Health Committee on Dec. 7th, 2006

[Christiane Gagnon, Bloc, Québec, QC]

Thank you.

This Act is very important for the Bloc Québecois. Some twenty sections are being challenged by Quebec, including section 8.

In the event the regulations are adopted and the Act is thus implemented, would it be applicable in Quebec, since this province is challenging it?

[Francine Manseau]

I can’t speak to the legal consequences. All I can say is that Parliament approved the Bill and, consequently, we are obliged to develop the regulations and set up the agency.

[Christiane Gagnon, Bloc, Québec, QC]

The Act is still not implemented because the regulations haven’t been established. It is the regulations that are being challenged, including the one relating to section 8 on the application of consent. I thought you could clarify the legal ramifications. If the regulations were implemented, would Quebec be obliged to opt out?

[Francine Manseau]

Unfortunately, I do not believe we are qualified to answer that question.

[Christiane Gagnon, Bloc, Québec, QC]

You say that section 8 is very complex and that other provisions of the Assisted Human Reproduction Act with respect to consent bring up practical problems, but you cannot give us all the whys and wherefores of these problems.

Regarding what issues with respect to consent are you unable to provide more information?

[Francine Manseau]

Section 8 contains one of the last prohibitions not yet implemented. It is precisely for this reason that much importance has been given to the development of the regulations; we want to allow the implementation of section 8.

The purpose of section 8 is to recognize the importance of a person’s choice whether to reproduce or not. It states that an embryo cannot be created without the written consent of the person who provided the gametes. Furthermore, the use of an embryo requires the consent of the people who provided the gametes necessary for its creation.

Section 14 states that the person who accepts the donation of gametes is required to make sure that the donor has been consulted and received information on the requirements of the Act with regard to the use that will be made of his gametes, etc. All this requires the creation of an agency, since it will be doing the licensing. It is also partly why we are still developing this structure, because it is necessary for the application of this section. However, section 8 can be implemented immediately. We want to make sure that people can really consent to reproduction.

[Christiane Gagnon, Bloc, Québec, QC]

There are references to compulsory counselling so as to enable people to make a more enlightened choice. Where can people get this counselling? Who will provide it? Will it be left to the discretion of those who make the request, or will it be a more structured counselling given by specialists in the field?

[Francine Manseau]

We’ve consulted people who currently give counselling, and we’ve met with patients to find out what type of information they need. We then developed a consultation document that presents various options. It will be available in the weeks to come.

The counselling will in fact be more structured.

[Christiane Gagnon, Bloc, Québec, QC]

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you.

Ms. Davidson, you have five minutes.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you.

And thank you to the presenters.

I have a few questions on the public consultation process. I think there were regulations gazetted in September of 2005, and then following the public consultation process. Is that correct, that those were gazetted after the public consultation process?

[Francine Manseau]

They were gazetted, and that triggered a consultation process. But there was consultation prior to that also.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Okay.

What major changes were made then, after the public consultation? What came up during those consultation processes?

[Francine Manseau]

Most of the comments we heard through those processes were requesting.... It's not that the people were not in accord, I guess, with what was proposed, but that they sometimes required more clarification. That's what we did, I guess, with some of the modifications we made after the proposal was put in the Canada Gazette, part I.

There was clarification as to the time of withdrawal of a consent. There was clarification also to ensure that the original gamete provider is donating for third parties. That person would also have to provide consent for research, because that person will be told that those in vitro embryos are created for third-party reproductive use. If they have surplus to the reproductive need of the couple for whom the embryo would be created, that couple could decide to give them to research. The original gamete provider will have to have given consent for research also. These are the types of clarification.

We also had a transitional period that was taken into consideration, knowing that there are already gametes that have been donated and are there waiting, I guess, to be used. We want to ensure that with the coming into force of the regulations, we would not allow the use of those unless there was a written consent, which would have been dated.

Also, there was a clarification, I would say, to the definition of an in vitro embryo donor, making it clear that it is the individual or the couple from whom the in vitro embryo was created.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Just further to that, “consent” has been defined in section 3 of the act.

[Francine Manseau]

Yes.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

The guidelines have been updated twice since then, though. They were updated in June 2005 and then again in June 2006. So what are the implications of the updated guidelines on the definition of “consent”? Do you have to change the definition? How does that affect that?

[Francine Manseau]

The relevant provisions of the CIHR guidelines that are pertinent to the consent, because this is where they overlap, have not changed.

So there has not been an impact on the proposal that you have in front of you. We also have been in consultation with CIHR when they were thinking of making modifications. Where we do overlap with the CIHR guidelines, those relevant sections have not changed. In that sense, there is not at this point any problems.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

In 2002 the guidelines only refer to frozen embryos, and then subsequently they refer to fresh or frozen. So how does that change or affect the informed consent?

[Francine Manseau]

The legislation doesn't make a distinction between frozen or fresh embryos. It just talks about the use of an in vitro embryo for research.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Okay, thank you.

[The Chair, Conservative, Rob Merrifield]

I need a clarification for the committee on that. All embryos are created for the purpose of reproduction. That's the sole intent.

[Francine Manseau]

There are three purposes for which an embryo can be created.

[The Chair, Conservative, Rob Merrifield]

Isn't research one of them?

[Francine Manseau]

No. It is to improve knowledge on AHR. It's dictated in the legislation. It's to improve or provide instruction in AHR and also to create a human being.