HEAL Committee Meeting
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STANDING COMMITTEE ON HEALTH
COMITÉ PERMANENT DE LA SANTÉ
EVIDENCE
[Recorded by Electronic Apparatus]
Wednesday, November 21, 2001
The Chair (Ms. Bonnie Brown (Oakville, Lib.)): Good afternoon, ladies and gentlemen. I'd like to call this meeting to order.
Before we have our witnesses, I have a little bit of committee business. It's really just in the form of announcements.
Most of you know we're coming close to the end, and we're aiming to go over a first draft of the report on Monday, December 3. We decided that at a meeting about a month ago. Since Mr. Ménard was a bit upset about us having a meeting on Monday, November 26, because he had not attended the meeting at which we decided on that date, I just want to remind everybody that we have agreed on two separate occasions now to meet on Monday, November 26, to hear witnesses we missed, because we did not travel. And we've agreed to meet on Monday, December 3, to have the first run at the draft report.
I think both meetings will start at 10 o'clock. So for those who aren't too far away, they might even be able to come on Monday morning.
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In addition to that, I wanted to tell you that on
November 27, that is the Tuesday, that meeting will be
the regular two hours, 11 a.m. to 1 p.m., and it will be
teleconferencing with the United Kingdom. On
Wednesday, November 28, it is a little bit of an odd
timing, at 3:30 p.m., which is the regular time, we
will sit for one hour and we'll hear two witnesses and
interview them, and then we'll have a break. We have to
come back at 7 p.m. I'm sorry about this, but it has
to do with the time change between here and New
Zealand; the witnesses are from New Zealand and they
are in the same time zone. So at 7 p.m. we'll resume
our Wednesday meeting for probably an hour or so of
teleconferencing with witnesses from New Zealand.
I had a question for you about November 29. The researchers tell me there are still a number of topics in the bill for which they are having a difficult time reading the committee, reading your intention. What they would like to do is put down on paper some of those issues and have us debate, in camera, so they get a view as to where you are standing on those issues. We know we have come to some agreements, but there are some they really haven't had a chance to hear us say what we think about.
Here's the problem. On November 29 we have two witnesses at 11 o'clock; I am hoping we can finish them in an hour. The other thing is, one of our colleagues, Ms. Beaumier, is seeking election as president of the Inter-Parliamentary Union on that day, and that meeting takes place at noon. I know for sure she won't be able to be here, and I think a lot of her colleagues will want to go and vote for her. But the discussion of those controversial issues was supposed to be the second half of that meeting. I'm wondering if we could work from 11 a.m. to noon, and then perhaps go down and support our colleague, if that's your choice, and then come back, even if it meant 12:30 p.m. to 1:30 p.m., or 12:45 p.m. until 1:45 p.m.
Would that be agreeable?
Mr. Rob Merrifield (Yellowhead, Canadian Alliance): I think it would be agreeable.
The Chair: If you didn't want to go to the IPU meeting, you could have your lunch at that time, or something.
With your approval, we will move forward with that plan.
Thank you very much.
Today we have three witnesses. Our first is well known to you, Maureen McTeer, a former commissioner on the Royal Commission on New Reproductive Technologies.
We welcome you here, Ms. McTeer, and the floor is now yours.
Ms. Maureen McTeer (Former Commissioner, Royal Commission on New Reproductive Technologies): Thank you very much, Madam Chairwoman, and thank you for the opportunity to speak to this group about issues that are not only of interest to me but I think of great concern to most Canadians.
This parliamentary committee will have two distinct and difficult challenges. First, it must create a legislative and regulatory context for the practice of reproductive medicine in Canada that uses current and future technologies and reproductive and genetic practices.
Second, it must envision and it must establish a legal framework with sound ethical principles to guide the scientific community for the use of reproductive matter, including human embryos, ova, and sperm, in research and therapy.
This afternoon, as a medical law specialist focused on law, science, and public policy, I will offer my own suggestions on both of these challenges, which are among the most important of our time.
Let me begin with the basic principles, which I believe are an essential part of any law the government will draft and Parliament will pass.
During the past 12 years, I have researched and reflected upon these questions, including my two rather unhappy years as an original member of Canada's Royal Commission on New Reproductive Technologies. Throughout this period, I have urged upon parliamentarians the following four principles. I ask that you consider them as part of the preamble of the bill that the government will introduce.
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First, the human body, its parts and its processes,
are not objects of commerce and must not be bought and
sold. Second, the human genome is a public treasure,
not a private treasure trove, and cannot be the subject
of a patent. Third, each Canadian has the right to
know their genetic heritage and to have it protected by
effective privacy and related laws. Finally, whenever
reproductive and genetic technologies and related
practices are used, the interests of the child to be
created must be paramount.
Why is it important to include these principles in the actual body of any law we propose? I believe it is because they state clearly what we as a society respect and expect of those using human reproductive material and they emphasize that the commercialization of human life is unacceptable. Perhaps most important for those of us who have joined the battle for equality, it makes it clear that the interests of children and of life deliberately created in vitro cannot be seen as less important than the interests of others in a position of power and control.
While I will offer specific legal language for amendments, which I will leave with the clerk of this committee for your attention, I would like to use my limited time before you this afternoon to speak to one point, and that is the mechanism by which these technologies and practices will be controlled and developed. Unfortunately, because so little of substance is set out in this pre-bill, we must all try to imagine what is being proposed.
The minister's pre-bill wants all authority and power for the licensing of clinics, the follow-up, the regulations for their operation, indeed every single aspect of the practice of reproductive medicine using NRGTs and related practices, to be headquartered in his own department. These proposals are a recipe for a bureaucrat's heaven where complete control is exercised within one federal government department.
We have no idea what rules will apply to what is referred to as “controlled activities”, which the act would allow under licence. Under what conditions would the health minister allow research on human embryos? What research would be allowed, and for what purposes? What regulations will be introduced in the bowels of Tunney's Pasture to give shape to the edicts of the health minister, and who, other than the minister and his department, would decide these major matters of public policies?
For those concerned with both democracy and transparency, these draft proposals are as clear as mud. In your work these coming weeks, I urge you to look beyond the narrow site of one federal government department and to create a regulatory mechanism outside of government responsible to Parliament that meets the needs of these revolutionary scientific advances. Why should you consider this? On the constitutional front alone I can think of at least four reasons.
First, one part of this challenge before you involves the delivery of health care to Canadians. This is a provincial responsibility. Second, doctors, nurses, and other allied health care professionals are licensed by provincial professional bodies. Third, it is provincial health care insurance programs that will have to be changed to ensure that all Canadians can have access to these technologies to help them found a family or obtain genetic information and testing. Four, it is provincial family, estate, property, and registration laws that will need to be amended to recognize the children born of these technologies and to protect their legal rights.
These are some of the reasons why the proposals here are both inadequate and untenable in the Canadian context. But the jurisdictional issue is not in my mind the most compelling one for refusing to create a new reproductive and genetic technology fiefdom in Health Canada. These issues are current; they're also controversial. They involve serious questions and they are profoundly political. Should we support stem cell research? Should we clone human embryos for research and therapy? Should we use reproductive material from aborted fetuses to create embryos for research, as is the case in Great Britain, for instance? Who will be denied IVF and on what basis? Will we allow patents on human life forms and the human genome?
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The challenge facing us goes far beyond the regulation
of fertility clinics and the doctors who practise in
them. There is a great deal of consensus on what we
want to happen and not to happen in fertility clinics.
We've come a long way here. Doctors, nurses, and
organizations like the Canadian Fertility and Andrology
Society, for instance, have done a great deal to
set standards of evidence and best practices in the
particular field of reproductive medicine.
If that were all that were involved, a law could have been drafted years ago, but this is not just about controlling fertility clinics. It is also about creating a mechanism, a think-tank, a place of real debate and dialogue, a place of some leadership, of decision-making, and of excellence in several fields, involving Canadians from many walks of life, including those in law, science, medicine, politics, health, and community advocacy. These are ongoing issues that involve ongoing challenges. This law must include a way for that ongoing debate and challenging to happen.
By their very nature, governments are married to the status quo. They resent those who interfere with their plans or dare to challenge their way of thinking. What Canadians need and what only Parliament can provide is a large, inclusive and dynamic collection of people and points of view with a mandate to communicate and educate on all the issues raised by genetic and reproductive technologies and practices, from sperm safety right through to research on human embryos, stem cells, cloning, and beyond. We need to ask and answer the questions of the future on an ongoing basis.
What are the current challenges and what are their benefits or threats to society's significant interests? What are the big research-in-science stories coming down the pike? How do we, as a community, want to meet the challenge of the commercialization of human life? What means are open to us to ensure that we, as individual Canadians, and you, as our elected representatives, keep control of this moving, growing, living challenge that science and medicine have offered us?
That is what I am urging, and nothing that I have ever seen in all of my past experience would suggest that this kind of leadership and challenge to the status quo can or would come from a government bureaucracy. This new law you are crafting must move us beyond the bureaucracy and control of the political and government machines. We can look to them for access to their expertise and to the thousands of reports and papers prepared at their direction with public money, but if we are serious about meeting the challenges that lie ahead in the fields of science and medicine, then we must not just pretend to think outside the box.
We must move the centre of power and influence on these questions back to Parliament and the people whose daily lives are affected by the threats and by the benefits of our incredible power to create, to manipulate, to alter human life in the laboratory.
These are the most exciting of times. Science is challenging us all, but all this pre-bill offers Canadians is government business as usual. That won't work.
I urge you to create the mechanisms we need to meet these exciting and revolutionary new challenges, to create a strong, publicly funded, nationally based and inclusive body, independent of any current government but responsible to us all through you, through Parliament.
I ask the members of this committee to give to Parliament and to the people the voice and power to set the rules. That is why you are here. That is what I believe we need.
Thank you.
The Chair: Thank you, Ms. McTeer.
Our next witness is Gordon Giesbrecht, who is a professor in both the Faculty of Physical Education and Recreation Studies and the Department of Anesthesiology.
Professor Giesbrecht.
[Translation]
Mr. Gordon Giesbrecht (Professor, Faculty of Physical Education and Recreation Studies, University of Manitoba): Thank you, Madam Chair.
Madam Chair, members of the committee and colleagues, it is an honour to speak to you today about the proposed legislation governing assisted human reproduction.
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I am a professor of thermophysiology at the University of
Manitoba, where I conduct experiments on humans under extreme
conditions. This work requires me to consider research ethics on
a regular basis. Although I am not an expert in the specific
experimental techniques covered by this proposal, as a scientist
I have several comments to make.
[English]
I might also add that for the past eight years I was a member of my faculty committee on the ethical use of human subjects in research.
My first observation is that the proposal deals with the creation of embryos for either reproduction or research. Sections relating to assisted human reproduction focus on children and families. In in vitro fertilization clinics, oocytes are obtained from donors or patients and embryos are created. Some of these embryos are introduced into either infertility patients or surrogate mothers with the goal of successful pregnancy and delivery.
The regulatory aspects of the proposal are welcome, and I support the approach of prohibiting payment or commercialization of either genetic material or surrogacy services. The proposal also focuses on genetic material for research purposes. I'm pleased to see that the proposal specifically prohibits work on human cloning. However, it certainly seems that the intent is to regulate but allow research resulting in destruction of human embryos for other purposes such as stem cell research.
My approach in analysing this proposal could best be described as embryo-centric. You've heard many ethicists and scientists agree that our human lives begin at conception. I would like to relate this to those of us here in this room and urge you to understand and appreciate that at the moment of conception our one-cell zygote was equipped with a totality of genetic material that makes us human beings.
That fertilized ovum had a complete complement of 46 chromosomes. Within it, three billion DNA base pairs made up all of the 30,000 or more genes that pre-programmed the cell for division and differentiation to various tissue types, organs, and biological systems required for growth and function. At that moment our sex was determined, along with our genetically inherent strengths, such as intelligence, and weaknesses, such as some diseases.
At a basic level, two main factors were required for our progression from embryo to fetus to birth to the leaders we are today. They were the physical environment to permit survival and time. Obviously other factors were important. Medical interventions may be required to permit survival in the face of non-genetically linked disease, physical trauma, poor nutrition, etc. As well, our socio-psychological environment does influence how or whether we achieve our potential. However, there was no magical point when the genetic programming changed to alter who we are.
In the remaining time of my presentation, I would like to emphasize two particular points. My first point is that destructive embryonic research should not be supported on moral, ethical, or legal grounds. As stated earlier, several embryos are created for reproduction in IVF clinics. They are sequentially implanted until pregnancy occurs. The remaining embryos have been euphemistically referred to as “leftovers”, “spares”, “not needed”, or even “supernumerary”. These embryos are frozen and can be stored indefinitely, donated to other infertile patients, or destroyed. It has been proposed that these embryos be used for research, which would ultimately result in their destruction.
I support the prohibitions listed in clause 3 on human cloning, germ-line alteration, and creation of a human embryo for research purposes. This prohibition is at least partly based on ethical considerations and the recognition that embryos are human beings and they deserve to be treated with dignity and respect.
However, it seems that clauses 8 and 9 set out conditions under which some of these prohibited activities may be approved under special licence from the minister. I would encourage the committee to limit the scope of subclause 8(1) to creating embryos solely for reproduction and not research.
I'm also deeply concerned with the pressure to license destruction of leftover embryos under subclause 8(2) for research primarily related to stem cells. This destructive research has been justified because these embryos will be destroyed anyway. I've always been concerned with this logic. In actuality, the leftover embryo in the IVF clinic is biologically equivalent to an embryo created specifically for research, which is prohibited under the proposed legislation. It follows that there should be no moral or ethical differences either. Thus, if it is believed that a human embryo deserves respect and protection, we should not sanction destruction of leftover embryos. Rather, we should prevent the creation of leftover embryos in the first place.
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This is not an unrealistic suggestion. First, it is
important to note that Germany and Austria limit the
IVF creation of embryos to those that will be implanted
at any one time. Second, some work has been done on
freezing of oocytes prior to fertilization. This
would allow the usual one-time harvesting of oocytes
from the woman while limiting the creation of embryos
to only those that will be implanted at any one time.
Legislators and funding agencies would provide a great
service by encouraging further research to perfect this
technology.
The other issue I'm concerned about is the changing value and protection of the human being during development. The age-old question arises: where do we draw the line for full respect and protection?
One common criterion used to determine when embryos can be destroyed for research is time. This is often 14 days, representing when the nervous system starts to develop. Any time-based criterion is troublesome. Do you use midnight of day 14 or do you actually keep track of the time of day at which each embryo was created? In either case, does it really make sense that an embryo could be morally and legally destroyed five minutes before the deadline but not ten minutes later?
Another criterion relates to observable events, including conception, the appearance of the primitive streak, organ formation, and birth. Since no one would sanction harvesting a 38-week-old fetus for research purposes, the line must surely be drawn at some stage prior to birth. As I stated earlier, the main difference between these pre-birth stages of development is simply the time allowed for that development to progress. The genetic material and programming in each cell or cells is unchanged from conception. Therefore, it would seem that protection at the earliest stage is warranted.
Now I understand that some members of this committee might resist adopting this position because it could potentially be applied to the issue of abortion. Although I do not personally support abortion, I feel that the position outlined above can be adopted without confounding the abortion issue.
Here I will refer to testimony given this past summer to you by Jennifer Leddy, from the Canadian Conference of Catholic Bishops.
She said this:
-
...in abortion there is a unique life situation in which
one life is within another.... There are competing
charter values.
-
In the case of an embryo that might be
experimented upon, the embryo is standing alone by him
or herself. They are alone. There are no competing
charter values.
This brings me to my second major point. Destructive embryonic research is not necessary on practical grounds. Until recently, it was believed that human embryos needed to be available for research because embryonic stem cells were the only significant source of undifferentiated cells, which may prove valuable for prevention and treatment of disease. Aside from the obvious ethical issues, there are several practical problems with destructive embryonic stem cell research.
These include: instability in gene expression and the potential to form the wrong tissue; uncontrolled cell division and the tendency toward tumour formation; and the possibility of immune rejection by the patient. As you know, recent breakthroughs have demonstrated another source that is unencumbered by many of these ethical and technical concerns. Adult stem cells can now be extracted from post-natal tissue, such as the placenta and blood from the umbilical cord, as well as from living humans and even cadavers. Advances in this area are proceeding at a rapid pace.
Next week you will hear a very detailed presentation by Dr. David Prentice on the clinical advances in human adult stem cell research, so I'll be brief on these points.
Human adult stem cells can be found in muscle, blood vessel walls, fat, blood, bone marrow, and brain tissue. These cells have been transformed into functioning muscle, heart, cartilage, skin, blood, and neural cells. In fact, adult stem cells have been successfully used in humans to treat breast cancer, brain tumours, multiple sclerosis, and sickle-cell anemia, and to repair heart damage due to heart attacks.
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The advantages of using adult stem cells include:
reduction in tissue rejection and in the need for
anti-rejection drugs; cell differentiation is easier to
control; and treatment is easier to implement as
injected cells migrate to areas needing repair.
Contrast this to the fact that, to my knowledge, no
successful treatments have been reported in humans
using embryonic stem cells.
Continued support for destructive embryonic stem cell research is often based on the philosophy that the ends justify the means. Individuals and organizations have highlighted the plight of unfortunate patients with potentially curable diseases such as Alzheimer's disease, Parkinson's disease, and diabetes. What means will a society tolerate if it perceives the ends to be important enough? I regularly conduct studies where I subject human subjects to significant discomfort in fairly extreme cold conditions in order to provide relevant information for medical practitioners.
My colleagues and I are constantly reminded of the possible abuses of the ends versus the means paradigm. During the Second World War, Nazi physicians blatantly killed over 100 prisoners in brutal cold experiments. This work is disdained today. However, it was originally initiated with the lofty goal of saving lives, as over 30,000 pilots and mariners died in the cold waters of the North Atlantic during the war.
What means would we tolerate today? We would never consider taking organs from prisoners to shorten transplant waiting lists. As we consider the destruction of human embryos for the purpose of research, we need to reverse the ends and means paradigm. We should first set our ethical and moral template, which would then govern, direct, and even focus future ethically acceptable medical research, even if it is more expensive and takes a little longer. As a biological scientist, I would predict that specifically encouraging, regulating, and funding adult stem cell research will provide timely benefits.
To conclude, I would encourage the committee to consider the following suggestions, which promote the protection of human life and the pursuit of alternatives for infertile couples and for therapeutic research.
First, I would encourage you to commit to the protection of human life in the preamble. Second, I would encourage you to maintain the prohibition on human cloning research. Third, remove the prohibitions that would allow the destruction of human embryos for research. Fourth, regulate the production of IVF embryos to reduce or eliminate the occurrence of leftover embryos. Fifth, promote technology that would allow preservation of human oocytes prior to the creation of embryos. Sixth, promote counselling of infertile couples to use other techniques including fertility care facilities and embryonic adoption services, such as the Snowflakes Embryo Adoption Program in California. Finally, focus and promote research using adult stem cells for therapeutic purposes.
You will note that some of these recommendations are not directly covered by the draft legislation. However, they could each be dealt with at some level by the proposed arm's-length regulatory body.
As a last point, I would encourage the committee to ensure that representation on this body include not only politicians and scientists but faith-based and ethics groups as well.
Thank you again for the opportunity to address the committee. I've cut out several parts of my comments to save time. I have the full text available, including the visual slides, if you want to see me after the presentation. Thank you very much.
The Chair: Thank you, Dr. Giesbrecht.
We were expecting a third witness, but she doesn't appear to be here yet, so I think we'll begin the questioning.
As usual, we'll begin with Mr. Manning.
Mr. Preston Manning (Calgary Southwest, Canadian Alliance): I'd like to thank you both, and I have a lot of questions for both of you. We'll probably get two rounds, so I'll start with Ms. McTeer.
I'll come to you second, Dr. Giesbrecht.
Maybe you'll deal with Dr. Giesbrecht in your round, Rob.
First of all, with respect to the fundamental principles that you felt should guide the regulatory body and be embodied in the preamble of the legislation, the first of those was that the human body and body parts should not be the object of commerce. I assume you mean they should not be treated as property.
How would you state that positively? How should they be treated in law? You've made it clear: not property because it leads to commercialization. What's the positive definition?
Ms. Maureen McTeer: Again, I think one of the important things is to remember that the law has been very remiss in not assuming that because a human embryo is different from a chair, it had the responsibility to find new ways of protecting innovation, as in the case of a patent, for instance, without necessarily reverting to the notions of property, which we think of in the context of inanimate objects, as an example, or even of certain higher life forms like animals.
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I am presently, as part of research I'm doing myself,
looking at legal options to the notion of property as
it relates to patenting of genetic material. I think
that's important because we have certain laws already
in place, for example, anti-slavery legislation, which
assumes that humans, post-birth, cannot even agree or
consent to bind themselves into slavery or to sell
themselves into slavery. It is a common human value
internationally, even though there are obviously abuses
in certain countries. It is an accepted grundnorm,
as the Germans call it, for any public policy
or public legislation that you in fact do not allow the
human and all that is human to be treated as private
property.
I think it's important, and you raised it and I know Dr. Leddy raised it: there is a need to finally begin to recognize that these technologies force us all to rethink, and to do so outside of the context of the abortion debate, because there are two competing interests. There is a public policy decision that has been taken, but in this case, where you deliberately create human life in vitro, you have the opportunity to in fact enlarge law's definitions to provide protection because it is human life.
I'm sure your Justice drafters can figure it out. It's something I will be addressing in terms of the actual wording, but I wanted the principle to be clear: that what is threatening here is the notion of the human body being trivialized, the notion of human being trivialized, which I believe it is when we allow law's language of private property to encompass it.
Mr. Preston Manning: Secondly, as you've noticed in the draft bill, in fact, the only statements of values or principles are in the preamble. I think you've connected your four principles as though they should be part of a preamble.
Do you worry about the status of preambles in law generally, that courts don't treat preambles with the same authority as other sections of a bill? Do you recommend that, whatever the values and principles in the preamble, they somehow be infused in particular clauses in the bill itself?
For example, let us take your provision that the interests of the child should be paramount. We can state that as a general goal in the preamble. In fact, I think there is a vague reference to it there. Is that good enough? How do you infuse the rest of the bill with that ethic other than just in the preamble?
Ms. Maureen McTeer: I think that's a hugely important point. There's no doubt that preambles usually serve to guide judicial decision-making. They're a way in which Parliament can remind judges that this was what it had in mind and that it wanted the actual judicial interpretation to be tempered or enlarged or enhanced by the wording of the preamble.
I agree with you that it needs to be clear that it is more than a statement of values, that it is in fact a part of the legal framework. I think this is an essential responsibility of the legislation. So many of the international covenants have “whereas” and “notwithstanding” and all the language of law in their preambles. I want these values to in fact be protected, to be legally protected, and I don't see, for instance, the treatment of the interests of the child as paramount as a value. I see that as a right.
If that is the case, then, the lawyers, the drafters, have to find a way to integrate that into the body of the bill.
Mr. Preston Manning: Do I have two more?
The Chair: One more.
Mr. Preston Manning: One more? I'll have to try to combine the two.
You mentioned the external regulatory body. You mentioned that it was actually on sounder constitutional ground than if the whole regulation were under the minister. I wasn't quite clear on the reason for that, but here is my main question. We have heard a lot of witnesses talk about the need for independence of the regulatory tribunal, but also about the desire for accountability, that it not be so independent that it's just floating out there, so that when you ask the minister questions in the House he can say, “Look, you built all these firewalls between me and the regulator, so don't ask me what they're doing. You set them up as independent, quasi-judicial, and at arm's length.”
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I agree with the need for an external independent
regulatory body, but how do you hold it accountable? I
mean really accountable, not just the nominal “reports
to Parliament, reports through a minister” kind of
accountable. We all know of all kinds of bodies that
have that nominal accountability, but it's not much of
a tie or a link. How do you get accountability matched
with your external independent agency?
Ms. Maureen McTeer: It's always a very fine line between accountability and political interference. I did live through that in terms of the royal commission. When governments have their own agendas, they do have a tendency to want to control those agendas.
I think we have to be realistic here. If we are in fact going to create a body that's independent, the reason we're creating it as independent is that the issues are of a nature that moves us beyond the political process in both a specific and a general sense. These are issues of science, they're issues of medicine, and they're issues some of which have yes and no answers. Is the sperm safe? That is a yes or no answer. There is a way of finding out if the sperm is safe. Is the embryo viable? Is the embryo suffering from a genetic anomaly? Increasingly these will be answers to which we can have a yes or a no.
In regard to the larger public policy questions, the government has to generally set lines, and as you know, you will be doing that with your legislation. That is the purpose of the legislation. You're going to need to have ongoing thinking. As an example, England has a model that I feel is a good model, because unlike some of the American models it comes from a legal history that we share. I think the British model, the Human Fertilization and Embryology Authority, is a good example. I'm glad you will have an opportunity to speak with them there. I did my Master's thesis on it. I didn't really adopt it because it suited me for my academic purposes, but I felt I had an opportunity to look at it in some depth.
One of the things this does is establish a body that has several purposes and mandates. I think it's very important. If you give a mandate to a group that's independent, Parliament can hold it accountable because it has a specific mandate. If the group goes off and starts growing tulips somewhere, then obviously you know that is not within its mandate and you should have some control to reign in the group.
When I say they're political issues, I mean they are very political. Some people want to have research on human embryos. Some don't. Some religions, of which mine is one, do not believe we should have most of these technologies; they believe they should be used in very few situations. We have this conflict.
The purpose of such an independent body is to in fact work continually to educate, to inform, and to communicate, but also to try to reach consensus beyond the narrow internal nuts and bolts, which I identify as the responsibility of a government department.
For whatever reason, we don't seem to have many of these kinds of think-tanks, as I call them, in Canada. We don't make that a priority. We don't seem to have either the funding or the tradition that they have, say, in the United States. Even if there's a political ideology to it, there is that kind of money.
I believe that this Parliament, any parliament, can hold independent bodies to account, but they must have a clear mandate and they must know what they're doing. Once they have that mandate, there should not be political interference. There should be parliamentary involvement; there should not be political interference.
The Chair: Thank you, Mr. Manning.
Mr. Merrifield.
Mr. Rob Merrifield: I want to thank you both for being here today. It has been really interesting.
I want to pick up from where Mr. Manning was at with regard to the regulatory body, because it's really paramount that we get this as right as we possibly can. I'm struck by what Ms. Maureen McTeer has said with regard to the provincial involvement and the provincial jurisdiction that we're treading on.
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For this regulatory body, would we be best to have a
broad canopy that is maybe not that intrusive on a
federal side and have this dealt with in a regulatory
body on a provincial basis because of its provincial
jurisdiction? Although there may be some patchwork
underneath that, is that something we should have? How
would we get around, let's say, the jurisdictional
issues if we don't go somewhat down that line?
Ms. Maureen McTeer: It's a lawyer's heaven, too, if you think about it, because if you proceed this way you'll be guaranteeing litigation for years. Many of us will have a great time.
I think we have to be very aware of the nature of our country. As an example, the dilemma with the royal commission's recommendation that we in fact adopt the British model, which in fact is the model of a unitary state, is that it is unrealistic because of the division of powers in our country.
I have no objection to the federal government creating this arm's-length model and setting, if you will, the umbrella, but within that there are different challenges. For instance, there's a technical challenge: the technical challenge of licensing fertility clinics. That's a technical challenge that has need for a large provincial involvement because it involves the practice of medicine in different provinces and it involves the access—or not—to provincial health care schemes and to funding, which is, I think, a huge issue in terms of these questions.
So you would have in this large body a specific set of mandates. One mandate would in fact be the regulation, licensing, etc., of fertility clinics and the activities that go on within fertility clinics. It would be essential, I think, that the medical profession be on that body. It would be essential, I think, that the provincial government be on it, and it could make the decision as to membership, but obviously they would be health-related people.
There are other aspects of it. For instance, there are the think-tank elements, if you will. What are the issues coming down the pike? Are we going to allow patents on the human genome? If we're not going to, how are we going to respect innovation and keep our international leadership in terms of biotechnology? You have all these questions, which would have a different grouping of people, and I think a larger rather than a smaller number of people. Even when there doesn't appear to be any cohesion or consensus, I think with correct leadership or proper leadership within these groups we can achieve that.
Why do I think it's important to keep it outside of government? If I were a government, I wouldn't want that responsibility. I just wouldn't want the hassle of the politically explosive nature of most of these issues continually coming before me and before my cabinet and Parliament every day. I would want to be able to say we have an independent body, we have given it the best possible membership and mandate, and we must now assume that it will do its job.
Of course you want to control it to the extent that you have accountability, but if I were a government I wouldn't even want this within the Ministry of Health. These are hugely explosive issues. No government would want to have this coming down every time they turned around in terms of question period.
Mr. Rob Merrifield: Okay. I'm not sure if that really answered it, but I appreciate what you're saying and I understand what you're saying.
I still think the jurisdictional issue becomes a real problem, but I know my time is limited and so I want to—
Ms. Maureen McTeer: I think it would be delightful if there's any issue in Canada where the jurisdictional issue doesn't play. I mean, if this is it, then that's great. We've discovered one.
Mr. Rob Merrifield: Yes, exactly.
Mr. Giesbrecht, I'm intrigued by your presentation with regard to this piece of legislation.
I think both of you are on the same page when you are suggesting that this is in the best interests of children and that's what the preamble should dictate.
I see such a hypocrisy within this piece of legislation from the preamble to actually going on to suggest that we're doing things in the best interests of children, and yet we're allowing in vitro fertilization in which perhaps spare embryos are being produced that under the definition of the biology are children and would be destroyed under the present draft.
The 14 days is something that strikes me as to where we have the cut-off. I was struck by your questioning that as well. When we go back to that, from a purely physiological perspective, can you expand on that a little bit as to how you see it?
Prof. Gordon Giesbrecht: Yes, there are at least three criteria I know of that make 14 days magical. One is that implantation is usually finished by that time. Related to this legislation, that's not relevant because we're talking about things happening outside of the womb.
Second, the primitive streak usually starts to appear at this point, which is the beginning of the formation of neural tissue. Also, the embryo is now developmentally single. All this sort of came out in the late seventies, early eighties. Supposedly, after the primitive streak is formed, twinning cannot take place. Genetically and developmentally it's single. That is one of the reasons 14 days has been used.
There are problems with all those criteria. The first one, implantation, of course, is not relevant in this case for using embryos for research. If I want to play devil's advocate and talk about the primitive streak and formation of neural tissue relating to the brain, I could just as easily say, “Don't bother me about neural tissue. Tell me when there's a brain in there and that you can actually measure activity in the brain and I'll buy the fact that this is now a human being.” Of course, I'm not sure exactly when that would happen along the developmental process, but nobody is accepting that.
As far as the developmentally single aspect goes, indeed, once the single axis has been created, generally twinning can't take place, but there are examples of when it can happen after that. Conjoined twins or Siamese twins happen when twinning occurs after the primitive streak has been formed. There is also a condition called fetus-in-fetu, where another fetus has actually formed inside the first fetus. These are examples of twinning taking place or another individual occurring after this 14-day limit.
So could we say—and I don't know the number for this—that if we know that conjoined twins can't occur after x number of days, whether it's three or four weeks, I don't know, maybe we should wait until that point, at which point we could say for sure that twinning can't take place so that indeed this is guaranteed to be a single entity? Now you've opened the window for research even farther.
So all those things are questionable, but what is not questionable is that at conception you have the full genetic complement. If I take a skin cell from me right now, the DNA complement in that cell is exactly the same as my one-celled zygote had at conception. There's only one difference in it. As I said before, you have all this programming in that first cell, and the only difference is that those programming subroutines haven't had a chance to run yet.
I liken it to having a comprehensive office computer program like I have in my computer. I might use only 3% or 4% of it. For instance, if I have Microsoft Office and I only write one-page letters from the word processing program, from what I see and what I use it's a very limited program, but that's not the fault of the program. There are many programs and subroutines in there that just haven't been used or run yet. If I go to the store I still have to spend $500 or whatever it is for the program. It's not worth any less because all the pre-programmed subroutines haven't been used.
The Chair: Thank you, Mr. Merrifield.
Ms. Maureen McTeer: Would it be possible to just add one tiny comment on this, if I may?
The Chair: Yes.
Ms. Maureen McTeer: I hope the committee realizes that as for language like pre-embryonic, which is really what the British use and which is generally accepted as being acceptable language for the human embryo developed in vitro prior to the appearance of the primitive streak...I hope this committee will be willing to include all embryonic life and not accept differentiation based on times of development, because of course the most controversial research is in fact at the earliest stages, much prior to this.
• 1630
As a lawyer, I think if the human embryo, life
before birth, has no legal status, why is it that we
have created a new category and called it pre-embryonic,
if for no other reason than to create the
opportunity to dismiss that stage as not embryonic per
se, as not part of the human family, and as no
more than reproductive tissue? Of course, that has a
profoundly different impact on us morally, and since it
has no legal difference morally because we think it is
not part of the human family, it is no more than
human reproductive tissue.
So I would hope this committee would be aware of that and unwilling to separate the challenges based on a period of development and call it pre-embryonic.
The Chair: Thank you.
[Translation]
Ms. Picard.
Ms. Pauline Picard (Drummond, BQ): Thank you, Madam Chair.
Mr. Giesbrecht, in your presentation a few minutes ago, you seemed to think there was some contradiction between clause 3 of the draft legislation, which prohibits human cloning, and clauses 8 and 9 which, you stated, "set out conditions under which some of these prohibited activities may be approved under special licence from the minister." You also have concerns about clauses 9(1) and 9(2), "which may licence creation of chimeras or the combining of animal and human genomes."
Could you explain why you see a contradiction between clause 3 and clauses 8 and 9, and also explain your concerns regarding clauses 9(1) and 9(2)?
[English]
Prof. Gordon Giesbrecht: First of all, I think Ms. McTeer pointed out very clearly that this bill is very ambiguous in many ways in that so much is left open to interpretation and control of the minister as he or she grants licences.
Clause 3 is under “Prohibited activities”, and I'm not sure exactly what you're getting at with the question. But in clauses 8, 9, and 10 actually, there are different situations where if you can get a licence from the minister you can conduct these activities, and they're very, very...getting to combining non-human and human genomes. It's a pretty wide spectrum of things that can happen in there. That can be anywhere from just sort of inserting something, genetically splicing to allow an enzyme process to occur better, to creating organs, to creating an entire entity or a being that has genetic material from animals and humans.
First of all, the ambiguity and the wide scope of that concerns me. Indeed, it says it's prohibited, in at least clauses 3 and 4. There are ways to get around that, if you can convince the minister to get a licence for it, and of course at least in the bill there's no provision or description of how that will happen. We've heard about a regulatory body—the background information for the bill discusses that that should happen—but the information I've seen is just one paragraph that talks about there being this governing or regulating body.
That's a lot of power to put in the hands of a regulating body, to say that this activity is prohibited, but if after your deliberations you see fit to provide a licence...so if you have a scientist or an institution come and make the right argument, those things that were prohibited will be allowed; even if it's in a specific area, a focused area, it's still....
• 1635
Without more of a framework in the legislation—and
here you get the legislation versus
regulation aspect—and you go on years from now, when
the scientific advances have changed and
people's opinions may have changed, a regulatory body
can have a lot of power to allow things that we might
not accept today. But because it's not set out in
this legislation, they're free to do as they will.
[Translation]
Ms. Pauline Picard: I would like to clarify another point. From your presentation, I take it that you agree fully with prohibiting therapeutic cloning. Is that right?
[English]
Prof. Gordon Giesbrecht: The words I used were that I'm happy with the prohibition on human cloning. That is what I said. Of course, then we get the differentiation between reproductive cloning and therapeutic cloning.
Just like any other aspect in this broad continuum of things we do once we move outside of the womb and start playing around with things, this therapeutic cloning is the thin edge of the wedge on our way to allowing human cloning. I have big concerns about that.
Right now it seems that most Canadians would flat out say “We don't support human cloning”. Ten years from now, if we've been conducting therapeutic cloning, maybe public opinion will have changed because of that. Even though now it might be clear, several years from now it might not be so clear. Public opinion changes over the years. Many things we thought were unthinkable 10, 20, 30 years ago are commonplace now, because either we've improved on the technologies.... Five years ago it was unthinkable that we could actually use adult stem cells to do anything meaningful. So technology has allowed us to do things that we didn't think were possible. As far as other issues, 40 years ago we would have thought it unthinkable that we would have state-sponsored abortion, for instance. Over time people's opinions changed and now we have it.
One thing is for sure. I do not support, and I think most people today would say they do not support, the concept of human cloning reproductive-wise. I'd be very leery about opening the door through therapeutic cloning.
[Translation]
Ms. Pauline Picard: Ms. McTeer, what do you think? It is clear that you agree with prohibiting cloning for reproductive purposes, but what is your view on cloning for therapeutic purposes? And how do we go about this, since, as you mentioned, we do not want to hold up scientific progress if it may lead us to a cure for diseases such as Alzheimer's or cystic fibrosis, or genetic disorders?
What should we put in the legislation to avoid abuses and to ensure that human beings, or their cells, are not used for other purposes that would shock us, that would be inconsistent with human dignity?
Ms. Maureen McTeer: In my view, that is one of the main reasons why we must absolutely establish a framework in which decisions will be made. That is why I think that it is not possible to settle everything by means of a bill. We must therefore develop basic guidelines and flesh them out sufficiently so that people will know what the prohibitions are based on.
However, we must realize that these issues do not relate solely to current situations; they continue to expand. It's a dilemma. I follow all developments having to do with stem cells very closely. I was glad I was able to be in Washington, in early September, when Senator Kennedy invited some very interesting people—people who had prepared draft legislation, but also ethicists, philosophers, members of the clergy—people who came there to share not only their experience, but also their wisdom, in these matters.
• 1640
The framework in which these decisions will be made is a very
important consideration. We have to be careful when we talk about
cloning. We cannot start off, as we did in the earlier Bill C-47,
by saying that there will be no more cloning because we want to
prohibit it entirely. There are different kinds of cloning. We have
the case of people who are in great pain, who have been in an
accident or who have suffered burns to almost all of their body.
Cloning of skin cells is already taking place. Consequently, there
are some aspects of cloning that are less threatening to us as a
society than reproductive cloning.
I am a lawyer specializing in medical law. I am not a physician and I do not do any medical research in this area, but I can affirm that it is very difficult for some people to accept that, where there is a possibility of curing some diseases by using stem cells, a ban is imposed right away, without consideration being given to the circumstances. You have perhaps known people like this, or you may even have people like this in your families.
I agree completely with Dr. Vandelac on one point. I know her very well and I know that she is always late, although I find that she has gone too far today. At the beginning of our work for the Royal Commission on New Reproductive Technologies, Louise Vandelac made a point that I found fundamental, that is, that we should not restrict ourselves to what can be done currently, but always look to the future and consider what kind of research is being done, on domestic animals, for example. This will give us an idea of the issues that will have to be examined in one, two or three years.
I do not think that we are in a situation where we have to deny our research. We have adult cells. I find that what President Bush did is fascinating. Before August 11, stem cells and embryos were not worth very much. Now, they are protected as though they were sacred beings or objects. We must be careful. There is a certain logic to it, but we also need a defensive framework in which we will be able to make decisions continually. We must not say that something is worthwhile today, but that tomorrow it is not worthwhile. We must be disciplined, and these frameworks are already available.
The Chair: Mr. Bachand.
Mr. André Bachand (Richmond—Arthabaska, PC/DR): Thank you, Madam Chair.
Thank you very much for coming today, Ms. McTeer, and thank you for raising the question of jurisdictions as well as the important issue of the powers of our ministers. We should review this issue, and that is why the committee will continue to work on drafting the preliminary version of the bill next week.
I have a few brief questions. Earlier, you mentioned the British legislation, the Human Fertilization and Embryology Act. The court case was lost in this regard, supposedly because of the pro-life movement, because the British allow cloning for therapeutic purposes. Is it your opinion that human cloning for therapeutic purposes should be allowed?
Ms. Maureen McTeer: I do not think that we are there yet. I believe it is important to set priorities that acknowledge the fact that scientific research is essential, but it is also important for us as Canadians to determine the context in which we will allow this research. We know that research on embryos is already being conducted. There is pre-implantation diagnosis to help couples who have a genetic disease in their family make important decisions. They use pre-implantation diagnosis to make sure that only unaffected embryos are transplanted into the woman's uterus. At that point, there is a possibility of doing research on this disease using embryos. In this sense, we are already conducting research on embryos carrying these diseases.
Mr. André Bachand: Excuse me for interrupting you, but the chair is very strict with our time. I am sorry and I am doing it with all due respect.
Therefore, you think that this part of the British legislation goes too far.
Ms. Maureen McTeer: It is the only country in the world to allow this, moreover. We must realize that, for them, what is at stake here is keeping up with American researchers. They want to win this biotechnology race with the Americans. There is thus a very specific reason behind their decision.
I do not believe that we have reached that stage. As the doctor said, our research can be taken much farther before we get to that point. I do not agree with research that leads to the destruction of embryos. That is a personal decision, but it is what I recommend. There are other options available, and we have an obligation to consider them before beginning to destroy embryos.
Mr. André Bachand: The current draft bill is flawed, but we hope we will be able to change it. You very clearly pointed out—as a number of other witnesses did—that clauses 8, 9, 10 and 11 prohibit certain activities, but makes them controlled activities. Therefore, the minister may, through the power vested in him, decide whether or not to authorize these activities. The bill states that everything in those clauses can be done. Which of the activities do you find acceptable, and which do you find unacceptable?
I know that this is perhaps going into the details, but would you be in agreement, for example, on the issue of chimeras? In the final analysis, the bill permits the creation of an animal species genome. Do you agree with this or should we simply withdraw it at this stage? Similarly, there is the issue of surrogacy. Do you agree with the principle of surrogate mothers? Which of all these activities should we allow, in your view?
Ms. Maureen McTeer: I will deal with this in writing for the committee.
As for surrogate mothers, I know that Louise opposes this. We have had many discussions on this subject. I think that the commercial aspect is very important and I think that it is also crucial to ensure that the reason behind the use of these techniques is to create intimate, permanent relationships, rather than just make someone happy.
For example, it often happens that a woman will be a surrogate mother for her sister, without money changing hands. If we are talking about a long-term, permanent relationship that is truly in the child's best interest, then I am not against it. I know that Louise is against it, but I personally am not. I am against it if money is involved.
Furthermore, it is very difficult to understand how one might be able, even between sisters... If the sister is infertile and wants to have a child, and she is only asking her sister for an ovum so that she can become a mother, how can her sister refuse her? In such situations, the law has a responsibility that goes beyond the law, taking it for granted that there are certainly important circumstances in which undue pressure may influence decisions made by people.
Mr. André Bachand: I have one last question for the doctor.
In your recommendations, you talk about human beings and you talk about including, in the preamble, the phrase "committed to the protection of human life". Could you give us a definition of human life? We have heard various opinions: 14 days after conception, three months for the brain. You do not have to do it today, but could you give us a definition of what is a human being? In the draft bill, a woman is defined as a female person 18 years of age or older. Why 18 years of age? It is a choice that was made, as in the case of the 14-day period. These are choices that we as a society must make. However, the human being is not defined anywhere in the draft bill. Do you have a definition to propose? That could give us some guidance in approaching the bill as a whole.
Prof. Gordon Giesbrecht: You had fairly well unanimous feelings from the bioethicists you had here that a human being is formed at conception. That would certainly be my position. From my reading of the testimony here and my own feeling, I don't think there's that much conflict on whether it's a human being at conception or not. The question always comes around to the person. Who then should that be, when do we apply protection, and does the protection change throughout gestation? That was one of the points I mentioned.
I'm always very leery about...because if you name any criterion, whether it's time-based or because of some observable event, I can always make an argument, as devil's advocate, that if we go just a little before that, this would be better, or a little after that.
The only event you can't do that with is at conception, where you have the totality of the genetic programming in that cell and it becomes different from the previous cells. An oocyte can only be an oocyte, but once you become an embryo or a zygote it has everything in there to...if you run all the subroutines in the programming, you end up getting differentiation, division, and you start growing to the bodies we have now.
I should like to clarify an argument I made earlier. I'm not sure with the translation how this....
I said I could make an argument that we could go further on past the 14 days because even though we have neural tissue, it's not a brain yet. That wasn't my position.
The Chair: Thank you, Mr. Bachand.
Dr. Dromisky.
Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.): I'd like to direct my questions to Madam McTeer.
It's regarding your principles, and I think on the third one you emphasized transparency. I'm not too sure how far that transparency goes and whether it includes all information pertaining to donors and sperm donors and so forth.
Would you clarify the third principle for us?
Ms. Maureen McTeer: I believe donor anonymity has to end. I believe this is obvious when we have the right to protect our genetic heritage. We need to have access to it.
When we started the royal commission, of course, this was less important in some ways than it is now because we now see the strong links between genetic health and general health. So if I can never know who my genetic father or mother was, if I was conceived by donor sperm, by donor ova, and gestated by a surrogate and raised by a different set of persons who act as my social parents—if I can't know my genetic heritage, then I can't protect it.
It also affects us in other ways. For instance, one of the stories of the royal commission, which I often share with people, was of two women who came to talk to me about the fact that they had, after a long process, discovered that their son and daughter were half-brother and half-sister because they had the same donor. Part of the interesting thing was how they came to find that information, but I won't detain you here with it.
The idea was that here they had two children, one male, one female, who adored each other, who even looked like each other, who were inseparable from the time they met in junior kindergarten, who only through happenstance discovered that they had a genetic father in common.
• 1655
The dilemma with that is that the Criminal Code is
very clear. It is punishable by 14 years in prison to
have sexual relationships with a half-brother
and half-sister.
We are in fact now allowing these technologies to create children who can never exercise their genetic health options available to them because some of these genetic conditions can be treated successfully if you know you have them before. Also, they would never be able to have full advantage of existing laws, and in fact they could fall subject to very serious recriminations and sanctions under the Criminal Code simply because they didn't know who their genetic father or mother was, depending on whether or not it was a donation on both sides.
So I think it's very important that these kinds of questions, donor anonymity being one, be addressed by this committee, because I do think it is no longer possible to pretend it doesn't matter.
Mr. Stan Dromisky: Being a lawyer, you'd appreciate the kind of legal situation we find ourselves in. Much of the sperm used in the clinics in Canada is from the United States and from a variety of states with different rules and regulations. And they purchase these donations from a wholesaler in Toronto.
Here you have a situation where you have provincial laws, state laws, and federal laws making the whole problem very complex. I don't see how we could possibly be successful in getting to the goals you have set in your third principle.
Ms. Maureen McTeer: Nothing's impossible. I agree that now that the horse is out of the barn there's not going to be much value just to close the gate. We're also going to have the catch the horse and bring it back to the barn.
It is important that we do that because it's obvious to us now that we allowed a whole two decades to go by where we just simply said these are good technologies because they give people the chance to have children. All of a sudden this committee is realizing, as it listens to all of this testimony, that there are so many other interests at stake, so many other rights at stake other than the interests of the infertile or sterile couple in having a child. Whether or not there's a right to found a family as opposed to a right not to be interfered with by the state in founding a family, I think we have to be very conscious that there are other players.
We have the human embryo, for instance. We have the opportunity around which to create a zone of legal protection that until now we've just never thought there was any need to do, or we thought it was impossible to do. We have children born of these technologies. We have adults who are now reclaiming their right to know who their genetic father or mother are, who their genetic brothers and sisters are.
When you have a country like Canada and you have doctors who actually admit there are some donors who get used and used again, because it takes every time.... And they have 500 to 1,000 live births. As a society, of course, it's a difficult challenge, but it is morally unacceptable that we not deal with that challenge because time has passed and we didn't do it in the first place. I think it's worth trying at least.
Mr. Stan Dromisky: Thank you.
The Chair: I see that our third witness, Dr. Vandelac, has arrived, and I would like to ask her to come to the table and make her presentation, although I can't promise that we will have time for a round of questions.
Professor Louise Vandelac (Department of Sociology, Institut des sciences de l'environnement, Université du Québec à Montréal): First of all, I must apologize. I've been searching for my wallet for an hour, and that's why I'm late.
Ms. Maureen McTeer: I'm sorry, but that's a whole Quebec-Canada issue right there. You come from Montreal and you lose your wallet in the nation's capital. We've had this debate before.
Prof. Louise Vandelac: We've known each other for a long time.
[Translation]
Good afternoon, and thank you for your invitation.
I will begin with a brief quotation from the last book by Jean-Claude Guillebaud, Le principe d'humanité:
-
In 1945 and 1946, the western world suddenly discovered with horror
that one could destroy a truth more precious than life itself. The
humanity of human beings.
-
All the major accounts of the post-war era, which tragically
reinforced our perception of human dignity, focus on this historic
terror. One who bore witness to these events was Primo Levi, who in
his book entitled Si c'est un homme [If This Be A Man], continually
returned to this theme of how deportees were deliberately,
fanatically reduced to the level of “animals”, “raw materials”,
“garbage”.
In fact, by the time of the post-war era, it was becoming clear that men should never be likened to an animal, a machine, or a thing. Jean-Claude Guillebaud also wrote:
-
So, one must understand the extent, the seriousness and the depth
of the contemporary disturbances in light of what occurred during
the last war, because it is now science that today brings the
questions that haunted Primo Levi back to the forefront.
One wonders what he would think if he could read titles in the
area of genetics such as “Inquiry into the making of a superman” or
“Drifting away from the human race”.
Which was the title of an article that I published in Courrier international last December. It says:
-
Yet that is the question. Will we still be able to define human
beings, distinguish them from animals, from machinery and from
things? In all logic, such fundamental questions should have a
place of honour within our democratic system. Fundamentally, these
questions relegate traditional politics—the distribution of
wealth, deliberations, elections—to the level of pleasant yet very
much secondary conjecture. Yet, oddly enough, this is not what is
going on. We are walking through this mine field in a state of
frivolous confusion.
I chose to preface my remarks in this manner in order to underscore the seriousness of this issue. I must say that after 20 years of working in the field of reproductive technology, when I read the current bill, I was somewhat saddened.
Since we have very little time and I will be leaving a written brief with you, since I also brought a documentary that we did for the NFB last year, which is entitled Clonage ou l'art de se faire doubler, in English Clone Inc., since I realize that a title such as Clonage ou l'art de se faire doubler translates poorly in English, since I brought you some other documents, I will basically restrict my remarks to a few of the points that I think are significant in terms of the shape that this debate is taking.
I was particularly struck by just how slowly we have taken action. As you are well aware, Canada is one of the most lax countries in the world in the area of reproductive technology, one of the few that has spent more than 30 million dollars and has managed to do nothing for more than 15 years. This is already enough of a problem, as is the fact that it took three bills on cloning, two of which died on the Order Paper, which were tabled by Ms. Picard, before we took another look at this issue of prohibiting human cloning.
I think it is extremely important to stress that some key elements of reproductive technology are barely covered in the bill, if at all. The first aspect is something that we focused on a great deal during the first two years of the Royal Commission that I was on along with Maureen. The bill says nothing about the extremely important work of protecting fertility and preventing fertility problems.
You are well aware that here in Canada we have one of the highest rates of voluntary sterilization and we are like a huge laboratory in terms in what we are learning about the effects of persistent organic pollutants. These pollutants disrupt the endocrine system, and this disruption is itself responsible for the increase in the incidence of cancer, particularly cancers of the reproductive organs. These include prostate cancer, testicular cancer, ovarian cancer and endometriosis. These problems also explain the significant drop in sperm counts and sperm quality in developed countries, a drop that has been estimated at nearly 2% per year.
• 1705
We already know that under current conditions, unless there
are very significant changes, sperm counts will drop to less than
20 million within 30 years, which is the level that the World
Health Organization currently considers to be the minimum fertility
level.
Of course, we currently have techniques such as intracytoplasmic sperm injection (ICSI) which allows us to use a single sperm. Even so, you can certainly see what is coming our way given that we are doing so little about issues such as persistent organic pollutants, and what we are doing is being done so poorly. I should point out at this juncture that more than 70 persistent organic pollutants have been identified, and 40% of them are pesticides.
Over the next few generations, human reproduction will become an entirely technological process. We will be using reproductive technology systematically.
Furthermore, one of the draft bill's premises is that the purpose of the legislation basically is to deal with fertility problems. I think that the bill is silent on other issues that have been just as important over the past 20 years. I did a thesis on infertility and sterility, which the reproductive technology industry was already using as an alibi in 1988. The great advances in this field are not first and foremost a response to these issues. This progress comes first and foremost from research interest, particularly in the area of embryos, something that we previously cast light on in part of the Royal Commission's work.
Some progress can also be attributed to issues relating to eugenics. Some Nobel prize winners are starting to articulate their intentions more clearly, including Mr. Watson, who with Mr. Crick first identified the genome. These issues relating to eugenics are nowhere to be found in the draft bill.
Nor does it say anything about pre-implantation genetic diagnosis. There is nothing in the bill, or very little, on the genetic screening of embryos. Similarly, the bill has very little to say about ovarian stimulation and its byproducts. Nor does it mention selective reduction. In short, we have the impression that many sectors have been completely neglected. The bill says nothing about things that are currently happening, such as the business of DNA services. Yesterday, a firm by the name of PRO-ADN Diagnostic Inc. announced the launch of its commercial Web site, the only Canadian site that offers these DNA services on line to the entire community, as well as payment of these services on-line.
These questions are extremely timely, extremely relevant, and yet, the draft bill does not seem to bear in mind at all some of the most recent and most important developments.
Admittedly, we can be pleased that there is a willingness to oppose the cloning of human beings. However, this draft bill is recognizing or allowing for the possibility of using some cells for research, since this draft legislation says throughout clause 8, and in part of clause 9, that nearly everything is authorized as long as it is done within a licensed clinic. In our opinion, this is quite weak and quite limited.
• 1710
For the time being, we must realize that we are the first
generation in the world that, over the course of 20 years, has
succeeded in conceiving human beings from material in separate
rooms, sometimes kilometres and years apart, without seeing each
other, without touching each other, over the Internet, through the
mail, through business dealings and sellers of sperm and of eggs,
through childbirth contracts or even gestation contracts involving
two or three gestational mothers at a time, and of course, two,
three or four children. Obviously, these practices have radically
changed the conception of human beings, in the meaning of their
coming into the world, but also the meaning of the word
"conception" in our minds.
The conception of human beings is being altered. Paradoxically, we are literally leaving behind the human species as it was defined a very long time ago. The projects that are before us are of considerable import, but we are dealing with them as if they were just new medications.
This is the first time that human beings have gone from begetting human beings to the production of living entities, since these technologies are not merely assisted human reproductive technologies, they are reproductive technologies, which is something broader. Why? Because we are changing the very parameters.
At present, we are producing living beings, basically in an attempt to make up for the shortfalls of these technologies, which were very ineffective when they were first introduced. As you know, in the early 1980s, the success rates were between zero and 5%, and they remained so until 1985-86.
In order to make up for these shortcomings, we began to stimulate the ovaries to produce 5, 10, 15 and sometimes even 30 embryos or more. Some teams were allowed to transfer up to nine embryos at one time into the uterus of a woman. These practices were never sanctioned, including the transfer of nine embryos at one time into a woman's uterus. As a result of this experimentation on human beings, we came to the conclusion that it was not very effective to transfer 5, 6 or 7 embryos at one time. It was after the experimentation on women that we came to that conclusion. We have now begun to reduce the number of embryos somewhat, but even so, I would say that we have crossed a border.
For the first time, we have produced "surplus" embryos, an expression that is very significant. For the first time, we have produced beings that were intended to come into the world and others intended solely for experimentation or for donation. This is an extremely important development.
So, we are the first generation of human beings to have produced living beings, some of which are intended to be born, while others are to be eliminated in the womb by way of selective reduction, or are meant to be donated to another couple, or reduced to laboratory material or even to be put literally on ice, since hundreds of thousands of embryos are patiently waiting on ice.
We are the very first human beings, in this strange race against the clock and against ourselves, to have manipulated the genome of embryos to judge them, assess them, screen them, while some people are even thinking of correcting their flaws, or even changing some of their characteristics, in order to improve the human race, they say.
In the last 15 years, we have begun to speak of post-human beings. We are talking more and more about cyborgs. That is what lies at the horizon of these technologies. We can no longer argue that these technologies are only intended to solve fertility problems, some of which are related to voluntary sterilization in Canada, fertility problems that we unfortunately do very little about, very little in a consistent, comprehensive and effective manner. Fertility problems that this draft bill says absolutely nothing about.
• 1715
We are also the first generation that, while recognizing the
complexity and fragility of human beings' psychic makeup, is
submitting our descendants to all kinds of crazy parental
acrobatics: several mothers sharing motherhood; mothers giving
birth to their grandchildren or the opposite; pregnancies at 60
years of age or more; babies conceived using the reproductive
material of a deceased spouse; the institutional amnesia of sperm
banks that make a father a stranger to his child and his mother
unrecognizable and unknowable. Over 25 years, we have succeeded in
collapsing some of the major biological, social and anthropological
parameters of producing children, some of the parameters that
define the human race.
Of course, you will respond by telling me that some aspects of this draft bill will deal with some of these shifts.
Regarding surrogate mothers, as we call them, here again, the bill does not reflect the complexity of the issue we have before us now, because now we are dealing with childbearing contracts on the one hand, or surrogate mothers as they are traditionally called; on the other hand, we're dealing with gestation contracts where two, three or four women all collaborate to carry one couple's embryos; moreover, there is the possibility of using the ovum of one woman and the nucleus of another woman, which has been done in American clinics. None of these hypothetical cases are raised in any way by the bill, which is content to state, as regards these practices in general, that the basic problem is that these women are being paid. I think this is a very misleading oversimplification.
The real problem lies in reducing potential human beings to the level of merchandise, donations, commodities to be bargained for, even if this does not happen within a strictly commercial context. This, in fact, reifies them, reduces them to the level of mere objects or instruments. This in itself is a major problem with this trade. Since 1985, I analyzed all the texts dealing with surrogate mothers, as I analyzed the entire French and Quebec press over a period of 15 years. This speaks eloquently about the phenomenon of—
Am I speaking too fast?
[English]
The Chair: In actual fact you're over the time. I wonder if we could stop here. Some people might wish to ask questions, to get a few in.
Is there anyone on the government side who has not yet spoken and who would like to ask a question of any of the witnesses? No?
Mr. Manning indicated he would like to have another chance.
Mr. Preston Manning: I have a couple of questions.
Before you came in, Dr. Vandelac, we were talking about stem cell research. I just wonder if all three of you might give us a short answer on this.
Do you feel stem cell research is such an important category and has so many issues in itself that the bill should, maybe under the regulated activities, actually have a section that deals with stem cell research per se? That is, should we define “stem cell” and spell out right in the bill some regulations and prohibitions or possible conditions for research? We're trying to deal with stem cell research through general principles, yet stem cells aren't really even mentioned in the bill. Do you feel that should be a separate category, one where we deal with the rules and the definitions? Is it that important?
Ms. Maureen McTeer: I think it would certainly be very helpful. There are so many different issues you're being asked to deal with in this bill, and whether we like it or not, they do cross jurisdictions. I have a tendency to divide them into two things: these are the technical questions related to fertility clinics, and these are the more difficult questions, the ones where not only is there not really a consensus, but even the science isn't sure what to do. I think stem cells fit into that category.
• 1720
I think we're all ad idem that if good research
can be done using adult cells, let's start there, let's
focus there, and let's provide funding for that. But
certainly, the jury is still out in terms of embryonic
stem cells, and I've made it clear that I do not accept
research that destroys human embryos as a precondition
of research being done on them. This is one of the
areas where there's not only need for having its own
category, there's need for us to commission the
best minds on this to provide you with the kind of
ongoing briefing and information that you as
parliamentarians can make decisions on whether
we've moved along enough to go to the next stage.
I would personally hope that this committee would, in terms of legislation, make a point as to whether or not the destruction of human embryos for research purposes—or for any purpose, for that matter—is going to be allowed. I think it has to be prohibited or at least a decision has to be made as to one or the other. This committee has to proclaim itself on that.
[Translation]
Ms. Louise Vandelac: Personally, I think that the progress of research on adult cells already allows some amazing work to be done and it would no doubt be much more prudent to continue with adult cells than to move to the cloning of embryos for stem cells.
This is extremely important to me because, in a certain way, there is, to say the least, a problem with intending to clone one's own embryos for one's own cell regeneration. This would amount to beginning a new lineage of the human species, a lineage that would be merely an instrument. I believe that these are very grave responsibilities. With regard to research this can certainly be attractive to researchers, but nonetheless, for society as a whole, I think that we are crossing some very controversial limits. In my opinion, the work on stem cells should be put on hold for now, but this act should also deal with transgenesis, which it mentions very little. We already use human genes to produce transgenic animals and plants. Canada is one of the leading producers of transgenic food. These questions should also be raised. And they have not been raised.
Another element that should be added and that I have not dealt with at all is that this bill makes no mention of a responsible, comprehensive body that would be responsible for doing analysis, investigations, research, supervision of clinics as a whole, certification and follow-up. This all seems to be piecemeal; of course, the minister is responsible, but it is still piecemeal. For me, this is an extremely serious problem, given the confusion that has already reigned in the sector for years in Canada, which has lagged behind, even when it comes to setting up some kind of decent registry.
[English]
The Chair: Thank you, Mr. Manning.
Madame Picard would like a few minutes, and we're almost done.
[Translation]
Ms. Pauline Picard: Thank you, Madam Chair.
Good day, Ms. Vandelac. I'm very glad to have you with us.
I just put this question to Ms. McTeer and to Dr. Giesbrecht. Clearly, you support a ban on reproductive cloning, and I entirely support you. However, in the draft bill, therapeutic cloning is forbidden, as well as genetic manipulation of germ lines. I know that you detected a contradiction between clause 3 and clause 8 regarding prohibitions. I think that clause 8 allows you to do in a roundabout way what is forbidden by clause 3. The department officials will have to correct this. If something is prohibited, it must really be prohibited.
• 1725
Do you support the prohibition of therapeutic cloning and
genetic manipulation of germ lines? And if you support this
prohibition, do you agree with the way it will be imposed, namely
by criminalizing these activities? Do you favour a criminal
prohibition or a regulatory one?
Ms. Louise Vandelac: With regard to cloning human beings, I think that it should well be a criminal prohibition. Further, we will have to consider an international prohibition in the very near future. Cloning human beings is truly a crime against humanity because it deviates from the human species as it has been defined up to now, as issuing from sexual reproduction. Here we are really trying to make photocopies of the same individual. Thus, in this matter, we'll have to consider going even further.
Having said that, when the text of paragraph 3(1)(b), says:
-
(b) alter the genome of a cell of a human being or in vitro embryo
such that the alteration is capable of being transmitted to its
descendants;
this is essentially aimed at transforming germ lines. Even if there is, in fact, no such intention, we know that things get much more complex in genetics and that even if we did not intervene on germ cells, but still intervened on somatic cells, we could not guarantee that there would be no consequences. Thus, I think that we should be a bit more prudent in this matter.
To me, the problem seems to be the fact that there is a prohibition here, but other practices are allowed under the guise of reproduction technology. Obviously, things are being prepared in a way to ensure that this act will be quickly overtaken by events.
An issue that worries me, given the time it took for Canada to legislate on these matters, is to know when at least some elements of the act will be adopted. Do we intend to pass this act as a whole before the next elections or is there a chance of it dying on the Order Paper once again? Will Canada have the reputation of having rejected a bill on human cloning three times? I think that this is quite embarrassing to us internationally.
Ms. Pauline Picard: Thank you.
[English]
The Chair: Mr. Merrifield, you have one minute if you'd like to slide one in.
Mr. Rob Merrifield: I can ask the question in a minute; that's not a problem.
I'm a little intrigued by the fact that we've had a lot of researchers come to committee and a lot of individuals say we need to rush down this whole area of stem cell research using embryos. But I am struck a little bit by some of the information that you, Mr. Giesbrecht, have given us with regard to the elasticity of the embryos, suggesting that perhaps there are some cautions there. I've suggested...but I haven't heard it from a witness before. Can you expand on that part of it at all, in that you suggested that it's perhaps uncontrollable and that perhaps no one has ever been cured by stem cell research?
Prof. Gordon Giesbrecht: There are actually two issues.
The first one is that the supposed advantage of embryonic stem cells potentially becomes the disadvantage. The advantage of embryonic stem cells is that they are pluripotent and not quite committed yet as to what they can produce. We can steer them whichever way we want, but the disadvantage of that is indeed the lack of control in determining that. I can point you towards a review paper that deals with it.
In situations where stem cells were injected so that hopefully they would produce a muscle cell, for instance, they ended up turning into bone cells. Also, because it's so hard to control them, they've actually resulted in tumour formation.
It's on those lists I showed you, and it's on one of the slides in my presentation. Those indeed are examples of things that have happened, which brings you to the advantage of the adult stem cells, namely that they are easier to control.
• 1730
In addition to that really great advantage is
the fact that if we can work on the research to harvest
stem cells from an individual and use them for the
individual's own treatment, we don't have to deal with
rejection issues and confining someone to a lifetime of
anti-rejection drugs.
The Chair: Thank you, Mr. Merrifield.
Ladies and gentlemen, on your behalf, I would like to thank our witnesses and express my regret to Dr. Vandelac that she was so late and that she ran into this trouble. In any case, may I suggest that if our researchers have other questions of you, they would have the right to phone you and you would give them a little bit of your time. Thank you very much. Thank you for your time, and thank you to my colleagues.
This meeting is now adjourned.