HEAL Committee Report

The Canadian Alliance members of the Standing Committee on Health wish to commend the Chair, Bonnie Brown, M.P., and our fellow Committee members for their diligence and non-partisan approach in scrutinizing the draft bill on Assisted Human Reproduction and Related Research. We have participated fully in the preparation of the Majority Report and concur in many of its recommendations, particularly those pertaining to the statutory declaration of purpose, the activities to be prohibited by statute, and the provisions establishing the Regulatory Body.

The purpose of this Minority Report is to highlight subjects on which we would place a stronger emphasis and on which we recommend an alternative approach for consideration by the Minister of Health.

It has been more than ten years since the Royal Commission on New Reproductive Technologies began to study this issue. It has been five years since the government’s last attempt to legislate on this subject (Bill C-47 died on the Order Paper). It has taken eight months for the Health Committee to report on the government’s current draft bill, and it will probably take another six months before draft legislation actually becomes law. Meanwhile, scientific and clinical advancements respecting assisted human reproduction and genetic science are proceeding by leaps and bounds.

Patricia Baird, the former Chair of the Royal Commission stated to the committee: "We’ve been discussing and consulting widely on these topics in Canada for over a decade, and I think the overriding need now is to put in place a system to deal with reproductive technology." (June 5, 2001)

If the government is prepared to bring forward the prohibition sections of the re-drafted bill in January 2002, we would be supportive of such a procedure. In any event, we urge the government to give the highest priority to fast-tracking legislation based on this report.

We concur with the Majority Report that an "over-arching consideration" in framing this legislation must be "respect for human individuality, dignity, and integrity." But we believe that this description of an over-arching consideration should be strengthened by using the phrase "respect for human life."

Bartha Knoppers (Adjunct Professor, Faculty of Law, University of Montreal) testified to the committee as follows: "I am surprised that nowhere in the Preamble do we find an allusion, not to the issue of knowing when life starts or when we become a human being, but to the ethical principle of respect for human life. I am surprised that it is not in the Preamble, which serves as a statement of underlying principles." (November 7, 2001)

The committee responded in part to Professor Knoppers’ concern by recommending that an over-arching consideration in framing the legislation should be "respect for human individuality, dignity, and integrity." But we believe that the description of this over-arching consideration would be stronger and more accurate if it insisted on "respect for human life."

This, for example, would require respect and protection for the human embryo not simply because of its potential but because of the fact that it is human life.

A great deal of attention has been given to the possible conflicts between what science may desire to stretch the frontiers of knowledge and what society in general may consider "ethically acceptable." It should be acknowledged, however, that scientific research and advancement can also mitigate certain ethical concerns. For example, embryonic stem cell research raises a major ethical concern in that the embryo must be destroyed in order to obtain the stem cells. Recent scientific advances with respect to adult stem cells, however, provide an alternative which is more ethically acceptable.

Nevertheless, there will always be situations where what is scientifically possible and what is ethically acceptable conflict. In such situations, we concur with the Minister when he told the committee, "There must be a higher notion than science alone … that can guide scientific research and endeavour. Simply because we can do something, does not mean that we should do it." (May 3, 2001)

We also concur with Professor Jocelyn Downie (Director, Health Law Institute, and Assistant Professor, Dalhousie University) when she said, "Establishing a clear set of standards about ethics in science with respect to assisted human reproductive activities ensures that practitioners and researchers can know what is expected of them in relation to these activities. Similarly, establishing a clear set of standards ensures that recipients of such activities and the general public can be assured that only ethically acceptable activities are permitted and that they are conducted in a scientifically sound and ethically acceptable manner." (November 7, 2001)

The Majority Report expresses strong support for stem cell research utilizing non-embryonic sources and expresses concern that embryonic stem cell research "commodifies the embryo." While we share this concern, we feel that the greater problem with embryonic stem cell research is that it involves the planned destruction of the embryo which is contrary to the ethical commitment to respect human individuality, dignity, integrity, and life. While we welcome the sentiment behind the Majority Report recommendation that no licence for research using embryos should be issued "unless the applicant clearly demonstrates that no other category of biological material could be used for the purposes of the proposed research," we consider this proviso unclear and unenforceable.

The committee heard compelling scientific evidence (Lippman, Prentice, Giesbrecht) about the advances in adult stem cell research, including the fact that they are easily accessible, are not subject to tissue rejection, and pose minimal ethical concerns. Adult stem cell research has shown remarkable advances in the past year and holds great promise for the future.

We are concerned that the draft legislation contemplated by the Minister may well infringe seriously on provincial jurisdiction in several key areas. These include the provision and regulation of health care services related to assisted human reproduction, the establishment and operation of health information systems, and provisions dealing with privacy and access to health care information. We are concerned that attempted federal regulation of assisted human reproduction facilities may raise constitutional challenges.

The Canadian Alliance members wish to ensure that provincial jurisdiction with respect to health care is respected. The regulation of assisted human reproduction services and related research involves both the federal and provincial jurisdictions. This is why we urged the federal Minister of Health over a year ago to convene a federal-provincial conference for the purposes of developing a Federal-Provincial Agreement on Assisted Human Reproduction and Related Research to provide the basis for joint action and cooperation by both levels of government across jurisdictional lines. We still believe that such an agreement will ultimately be necessary, particularly to ensure that the Regulatory Body established under this statute will have sufficient authority to carry out its assigned purposes.

The development and maintenance of a health reporting information system and a personal health information registry in the area of assisted human reproduction as envisioned by the draft bill is another area where federal-provincial cooperation is required. Many witnesses at the committee hearings complained about the inadequacies and deficiencies of the current patchwork system.

Also, the original provisions of the draft bill pertaining to privacy and access to information (Sections 18-22) attached a higher weight to the privacy rights of donors of human reproductive materials than to the "access to information" rights of children produced through assisted human reproduction technologies.

While a number of the recommendations of the Majority Report shift this balance more in the direction of the affected children, we would also make the following recommendation:

The Canadian Alliance members are strongly supportive of recommendations of the Majority Report that the Regulatory Body established to carry out the provisions of the act should be external to the Department of Health, preserve the principle of ministerial accountability, and be subject to special provisions to ensure strong links with Parliament and the public.

The Majority Report also recommends that the Regulatory Body be authorized to establish expert panels and advisory committees to ensure input from a variety of perspectives and interests. These provisions should be strengthened by adding a section giving specific legal "standing" to such interests and perspectives which would guarantee them a "voice" before the Regulatory Body.

We also note that the one part of the draft bill which received the least commentary by witnesses and the least scrutiny by the committee is the part dealing with Inspection and Enforcement.

The Health Committee received very little input describing the assisted human reproduction service sector in economic terms or the role of the private sector. The committee received no input whatsoever on the potential costs of regulating this activity and related research. Given the fact that Canada is heading into a recession, and that the growth of federal revenues is now contracting, it is imperative that Parliament be given a better picture of these important aspects of the subject.

Because of the regulatory nature of the draft legislation, many of the provisions of the Majority Report and this Minority Report of necessity deal with prohibitions of activity and the establishment of limits and conditions on scientific research relevant to assisted human reproduction and the alleviation of human suffering.

While recognizing the necessity for these prohibitions and constraints, the Canadian Alliance members wish to affirm their support for the work of scientists and medical practitioners in this area and their dedication to the amelioration of human suffering associated with human infertility and genetically transmitted diseases.

We specifically wish to thank the associations and witnesses representing those suffering from infertility and genetically transmitted diseases for sharing their hopes and fears with us.

            Recommendation: That, because of the moral and ethical dimensions of legislation dealing
            with assisted human reproduction and related research, all parties permit a free vote on
            this legislation at all stages.