HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Tuesday, June 8, 1999

• 0912

[English]

The Chair (Mr. Joseph Volpe (Eglinton—Lawrence, Lib.)): Good morning, and welcome, colleagues and witnesses. This is pursuant to the order of reference of March 8, 1999, reconsideration of clause 1 of Bill C-247, an act to amend the Criminal Code respecting genetic manipulation.

We began deliberations last Thursday, and as I said last Thursday, every cloud has a silver lining. The silver lining is that there were fewer members around the table than we are accustomed to having. As a result, we were able to be a little bit more flexible with the way we normally conduct our business. The way we normally conduct our business is that witnesses speak for about five minutes—give or take, but usually about five—and then we go into rounds of questioning by colleagues around the table.

Colleagues allowed me a little more flexibility with the timeframes. They kept their questions short and we allowed witnesses to speak for a little bit longer. I'm going to push that kind of approach for as long as I can today until members call me to order. Then I'll ignore them.

Colleagues, we have with us this morning some eminent specialists in the area of genetic manipulation. Some of our witnesses unfortunately are not here yet and may not even make it despite all of their best intentions.

We have with us this morning, Dr. Arthur Leader, who is president of the Canadian Fertility Andrology Society. Welcome, sir. We have Dr. Patricia Baird, former chair of the Royal Commission on New Reproductive Technologies from the University of British Columbia. And good morning to you, Dr. Baird. From the Evangelical Fellowship of Canada we have the chief researcher, Beth Hiemstra. Welcome, Beth. From the same organization we have the director of national affairs, Bruce Clemenger. Welcome, sir. From Health Canada we have Phyllis Colvin, director of the health policy division, policy and consultation branch. She's the person on this file, as they say in these circles. Right? So we know Phyllis from Bill C-47 days. Welcome, Phyllis. And, finally, we have Glenn Rivard, who is the counsel from the justice department on the Criminal Code aspects for this bill and I guess the bill that originally spawned this. Have I got that right?

Mr. Glenn Rivard (General Counsel, Health, Department of Justice): I wasn't involved in Bill C-47.

The Chair: No, but you're on this file.

Mr. Glenn Rivard: I'm counsel on this matter now.

The Chair: Okay. So you'll be able to answer all the Criminal Code questions for us.

Mr. Glenn Rivard: Yes.

• 0915

The Chair: Good. Welcome, Glenn.

Thank you very much for your patience. We'll go immediately to the five-minute presentations, and why don't we start in simple chronological order. I don't know whether both Beth and Bruce want to speak, if they want to share their time or whatever, but we'll start with Dr. Leader. We'll go to Dr. Baird, and then we'll go to the two of you, Beth and Bruce, and then we'll go to Phyllis and Glenn. Is that okay? Does that feel comfortable?

You're first up, Dr. Leader.

Dr. Arthur Leader (President, Canadian Fertility Andrology Society): Good morning and thank you, Mr. Chairman, honourable members of Parliament, and guests. On behalf of the CFAS, I would like to express our appreciation to those responsible for permitting this presentation to the Standing Committee on Health.

We recognize the appropriateness of prohibiting human reproductive cloning. However, the issue of genetic manipulation is much more broad and encompassing than just reproductive cloning. Legislation in this area needs to be more comprehensive than what is currently proposed by Bill C-247. We recommend that the bill be withdrawn and the areas it covers be addressed within the comprehensive framework that's being proposed by the Minister of Health.

What is cloning? Cloning is the production of a cell or organism with the same nuclear genetic makeup as another cell or organism. We need to differentiate between reproductive cloning to produce a human fetus and therapeutic cloning to produce human stem cells, tissues, and organs.

Speculation in the popular press about the selfish reproductive cloning of humans has tended to obscure the real scientific challenges and benefits of therapeutic cloning for mankind. Therapeutic cloning techniques may one day revolutionize the medical treatment of damaged tissues should it become possible to use human adult cells as the starting material for the growth of new tissue.

At present, one human organ—skin—can be grown in the laboratory to provide self-compatible skin grafts for burn victims. The possibility of growing other self-compatible cells such as nerve cells for patients with spinal injuries, muscle cells for heart attack victims, or pancreatic cells for diabetics could one day be a reality, albeit within an unknown timeframe.

Significant advances in biomedical research make this more possible to contemplate. There are three advances, which include the cloning of mammals from adult cells, the establishment of cultures of so-called all purpose cells, which are otherwise known as human embryonic stem cells, and the demonstration that human fetal nerve stem cells can develop into multiple and appropriate nerve cell types when transplanted into experimental animals.

These findings taken together provide new opportunities for research in cellular and developmental biology and suggest that future possibilities may exist from self-compatible tissue and organ repair as opposed to donors. This may also diminish the need for and the risk of organ and tissue donation, which this committee has addressed on a previous occasion.

We consider that reproductive cloning to produce human fetuses is unethical and unsafe and should not be allowed. However, human cells, whether derived from cloning techniques, from embryonic stem cell lines, or from the primordial germ or reproductive cells, should not be precluded from use in approved research activities in cellular and developmental biology. A national regulatory framework would allow Canada to participate fully and capture the benefits from recent progress in cloning research.

Bill C-247 has been introduced at a time when the Minister of Health and Health Canada are undertaking a major initiative to introduce comprehensive legislation in the area of reproductive and genetic technologies. At a preliminary meeting with the minister earlier this spring, key stakeholders in this initiative, including the Canadian Medical Association, the Society of Obstetricians and Gynaecologists of Canada, and the CFAS, were assured that legislation would not be introduced until meaningful consultation had occurred. This was viewed as a positive approach to take to address the various issues, including the appropriate mode of regulation of this highly complex and technical area.

• 0920

It is our position that the areas covered by Bill C-247 fall squarely within the realm of reproductive and genetic technologies, and the issues should be addressed within the global framework. The framework, as presented to the stakeholders by the health minister, would recognize the need for consultation prior to the introduction of any legislation. This approach would allow issues to be addressed in an appropriate way through the capacity to utilize prohibition as well as regulation. One of the more significant features of this approach is that a regulatory body will likely be instituted at the time the legislation becomes law, making it possible to regulate specific practices.

Again, we are opposed to the passage of Bill C-247. We recommend that the bill be withdrawn and the areas it covers be addressed within a comprehensive framework, as being proposed by the Minister of Health.

I thank you for your attention and would welcome questions as the chair decides. Thank you.

The Chair: Thank you, Dr. Leader. We'll come back to questions in a few minutes. I'm going to go now to Dr. Baird.

Dr. Patricia Baird (Former Chair, Royal Commission on New Reproductive Technologies): Thank you very much. First let me say that I agree with much of the overall intent of Bill C-247. Human reproductive cloning to produce an individual by copying an already existing human, whether existing at a developing stage or at an adult stage, or even after death, shouldn't be permitted.

Similarly, I don't see any justification for altering DNA in a way that may be passed on to future generations. If people are interested, I can expand on that. However, a prohibitory bill aimed specifically at these particular issues is not the best way to go. Reproductive and genetic technologies are complex and they're rapidly changing. Using bills to approach single issues in this field is a recipe for unintended effects and confusion. Instead, there needs to be an integrated and ongoing management regime. What is needed is a national regulatory body that oversees legal limits around the use of new reproductive technologies and manages acceptable uses in research in an accountable way.

Both of these aspects, limits and responsible management, are important. But it's dangerous to enshrine each and every limit in a law in a fast-moving field. New things become possible that weren't anticipated in the legal wording of the law, and it may end up prohibiting some activities that may not have been intended. Then it's a very long process, which you would know far more about than I, to change legislation. Legal prohibition is an instrument that cannot respond to rapid change in a timely way.

In my view, it would be better to deal with the issues in Bill C-247 in a comprehensive and integrated way, along with other issues, and put a regulatory body in place. An advantage of the regulatory system that the royal commission recommended is that the minimum is embodied in legislation. Although the law would make it mandatory to obtain a licence to provide certain services to people, or to do research using human gametes or zygotes, the rules to be complied with by licensed facilities could be changed as the field changes and new things become possible without having to go back and change the law. This flexibility is essential in a field where knowledge is changing so rapidly.

Also, a regulatory body can not only set policy and monitor what's occurring in clinics and research facilities using human material, but it can also act as a focus for society for ongoing discussion with policy continuing to be made as the field evolves. We aren't finished; there will be many more things coming on to the horizon over the next decades.

• 0925

The bill we're considering provides a good example of what I'm concerned about. Even in the time since Bill C-247 was introduced, there have been—I think Dr. Leader alluded to some of them—rapid scientific developments with regard to embryonic stem cell research and cloning. These developments mean, as the bill is currently worded, it may make illegal some research that in the long term may be of great benefit to people who have devastating illnesses. I think there is an ethical imperative, in some ways, to explore what might be done in a humane and ethical way to pursue some of those opportunities.

It's theoretically possible that we may in the future—and we don't know exactly when in the future—be able to direct stem cells from zygotes to growing culture, so a particular tissue is produced directly. If this tissue is transplanted into someone dying of failure of that tissue, it may save their life.

A further theoretically foreseeable approach is to put a body cell nucleus from someone dying of a tissue failure into an emptied egg cell. It may become possible, when we know enough, to culture the resultant cell directly into the particular tissue they need, and it would be immunologically compatible and not rejected.

The technical possibilities of manipulating cells in these ways are very new. We have never made entities this way before, so we don't know yet how to deal with them. We haven't had the social debate to reach a consensus on how to deal with these new entities.

Embryonic stem cell research in future may benefit many people, and provided it's closely regulated, it may be acceptable. Yet, as worded, Bill C-247 may prohibit some of this research, which I note wasn't even on the table when the bill was introduced. The wording is correctable, but it highlights how very carefully legislation must be worded.

In conclusion, my main point is that we shouldn't approach this area piecemeal with a series of bills addressing different issues, one by one. It is really time we had a comprehensive, ongoing, and integrated approach. As Dr. Leader mentioned, I understand that the government plans to suggest one to Parliament before the end of the year. It seems to me wiser to deal with this issue within the umbrella of an integrated and comprehensive approach. Thank you.

The Chair: Thank you, Dr. Baird.

Now we are joined by Dr. Pierre Miron, who is the president of Procrea BioSciences Inc.

Welcome, Dr. Miron. We're not going to ask you to speak to us right away. You can still catch your breath and get yourself acclimatized. We will go to Beth and Bruce.

Beth Hiemstra, do you want to go first, or do you want Bruce to go first?

Mr. Bruce Clemenger (Director of National Affairs, Evangelical Fellowship of Canada): I'll make some introductory comments, and Beth will talk a bit about cloning. I'll come back to genome therapy.

The Chair: Good.

Mr. Bruce Clemenger: The Evangelical Fellowship of Canada appreciates the opportunity to be here and to participate in this review. The Evangelical Fellowship is an association of some 32 Protestant denominations, and our members include numerous church-related organizations, individuals and churches.

Ms. Beth Hiemstra (Researcher, Evangelical Fellowship of Canada): First we'll deal with our concerns about cloning. We support Bill C-247's prohibition on human cloning. Our opposition to human cloning stems from our belief in the principles of the need to respect human life and dignity, care for the vulnerable, and maintain family integrity.

The first concern we have is that the attempt to clone involves experimentation on human life in its earliest stages. Human life in all its stages must be protected and shown appropriate respect. This means human embryos must be given every chance for healthy development and full lives and not be created to push the limits of human understanding and risk death or serious handicap and disease. Early human life must not be treated as a material for experimentation in the laboratory.

• 0930

Our second concern is the risk of long-term harm for those who survive the experimentation. We note the recent developments on Dolly aging before other sheep. We're concerned that even if the procedure is perfected with animals, the effect for humans may be quite different.

Our third area of concern is the resulting family relationships that may come from human cloning. Who would be the cloned child's parents? The child's sociological grandparents would be his or her biological parents. In the future it may become possible for one woman to donate the nucleus and the ovum and then carry the child. That woman, in a sense, would be giving birth to her own twin. Cloning raises the prospect of tangled family relationships, such as mother-sister or father-brother. As a society, we reject this kind of outcome from incest.

The participation of two parents, a male and a female, and the procreation of children has inherent wisdom. There's the biological aspect of the genetic uniqueness of the resulting child, who is a blend of the genetic makeup of his or her parents. There is also a sociological consideration: evidence and studies on the effects of family structure on children. Before rejecting this inherent wisdom, we must be positive we're not putting our children and our society at risk. The results of this kind of experimentation would have profound effects on the way we live.

Our fourth concern is motivation. What would be the motivation for cloning to produce a child? Are any of these reasons of benefit to the common good of society?

Our fifth concern, the foundation of all the others, is what this procedure communicates about human beings. Genetic alteration and cloning both feed into a sense of manufacturing, as if people are objects made to order or in need of replaceable parts. This relates to the idea that everyone who wants a child should get one and in fact has a right to their own biologically related child. Are the child's best interests being sought? Can we really agree that one person should have a right to another?

As well, the human body is so complex that in our attempts to fix perceived problems, we may unwittingly destroy a delicate balance. Respect for human dignity requires that we keep in mind that we are humans, not objects or machines, with all the wonders and limitations this entails.

Our recommendation for the section on cloning is to replace the prohibition against manipulating an ovum with a prohibition against manipulating a human cell, including sperm and ovum. We believe this recommendation will give the bill a broader scope.

Mr. Bruce Clemenger: On genetic alteration, many of our reasons for supporting this provision of the bill are echoed in our concerns about cloning. There are the issues of unforeseeable risk, and the effects of genetic alteration may not become evident for several generations and may be severe for those resulting generations.

Also, genetic manipulation affects who we are as humans at a very base and foundational level. This is not even comparable to the highly invasive medical interventions, such as organ or tissue transplants. These changes are to our genetic structure: the building blocks of who we are, our children and the children after them.

We also know that Bill C-247 requires the consent of the Attorney General of Canada before the prosecution can be instituted. We believe this is an unnecessary legislative hurdle that may allow politicization in the enforcement of the bill. So we urge the committee to amend this section of the bill.

In conclusion, we urge the committee to support this bill and to reiterate its previous recommendation. This bill is urgently needed. The cloning of goats in April by a Canadian biotechnology company demonstrates that this is an issue in Canada, for Canadians. We believe Parliament needs to act expeditiously in this area.

Thank you.

The Chair: Thank you, Mr. Clemenger and Ms. Hiemstra.

Now we are joined by yet another one of our witnesses from l'Université du Québec à Montréal, Dr. Louise Vandelac, professeure. Bonjour, madame. We'll go to Dr. Louise in a few minutes, but let's hear from Dr. Pierre Miron first from Procrea BioSciences Inc.

[Translation]

Dr. Pierre Miron (President, Procrea BioSciences Inc.): Thank you. I'd like to note that I am also Assistant Professor at the University of Montreal within the Department of Obstetrics and Gynaecology.

Mr. Chairman, members of the Standing Committee on Health of the House of Commons, first of all I'd like to thank you for giving me this opportunity to discuss Bill C-247 with you.

At the outset, let me say that I do understand the concerns that society may have at the present time and that I respect the different points of view relating to human genetic manipulation.

We are all aware of the fact that it is essential to preserve the concepts of human individuality and dignity in Canadian society. In this respect, Bill C-247 sets out to prevent any genetic manipulation that might undermine such values.

• 0935

On the other hand, I believe that it is also our responsibility as a society to encourage the scientific advances that allow for an improvement of the health of Canadians. This principle is recognized in the Charter of Rights and Freedoms in the article on the right to equality, that is the right to be free of discrimination based on physical or mental disabilities, for example.

Today I shall attempt to give you a brief summary of certain applications of new scientific breakthroughs that might be affected by Bill C-247. And I shall be making particular recommendations to you on the wording of the proposed subsection 286.1(1) of the Criminal Code.

Let me first of all say something about the recent scientific breakthroughs. In 1997, the cloning of the sheep Dolly attracted a great deal of public interest. Although perceived as a remarkable scientific breakthrough, it gave rise to serious concerns, both nationally and internationally, about the possible use of this technology for the cloning of a human being.

Dolly was cloned through a technique known as nuclear transfer whereby a nucleus of a cell containing a pair of chromosomes is joined to a non-fertilized ovum from which the nucleus was previously removed. It should be mentioned that the main purpose of this discovery was to bring about a genetic improvement in livestock. Another significant application of this technique is the industrial production of human proteins in the milk of genetically modified animals; such proteins could be used, for example, in treating certain blood coagulation disorders such as hemophilia.

Thus, research on nuclear transfer could generate a number of benefits for society. It would enable us, for example, to improve our knowledge relating to physiological processes and the human genotype, to have a better understanding of the origins of cancer and perhaps to prevent it, and also to have a better understanding of the processes involved in aging. It will also enable us to produce better animal models for different human diseases.

Recently, two other very important scientific breakthroughs for human biology occurred—Dr. Baird referred to them—that is the obtention of human embryo stem cells from human embryos at the stage where they are known as blastocysts, that is five days after fertilization, of from primordial germ cells.

In November 1998, the team led by James Thompson from the Wisconsin Regional Primate Research Centre in the United States, in co-operation with the department of obstetrics and Gynaecology of the Ramban Medical Centre in Israel and the University of Wisconsin, reported in Science that they obtained five independent cell lines from the internal cell mass of 14 blastocysts. The internal cell mass of the blastocyst is the collection of cells inside the embryo that, through the process of differentiation, will eventually result in a foetus.

These human embryo stem cells have the distinctive feature of proliferating without differentiation or limit since they also have the potential of differentiating in vitro into several cell types, such as muscle, heart, nerve, bone, blood and other cells. They could prove to be extremely important for science and to hold great hope for the improvement of health care in the future.

In the same month, last november, John Gearhart's group—I'm giving you all this information so that you can understand how quickly technology is evolving—from the John Hopkins University School of Medecine announced in the Proceedings of the National Academy of Sciences, a highly-reputed journal, that he had also successfully established a cell line of human embryonic stem cells from primordial germ cells that had been previously isolated from medically aborted foetuses.

This new data has significantly changed the orientation of research and in view of the importance of the breakthroughs, the Department of Health and Human Services of the American government approved on January 15 the public funding of this research using pluripotential human ES cells.

Last January 26, the director of the NIH in the United States, Dr. Harold Varmus, drew to the attention of the members of the American senate the promising state of research attributable to human ES cells.

Among the many benefits expected to result from human ES cells are a better understanding of developmental biology, the development of new transplant therapies for diseases such as Parkinson's disease and diabetes, the discovery of new drugs and the study of fertility and foetal malformations.

In an article in the March issue of Science, Soler and Gerhart proposed other potential applications for human ES cells, including therapeutic cloning. These researchers maintain that the full therapeutic potential of ES cells is to be found in the use of ES cell lines derived from the patients' own cells, thus preventing any reaction of cellular or tissue rejection.

• 0940

I'd now like to undertake an analysis of Bill C-247. This bill prohibits human cloning and makes it crime punishable by imprisonment for a term not exceeding 10 years with a substantial fine for anyone who manipulates an ovum, zygote or embryo for the purpose of producing a zygote or embryo that contains the same genetic information as a living or deceased human being or a zygote, embryo or foetus. Thus the bill would prohibit the production of genetically identical zygotes or embryos even if the proposed objective has nothing to do with the cloning of a human being.

I am therefore of the opinion that the bill does not clearly define the term “human cloning”. It should be noted that in the January 1998 report of the Human Genetics Advisory Committee and the Human Fertilisation and Embryology Authority of the British government, it was proposed that a clear distinction be made between two types of human cloning. I think that this is very important for the future of the bill, if it is adopted.

First of all, there is reproductive cloning whereby a whole animal is produced from a cell through asexual reproduction. The creation of Dolly is an example of this. Hence, the term “human reproductive cloning” would imply the creation of a full human being genetically identical to another.

Secondly, there are scientific and therapeutic applications of the nuclear transfer technique that do not result in the creation of entire genetically identical individuals. The British commission and licensing authority refer in this case to therapeutic cloning.

The definition of “human cloning” as found in the proposed subsection 286.1(1) of the Criminal Code gives too much latitude to interpretation by the legislator and creates unbearable confusion for researchers that could possibly lead to their exile from Canada.

As for subparagraph 286.1(10(b), it prohibits the alteration of the genetic structure of an ovum, human sperm, zygote or embryo if the altered structure is capable of transmission to a subsequent generation. This provision would henceforth make it impossible for certain women or certain couples in Canada to undergo treatment allowing them to prevent the transmission of hereditary diseases such as those caused by mitochondrial DNA or to improve their fertility through ovoplasmic transfer. These results were recently published by the team of Jacques Cohen.

Lastly, the bill, and this is another very important point, does not contain any mechanism providing for its regular review. Since it is difficult to predict the speed with which scientific advances will take place and the adaptations will be made by ethics, it would be prudent to set a date for the compulsory review of this piece of legislation.

Should Bill C-247 be adopted, we recommend that the standing committee limit the scope of proposed paragraph 286.1(1) of the Criminal Code and prohibit only the cloning of a full human being, that is human reproductive cloning.

We also recommend that the standing committee endorse the continuation of research involving the cloning of human and animal cells, genes and proteins since this research has already contributed greatly to society and stands to provide even greater benefits in the future.

We also recommend that the committee convey to the government of Canada its concerns with a bill lacking in precision that could inhibit and even prevent scientific research aimed at improving the quality of care in Canada.

Any regulation or Act that merely or generally refers to the term “human cloning” could, first, prove to be devastating for millions of patients whose hopes rest on research aimed at discovering new therapies and treatments and, second, keep away from Canada investments in biomedical research by pharmaceutical and biotech companies, university research centres and government organizations.

We recommend that the committee make the federal government aware of the importance of cooperating with the provincial governments. In Quebec, for example, the use of existing structures such as the Quebec College of Physicians, the Quebec Medical Act and public health labs would allow for the achievement of the objectives of Bill C-247 in a simpler and less costly manner.

• 0945

In conclusion, should Bill C-247 be adopted, and in view of the constant evolution of science and ethics, we recommend that the standing committee limit its application in time and require a regular review.

Thank you.

The Chairman: Thank you, Dr. Miron.

Dr. Vandelac.

Dr. Louise Vandelac (Professor, Université du Québec à Montréal): Good morning, Mr. Chairman, and members of the House of Commons Standing Committee on Health.

Who could have foreseen, at the end of the 60s, that we would find ourselves here this morning, attempting to prevent cloning from actually taking place in our society? At the time it would have been seen as science-fiction but now, this possibility is within our grasp.

First of all, I would like to thank Pauline Picard, MP, for her lucidity, her courage and determination in proposing this bill which, in my view, contributes to enhancing the function of member of Parliament since what is at stake here will have an effect on the very way in which a human being is conceived in the future.

That being said, no one has any illusions about the likely fate of this particular bill whose essential merit, at the present time, is to encourage the government to finally make comprehensive and consistent legislation after a wait-and-see period, lasting from 12 to 14 years, since the first social debate on reproductive technologies goes back to 1985 and the Royal Commission on New Reproductive Technologies was set up in 1988 and cost more than 30 million dollars, without taking into account the costs involved in analyzing and preparing for the bill.

In short, it is high time the government stop allowing developments in research to serve as a substitute for policy on the technicalization of reproduction.

My remarks will focus on three particular points: first of all, the imminence of human cloning for so-called reproductive purposes, although things are far more complex, as we shall see in the second and third parts. I'll emphasize the fact that what is referred to as cloning for therapeutic purposes includes first and foremost experimental cloning, and even cloning for productive purposes.

I'll deal quickly with the imminence of human cloning. We are all aware of the different stages in the evolution of this practice among animals: the cloning of sheep, mice, calves, of goats recently in Montreal, cloning still at the experimental stage on superior primates and, more recently, the cloning of human cells in Korea, in fact, the cloning of embryos at a very early stage, cloning that was stopped at an early stage, without forgetting to mention the human cloning experiments begun at the start of the 1990s and presented by Hall et al. in 1993 in Montreal at the convention of the American and Canadian associations of fertility and andrology; and of course this work was awarded the convention prize.

Last April, Richard Seed, who is now campaigning for funds to make 200 human clones a year, gave a lecture to the Royal Academy of Sciences in London.

From the ideological point of view, the cloning situation is also developing before one's very eyes. Nathan Myhrvold, Bill Gates' top technology officer, one of the biggest investors in biotechnology, recently justified human cloning in an article in Slate Magazine, Microsoft's on-line magazine, when he said:

[English]

What is so special about natural reproduction anyway? Cloning is the only predictable way to reproduce, because it creates the identical twin of a known adult. Sexual reproduction is a crap shoot by comparison—some random mix of mom and dad.

Then he adds:

In any case, fear of clones is just another form of racism.

• 0950

[Translation]

We could of course continue for a long time in the same vein noting, for example, that an Internet company, CLONE-ALL, offers a quality product using celebrity cells or even the cells of serial killers. A Christian Website advocates the cloning of Jesus using DNA samples from the Turin Shroud. In other words, there are all sorts of crazy ideas and a considerable risk that someone will give them a try.

The important thing to note here is that before the actual work takes place, there is generally a period of ideological preparation lasting several years to get people used to the actual idea of cloning.

Last week, the creation of a small American firm was announced, under the name of PerPETuate, offering clonage insurance for your favourite pet, thus the name PerPETuate, based on the cells of your living or dead dog, canary or cat. In other words, it is important to understand that the idea of cloning is becoming commonplace in our society.

The present bill, in spite of its importance in raising the overall awareness of such matters, fails to take into account what I consider to be quite fundamental, namely the very significant other uses of cloning.

In the question period, we may perhaps have time to talk about the reasons in favour of prohibiting the cloning of human beings, but I have the feeling that a good many committee members are rather inclined to agree with the idea that we should not clone human beings.

Let me deal at greater length with what are called stem cells. At the present time, there are two proposals relating to the use of embryos, for the production of organs that can be easily transplanted to adults and for the reduction of immune problems. That is one of the reasons advanced.

It should be noted with respect to ES cells that there are both pluripotential and totipotential cells. The problem is that although the totipotential and the pluripotential cells can be identified in animals, it can only be done in humans as in animals to the extent that these cells are cultivated and this gives rise to a serious ethical problem.

The mere idea of producing embryos from adult human cells implies the taking of human embryos and carrying out the work that will allow for their production in order to make cell lines that will make possible the production of organs. This implies both the utilisation of human embryos and the production of such embryos and leads to very serious questions about the use and indeed the commodification and instrumentalization of the human embryo as such.

All sorts of partial solutions have been found for such problems. Recently, among others, in an article that was not published but was only reported in the press, mention was made of an adult nucleus that had been transferred enveloped in a cow embryo in order to get around this part of the problem.

• 0955

In any case, we must ask ourselves whether research can indeed justify all such possible practices, particularly since interesting research is now starting to be done that, in my view, deserves support. I am thinking of the research being done on tissues, particularly in Quebec City, under Dr. Auger. Tissue engineering makes it possible through the use of adult tissues, thus obviating the need for embryos and ES cells, to produce skin, cornea and now vessels, for the first time ever.

Thus there are avenues for research other than those that consist in instrumentalizing the human embryo. It is interesting to see the extent to which public authorities could support certain types of research that are much less far-reaching in their social implications and more closely linked to a medical perspective.

In conclusion, I'd like to emphasize that there is far too often a tendency to confuse that which relates to health and that which relates to the medical industry. We know for a fact that in our societies the quality of both individual and collective health is basically linked to social health determinants, that is, living conditions in early infancy, environmental conditions and working conditions.

There is no denying that certain approaches may appear attractive, but we must always ask ourselves whether the solutions proposed will not give rise to problems more numerous than those we are attempting to solve.

Thank you.

The Chairman: Thank you, Madam.

[English]

Phyllis Colvin, I know you want to say some things. Did you want to speak now or when we go into another session?

Ms. Phyllis Colvin (Director, Health Policy Division, Policy and Consultation Branch, Health Canada): I would just remind the committee of a number of things in terms of the history of this file. Of course, the royal commission made specific recommendations with respect to cloning and genetic manipulation. These two practices are in the ongoing, in effect, moratorium that was instituted in 1995.

Bill C-47 obviously was introduced in 1996 and failed to complete the legislative process, but it did indicate the government's position on some of these very complex issues, and I want to reiterate some of the previous statements by witnesses that these are very complex issues.

I would also remind the committee of the fact that we have published a discussion paper in this area, entitled New Reproductive and Genetic Technologies: Setting Boundaries, Enhancing Health, and that the issues associated with cloning and genetic manipulation were dealt with in that context.

Also, as the committee is aware, we have a statement from our minister with respect to comprehensive legislation sometime before the turn of the year.

So I would just put that on the record.

The Chair: That was really brief, Ms. Colvin, but thank you very much.

Just as a reflection, Dr. Vandelac said a moment or two ago that ever since this legislation was presented, there have been some rather significant developments in the field of research. Ms. Colvin, I wonder whether some of those developments in the field of research fell into the class of items that were under that voluntary moratorium established in 1995.

Ms. Phyllis Colvin: That's a very challenging question.

The Chair: No, it's just an observation.

Ms. Phyllis Colvin: To our knowledge, and we do have an advisory committee operating within this area, with respect to, for example, human cloning, we have taken a survey of the clinics that are operative in this field, and we do not have an indication that existing medical practice in Canada is in violation of the specifics of the moratorium. We have constant vigilance in that area, and we have the advisory committee to help us with that. So we're working on that, but it's something that remains to be developed in Canada. We are working closely with the medical profession in this area. We have established linkages with the medical profession, especially with the governing bodies of the medical profession. So that is ongoing.

• 1000

The Chair: Do you make a distinction between medical practice and medical research that leads to changes in medical practice?

Ms. Phyllis Colvin: When we first appeared in the context of Bill C-47, the major issue at that time was Dolly. I think there was a very deep sense and understanding in the Canadian population of the risks associated with cloning technologies in so far as they could be extended to human beings. At that time I don't think the kinds of issues that are before you today were as actively discussed, although some preconditions and precursors of that debate were available in the literature. This is something the department is looking at in an ongoing fashion. We will be approaching this issue in terms of the comprehensive legislation that's coming forward.

The Chair: So you do make a distinction between medical practice and medical research.

Ms. Phyllis Colvin: There is a distinction, yes, between medical practice and medical research.

The Chair: Mr. Vellacott.

Mr. Maurice Vellacott (Wanuskewin, Ref.): Off the top, my understanding with regard to proposed paragraph 286.1(1)(b) is that it only prohibits germ line genetic alteration. I would be interested in a response from those of you who wish to answer. The question would be, can a lot of good not be done by carrying out research on non-germ line therapeutic genetic alteration? Do we necessarily need to go down the road of germ line? Can a lot of good not be done in terms of illnesses such as Parkinson's disease with just simple non-germ line therapeutic genetic alteration? Perhaps Dr. Baird would like to answer.

Dr. Patricia Baird: I agree. I don't see very much need for genetic alteration that would be inherited.

If you look at categories of genetic disease, for example, recessive disorders or dominant disorders, the people who are affected by those do make some eggs and sperm that are normal. So it would be possible to actually use those normal ones for the next generation without actually altering their germ line.

There's a distinction between somatic cell gene therapy and gene therapy that is done so early in the embryo that it will affect the germ cells of that individual when they're fully formed. I see really no reason to do it at that stage, because the major motivation for doing gene therapy, which is a fairly major invasive and risky thing to embark on, is to relieve human suffering that cannot be dealt with in any other way. For individuals who have devastating genetic diseases, somatic cell gene therapy under certain circumstances may be ethically defensible. But I see no reason to actually change ova or sperm when you don't need to in order to relieve suffering, because you can in fact select normal sperm or eggs from those people. I see no reason for doing genetic alteration that will affect the germ line.

Mr. Maurice Vellacott: Do I misunderstand something in regard to proposed paragraph 286.1(1)(b)? Some of the witnesses, Dr. Miron in particular, seemed to imply that proposed paragraph forbids a lot of good being done. I only see a prohibition with regard to germ line genetic alteration.

• 1005

Dr. Patricia Baird: Could I just add something before Pierre says something?

Mr. Maurice Vellacott: Sure.

Dr. Patricia Baird: This illustrates how complex this area is and how very dangerous it is to do legal wording for things. For example, there are now known to be some serious human disorders due to defects in the genes that are in the mitochondria, which are not in the nuclear genome. It's possible that a fertilized ovum, a zygote, may not in fact implant and grow because there are defects in the mitochondria and the cytoplasm. There is some theoretical and research evidence that if that cytoplasm were supplemented with additional cytoplasm from a normal cell, it would enable that zygote to grow. So I see no need to tamper with nuclear genes, but there may be a place for supplementation of mitochondrial genes in some instances.

But, again, it's the kind of thing that is much better dealt with under legislation requiring licences at facilities doing this and then having conditions the facility has to comply with, because it can be designed to take into account these kinds of advances.

Mr. Maurice Vellacott: Do you call that germ line genetic alteration then?

Dr. Patricia Baird: It would be germ line if you defined it as affecting the gametes, the eggs and sperm, because you would be putting mitochondria into a gamete or into a zygote, and that could then be transmitted to all the germ line cells of that individual when they actually develop.

Mr. Maurice Vellacott: Into the next generation.

Dr. Patricia Baird: Yes. So it's complicated.

[Translation]

Dr. Pierre Miron: I share Dr. Baird's opinion. The clause refers to altering the genetic structure; this can include an alteration of the genetic structure of the mitochondrial DNA. Before enacting legislation, it would be prudent to establish a framework for this technology rather than prohibiting it outright in view of the fact that ethics changes and that science evolves a great deal. Before 1997, we did not know the changes that occurred, that can bring about significant benefits for health and society. I want to make you realize the need to be very prudent in amending the law when this can have the effect of preventing important future scientific advances that we are not necessarily able to predict today.

[English]

Mr. Maurice Vellacott: My concern in this is that, as you implied, Dr. Baird, while it needs to be left up to the “experts” or “specialists”—

Dr. Patricia Baird: No.

Mr. Maurice Vellacott: You're not necessarily saying that? Okay.

But the concern is that sometimes in our enthusiasm for science—and I am grateful that a lot of things can be done that way—we can have individuals who basically say, don't curtail us, just let us do what we need to do. I believe in the case of some people like yourself and others there would be those very careful ethical kinds of considerations. But others in their enthusiasm may say, just don't hamper us, don't crimp us on this thing, because we're the ones who know best. They want to leave it regulatory instead of legislative.

Dr. Patricia Baird: By regulatory I didn't mean self-regulatory. I meant by some kind of national regulatory body that has wide representation from a range of people with many different perspectives, not expert. I think there's a need for medical self-regulation, but that's not sufficient. In this area you really need to have input from many different perspectives, because many times the decisions to be made are moral, ethical, and social. So when I say regulatory, I mean accountable to the larger society through a statutory body.

The Chair: I'm going to jump in for a second. Last week we had witnesses before this committee who made a distinction that went beyond that definition of regulatory. In fact, the distinction was one that tried to identify the differences between legislation and regulations. There was a preference that this be dealt with through regulations rather than through legislation. You've introduced a different element here about regulatory, bringing in, to my way of thinking, a third category of individuals, experts from a variety of fields who would have input into whatever might emanate from a statutory environment.

• 1010

I'm wondering whether I'm being led down a different route or whether in fact you and Dr. Leader and the other two doctors at the table favour dealing with this issue through regulations, in our sense of the word, and therefore not through legislation, or whether you're talking about bringing together an advisory group that would help governments understand and find their way through this. You're not. Okay.

Dr. Leader.

Dr. Arthur Leader: I think the organizations I'm involved with—the Canadian Medical Association, the Society of Obstetricians and Gynaecologists of Canada, and the CFAS—have gone on record as supporting legislation that would empower the government and through the government any agency that it would set up to regulate the activities. The problem with this area is that hasty legislation is usually bad legislation.

For example, Bill C-47, which would have prohibited the fertilization of a human egg for research purposes...in the intervening two years approximately since that bill was introduced, there have been centres that have been able to mature an egg in vitro for women who normally would require fertility drugs to become pregnant because they don't ovulate or make eggs on a regular basis. There are risks associated with that current medical treatment of multiple births, which are expensive to society, and also there are risks to the woman and the child.

By maturing the egg in vitro and fertilizing it in vitro, you can put back one or two embryos. The woman doesn't require medication. You don't have the risk of multiple births. Yet that particular legislation, which was well intended, would have prohibited research in that area that required two years to get to the point where you now have ongoing and soon-to-be-delivered pregnancies.

The framework has to be legislative, and the societies accept that. It should be comprehensive and it should have a representation from all of the people who have expressed interest in the royal commission deliberations, in the deliberations on Bill C-47. They need to be represented because physicians do not have the breadth of knowledge that society has, to understand what's important. There are scientific, there are medical, but there also is a context.

So I think what the societies are proposing is that there be legislation that enables a regulatory body to exist. Our preference is for a regulatory body to exist, separate from any department, to be responsible ideally through this committee to Parliament and to the minister, that will allow the flexibility, where appropriate, for research to be undertaken, but that there should be penalties associated if people do things that society and the regulatory authority deem to be unethical or unacceptable. That would allow the flexibility to make adjustments based on evidence, but in conjunction with the opinions of those people, not just physicians and not just scientists, who have an important role to play in this.

The Chair: I'll leave it to the mover of the bill to address whether this was hastily drafted or whether it addressed any of the other prohibitions that were proposed under Bill C-47. It seems to me that some of the argument—it is always a valid argument by virtue of retrospective insights—is that something that was prohibited yesterday now is proven to be beneficial today. Therefore, if we had had this legislation yesterday, we wouldn't have the benefits today. This is a problem for legislators whenever we're looking at this. Sometimes it seems we're antagonistic, but it's a very important issue for us.

I'm glad you recognize it, but you're right, if we had passed Bill C-47, maybe we wouldn't have had that. But Bill C-47 had a different context, and we'll get to that in the question and answer session.

[Translation]

Ms. Picard.

Ms. Pauline Picard (Drummond, BQ): Mr. Chairman, I believe that Ms. Vandelac would like to add something.

[English]

The Chair: Sorry. We'll go to Dr. Vandelac first and then to Madam Picard.

• 1015

[Translation]

Dr. Louise Vandelac: I think that the points raised about the complexity of the formulation are quite obviously problematic. I'll give you two or three examples to show you that as drafted, the text could give rise to problems.

Mr. Leader referred to the maturation of oocytes and referred to one laudable application with respect to the transfer of multiple embryos. Some teams have gone so far as to transfer up to nine embryos at a time to a human uterus. It is quite clear that the possibility of reducing these multiple transfers would be well received.

That being said, we must not forget that some years ago already there was a proposal made in medical journals—I was looking for the reference but I don't have it with me, I think it was in the New England Journal of Medicine—a doctor proposed using the maturing of oocytes in order to produce, from maggots taken from corpses or even from embryos, children for sterile couples.

A technique is a technique but it can have many applications. The examples we have been given are laudable. However, a strict and rigorous framework is absolutely necessary to avoid such extreme practices.

Moreover, when we talk about altering the genetic structure of an ovum, human sperm, zygote, etc., we must understand that there are some techniques that are applied and that can produce such an indirect result, even if their main purpose is not to influence the genetic structure. Let me give you an example.

A great debate is taking place at the present time in France on ICSI, that is intracytoplasmic sperm injection. The debate relates to the fact that when a single spermatozoon is taken—and it is now possible to use other techniques such as ROSI, using non- mature cells, at an earlier stage of development than the spermatozoon—there is a strong risk of causing among the children to be born genetic problems relating to fertility. It is said that if sterility is really linked to this type of problem, it could have repercussions.

These issues are controversial. People are wondering how the section with respect to “altering the genetic structure” is going to be enforced. This does pose a bit of a problem. It is true that these issues must, without question, be examined and dealt with by a regulatory agency. In the United States, as a result of the Wiladsen study, it is now becoming possible to have a child literally born from the ovum of two mothers, since the nucleus is transferred into the envelope of the other woman. This is a case of potential indirect alteration. So there is the problem associated with the definition of genetic structure and, in addition, the genetic impact that this may have on the other generation.

In summary, we can see that there are some ambiguities and problems, and I would agree that certain practices, such as the cloning of human beings, should indeed be criminalized. In addition, I think that there should be a legal sanction against those who fail to abide by the rules set by a regulatory agency. There may be some problems in this respect given the way that the bill is currently written.

The Chairman: Thank you.

Ms. Picard.

Ms. Pauline Picard: I'm very pleased to welcome you here. Perhaps you're right; perhaps the drafting of the bill is not adequate. Science is evolving constantly and very quickly and there are also very good reasons behind all this research.

• 1020

The wording of Bill C-247 is based on that of Bill C-47. It was amended because we were told that the wording would hamper science in its quest for solutions to certain problems and diseases, when in fact this was not my objective. My objective is to preserve human dignity. My values and those of the people who live in this country and in Quebec include a great respect for human life. When it comes to human cloning, we are going to have to differentiate between therapeutic cloning and human reproductive cloning. First and foremost, I want to preserve human dignity which, in my mind, is a basic right.

If the Criminal Code is not the most effective tool to regulate these procedures, are there any other avenues that would enable us to ensure that, despite all of the positive things that scientific progress has brought to man, we will not wind up with clones?

We heard from other witnesses last week and someone said that in a few years' time, we would have, in the name of science, a headless clone that would enable us to attain immortality because we could use the clone's heart and organs. This is serious and we must establish some strict guidelines so that this situation does not occur.

Doctor Baird, I'm very surprised by the statement you made earlier, because one of the first recommendations in your report was that human cloning should be prohibited. Today, you stated that you are against human cloning but with certain reservations. I'm not reassured when I hear the chairperson of the former commission soften her stance on the prohibition or criminalization of human cloning two years after the report has been tabled, when in fact the Council of Europe and the World Health Organization have just passed resolutions prohibiting human cloning. Could you clarify your thoughts on this issue?

[English]

Dr. Patricia Baird: No, I haven't changed at all in my position. If this wording of the bill read “No person shall knowingly implant in the uterus of a woman an ovum zygote embryo that has been manipulated for the purpose of producing a zygote or embryo”, then I would have no problem with it. It's the wording of it that now actually prohibits some other research that does not result in a human being who has been cloned.

My position hasn't changed at all. I think human reproductive cloning to produce a living human individual should not be permitted, and I would actually be quite happy to see it in the Criminal Code, but I think that's probably not the best way to go. However, I think the wording of this, inadvertently in my view, prohibits a range of other things that were not even possible at the time we reported five and a half years ago.

The Chair: Just a second, Madam Picard. I want to get Glenn's response from Justice on that question. Okay, go ahead.

[Translation]

Would you like to hear what Glenn Rivard has to say?

Ms. Pauline Picard: Yes.

[English]

Mr. Glenn Rivard: As I read the provision, it doesn't simply address cloning in general, but rather cloning that leads to, if you will, the production of a zygote embryo or fetus. Therefore, if the science evolved to the point where you could, for therapeutic purposes, clone simply organs, then I don't believe that would be captured by this particular prohibition. However, it would capture any cloning that leads to a zygote embryo or fetus.

• 1025

The Chair: Madame Picard.

[Translation]

Ms. Pauline Picard: Are any of you familiar with the English model? It appears that the bill tabled by the Department of Health, which is to be tabled in the fall, was influenced by the English model pertaining to genetic manipulation.

The Chairman: Does someone want to answer this question?

Ms. Pauline Picard: It seems not.

The Chairman: Ms. Vandelac.

Dr Louise Vandelac: I would simply say that in the developed countries, up until now, the English model has been the most permissive one for researchers and doctors; it is not necessarily the legislation that has afforded the best protection for human dignity.

I will make more detailed comments once the bill is tabled, but initially, it does not necessarily look good with respect to the underlined intent of this bill.

[English]

The Chair: Ms. Colvin.

Ms. Phyllis Colvin: I think it's important to recognize that there are a number of international models, of which the British model is one, and the current exercise is to learn as much as we can from the operation of each model. There are things to be learned from the Australian experience, from the French experience, from the British experience, and we're taking those into account as we move forward, among others. There are many other instances.

The Chair: What about the British one in particular?

Ms. Phyllis Colvin: The British model is an established model. It centres on the Human Fertilisation and Embryology Authority, which is created under legislation in Britain, and provides a fairly independent context for the regulation of these practices, characterized by a great deal of public consultation as the authority moves forward in terms of its own deliberations. It provides one model that can be reviewed in this context.

The Chair: No lessons for Canada?

Ms. Phyllis Colvin: In the sense that the authority is.... It provides a comprehensive model in the context of the combination of prohibitions and regulatory apparatus. I think there are some lessons for Canada. I think there are circumstances in which we can look, for example, to the flexibility of the type of code of practice that operates in Britain in order to be able to accommodate the fact that obviously this is a fast-changing field. Without moving away from the requirements to have a framework society operates to, it gives you the flexibility to respond to developments as they take place. At the same time, and I want to stress this, the British regime is fundamentally based on prohibitions as well. So it's a combination of the two.

The question remains as to how effectively each individual country develops its particular regime. There are pros and cons for the British regime. Some people are very happy with the independent model. Others would be perhaps more in favour of linkages to either government departments or more control in respect of the machinery context. Certainly it exists out there; it has a track record. We're looking at it very seriously.

The Chair: Dr. Leader.

Dr. Arthur Leader: To answer the specific question, following public consultation, HFEA advised that with respect to the cloning of human beings, the U.K. government consider the possibility of introducing legislation that would explicitly ban human reproductive cloning.

• 1030

With respect to research and therapeutic cloning, which both Dr. Baird and Dr. Miron have spoken about, using ES cell lines for the cloning of human tissues, HFEA has recommended that the Secretary of State for Health should consider specifying in regulations two further purposes for which the HFEA might issue licences for research, so that potential benefits can clearly be explored: firstly, the development of methods of therapy for mitochondrial disease, which Dr. Baird alluded to; and secondly, the development of therapeutic treatments for diseased or damaged tissues or organs, which is therapeutic cloning.

With regard to the World Health Organization, it reaffirmed that cloning for the replication of human individuals is ethically unacceptable and contrary to human dignity and integrity, but in fact established a study group with the aim of developing guidelines to the use of therapeutic cloning procedures for non-reproductive purposes.

With regard to UNESCO, it's much the same.

In the United States, President Clinton asked the NBAC, which is the National Bioethics Advisory Commission, to undertake a thorough review of the issues associated with the human stem cell research and allow that the national institutes of health could fund research in the so-called area of therapeutic cloning, in cells grown by privately funded scientists.

So I think if you ask what the landscape is saying, it is saying that the cloning for the purpose of creating a fetus or human being is unethical and should be banned, and that cloning of human tissues or so-called essential or stem cell line is recommended by almost all of the authorities, whether it be the World Health Organization, UNESCO, HFEA, or the Congress of the United States. So that's what's going on internationally.

The French example is different. They have recently passed legislation that is highly specific, which specifies exactly what you're supposed to do in every step of care. It's a very different approach from the approaches taken either internationally or by the Council of Europe or by the United Nations, whether it be the World Health Organization, UNESCO, or by HFEA in the U.K.

[Translation]

The Chairman: Dr. Vandelac, do you wish to make any brief comments?

Dr. Louise Vandelac: Yes. During a recent discussion with the Vice-Chair of the Académie de Médecine de France, I learned that he was interested in having the Comité national d'éthique, in Paris, make a distinction between therapeutic cloning and reproductive cloning. However, we must understand that this distinction leads to the introduction of another aspect, namely, productive cloning. In other words, we must realize that although we may agree that human cloning should not be allowed, we must be extremely careful when it comes to the authorization currently given to use, for so-called therapy, cloned human embryonic cells to make replacement parts for adults. This is a very serious problem. Earlier, I talked about the advantage of studies on biomaterials that could enable us to get around this type of problem.

Finally, as far as basic research on embryos is concerned, this is already being done. Cloning is another technique. We may be for or against the use of human embryos, and this debate must take place. Just because the science is already under way doesn't mean that the debate on the issue shouldn't take place. Nevertheless, we have to see how all of this should be applied.

We could theorically use embryos to conduct toxicity tests, for instance. Would it not be in our interest to develop tissue that would enable us to conduct toxicity tests? In other words, how far will we go in using human embryos?

• 1035

This is a question that we must ask ourselves. The distinction pertaining to the so-called therapeutic use, which is at the moment a bit premature since we have not yet got any therapies—that's one perspective—, must not camouflage all of the other uses, including potential industrial uses. Thank you.

The Chairman: Thank you, Doctor.

[English]

Dr. Leader, I wonder if you could make available to the committee the document from which you were reading when you were addressing some of the scope of research that is currently going out in the larger market area.

Dr. Arthur Leader: Sure. It would be my pleasure.

The Chair: I think committee members might find it useful as they review some of their thoughts on this a little later on.

Madam Minna.

Ms. Maria Minna (Beaches—East York, Lib.): Thank you, Mr. Chairman. It seems to me that from the discussion we've had today and previous discussions around this committee, there tends to be.... Certainly for myself, I felt that the issue of therapeutic versus human reproduction is clear, but from what Dr. Vandelac is now saying, there can be crossovers between the two. I guess that's the grey area that is the difficult part to understand for those of us who are trying to make these kinds of decisions.

My initial reaction to this bill was yes, I agree with the idea of prohibiting, if you like, the whole concept of human reproduction. I don't think too many people have trouble with that. I think Dr. Baird's suggested wording may even do that, or at least for this purpose, for this particular bill.

But then there's the larger issue of the crossover. Maybe, Dr. Vandelac, you could talk a little bit more about the two at some point, where the overlap is—and maybe Dr. Leader as well, because you had much of the same discussion earlier.

Neither Dr. Leader nor Dr. Baird talked about the possible linkages between these two. Are there linkages, as Dr. Vandelac is suggesting? Maybe between the three I could get a clearer sense of whether or not there are linkages. Or are they clearly demarcated, as earlier mentioned, therapeutic versus reproductive?

Dr. Patricia Baird: I think this is an area that we simply don't know yet how it's going to evolve. If it becomes possible to grow directly from a cell that has had some body cell nucleus put into it, a tissue, I think the vast majority of people wouldn't have problems with that. Obviously if you are going to instead go through a stage where you grow an embryo and then start taking organs from an embryo, that's a different matter.

In my view, we should not be doing human reproductive cloning to produce a living human being. Exactly what should be permissible under the rubric “therapeutic cloning” also needs a great deal of regulation and accountability. It should not be that anything goes. Each facility that is conducting research in that area should be required to have a licence. To get that licence, they should be proposing what research will be done, it should be reviewed by a multidisciplinary body that will evaluate what the ethical and other ramifications are of doing that research, and it should decide whether or not it will be permitted. I imagine it will be that some kinds of research will be permitted and others will not.

The Chair: Dr. Baird, are you suggesting that every proposal for research be judged on its merit?

Dr. Patricia Baird: No, I think what is going to be needed is a mandatory statutory requirement that any facility doing research using human eggs should be required to have a licence. If they are going to be applying for a licence, they should say what they are proposing to do during the period of the licensure. I think there will need to be criteria about what is acceptable research and what is not, and we actually laid out some of those things in the royal commission report.

The Chair: Not all research is done in an open and transparent fashion. Those are political terms, but....

Dr. Patricia Baird: In my view, any research done in Canada using human eggs should need to be licensed and it should be open and transparent.

The Chair: Okay, so the operative word there is “should”.

Dr. Patricia Baird: Yes.

The Chair: Thanks.

I'm sorry, Ms. Minna, it's still your—

Ms. Maria Minna: It's quite all right. It's part of the same track on which we're all going here.

Before I get back to it, does anyone else want to comment on the crossover stuff?

• 1040

[Translation]

Dr. Pierre Miron: I will turn the floor over to Ms. Vandelac because I would like to talk about another issue.

Dr. Louise Vandelac: As far as this issue is concerned, I think that it would be very good to talk about reproductive cloning, on one hand, and on the other hand, research cloning for transplants or other purposes.

The term “therapeutics” is, in my opinion, very ideological. This is a desire, a potential wish; we wish that this may eventually lead to therapeutic uses, but we have to understand that cell lines may also be of very strong commercial interest. As far as the pharmaceutical industry is concerned, these questions are extremely significant. Consequently, I think that we have to be very clear about the various types of uses that could be made of them.

With respect to this bill, it is clear that there is relative unanimity about prohibiting human cloning. However, for the work to follow, I would really like to see us make a distinction between what is experimental, what is research and pure research, and what is simply wishful thinking as far as some so-called therapeutic uses are concerned. That masks the stakes involved in the market, which were quite significant in the decisions made by the various international bodies and by various countries. This was an issue of competitiveness and, particularly in France, it is common knowledge that the decisions, including those made by the Comité national d'éthique, were strongly influenced by the risks associated with being dependent on the American market. Accordingly, we must understand that there are other extremely important stakes involved.

[English]

The Chair: Mr. Clemenger.

Mr. Bruce Clemenger: I'm finding this discussion very helpful. I'm not a scientist. We did have some scientist-medical people help us think through our brief, and we're really here to try to apply some more general principles of human dignity to a very complex field.

I am concerned, though, about just leaving it to a regulatory body and regulatory framework. I would like to see Parliament at least set some outside parameters, and that's why I'm trying to understand the difference between the reproductive cloning and therapeutic cloning. I'd have to go back to the people who advise us and find out what's happening here.

For us, I think it goes a little further in terms of even the experimentation on zygotes and embryos. We would see that as an early form of human life. Dr. Baird kind of implied that the therapeutic cloning could be understood to also be manipulating embryos or zygotes or producing embryos or zygotes for the purpose of research and then destroying them. We think that's too far to go.

There seems to be some consensus in terms of at least some type of cloning, and yet there seems to be resistance to the idea of kind of banning certain practices. To push the point underneath this, again, we want to keep this open for whatever science or progress or technology can open up to us in the future, and I guess our concern would be, is that our chief guide? Is it what we might be able to do, or what is appropriate and a good thing to do?

So I'd still encourage this committee to explore and see if there are still not some minimum standards we can set up in terms of Criminal Code provisions that ban certain things that we agree are wrong, and then set up a regulatory framework within that framework to say, okay, then how do we judge these specific practices?

I find myself posing more questions, because I don't have the expertise.

The Chair: I gather, though, that you don't have a lot of confidence in the voluntary moratorium.

Mr. Bruce Clemenger: No. Human nature.

The Chair: Do you have any at all?

Mr. Bruce Clemenger: Some, but not when there's so much curiosity. Sometimes there could be elements of arrogance, but there's a lot of money to be made. There are a lot of factors—and again, just the desire to do good. I understand there are a number of diseases that could be addressed through this kind of technology and approach, and I certainly don't want to pre-limit that.

Another principle we always talk about is stewardship, the stewardship of human life, and medicine plays into that as well. But what we would be pushing for is, are there some things that we can agree that we should not do, some doors we should not open, some passages we should not go down? Let's frame those, and then, within the middle, let's talk about regulatory frameworks and licensing, and so on.

• 1045

The Chair: Okay. One of my colleagues here has a lot of faith in licences. Madam Wasylycia-Leis, please.

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Thank you, Mr. Chairperson. Your last comment, I think, is a good starting place for my question, and that really is, has the voluntary moratorium curtailed anything?

If you read the newspapers, over the last three weeks alone, it seems to me that everything the royal commission intended to do, everything Bill C-47 intended to do, and all the good intentions of Madame Picard's bill have all been sidelined by these new developments. These include the advertising of human eggs on the Internet, the offering of $2,000 a human egg, the sale of human sperm, the questionable tactics of some fertility clinics, the questions about regulations of sperm banks—the list goes on and on. In every one of those cases we're talking about areas that were clearly earmarked for either prohibition, as a result of the royal commission and the subsequent legislation, or would have been part of a very heavily regulated approach.

So my concern is, although we've had some talk this morning about how fortuitous it has been that we didn't have Bill C-47, I think we've got to look at it from the other point of view. That is what we've allowed to happen by not having anything in place after 10 years of work by the commission, after, as I understand it, and Dr. Baird can say more on this, having visited 17 centres in Canada, having 2,000 active participants, 6,000 people phoning in, 15,000 people answering surveys—the most extensive consultations we have had on this issue, and we all know the results of the commission's work gathering dust and a bill being allowed to die and all of this happening.

So my questions is, has the moratorium curtailed anything? That's one question. The second is, with this period of inaction, has so much happened that in fact the horse is out of the barn and we can't close the door? Can we do anything about the sale of sperm and eggs? We now have news reports saying that in the drafting of this new legislation, the government is now considering loosening its earlier position on this and allowing for profit-making when it comes to distribution of sperm and eggs. My question is—

The Chair: I'll give you a chance to ask the other ones. There's not a problem. Why don't you give them a chance—

Ms. Judy Wasylycia-Leis: My last question is, has Dr. Baird been involved in any of the drafting of this new legislation, and what can we expect in terms of consistency with all that work that's been done?

The Chair: Well, there are three questions. Do you want to start, Dr. Baird?

Dr. Patricia Baird: First, with regard to the moratorium, I don't think there's anyone who seriously thinks that's the right way to go. It's not been effective.

With regard to your question as to whether things have progressed, there has been a whole range of activities go on that I think are reprehensible, including the selling of eggs. I think it's way past time that we get going, in Canada, and actually enact appropriate and comprehensive and integrated legislation. I think many of the things the royal commission recommended would be very timely and appropriate, and I hope very much that the government is looking seriously at that kind of framework.

I haven't seen any legislation; I believe that what is going to be done, because Mr. Rock has said so publicly, is there is going to be a more integrated approach. I look forward with great anticipation to seeing it, and I'm certainly very happy to help in any way I could.

Was there another question, or have I dealt with...?

Ms. Judy Wasylycia-Leis: You've dealt with the three. Well, I guess the one question that I think is worth pursuing is, has so much happened in the space of these four or five years since we were hoping for a legislative framework that we can't ever curb some of these activities and go back to a fairly strong legislative and regulatory framework?

• 1050

Dr. Patricia Baird: I hope not. I think it's going to be a little more difficult than it was five years ago, because you have a range of people involved in areas of activity that weren't then—for example, people who are advertising and young women who are selling their eggs. But I certainly don't think it's too late, and I think Canadians were very strongly united when we went across the country and when we heard from them.

It wasn't controversial at all that we needed in this country an approach to put limits around and accountability within practice in the field. It was almost unanimous that this is what was needed. So I think it's probably somewhat more difficult now than it was five years ago, but I don't think it's impossible at all.

The Chair: Dr. Leader, is it reprehensible that there be a selling of sperm and ova? If they were given voluntarily, would it make the research involving those a little more acceptable?

Dr. Arthur Leader: Your language is a little bit strong, in the sense of reprehensible—

The Chair: I'm just repeating the word I thought I heard about two minutes ago.

Dr. Arthur Leader: Okay.

Let me give you an example. In the United Kingdom they decided they were not going to allow for the payment of any moneys to sperm donors. There was a great deal of fanfare, a great deal of publicity. It was based on a model in New Zealand, where there are 50 donors for the whole country and they could both not pay them and also use a known donor, which are two issues that came up in the previous bill.

They've had to back off from that in the United Kingdom, and they now do allow payment for demonstrated or out-of-pocket expenses. Are you paying for sperm or are you paying for the expenses and the inconvenience that people go through because of the requirements for screening? Interestingly enough, in the United Kingdom, and one of the things that's been considered inappropriate in Canada, it was the HFEA, the regulatory authority, that said egg sharing should be allowed.

It was in fact the profession that had some difficulties, but they were responding to the consumer. Egg sharing involves one woman going through the treatment of in vitro fertilization; eggs are retrieved from her, and she agrees to share that with another person, either in exchange for reduced cost—which again, is her out-of-pocket cost as opposed to payment. It's hard to draw a very sharp line between whether that woman is being paid, because it is costing her less, or whether the expense, which let's say is $5,000 or £2,000, is being reduced because she agrees to be compassionate in sharing her eggs with another person.

If it were all black and white, it would be really wonderful. And if it were easy to say it should be this and that, it would be wonderful. Each country has to develop its own culture toward this. So do I feel good about somebody advertising their eggs? No, but that's a commercial construct, and I think there are better ways to have that construct.

Should sperm donors be paid? I think they should be compensated for their demonstrable expenses. Would a system of non-payment work? Pilot a study and ask the question. As we've learned with the recent issue of sperm banking, if you impact a system very strongly, you shut down and the patients then suffer.

With regard to what's gone on in the media—I'm not going to do a journalism review of what went on, except that what we've learned from our standpoint is about the whole process by which guidelines that were meant to guide the profession were adopted by Health Canada and particularly the Bureau of Biologics. Again, with no consultation they were taken and said to now be part of the regulations. They were never designed to regulate sperm banks. If you wanted to get an A on a sperm bank examination and you wanted to be absolutely perfect, they were designed for that, and they were designed four years ago. Things have changed.

The ways in which you can test, which are specified in regulations, are different now. So what you have to keep in mind—what we would like you to keep in mind, I'll put it that way—is this is highly fluid. It is better to take an advisory group, or board, to give advice, and then, based on that advice, decide. If what is being advised is outside the bounds of what's acceptable in the culture we live in, ban it, period. If it's within the bounds of the culture we live in and it is acceptable, then allow it and monitor it closely.

• 1055

In the U.K. they allow research, but as Dr. Baird was saying, you have to have it closely monitored and you need a licence to do that. If you don't have a licence and you do that research, you're breaking the law. If you don't have a licence to do in vitro and you do in vitro, you're breaking the law. We don't have a problem with that. But it's a living aspect. Medicine is constantly doing that, and this area in particular is doing that.

As a group of professionals, by and large, Canadians are much more conservative, so if you read the articles where they talk about Colorado, what they don't say is that they transfer five embryos and they have a 60% multiple pregnancy rate, whereas Canadian clinics transfer an average of two or three and have a much lower multiple pregnancy rate.

Well, in Ottawa alone, that multiple pregnancy rate for every child that's born before 32 weeks costs the state $25,000. So yes, they make their $20,000 by treating the couple and then the patients come back to whomever they come back to and cost the state hundreds of thousands of dollars. It may be more responsible to say, let's accept a lower pregnancy rate, which is what they've done in the U.K. The U.K. pregnancy rates are significantly lower than some of the American centres. But then if families can live with it, the state can live with it. That's the type of trade-off that goes on. It doesn't really get well reflected in legislation. It does get well reflected in these discussions or at an advisory board discussion on this issue.

The Chair: Madam Wasylycia-Leis, did you want a response from Dr. Miron and Dr. Baird?

Ms. Judy Wasylycia-Leis: I think Dr. Baird had her hand up in response to something Dr. Leader said. I wouldn't mind hearing that.

The Chair: Yes. Dr. Baird.

Dr. Patricia Baird: It was just a small comment. Dr. Leader wasn't quite sure what to call the egg sharing. I think the right name for that is egg bartering. You're handing over half your eggs in exchange for medical services, and by doing so you're decreasing your chance of becoming pregnant because usually the first embryo transfer may not work. The chances are it won't, and so the rest of the fertilized eggs are put into freezing to use at a future cycle so that you don't have to undergo the invasiveness of having another egg retrieval.

If a women has handed over, in exchange for obtaining the services of IVF, half her eggs to somebody else and she then needs them, she's decreased her chances of becoming pregnant. So I think it's unethical. I think egg bartering is in some ways similar to egg selling. I think framing it as egg sharing sounds very generous and altruistic, but it certainly isn't what is going on, in my view.

Another small comment is that if you allow young women to sell their eggs for...$2,000 is too low now. You get much more than that. Depending on what your particular educational background is and ethnic background, you can get...the highest one I've heard of is $50,000, if you're in graduate school and you come from a particular background. But it induces young women to take risks with their health for money. When you look at some of the ads that have often been in student newspapers, certainly out west about the time when second-term fees are due...I think it's very dangerous, and I think most of us would not want our daughters to be selling their eggs.

I think it would be ideal to move to an altruistic system of donation, with regard to sperm donation. I don't think that can be done overnight, and I think we need to have a system eventually, ideally, where men who know what it is to have children and who have the consent of their families would act as sperm donors. This business where often young men, sometimes medical students, sometimes students at the university, unthinkingly...they don't really realize all the implications of what they're doing, when they think it's a little bit of a lark sometimes. Certainly in some of the facilities we found out about, there wasn't the really deeply informed counselling about what the act meant.

So those are just some small comments in response.

The Chair: Dr. Miron.

• 1100

[Translation]

Dr. Pierre Miron: I'm afraid that we are going beyond the terms of reference of today's meeting. I would like to remind you that one of the most simple and most effective ways of controlling these technologies is to ensure that the institutions involved in the sector have an ethics committee set up. We have an ethics committee that reports not only to the doctors, but directly to the board of directors. More than 50% of its members are outside members with a different type of training; they are theologians, ethics specialists, lawyers or even infertile couples.

My comment about this structure that is to be established is that I feel it's very important that there be an advisory committee at the federal level. Although perhaps there should not be a direct control mechanism, there could be one that is indirect in order to make sure that all fertility clinics or research programs involved in this area submit compulsory reports of their results or projects to an internal ethics committee.

I must say that this formula has worked very well for us up until now. Earlier, we were referring to ova donation. Our institution decided to stop ova donation because of certain concerns expressed by Dr. Baird, and because of situations that occurred in Quebec, where the Civil Code was amended a few years ago, which means the law is fuzzy about anonymous ova donation and gamete donation, whether anonymous or not. In an effort to avoid commercialization, our institution decided to withdraw from the field of ova donation following the recommendation of the Royal Commission and of the Conseil du statut de la femme in Quebec. We presented these recommendations to our ethics committee ourselves, and the committee ruled and eventually recommended that we no longer engage in ova donation.

I believe that there are some inexpensive mechanisms. It was stated that the Royal Commission had cost $30 million, whereas in Canada there are infertile couples who cannot gain access to treatment. The Standing Committee on Health should consider inexpensive mechanisms and suggest that the government co-operate with the provinces. Right now, there are mechanisms that allow us to achieve these objectives and reassure society.

[English]

The Chair: Karen Redman.

Mrs. Karen Redman (Kitchener Centre, Lib.): Thank you, Mr. Chairperson. It's a great segue to my question.

I was going back to something Dr. Baird brought up, and it's the broader social debate that needs to happen. What is the appropriate role of the federal government to make sure that debate is happening?

Dr. Patricia Baird: I'll answer it very briefly, and then let other people speak.

I think one of the needs for a national regulatory body is that it could also act as a focus for input and social debate and social consensus-making. I think right now people who are concerned have no particular place, or focus or nidus, to go. If in fact that body existed, and there were new technologies coming along, or new questions, or many of the questions that are before us, it could do white papers and circulate them widely, get input and develop a policy as things evolved. I think a national agency of that kind would have a very useful role in focusing some debate, because it needs to be ongoing.

Mrs. Karen Redman: I think that's the thing we've learned more than anything, the fact that it's a moving target. And I think there's a fair amount of consensus that there's a huge grey area and we need to continue to discuss it, because two years from now we may be talking about totally different issues, and we can't just rely on the media to bring up the flagrant, cutting-edge kind of outrageous stories. There has to be a more thoughtful process put in place.

The Chair: Did you want to direct that to anybody, perhaps Dr. Vandelac?

Mrs. Karen Redman: Okay.

[Translation]

Dr. Louise Vandelac: I would like to make a few comments about what has just been said. On the one hand, I believe that up until now we've had a rather lax attitude about the evolution of techno- sciences, and we have witnessed a number of practices that are absolutely undesirable. It's quite urgent that we establish a number of simple and clear principles regarding the major thrust of research and especially the instrumentalization of the human embryo, which, in my opinion, should not be considered simply research material.

• 1105

This is a very weighty issue. We are creating a human life that would be at the disposal of others. From an anthropological standpoint, the consequences of what we're doing are extremely weighty. Of course, there must be a regulatory body, and I agree with Dr. Baird on that, but that does not mean that we have to abandon any legislation on a number of key elements, as this is something that should be welcomed. Having said that, the control mechanism would target existing and emerging practices.

My dearest wish is that we spend more time looking into the cause of fertility and sterility problems in this country. As you undoubtedly know, we have one of the highest voluntary sterilization rates in the world, and a number of reproductive technology practices are linked to these sterilizations. That's quite the paradox.

Moreover, we've just passed an environmental law in Canada concerning, among other things, the work to be done or not done in the case of 23,000 toxic products. And yet, we set aside the analysis of various aspects related to endocrine disrupters. That's extremely important because in Canada, as you know, we have one of the largest laboratories in that field. Following work that was done in the Great Lakes and the St. Lawrence, we have the best information currently available on the extremely harmful effects of endocrine disrupters on health, which are related to persistent organic pollutants. There are currently a large number of concerns as well as a presumption concerning the effects of these endocrine disrupters on the reduction of spermatogenesis. Within barely 30 years, in the United States, Canada and Europe, wherever the data is sufficient and conclusive, we run the risk of ending up with a natural fertility threshold in males below 20 million sperm, which is considered the threshold for fertility by the World Health Organization. Thirty years is very little time.

If an all-encompassing bill was tabled in the fall, we must not only examine issues concerning the regulation of existing practices, but above all do work that would enable us to conduct research and examine the main causes of fertility problems that some of these technologies claim to address, often with more perverse effects than anything else.

[English]

The Chair: Merci.

Mr. Clemenger.

Mr. Bruce Clemenger: Certainly social debate is important, and I believe it also needs to be ongoing, whether this bill is passed or not, whatever happens in the fall with the bill from the health minister. Looking retrospectively, we already have had a large social debate under the mandate of the royal commission, and then we had another debate around Bill C-47 and we participated there as well. At some point, it's time, rather than to be passive and continue to delay for the purposes of more social debate, for Parliament to act. And again, we would encourage them to set some parameters and decide what is unacceptable. Legislation can always be revoked and other legislation can be passed, but I think, given the common wisdom where we're at, let's make some decisions and say, no, these paths we won't go down, and put the limits, set up the regulatory framework and body.

I think the regulatory body, if it's set up appropriately and has a good balance of different groupings in society that have vested interests in this...then that can be a forum for continuing dialogue and debate, and maybe then legislation needs to be revisited and so on.

Part of our concern is that it's easy for us to pay attention when Parliament has a bill before it. If you have a regulatory body, then you need someone monitoring what the regulatory body is doing, and all the memos and are you on the list or not, and so on. The equivalent may be with CRTC or other bodies. Sometimes those debates seem to be taking place behind closed doors. You go and make your appeal, but the people making decisions aren't accountable the way members of Parliament are accountable.

So some decisions, some frameworks, need to be left to Parliament to decide. But again, we have had social debates. The debates should continue—we don't dispute that—but at some point we need to stop being passive and be active in terms of passing the legislation. I think this is a good start.

The Chair: Thanks for the plug about the accountability of members of Parliament.

Dr. Leader.

• 1110

Dr. Arthur Leader: Thank you, Mr. Chairman.

To answer your question, I think there is a need for legislation. I think it needs to be well thought out. I think the problems that have occurred in the past are the problems of consultation. There are people in all aspects of society who have something important to say, and they ought to be consulted and they ought to be listened to in drafting the legislation.

The royal commission had set up a framework. Some of the issues that are on the table today, and the issues that will be on the table in the fall, are issues that weren't part of the royal commission. There are gaps that exist, because at that time—remember, time has unfortunately elapsed—there were issues that were not important, or hadn't been defined by society as important, which they are now. I think consultation is critical. So that would be the first thing, the broadest consultation on specific issues. You can't have another royal commission. I think there is an urgency to initiate legislation, because society over and over has said that there are important issues here.

I think the second thing to think about is you're going to, if you haven't already, be addressing a bill on the Canadian Institutes for Health Research. Those institutes provide a research framework, and I would agree with Dr. Vandelac that in fact we need to do research. There is a Health Canada initiative on environmental toxins, and we were fortunate enough to receive a grant to look at ones that affect reproduction, but there needs to be more research.

Under the current framework of the MRC, there is very little money that's available for research in this area to answer the questions that a regulatory authority, or society, is going to want to have answered. So I think when you look at the Canadian Institutes for Health Research, as proposed, there's no institute for reproductive health in that. That includes sexual and reproductive health, because getting back to what Dr. Vandelac talked about, it's not just the environment, but it's personal environment. Infectious diseases still are an important factor in couple infertility. We know dioxins lead to endometriosis in the monkey studies that Health Canada has funded over the years.

So it's all tied in, and you probably can't address it all, but at least enable the research structure that's being proposed, which I think is a good one. The Institutes for Health Research is an excellent framework, but I think in the area of reproductive health it doesn't address it, and so it's something that will probably come on your plate in the future. That's another way of facilitating, because it's not only basic research, it's also behavioural research; it's research into the implications of health policy and the impact of that.

I think to my mind the best way to address it is to make sure you give direction to the people who have to implement policy, as to what type of breadth and what type of approach you want to take. My bias would be that it be all-inclusive and that you think about reproductive health within that context.

The Chair: Thank you, Dr. Leader.

We'll go to Mr. Vellacott.

Mr. Maurice Vellacott: First of all, I need a little clarification. I see here Canadian Fertility Andrology Society, of which Dr. Leader is the president, and I also see a reference in Dr. Miron's...this joint SOGC and the Canadian.... Is this Canadian Andrology and Fertility Society the same as the Canadian Fertility Andrology Society? Are they one and the same?

I don't know enough about the Canadian Fertility Andrology Society. Can you give me a little background? I didn't see a bio on that; on the composition, the goals, the intent of the organization.

Dr. Arthur Leader: I have it. Unfortunately, it wasn't bilingual so it couldn't be distributed, but I can probably, if the chair will permit me—

The Chair: As long as you don't read from it extensively.

Mr. Arthur Leader: I won't read the whole thing.

Mr. Maurice Vellacott: Just the read the goals and the makeup of it.

Dr. Arthur Leader: Basically, we have three missions. It's to promote the study, education, and research on fertility, sterility, and andrology. Andrology is the study of male reproductive function. It's also to respond to social needs with regard to the complexities of human reproduction, which is part of why I'm here today, to provide expertise and accreditation of clinical and laboratory therapeutic facilities in new reproductive technologies and to establish a valid process for the measurement of outcomes of therapy. Those are our four missions.

We're about 700 physicians, nurses, scientists, mental health professionals, and private citizens who are involved in the organization.

Mr. Maurice Vellacott: But it's not a commercial enterprise per se. It's a public body.

Dr. Arthur Leader: No. Under the laws of Canada, it's a non-profit organization.

The SOGC is the Society of Obstetricians and Gynaecologists, and where we have combined with our partners, the Canadian Council on Health Services Accreditation, is to develop a model for accreditation similar to what's being used in hospitals. In fact, at a meeting this weekend the IVF directors from across the country reaffirmed that this model of accreditation should be taken forward, and they have recommended that if there is any regulatory framework established, that accreditation, which is what is used to determine whether hospitals are living up to the best practices, be used as part of our licensing process. I don't know if that answers your question.

• 1115

Mr. Maurice Vellacott: Yes, it does.

Sometimes in the whole scenario of discussion here, and elsewhere, in the journals and so on, there is this, and I think it was brought out by several people today. Sometimes the term “therapeutic” is thrown out. You wonder in some cases whether that may be a guise for some stuff that is maybe not so therapeutic. I would just like a yes or no response from each one of you. If you want to give a qualifier thereafter, before I get to this other overarching question....

Would you acknowledge, whether non-germ line or germ line, that there would be non-therapeutic use of that, such as a more questionable or unethical or even sinister nature? Could that be done? Would you acknowledge that? Yes or no—and qualify it. Sometimes we talk only about “therapeutic”. Would you acknowledge that there is non-therapeutic or that under the guise of therapy that would be questionable, or maybe even sinister? Yes or no, a one-sentence qualifier, and then I have another question.

The Chair: When you add “sinister”, you're just inviting a deluge. Can we restrict ourselves just to the yes or no and maybe about ten seconds of...? Forget about the word “sinister”.

[Translation]

Dr. Louise Vandelac: Actually, these days we have to be extremely cautious with a term like that. There are a certain number of individuals whose plan is to cure human beings of this disease we call humanity. I'm not joking here. For a number of people, genetic improvement of the human race is an objective. Intervening in germ cells is riddled with problems, and such practices will be presented as therapeutic above all else. But one must be extremely vigilant about the way we will proceed because this exists in the imagination, it's in the air. A number of researchers have already admitted very clearly that their goal is to genetically improve the human race.

[English]

Mr. Maurice Vellacott: Good. I think you acknowledged yes.

Dr. Leader.

Dr. Arthur Leader: I would agree with Dr. Vandelac, that yes, there is always room for good people to do bad things.

Mr. Maurice Vellacott: Dr. Pierre Miron.

[Translation]

Dr. Pierre Miron: It's difficult for me to answer that question. Actually, I think that the objective of any physician is to improve care, and not improve a particular race, as Ms. Vandelac is implying. Our objective is to treat people and to help them. I believe there's always room for virtue and that people generally act in good faith.

[English]

Dr. Patricia Baird: I think inappropriate and unethical use is a possibility.

Mr. Maurice Vellacott: Beth.

Ms. Beth Hiemstra: We would say the same.

Mr. Maurice Vellacott: You would agree with that?

Ms. Beth Hiemstra: We agree with Dr. Baird.

Mr. Maurice Vellacott: I guess I'd be interested to very quickly get from you—

The Chair: You thought you were off the hook.

Mr. Maurice Vellacott: I'm not looking for a doctoral dissertation or a master's thesis, but almost in a quick abstract or a synopsis, what is your ethical framework? Bruce referred to some overarching principles or guidelines that would guide you with respect to reproductive technology in this area.

The Chair: Mr. Vellacott, with respect, while we give a lot of latitude, this one might go just a little bit beyond the area.

Mr. Maurice Vellacott: How can I ask a question that keeps me in bounds then?

The Chair: I don't want to suggest the wording for you, but just try to restrict yourself to where we're going on this bill.

Mr. Maurice Vellacott: You bet. I'm interested in terms of some overarching principles that you would suggest to us that might govern or provide some basic direction.

The Chair: Take advantage of somebody who has moved around the country and sought out some of those views.

• 1120

Dr. Patricia Baird: It might be useful for you to know that there's a chapter in the royal commission report that talks about the broad ethical orientation of the commission. We took an ethic-of-care stance, and that stance gives priority to the connectedness and mutual care between people. Within that we had eight guiding principles, such as autonomy, equality, non-commercialization of reproduction. I would suggest if you're interested in what the commission's ethical stance was, that chapter specifically looks at that.

The Chair: It's fair to say that's what Health Canada was referencing when it proposed Bill C-47 and the ethics associated with Bill C-47. Is that right, Ms. Colvin?

Ms. Phyllis Colvin: Yes, in Setting Boundaries, Enhancing Health, we have an ethical frame. It sets out the principles that were used in arriving at the decisions we took vis-à-vis the provisions in Bill C-47.

The Chair: Dr. Baird.

Dr. Patricia Baird: Very quickly, because I know you want to wrap up, we've referred to the royal commission a number of times, and if it would be helpful and useful to people, I have a brief overview paper on the findings of the royal commission and its recommendations, if anybody would like one. Should I pass it around?

The Chair: Dr. Baird, you can leave that here and we'll have our clerk distribute that a little later on. I think the committee is already in possession of something like that, but we're appreciative of the fact that you—

Dr. Patricia Baird: I sent one specifically on cloning.

The Chair: Okay, but we're appreciative of the fact that you've brought that synopsis for us. Maybe we can do it afterwards.

I am going to ask the other three to be very brief so that we can satisfy Mr. Vellacott's question about the ethical background or whatever principles.... I speak only for myself. I think I know where Dr. Leader is from.

Madame Vandelac.

[Translation]

Dr. Louise Vandelac: I would say that if we had respected the rules of the Nuremberg Code, which was one of the key elements of the development of contemporary ethics, a number of practices would not have been implemented. We thus could have avoided many problems.

The main thrusts are experimentation on human subjects and, on the other hand, other ethical elements that are absolutely fundamental, that is the objectification involved, that is, reducing human beings to the status of objects and instruments for the use of others. When I'm talking about human beings, I do so in a very broad sense. I think that we have to pay close attention to the issue of embryos.

[English]

The Chair: Merci.

Dr. Leader.

Dr. Arthur Leader: Mr. Chairman, I'm originally from Toronto, but I live in Ottawa now.

In a sentence, I would say that practices that are contrary to human dignity are unethical.

The Chair: Dr. Miron.

[Translation]

Dr. Pierre Miron: I would adopt the same position as Dr. Leader.

[English]

The Chair: Merci. Thank you, Mr. Vellacott.

I'm going to go to Ms. Wasylycia-Leis.

Mr. Maurice Vellacott: Bruce had a response. I didn't hear anything.

The Chair: I thought you acknowledged that you already knew where he was from because—

Mr. Maurice Vellacott: He said something about stewardship. That was all I heard.

The Chair: No, in his opening statement I think he said it, but maybe you'd like to repeat it briefly, Mr. Clemenger.

Mr. Bruce Clemenger: We had three or four operative principles—sanctity of human life, care for the vulnerable. Under sanctity of human life would be the concern about commodification, concern about the idea that we can manufacture or make people. There would be the care for the vulnerable, family integrity. We use those kinds of guiding principles.

However, within that framework, and I think also in terms of the royal commission's framework, you list a series of principles, and sometimes those principles lead you in completely different directions.

Everyone would agree about care for the vulnerable and everyone would agree with sanctity of human life, but at what point does your desire to care for the vulnerable and people with certain diseases perhaps begin to threaten the sanctity of human life. So it becomes a balancing act.

I think the issue is also that of human dignity. Many people talked about being sympathetic to bans on cloning a whole human being, but again, the issue is, what is a human being and when does a human being become whole? I think that's a subset of a lot of the debates underlying reproductive technology and genetic technologies.

The Chair: Thank you, Mr. Clemenger.

We're coming close to the end of this. I'm going to go to Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: I just have three quick questions. The first has to do with the discussion we've just had on ethics. It seems to me that one part of that ethical framework is the question of non-commercialization of reproductive technologies, as outlined in the commission's report. My question to Phyllis would be, is that principle part of the ethical framework under which the department is currently operating? Why would there be any re-opening of the question of selling of sperm and eggs?

• 1125

My second question is to Dr. Leader, who has sort of left the door open on this whole question of selling eggs and sperm. Why would we treat eggs and sperm any differently than we treat blood or organs? I think we're all worried about some of the developments in the States around the sale of organs, and again, under the guise not of the organ, but of the expenses or the inconvenience, whatever. I think Canadians do have a clearly defined set of values on this issue, and there is a rejection of a market-driven system. So I'm wondering how you separate it. Doesn't it open up the whole area, and aren't we going to take ourselves down a path of commercialization that we'll regret?

My third question is to Dr. Baird, who, at the outset, said she would have preferred to deal with this as part of a broader package. I certainly understand and support that, but in the absence of anything else, and not knowing when we might get legislation and what shape it will take, isn't it important for us to at least support Bill C-247? Isn't something better than nothing?

The Chair: Ms. Colvin, do you want to do this one first?

Ms. Phyllis Colvin: Yes. The non-commercialization, non-commodification principle stands from our earlier work. The report that was cited in the media, that in effect the government was moving off that, was incorrect. It was a misinterpretation of a conversation between an official and a reporter. It has subsequently been corrected in the media. If you'd like, we can refer you to the specific reference.

The Chair: Dr. Leader.

Dr. Arthur Leader: I think if society and a future bill say that payment shall not be allowed, that it should be non-commercialized, then patients and professionals will live with it. That's the law of the land. And if that's the will of Parliament, then that's what we'll abide by.

What I raised was not to be a proponent of it, but we live in a world of practicalities. There is a need for donor sperm, albeit less since the introduction of sperm injection, and there are women who suffer premature ovarian failure, for many reasons, and have a need for donor eggs. There are women, who at a later reproductive stage, in the middle of their lives, decide they want to have families and they no longer produce eggs. If it is the will of Parliament and the country that the egg donors or sperm donors not be compensated, then so be it. The advice we have from that attempt in the U.K. to not compensate sperm donors is that it doesn't work, and they've had to put it on hold.

The second thing is that it was not the medical or scientific profession that asked for egg sharing, egg bartering, or whatever words you want to use; in fact, it came from the non-medical members of the HFEA board. There were physicians who had some concerns, and who still won't offer that service. That was a consumer-driven request. So whatever is decided will be abided by. And a regulatory framework, with legislation, will guarantee it, because to not abide by the regulations will be criminal, or it will be illegal, if not criminal. I'm not a lawyer. I don't know how they will frame that.

But we are saying that practicality, when you're dealing with infertility.... And what you have to be aware of perhaps is the Supreme Court ruling in the United States, which talks about the right to reproduce as being a right—and it dealt with patients who had HIV, which is tangential to all of this. But there will be a greater and greater claim by those who are infertile that their issue is an issue of health, and that their issue should be covered by the Canada Health Act and should be ensured by both third-party as well as provincial insurance.

So the consumer will drive this. The practitioners, in terms of the remuneration, for banking and selling of sperm.... It really is almost at a break-even point for sperm. And for egg donation, it's market-driven, but not as profitability for the price that's paid to the egg or sperm donor. To reiterate, whatever is decided will be abided by. If a principle of non-commercialization is accepted, then we'll live with that.

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[Translation]

The Chairman: Thank you, Doctor Leader.

Ms. Baird.

[English]

Dr. Patricia Baird: I'll be very fast, 30 seconds.

You said is it better to have something than nothing, and pass this? If there hadn't been the bill that we hear is coming forward before the end of the year, I might feel that way. However, I really would be very sorry to see this bill passed unless the wording was changed in the way I recommended. If the wording were changed in the way I recommended, I could certainly live with this bill. But given that it sounds as if we're going to be getting some legislation before the end of the year, I would much prefer to wait.

The Chair: You would rather live with a promise? Okay.

Dr. Patricia Baird: If you keep your promises.

The Chair: I always do. Health Canada does too, I think. A bird in the hand.

[Translation]

Ms. Picard, I would invite you to give us a few brief final words on this subject.

Ms. Pauline Picard: Mr. Chairman, I'm very sorry to hear that we have to wait again because I believe that we've already waited long enough. We've been talking about this for 30 years and the Baird Commission was quite costly. We should be in a position to make a decision.

I'm somewhat disappointed in Ms. Colvin's answer to my colleague who said she was prepared to adopt a wording without further ado, which would at least represent a first step. Even if we adopt words that may not be fully satisfactory, we can always correct it. Human cloning must be prohibited. Why wait until the fall, until November or December? We don't know. It will be very difficult to have this kind of bill passed because until it is brought up for consideration in the House of Commons, things will have changed again and our final decision will still not have been taken.

We mustn't think that what is done elsewhere will never be done here. We don't know that. The advisory committee never mentioned anything about dubious activities that may take place in Canada. Must we wait until some scandal erupts before we take action? I would like to close the meeting with these comments.

Mr. Chairman, I would like to thank all the witnesses who shed light on these issues in various ways, but always with great seriousness, which will enable us to see clearly and make well- informed choices when the time comes to pass this bill. Thank you.

The Chairman: Thank you, Ms. Picard.

[English]

I'll take it from where she left off. On behalf of all committee members, I want to thank each and every one of you individually for having come today and shared with us your perceptions and your expertise.

Every time we deal with this subject—and it's now been on several occasions—from a personal perspective, I find it more and more intriguing, and I know the committee members find it more and more illuminating and complex. But we all have a position from which we begin, and even though it becomes more amplified, at least we're firm in the decision we'll take.

Again, on behalf of all committee members, thank you very much. I'm sure this won't be the last time we'll be talking with you, and I hope the next time will be even better than this time. And this one has been really good.

Thanks a lot.

I'm going to suspend for two minutes, and then we're going to come back and deal with the bill.

Thank you.

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The Chair: First of all, let me thank all those people who were able to be here last Thursday, both personally and by proxy. I know all members around the table would probably, if not profit, at least enjoy the debate that took place last Thursday. If you get a chance, take it from the Hansard. I think you'll find it useful. You won't be able to do that for today, obviously, but it might be well worth your while to do later.

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As your chair, I have a responsibility to deal with this bill today, because under the new orders, 97(1), we have to report to the House on this bill. I know it's been debated before, and of course it's the second time the committee has dealt with this. Today's dialogue and round table picked up where last Thursday's timetable left off.

But we have to deal with this bill and report it to the House; otherwise we will be in contempt. I fully intend not to be in contempt. I reserve that for other occasions. So we're here to deal with Bill C-247 today.

Madam Caplan, I think you wanted to say something.

Ms. Elinor Caplan (Thornhill, Lib.): Yes, thank you very much, Mr. Chair. I don't intend to speak at length, but there are a couple of things I would like to say. Part of it has to be the history. To keep it very brief, this is a topic that has been on the agenda for quite some time, starting with the royal commission. We then had a bill that died on the order paper, Bill C-47, which dealt with prohibitions.

The witnesses we've had before us, and Health Canada in particular, have told us that a lot has been learned, and the experience of Bill C-47 and the criticism of that legislation suggested that prohibitions were an inadequate approach to a complex and rapidly changing field full of ethical dilemmas.

Madam Picard brought her bill before this committee. She spoke to the bill, and the issue of banning human cloning, in principle, was not only supported in the House of Commons, but at this committee as well. Following concerns that were raised about this approach, we've now had full public hearings.

From what I've heard today, and what I'm aware of from the hearings of last week, I think a consensus has emerged that there is a need to act. This is a very complex field of rapid change, but what is needed is a comprehensive and integrated approach. In light of the evidence we've had before the committee, I will move the following motion:

That this committee report to the House that we not proceed with Bill C-247 at this time.

I say, in just briefly speaking to the motion, that as parliamentary secretary to the Minister of Health I'm aware, as the witnesses have testified, that comprehensive and integrated legislation is being prepared. That legislation will heed the wishes of this committee and the House when it comes to the proposal to ban human cloning, or cloning of a full human being. I think what has occurred at this committee has been very helpful, as part of the consultation process in the developing of that legislation.

So I would move that motion at this time, Mr. Chair.

The Chair: I gather it's seconded. It doesn't have to be, but I gather it is. Comments? Madame Picard.

[Translation]

Ms. Pauline Picard: Mr. Chairman, I simply want to say that I'm against this motion.

[English]

The Chair: Madam Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Just briefly, I would certainly join with Pauline in voting against the motion for a couple of reasons. One, I think there's uncertainty about when we will see comprehensive legislation. It's important to act as quickly as possible and curb whatever we can, in terms of this whole difficult area of human cloning.

The second point I would make is I didn't hear a consensus today, although there may have been one the other day at the committee meeting I missed, around absolutely ruling out the idea of prohibitions. I got a sense from people appearing before this committee that there need to be some clear prohibitions around some very important issues, such as human cloning, commercialization of human sperm and eggs, and other areas, as well as a very strong regulatory framework.

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So I think Pauline Picard's bill still fits within the consensus of the witnesses before this committee, and I would certainly support her bill and speak against the motion.

The Chair: Thank you.

I want to give everybody an opportunity to make a quick comment but not necessarily to re-engender the debate.

I have Maurice and Elinor.

Mr. Maurice Vellacott: I have a question, and maybe Parliamentary Secretary Caplan can respond.

What would happen if we passed this now? When that bigger, more comprehensive legislation comes together, could that somehow take precedence, or would it supersede, or could we then set this aside at that point? Is that a possibility, that if this passed now, that would somehow supersede?

Ms. Elinor Caplan: If I could have the floor—

The Chair: Just a second.

Mr. Maurice Vellacott: Procedurally, I wonder how that works.

The Chair: It's a procedural question. New legislation would supersede this one.

Mr. Maurice Vellacott: The new legislation would supersede. So if we were to pass this and it comes up better in the next...then fine, this is off the table.

The Chair: That's the way it would work procedurally.

Mr. Maurice Vellacott: For my part, then, I would vote that we proceed now, and I see no reason not to. When this improves it late in the fall, we're better off.

The Chair: Last comment, Madam Caplan.

Ms. Elinor Caplan: Actually, the last comment I'd like to make is in response to the consensus that I heard, which was that comprehensive and integrated legislation is needed and that this comprehensive legislation would or could and should include prohibitions as well as a regulatory framework.

The other consensus I heard was the concern that moving at this time in this way would have a potentially chilling effect on some of the important work that is being done; that the voluntary framework, while not perfect, is in place; that it's important to move in a comprehensive way, and if you do it piecemeal, one bit at a time, the message you're sending out—that was the answer from Dr. Baird—is, would this be better than nothing? The answer was no. I heard that as well. To me, consensus doesn't mean unanimity, and I know that was not the unanimous view, but I believe that was the consensus that was brought forth over the last two days of hearings.

So I put forward the motion in the spirit that I know there is legislation coming and that it will respond to the concerns that have been raised both in the House and at this committee. It will give us an opportunity to debate, as part of the process of that legislation, within that comprehensive framework, the issues that are before us today and will be before us in the future as a result of this very complex and rapidly changing field, and a simple approach is simply not workable. That was what I heard as the consensus.

The Chair: Thank you, Madam Caplan.

You have the very last ten seconds, Ms. Minna.

Ms. Maria Minna: I want to thank Madame Picard for the work she has done on the bill; there's no question.

From the first time we dealt with this, at the other meeting, and then this meeting, having heard the witnesses...a comprehensive type of legislation is best. For me, listening to Dr. Baird, who in the end said if she had to choose she would rather see something, if I'm going to vote, I would really like to be able to vote for legislation that is accurate, that is reflective, rather than something that we hope will be changed at some other time.

The Chair: Thank you very much.

Ms. Caplan moved that this committee report to not proceed with Bill C-247 at this time, seeing that comprehensive and integrated legislation is being prepared for introduction in the fall.

(Motion agreed to)

The Chair: I want to thank each and every one of you for your support over the last part of this session.

Shall the chair table the report in the House, as the seventh report of the committee?

Some hon. members: Agreed.

The Chair: Thank you very much.

Mr. Maurice Vellacott: So the motion we just passed guarantees that this will be tabled in the fall?

The Chair: The motion is a guarantee that the committee's chair is going to report to the House that it had this deliberation—

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Mr. Maurice Vellacott: No. Was the motion we read a guarantee that it is coming forward in the fall?

The Chair: I don't see how a committee can bind the House, Maurice. The only thing a committee can do is bind itself.

Mr. Maurice Vellacott: I'm asking if the health minister is bound—

The Chair: You can stand up when I raise it and say, hey, I think the House should move unanimously that this is what the motion intends.

Mr. Maurice Vellacott: I just wanted to hear the wording of the motion.

The Chair: I'll read it for you again. Just hold on.

Mr. Maurice Vellacott: Fine.

The Chair: It says:

That the committee report to not proceed with C-247 at this time, seeing that comprehensive and integrated legislation is being prepared for introduction in the fall.

Mr. Maurice Vellacott: In the fall.

The Chair: Yes.

Mr. Maurice Vellacott: So there you have it. It's on the record.

The Chair: Thank you very much, all of you, for having supported us in the last part of this session. I look forward to working with everybody when we come back to this table.

The meeting is adjourned to the call of the chair.