculture and of course the justice department. All of these ministries have been brought into the consultation process for developing this legislation because they all have interests in the legislation and in the regulatory regime that we are planning.
This government's willingness to tackle an issue of this complexity is in accord with the pledge made in the red book to make the health of women and the well-being of children a priority. It is concrete evidence of our commitment to the health, safety and ethics in the field of new reproductive and genetic technology.
New reproductive and genetic technologies have the potential to enhance the health and well-being of women, children and families. Technologies such as artificial insemination and in vitro fertilization, the process of retrieving eggs from a woman's body, fertilizing them either with her partner's sperm or with that of a donor and implanting the resulting embryo back into the woman's body, have enabled children to be born to those who otherwise might never become parents.
Prenatal diagnosis has been used not only to identify birth disorders, for example, but to identify anomalies that can be corrected at birth thanks to the knowledge gained through diagnostic procedures. These technologies can confer significant benefits on those who use them. They also, unfortunately however, hold within them the potential to threaten human dignity and to treat women and their children as well as the whole reproductive process as mere commodities.
To give one example, to date at least seven advertisements have appeared in student newspapers seeking women willing to sell their ova. In return for cash, they ask otherwise completely healthy women to take powerful drugs with unknown long term effects to stimulate multiple egg production and to undergo invasive and often painful medical procedures to retrieve those eggs. This is an inappropriate use of medical treatment. Even worse, it reduces women and the eggs they carry inside them to sheer commodities.
It is understandable, I think members will agree, when we consider the applications of technology like this one why new ways of intervening in the reproductive process have created hope for many Canadians but have also become a source of unease. The profound social, ethical, legal and health questions they raise challenge our most fundamental values.
Canadians have asked the federal government to exercise national leadership to manage these technologies in a way that protects those most affected and reflects our collective values.
The Royal Commission on New Reproductive Technologies was created in recognition of the important role of the federal government in the area of new reproductive and genetic technologies.
Members in the House will recall the report entitled "Proceed with Care" as an impressive document, not only for the comprehensiveness of its 293 recommendations but for the means by which the commissioners arrived at those recommendations. Each of those recommendations was based on an ethical framework encompassing the principle of an ethic of care and eight guiding principles and on a thorough understanding of Canadian social values and attitudes.
This comprehensive and solid basis makes it difficult to disagree with the commission's conclusions that it is necessary to establish boundaries around the uses of new reproductive and genetic technologies prohibiting the most egregious and regulating those that are safe and ethical.
Since the release of the commission's report, the federal government has been working on the type of public policy called for by the commission. Because the responsibility for health is shared among the federal, provincial and territorial governments, discussions have been held between the two levels of government to identify possible areas of collaboration.
At the same time, Health Canada held bilateral consultations with some 50 key stakeholders on their reactions to the commission's recommendations. Those consultations expanded on the work of the royal commission. They confirmed that Canada needs a legislative and regulatory infrastructure to deal with the new reproductive and genetic technologies. Further, they demonstrated the necessity for the federal government to exercise national leadership in this area.
In exercising this leadership, we have been guided by a policy framework that includes a set of ethical guiding principles and a focus on the implications of the technologies for children. We have also focused on the prevention of infertility. It is sometimes identified as a priority both by the commission and by our own extensive consultations.
We feel that we must be guided by these basic principles. I will enumerate them for members. First, we must balance individual and collective interest in recognition both of the importance of reproductive autonomy and of the reality of the individual decisions in the area of reproduction that may affect the larger society.
Second, we must strive for equality between men and women. That does not mean that this issue affects men and women in the same way. The physical and social burdens and risks of reproduction are borne primarily by women and this reality should be acknowledged and be reflected as well in this reproductive policy.
Third, we must protect the welfare and dignity of vulnerable persons and groups and particularly the children who may be born through the new uses of these technologies, but also individuals or
couples seeking to use the technologies, as well as persons with disabilities.
Fourth, prevention must be a first priority to lessen the need for medical treatment of infertility. In cases where treatment is necessary there should be a progression from the simplest and least invasive treatment to the more complex. The principles of evidence based medicine must be applied to reproductive health care.
Fifth, non-commercialization of reproduction and of reproductive materials is essential. Commercialization modifies reproduction, offends human dignity and may lead to the exploitation of vulnerable persons or groups.
Sixth, accountability is paramount. Individuals have the responsibility to safeguard their reproductive and sexual health. Governments and medical practitioners have a responsibility to protect the reproductive and sexual health of their communities and of the individuals they serve.
I have given these ethical guidelines certain actions where clearly indicated for the government. It has begun to address the safety issues identified by the royal commission, among them the reported use of fresh semen for donor insemination with its attendant risk of HIV transmission and the potential risks associated with the use of fertility drugs.
Regulations concerning the process of testing and distribution of semen for donor insemination became legally enforceable on June 1 of this year and a surveillance program for drugs used to treat infertility is also being developed.
The voluntary moratorium on some new reproductive and genetic technologies was introduced one year ago. We recognized then that legislation in the area of new reproductive and genetic technologies would require a lengthy development process, therefore the moratorium was announced to cover nine problematic uses of reproductive and genetic technologies, together with the creation of an advisory committee on the moratorium.
This was a positive first step. It has helped the key medical specialties at work in this area in their process of policy formation. However, some unethical practices continue to be offered in Canada.
Many Canadians continue to feel that these issues are too serious for voluntary compliance. Government is responding to these concerns through this legislative action in order to transform the voluntary moratorium into one that is mandatory.
The Human Reproductive and Genetic Technologies Act is based on the common policy and ethical ground identified in extensive consultations with more than 50 stakeholder groups, and with the provinces and the territories. This legislation gives voice to the widespread agreement that some activities conflict so sharply with Canadian values and are so potentially harmful to the interests of the individual and of society that they must be prohibited.
The government has met three goals in this legislation: protecting the health and safety of Canadians; ensuring the appropriate treatment of human reproductive materials; and protecting the dignity and security of all persons, especially women and children.
The prohibitions listed in the legislation include the nine original prohibitions in the voluntary moratorium, together with five additional prohibitions not originally contained in the moratorium. In each case, the risks they pose to vulnerable Canadians and the offence they give to such basic values as equality between men and women and the non-commodification of reproduction justify a strong legislative response.
Let me outline them and explain in the process the ethical underpinnings for each prohibition. The first of these prohibitions is on sex selection. Attempting to select the sex of a child for non-medical purposes is abhorrent to most Canadians. I think most members here will agree. In fact, all of them agree. Despite the inclusion of sex selection in the interim moratorium, there are still at least two clinics in Canada offering this service.
Sex selection can take a number of different forms. It is prohibited under this legislation with only one exception. Sex selection is simply the most basic form of sex discrimination. To value a child primarily on the basis of his or sex is demeaning to the child and contrary to any principle of respect for human life and dignity. It also poses significant threats to the well-being of children.
The knowledge that a child was born primarily because he or she was the "right" sex can cause significant harm to a child's sense of self-worth, to say nothing of his or her siblings who must suffer with the knowledge that they are not the right sex.
If sex selection were widely used, it could cause the male-female birth ratio to become skewed with unknown consequences for our nation.
However, the government recognizes that some very serious genetic disorders are sex related and that parents facing this situation will want to know the sex of the fetus. The legislation allows for this possibility. All other the uses of sex selection techniques are explicitly and firmly prohibited.
The second prohibition is on the manipulation of reproductive materials. A number of prohibitions contained in the act fall into the category of manipulating eggs, sperm, zygotes or embryos for
various purposes. Many of the practices included in this category are somewhat familiar to us, usually from the late, late show on television for those who are insomniacs. Without making light of the issue, that is where they should stay.
Members would be horrified to see what some of those prohibitions include. It suggests practices that are beginning to develop that must be nipped in the bud. One of those is cloning the genetic materials of living or dead human beings or of zygotes, embryos or fetuses. This could produce identical copies of single persons which would diminish the value of human individuality.
We do not know yet what the health implications of being a clone might be. We know even less about whether there are any long term implications for population health by having large numbers of people who are genetically identical.
Another example is that of creating animal-human hybrids whether by using animal gametes together with human gametes or by implanting a human embryo in an animal or an animal embryo in a human. These procedures could potentially produce creatures that would be half human, half animal. The presence of these hybrids is not unusual in folklore but it is eminently undesirable in real life. The formation of such hybrids violates the most basic norms of respect for human life and dignity and denies the embryo's connection with the human community.
A third example is that which involves the altering of the genetic structure of reproductive material so that the alteration can be passed to subsequent generations or to germ-line genetic alteration. This has the potential to permanently alter the human genetic heritage at unknown risk to future generations.
We lack even a preliminary understanding of how genes interact and of how altering one gene would affect others. We do not know how altered genes would act in subsequent generations. It would be inconceivable hubris on the part of any society to risk the health of future generations in this way and completely contrary to any concern for the vulnerability of the children of the future.
A further example is the potential to manipulate the materials of reproduction that coexist with the speculation about the possibility of ectogenesis, that is, maintaining an embryo in an artificial womb until it is born. Its pursuit dehumanizes motherhood and marginalizes women from their previously central role in reproduction.
We have no idea what the health effects for children born in this manner would be. The interactions between a woman and the fetus she is carrying are essentially still a mystery to us. One thing is clear, however, as we learn more about them. These interactions are of far greater significance for the health and well-being of the child than we might suspect. The royal commission describes ectogenesis as "morally reprehensible". We would all be challenged to find anyone who would disagree with that finding.
The third prohibition under this legislation affects reproductive material from fetuses or cadavers. It is an indication of the speed with which developments have been made in this field that when the royal commission released its report, the issue of retrieving sperm or eggs from dead persons had not yet emerged. As members of the House are aware, it has since become a very real possibility.
Thus it is no longer sufficient to prohibit the use of fetal eggs as was the case in the interim moratorium. Bill C-47 must also and does prohibit the use of eggs or sperm from cadavers. To create a child from the reproductive material of a dead person or from eggs retrieved from a fetus is a frightening proposition and could create unknown psychological harm to children born in this manner.
We know that miscarriages are often the source of fetal eggs and we know that fetuses often miscarry because they carry disorders. Without knowing more about what that disorder is and whether it is genetically based, it would be taken unjustified and unjustifiable risks with a child's health to permit the use of the fetus' eggs.
The use of gametes from the deceased in order to create a child is a violation of reproductive autonomy. Even if a person gives permission for his or her gametes to be collected for fertilization after death, the potential for psychological harm to a child born in this way is too great to ignore. This prohibition is not intended to apply to the use of eggs from the fetuses or sperm or eggs from cadavers in research. Rather it is designed to prevent research aimed at producing embryos from this process.
The fourth prohibition is with regard to surrogacy. The effects of the prohibitions I have discussed so far relate primarily to what happens in laboratories. Surrogacy occurs much closer to home. Agreeing to carry and give birth to a child and then surrendering that child to another person or couple in return for monetary gain poses tremendous ethical and health related difficulties.
Surrogacy commercializes reproduction and women's reproductive capacity and it commodifies children. It forces women to undergo the risks and burdens of assisted conception and then of pregnancy and birth. It poses risks to the emotional well-being of children. When the child becomes the subject of a custody dispute or when the child is not wanted by either the birth parents or the commissioning couple, these harms are magnified.
Criminalizing such arrangements carries with it potentially serious penalties for those convicted. For that reason the targets of criminal prohibition have been carefully chosen. Anyone paying or offering to pay a woman to carry a child only to surrender it at birth
will be subject to a criminal penalty, as will any third party acting or offering to act as an intermediary in the surrogacy arrangement for profit.
Women who agree to bear children for others are often vulnerable because of the disparities in power and resources between themselves and those paying for their services. Rather than further burden such women with the risk of prosecution, the new prohibition targets the persons paying for such services. The behaviour of the so-called surrogate is not and will not be criminalized. As well, the legislation permits volunteer surrogacy arrangements so long as no payment is involved.
The fifth prohibition is on the buying and selling of reproductive materials. The prohibition against buying or selling eggs, sperm and embryos is consonant with that against commercial surrogacy arrangements.
Eggs and sperm are the basic building blocks of life. They contain the unique genetic heritage of the human being who produces them. When combined, they form embryos that have the potential to become human beings. To reduce these materials to commodities that can be bought, sold or exchanged for other goods or services is a grave offence to the principle of respect for human life and human dignity.
The practice of permitting payment for sperm and eggs also carries significant health risks. Short term financial need can induce a donor to be less honest about his or her own health and his or her own genetic family history. Unfortunately donor screening is only effective when the potential donor is forthcoming with information regarding his or her health.
Paying sperm donors thus increases the risk to the women who will receive the sperm and the children who may be born as a result. The risks inherent in paying for donated sperm accrue primarily to the recipients and to the children born as a result. There are relatively very few risks to the donor. Selling eggs on the other hand holds the potential for significant physical and medical harm to the donor as well.
A woman who agrees to sell her eggs is generally perfectly healthy. She would have to be in order to pass the same types of screening procedures that are used for sperm donors. She is quite probably not infertile. Yet this perfectly healthy woman will be prescribed fertility drugs with their unknown long term health effects to stimulate multiple egg production. She will also undergo invasive and painful medical interventions to retrieve these eggs. In exchange for the risk and burdens she will bear, she will go home probably about $2,000 richer but she will have taken unknown risks with her own health and her own future fertility.
This government cannot permit the health of vulnerable women and children to be put at risk by allowing a payment based system of sperm and egg donation to continue.
The legislation does allow doctors, clinics and sperm banks to recover expenses involved in the collection, storage and distribution of sperm, eggs and embryos. In addition, because the current practice of paying sperm donors is a significant incentive in donation, there will be a phase-in period for this aspect of the regulation to ease the transition from a commercial to a non-profit and volunteer based system.
The legislation is an advance on the interim moratorium because it prohibits payment for the donation of the human reproductive material for research purposes. This decision was made on the grounds that there is no compelling argument to be made for treating donations for research purposes any differently from donations for other purposes.
The sixth prohibition relates to embryo research. A further set of prohibitions not included in the interim moratorium have been added as a result of our extensive consultations. They have to do with embryo research.
Under the terms of Bill C-47 it will be illegal to use any human sperm, ova or embryos for research purposes without the explicit permission of the donors. Every person has the right to control the use of the products of his or her own body. Failure to obtain consent violates the principles of individual autonomy and respect for the vulnerable.
It will also be illegal to fertilize eggs or to create embryos outside the human body solely for the purposes of research. Some couples choose to donate surplus embryos from in vitro fertilization for research purposes. We acknowledge their generosity in facilitating research that could help other infertile couples. But the field of embryo research is growing and some scientists have argued for a more abundant supply of research embryos than can be achieved through donation. This government does not accept this argument.
Regardless of the potential for embryo research to give us much more information about the human condition, the need for embryos for research is not compelling enough to justify their creation and use solely for this purpose. All human embryos have the potential to become human beings. To create them without this end in mind commodifies them and undermines human dignity.
Finally, it will be illegal to conduct research on human embryos any later than 14 days after conception. Since human embryos may eventually become fetuses which will become human beings, the question of how far into their development research should be permitted is far from merely academic. The issue has been widely debated and there is an international consensus that 14 days is an appropriate end point. Bill C-47 signals agreement with the federal
discussion group on embryo research which accepted this international standard.
In addition to the specific prohibitions that I have outlined here, the legislation makes it an offence to offer to provide or to offer to pay for any of the services prohibited in the act. This will also help to prevent the creation of a supply and a market for these services.
The legislation sets significant penalties for those who are found to be in violation of any of the provisions of the act. There is a maximum penalty of $500,000 or 10 years in prison. As a government we are committed to the principles of non-commercialization of reproduction and the protection of vulnerable women and children. This legislation and the penalties for disobeying it demonstrate that commitment.
Critics of this legislation will argue that prohibiting reproductive practices violates Canadians' rights to reproductive autonomy. I think they forget that no right is absolute when it causes harm to society as a whole or to other individuals. We are mindful of the need to respect reproductive autonomy, but we are also mindful that the practices and uses of technology prohibited in this legislation have the potential for tremendous harm to children, to women and to the value of human life in our society.
Indeed many of the practices that are being prohibited in this legislation themselves have significant implication for women's reproductive autonomy. Factors that affect women's relative social and economic status can render the whole concept of reproductive autonomy meaningless. Some women may be tempted for instance to sell their eggs or to enter into commercial preconception arrangements to support themselves. Without adequate protection such as those found in this act, women can be particularly susceptible to the adverse consequences of these technologies.
Unlike most medical treatments in which the individual alone bears the burden or benefit of the intervention chosen, those using new reproductive technologies pass on those benefits and those burdens to their children. New reproductive technologies have implications for children's health, including the unknown risks arising out of the use of fertility drugs.
Children born through the use of donor gametes face legal uncertainty concerning their familial relationships, and they face uncertain impacts on their emotional well-being. Families of children born through donated sperm or eggs told the commission of the great strain caused by trying to keep the child's origin secret and by the lack of information available to them when and if their child asks about his or her genetic parents.
This legislation does not offend reproductive autonomy. It balances the need to protect the interests of vulnerable women and children with the right of individuals to become parents and the needs of research that will help them attain that goal.
Some may claim that prohibition against buying or selling sperm, eggs and embryos may result in a shortage of sperm for donor insemination. As I said earlier, the prohibition on buying and selling sperm will be phased in over time. This will allow sperm banks and medical professionals to adjust their recruiting practices and will also allow for education and promotion to encourage voluntary donation.
Human reproduction is far too precious to make the use of donated gametes a matter for the marketplace. Our commitment is to the realization of an open gamete donation model with no commercialization and no anonymous donation. This is in line with the international trend away from commercialization and toward more open systems. We are not alone in addressing this issue in this fashion. There are strong international precedents for all aspects of this legislation.
For instance, since 1990 the United Kingdom has prohibited the creation, storage or the usage of an embryo unless subject to a licence. The conditions of the licence include prohibitions against retaining or using an embryo later than 14 days, placing an embryo in an animal, cloning, or mixing human and animal gametes. Separate legislation prohibits commercial surrogacy arrangements.
Germany too has had a wide range of prohibitions in place since 1990, including fertilizing ova for any reason except pregnancy, using technology for sex selection, artificial fertilization after the death of a gamete donor, artificial alteration of human germline cells, cloning, and the creation of animal-human hybrids.
Recently France has created a series of new offences, including the creation or use of human embryos for commercial purposes and the creation of embryos for research or experimental purposes.
Most Australian states prohibit a variety of new reproductive technologies including cloning, the production of animal-human hybrids, altering the genetic structure of an egg or embryo and the sale of gametes or embryos.
This legislation puts Canada squarely in the position of supporting an international trend to limit the uses of science and technology when they contravene deeply held societal values.
This legislation is also squarely within the Canadian tradition of using the criminal law to protect Canadians' health, safety and common values. Most health law is based on misuse of the criminal law and the courts have traditionally recognized these as valid exercises of Parliament's authority.
The decision to prohibit certain technologies and practices was made in light of a commitment to the health and well-being of women, children and families in Canada. It is based upon a strong ethical framework that incorporates the fundamental principles of the non-commercialization of reproduction and the protection of those at risk, particularly the women who use them and the children who are born as a result.
The timely passage of this legislation will provide the needed protection not only to women and children but to a society that has shown it is apprehensive about its impacts.
Its passage, however, still leaves an estimated 500,000 Canadians affected by infertility. The inability to have one's own biological child is a source of grave distress to many people. We take this issue seriously. We believe there is a need for national leadership in responding to the needs of the infertile. That is why the legislation before the House today is but one part of the government's approach to a comprehensive management regime for new reproductive and genetic technologies.
The royal commission recommended, which in this regard has been confirmed by the government's own consultations, that technologies that are ethically and socially acceptable to Canadians and that have been shown to be both safe and effective should be available to Canadians within a regulated framework.
Madam Speaker, I realize you are signalling that I am at the end of my time, but I feel that the seriousness of the topic would warrant a few more moments of reflection. I ask if the House will give its unanimous consent to extend my time another few minutes.
