STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Monday, November 26, 2001

• 1006

[English]

The Chair (Ms. Bonnie Brown (Oakville, Lib.)): Good morning, ladies and gentlemen.

We welcome our guests to this meeting of the Standing Committee on Health and point out to members that we have representatives from five bodies, and we will do it as a panel. They will each present their case and then we will move to questions.

As the agenda says, we'll begin with the representative of the Canadian Bar Association, Brent Windwick, chair of the national health law section.

Mr. Windwick, you have the floor.

Mr. Brent F. Windwick (Chair, National Health Law Section, Canadian Bar Association): Thank you, Madam Chairman.

The Canadian Bar Association is an association of approximately 36,000 lawyers, law teachers, law students, and other jurists. One of its mandates is to assist in improving the law and the administration of justice. I am the chair of the Canadian Bar Association's national health law section, and I am appearing to make a submission on behalf of the health law section and the national family law section.

[Translation]

I appear today on behalf of the Canadian Bar Association's National Health Law and Family Law Sections. We would like first of all to thank the committee for the opportunity to make a presentation on the assisted human reproduction Bill.

I am not very confident of my ability to express myself in French on this important topic and I would like, if I may, to continue my presentation in English.

[English]

I also appear to have the squeakiest chair in this room, so if I fidget in response to your questions, I think you will know it immediately.

As you may know, we made a submission in 1997 in relation to Bill C-47. This submission is to a large extent built on the foundation of that one. However, the legislative proposals tabled this year represent, in our submission, a very positive step beyond Bill C-47. The scope of our comments on the new proposals is, accordingly, more limited. Our written submission and this oral submission will focus on a few key areas where we believe the draft legislation can be improved. I think the clerk has received copies of our written submission.

In this brief submission we will focus on four specific issues. The first is whether to enumerate prohibited assisted human reproductive activities in the legislation or in regulations. The second is what an oversight body should look like and do. The third is whether the legislative proposals adequately address the reimbursement of reasonable expenses for surrogates. The fourth is how health reporting information provisions square with existing and foreseeable health information privacy laws.

Before addressing these issues we feel it is important to emphasize our support for moving ahead with legislation as soon as is reasonably practical. The types of social values and ethical principles that are articulated in the preamble to the draft legislation need to be placed firmly in the public domain to frame constructive public discussion of the many issues that will inevitably arise as these technologies develop and to promote public confidence that assisted human reproduction activities are being conducted for the right reasons and in the right way.

A strong and comprehensive oversight framework is essential to national standard-setting and quality control, both essential tools for achieving these objectives. I think if one looks at the headlines in the newspapers today—and I have the Globe and Mail and the Ottawa Citizen with the announcements of the first cloning of human embryos, or reports of same—it will illustrate how fast the scientific ground is shifting and how important it is to move forward with this process.

• 1010

We now turn to what remains, in our view, the most important legal issue raised by the legislative proposals, whether to prohibit certain activities expressly in the legislation or to prohibit those activities in regulations created under the authority of the legislation. You have no doubt already heard various arguments in favour of each of these two options.

From our perspective, there are compelling practical reasons to favour prohibitions in regulations rather than in legislation—in particular, the speed of scientific and technological development; the absence of clear social consensus in relation to many assisted human reproductive activities, present and contemplated; the need to use the expertise of many scientific and non-scientific disciplines to analyse these difficult issues as they arise; and the absence of clear policy justification for the distinction the draft legislation makes between activities that should be prohibited and activities that should be regulated by a licence. We've outlined these reasons in greater detail at pages 2 to 4 of our written brief.

At the same time, we understand the nature of the legal arguments that favour prohibitions in the legislation, such as the need for the government to enact legislation that is solidly anchored in federal constitutional jurisdiction, the importance of democratic accountability and transparency in establishing and later changing the scope of prohibited activities, and the arguably strong public view that certain activities should be criminally prohibited in a very visible and permanent way.

We address these latter arguments on pages 5 to 7 of our written brief. The bottom line of our analysis is as follows. First, a prohibition list in the regulations, developed by an oversight body, with political sign-off, is in our view a legally acceptable and sustainable proposition. However, we accept the rationale for a very limited number of expressed legislative prohibitions, bearing in mind the kinds of concerns that are raised about constitutional jurisdiction and the other items that I've just referred to.

Continuing to prohibit human reproductive cloning and commercial surrogacy expressly in the legislation, which in our submission is consistent with the principle of limiting the use of criminal law power to areas where there is a high degree of social consensus, should, in our submission, allay any concerns about constitutional jurisdiction and the other issues that I think have been raised in relation to this.

With respect to democratic accountability, in our submission this is a process issue that can be addressed by constituting the oversight body—and the powers it has to establish or change prohibitions—in a way that resolves any such concerns. In our written submissions we suggest a number of methods of accomplishing this objective, including mandatory prior public consultation, broad-based representation on the oversight body, and making any changes to a prohibition list subject to parliamentary negative resolution, or some sort of concept of that nature.

In relation to the oversight body, as noted previously, we support a strong oversight body that would be given the power to establish, amend, and interpret a prohibition list for all of the activities that wouldn't be expressly prohibited in the legislation. Our vision of this oversight body is detailed in our written brief.

Concerns of democratic accountability and transparency are, of course, relevant to discussions of this option. However, in our submission these are implementation and process issues that, if properly handled, will not in any way weaken the rigour of the regulatory framework. We would argue to the contrary that a properly constituted multidisciplinary oversight body with the power to interpret, educate, and debate the content of the prohibition list on an ongoing basis would be more responsive, more effective, and no less democratic than the type of process that would be required for amending legislation to accomplish these objectives.

With respect to the issue of what I would characterize as the family law issues in the draft legislation, our written submission at pages 7 to 9 focus on one particular aspect of the draft legislative provisions dealing with surrogacy. It also makes a series of more general comments about the types of family law issues that may arise as these technologies become more prevalent and the need for the federal government to lead and facilitate national standard practices in areas that are for the most part within the legislative jurisdiction of the provinces.

• 1015

The specific feature of the draft legislation that in our submission needs to be clarified is the nature of consideration in clause 4. In our submission, although payment of a fee or any other consideration for services to a surrogate mother ought to be prohibited, she should be entitled to be reimbursed for reasonable expenses related to the pregnancy. We acknowledge that paragraph 10(d) allows this to happen as part of the licensing regime, but we feel the way clause 4 is drafted leaves open the possibility that, for example, loss of income incurred by a surrogate mother who is required to be absent from work because of her pregnancy would not necessarily be covered. These are the kinds of issues that need to be addressed.

With respect to health reporting information, we found three features in this part of the draft legislation worthy of comment: the mandatory nature of the reporting, albeit with this fact being disclosed in advance to the assisted human reproduction recipient; the lack of reference to some important standards of fair information practice that are now becoming integral features of health information legislation in Canada and internationally; and the extent to which principles of information use and disclosure will be made by regulation.

In pages 9 to 11 of our brief, we lay out what we see as the good and the bad of this part of the draft legislation. On the positive side, some of the central principles of fair information practice are in the legislation, like the obligation to inform, and a right of access and correction. However, it is clear this part of the draft legislation makes the provision of health reporting information a necessary precondition of access to assisted human reproductive services arguably at odds with the principle of free and informed consent articulated in the preamble.

In this light, the justification for collection, use, and disclosure of this information is very important.

In our submission, it is what is missing from the draft legislation that is of some concern—a clear statement that this information will not be used except where necessary; a clear statement that the least amount of information should be used; and a clear statement that information must not identify the provider of the information, unless identifying information can be justified.

It might be the government's intent to state these principles in the regulation, or perhaps to append them as a schedule, as is done with the CSA code of information practices in the Personal Information Protection and Electronic Documents Act. However it is done, we feel it is important it be done.

In conclusion, we appreciate this opportunity to provide our views to the committee. The government is to be commended both on its work so far and its commitment to public and other stakeholder input before tabling a bill. However, in our submission, the time has now come to proceed to this next step.

Thank you very much.

The Chair: Thank you, Mr. Windwick.

Our next guest is representing the Catholic Health Association of Canada, Mary Lou Cranston, director of St. Joseph's College Ethics Centre in Edmonton, Alberta.

Ms. Cranston, you have the floor.

Dr. Mary Lou Cranston (Director, St. Joseph's College Ethics Centre; Member, Catholic Health Association of Canada): Thank you very much, Madam Chairperson.

On behalf of the Catholic Health Association of Canada, I want to thank you for the opportunity to provide our response to the draft assisted human reproduction act.

The Catholic Health Association of Canada is a national voice for Catholic health care. It is a bilingual, not-for-profit organization committed to advancing a vision of health and healing that encompasses the psychological, spiritual, social, and physical well-being of people. The association provides an important forum for the discussion and analysis of health and social issues and for the development of public policy. It represents seven provincial Catholic health associations, 127 hospitals and homes across the country, numerous sponsor organizations, health care professionals, and individuals. The Catholic Health Association of Canada, as a health organization, brings to this committee the perspective and views of health care providers, organizations, and individuals from throughout Canada.

We have submitted a brief to the clerk. I believe you already have copies in both French and English.

• 1020

This brief identifies those elements of the draft legislation that we affirm and support. It notes concern in some areas, and highlights questions we have about the legislative framework, the guiding principles, and the regulatory component of the legislation. During this presentation I will highlight for you five points from our brief.

The first is that we believe there is a need for foundational ethical values and principles. Remarkable advances in reproductive and genetic technologies in recent decades have provided resources for human betterment that exceed anything previously available to humankind, and as the previous speaker said, we just had to turn on our radios and televisions this morning to be reminded of that.

Clearly we have an obligation as a society to use this knowledge and related technologies to continue to improve the human condition. These same technologies, however, have forced upon us a unique and perplexing ethical responsibility. They have provided us with an unprecedented power over the human person. In this situation, responsible stewardship has to be grounded in fundamental human values and strong moral imperatives. We would argue that without these values there can be no good policy.

We live in a society of religious and moral pluralism, one in which people do not always agree on the ultimate questions of life. In a democracy, we respect and seek to protect the right to disagree. Nonetheless, while it may be impossible to get universal agreement on all moral issues in law and policy in society, some issues are of so vital a nature that government cannot forsake its responsibility to enshrine in law and policy foundational ethical values and principles that will provide guidance for this society, precisely because failure to do so can sacrifice the good of the sacredness of life, the dignity of the human person, and the question of justice in society.

The Catholic Health Association of Canada regards reproductive and genetic technologies and the effort to enact legislation to govern these technologies as being of this kind of vital nature. The legislation that is ultimately adopted for banning unacceptable practices and establishing regulations for acceptable technologies and research will say much about what we value as a society and what truly are our priorities.

The issue of values within the proposed legislation is of particular concern. In the brief you have before you, we propose a series of foundational ethical values and principles by which to judge the various technologies and practices addressed in the legislation. The list represents long-standing principles within the Judeo-Christian community. These same principles are also at the heart of the Canadian political language and heritage. We believe such principles should be incorporated explicitly in the legislative preamble. That's our first point.

Second, perhaps we overdo, or at least place very strong stress on, the benefits of assisted human reproductive technologies, and perhaps not place as much on the other side of that question. We're concerned that in its presentation of values and guiding principles, the preamble gives propriety and priority to safeguarding the benefits to individuals and to society in general, and only subsequently to human dignity and rights.

• 1025

Bill C-47 was much more forceful about how some of these technologies contravene human values. In its opening clause, Bill C-47 indicated that certain technologies would be prohibited, because Parliament was gravely concerned about the significant threat these technologies posed to human dignity.

To our minds, the exclusion of such a statement from this draft legislation seriously weakens the bill. We therefore recommend that in the preamble greater emphasis be given to respect for human life and the transmission of human life.

Third, in our brief we affirm the importance given to free and informed consent in the preamble. That affirmation, though, needs to be qualified. It needs to be qualified by a recognition of a trend today to focus only on the question of whether free and informed consent has been given. When this happens, questions about the propriety of what is being consented to can easily be overlooked. If an act is in itself wrong, free and informed consent doesn't make the wrong act right.

This emphasis on consent as a sufficient condition for determining propriety means that a wrong act might be deemed acceptable because consent has been obtained. This is particularly dangerous in our economic health care climate, where industries drive the direction of research. Reproductive and genetic technologies in Canada today are driven by organizations that have a major financial stake in them. With that in mind, it is important to note that where commercial interests dominate, there is a temptation to narrow the definition of ethics so that it won't interfere with the research or enterprise being pursued.

The fourth point we want to bring out is the use of embryos for stem cell research. Subclause 8(2) of the legislation would allow research on so-called spare embryos left over from in vitro fertilization procedures. That would include use of those embryos from stem cell research, as recently recommended by the Canadian Institutes of Health Research.

Given the emphasis that we, at the Catholic Health Association of Canada, place on respect for human life from the beginning of the process of fertilization—be it within the woman's body or in vitro—our position is that research on embryos left over from in vitro fertilization procedures should be included on the list of prohibited activities, and that the use of adult stem cells is the ethically justifiable method of stem cell research.

One of the arguments for the use of embryos for stem cell research is that there has not been an alternative to the use of embryos that would offer equivalent potential for developing tissue for therapeutic uses. In recent months, however, major developments in adult stem cell research have provided evidence that the adult body harbours stem cell production—as we note, even in our fat cells—that may be as good as or better than embryonic stem cells for a variety of the proposed therapeutic goals for stem cell research. We believe advances in understanding how to reprogram adult stem cells would give rise to significant medical benefits and should obviate the need to use embryos as a source of stem cells.

The last point we have, our fifth, is the need for a stronger statement about the dangers of commercialization. Paragraph 2 of the preamble to Bill C-47 had stated:

Whereas the Parliament of Canada acknowledges the health and ethical dangers inherent in the commercialization of human reproduction, including the sale of reproductive materials, the trade in reproductive capacities of women and the exploitation of women and children for commercial ends;

• 1030

We at the Catholic Health Association of Canada are very concerned about the much weaker and less specific reference to commercialization in the preamble of the proposed act.

In conclusion, in the debate about the ethics of reproductive technologies the argument is often made that while some of these technologies are contentious given the use of embryos, if embryonic and fetal tissue research were discontinued, important and promising fields of science would be slowed down. The Catholic Health Association of Canada believes that both the scientific imperative that says research must proceed as quickly as possible and the concomitant belief that the end justifies the means must be challenged. The technologies and research addressed in this draft legislation touch upon Canadians' most important values as individuals and as a society. While affirming the potential benefits of such technologies, we believe the proper stance in relation to them should be one of caution and restraint.

The Catholic Health Association of Canada strongly supports the prohibitions set out in the proposed legislation, in particular the prohibitions against human cloning and the creation of in vitro embryos solely for research purposes. We commend the government's leadership in taking steps to promote and protect human dignity. It is our view, however, that this draft legislation, while focusing on the important issues of health and safety, does not give adequate attention to the risks and harms to what one witness before your committee called the human spirit. By that we mean the important fundamental human values, the fundamental norms, principles, and beliefs that are central to our humaneness and humanity, and that are crucial to our human well-being.

The Catholic Health Association appreciates the opportunity to provide comments on this draft legislation. We wish you, the members of the standing committee, well in this important and challenging task of ensuring that reproductive technologies and associated research are consistent with the values of human dignity and respect, and that human health and safety will be protected.

Thank you.

The Chair: Thank you, Ms. Cranston.

We'll move on to the Juvenile Diabetes Research Foundation International and its director of government relations, Mr. Lawrence Soler.

Mr. Soler.

Mr. Lawrence Soler (Director, Government Relations, Juvenile Diabetes Research Foundation International): Thank you very much, Madam Chair, for the opportunity to present today.

JDRF International was founded in 1970 by parents of children with diabetes who were dedicated to supporting research to find a cure. This year alone JDRF will contribute more than $190 million for diabetes research.

I'm also chairman of the Coalition for the Advancement of Medical Research. It's an organization comprised of universities, scientific societies, patient groups, and other entities devoted to supporting embryonic stem cell research.

Before I begin, I want to thank the committee for its strong support for the Canadian Institutes of Health Research. JDRF sees CIHR as an important partner in our research work, and we very much hope the government will be able to continue its goal of doubling the CIHR budget.

I want to express JDRF's appreciation to the committee for holding these hearings on the draft legislation on reproductive technology, a key component of which is embryonic stem cell research, which we believe is of critical importance to finding a cure for juvenile diabetes. You may recall similar hearings held in the 1970s over the then controversial issue of research on recombinant DNA, involving the manipulation of genetic material. Many people feared this area of research could lead to extreme hazards. Eventually, as a result of public hearings and the establishment of government guidelines, the research was permitted, leading to an explosion in biotechnology advances, including the development of human insulin for people with diabetes.

Similarly, other areas of research have also been controversial. Fetal tissue has been used in research since the 1930s. This research has sometimes drawn criticism because the source tissue is obtained following an abortion. Today fetal tissue is widely used in basic research laboratories. As well, fetal tissue is an integral means of developing vaccines against such diseases as polio and rubella. In fact, the 1954 Nobel Prize for medicine was awarded to researchers who used fetal kidney cells to help develop the polio vaccine.

• 1035

My point is, the idea that new areas of science may trigger opposition on ethical grounds is not new. We've seen our society work through other complex issues to see great benefits. In order to fully understand why we are so concerned that national support for embryonic stem cell research be permitted, let me tell you about the devastating nature of the disease diabetes. It affects more than 2.25 million Canadians, from the youngest children to the oldest adults. It is a leading cause of life-threatening and debilitating complications such as blindness, end-stage kidney disease, nerve damage, heart attack, stroke, and amputation.

In addition to its human toll, it is also extremely costly. Indeed, a few years ago Health Canada suggested, quite conservatively, that diabetes costs Canada approximately $9 billion annually, making it one of the nation's most costly illnesses.

Beyond these facts and figures, diabetes is, as one young child told me, “hard and scary”. I've heard a lot worse, but I thought I'd just stick to that. Having suffered from the disease myself for more than ten years, I fully agreement with that sentiment. I also think the families in this room, including young Bronson and Vivian, who are sitting behind me—say hello, Bronson and Vivian—who have juvenile diabetes, or are touched by diabetes, would agree.

Every waking moment is spent trying to do what someone without diabetes does naturally—that is, keep blood glucose levels as normal as possible. This is done by a very complex regimen of up to four or more insulin injections daily; up to eight or more fingersticks daily to test one's blood sugar level; and through closely monitored nutrition. But even when you do everything right, things often go wrong. When blood sugar levels drop too low, one is at risk of seizure or death. When blood sugar levels rise too high, the complications of the disease begin to develop, as does the risk of developing ketoacidosis, a potentially fatal illness. Diabetes strikes quickly and can kill quickly.

As you see, the burden of the disease on individuals and on society is extraordinarily high. That is why we are so devoted to finding a cure.

What I've told you so far is the bad news, but there is very promising research advances that could lead us to a cure. There is no better place to discuss the state of diabetes research than here in Canada, where researchers, using innovative techniques and basic ingenuity, have persevered to make dramatic advances in fighting diabetes. After all, it was 80 years ago when doctors Banting and Best, at the University of Toronto, worked against great odds to discover insulin. Their discovery is the reason that people with the disease are able to avoid immediate death.

As you know, however, insulin is not a cure. As someone who lives with juvenile diabetes, I must also confess frustration—frustration at harking back some 80 years and pointing to that time so long ago as the last significant breakthrough in the treatment of diabetes.

Let me now tell you why, today, I have hope and why embryonic stem cell research is so critical to that hope. For years researchers have tried to achieve a cure by transplanting insulin-producing cells from donated cadaver pancreata to people with diabetes. Until 1998, after decades of research, only 8% of those receiving such transplants had one year of independence from insulin.

However, through the truly pioneering work of Dr. James Shapiro and his team at the University of Alberta, new transplantation and cell isolation techniques have been utilized, enabling 15 of 18 patients who have received transplantations to receive treatment through a simple out-patient procedure and to no longer require insulin. To someone with diabetes, this is truly a miracle.

JDRF, which helped support Dr. Shapiro's early work, earlier this month announced that it has awarded a $24 million five-year research grant to establish the Juvenile Diabetes Research Foundation Clinical Centre at the University of Alberta. This centre will work to refine this research in order to overcome some of the remaining challenges, including finding ways to increase the number of insulin-producing cells and to overcome the body's natural defences that attack foreign tissue.

JDRF is very concerned that although we could have a cure for diabetes through transplantation, there is a shortage of insulin-producing cells. Therefore, transplantation can benefit only a few hundred or a few thousand individuals with the disease. That is why stem cell research offers what our researchers believe is the best hope to solve this problem. Because embryonic stem cells are undifferentiated master cells, scientists believe they can be grown into an unlimited source of insulin-producing cells capable of transplantation.

Worldwide, hundreds of thousands of excess in vitro fertilized eggs are frozen and await destruction. JDRF supports public funding for research on a small number of these excess IVF eggs, as well as stem cells that are isolated from them. The IVF eggs used are less than 14 days old and are comprised of a mass of undifferentiated cells. We view support for the life-saving process of organ donation to be analogous to support for embryonic stem cell research.

• 1040

JDRF encourages the pursuit of embryonic stem cell research within the framework of appropriate scientific and ethical safeguards, including requirements that informed consent be given before IVF eggs may be donated for research.

There's been much discussion about whether stem cells derived from adult tissues make suitable replacements for those that come from excess IVF eggs. JDRF firmly believes research should proceed using all types of stem cells, because it is impossible to know which will provide the most medical benefits.

Embryonic stem cells have two distinct advantages over adult stem cells. First, embryonic stem cells are able to grow indefinitely in laboratory, while adult stem cells have more difficulty growing, especially in the large numbers that will be needed to help in curing diseases. Second, unlike adult stem cells, embryonic stem cells can grow into any cell type. The National Institutes of Health issued a report earlier this year outlining the state of stem cell research and found key limitations in adult stem cells as compared to embryonic stem cells.

Madam Chair, I want to thank you and the committee for holding these critically important hearings. Canada finds itself once again in a position to lead the way on diabetes research, this time through supporting embryonic stem cell research and giving hope to the 2.25 million Canadians with this devastating disease. JDRF looks forward to working closely with you to make this area of research a major success.

The Chair: Thank you very much, Mr. Soler.

Our next representatives are His Excellency the Reverend Terence Prendergast, Archbishop of Halifax, and Father Ron Mercier from the Toronto School of Theology at the University of Toronto.

Which one of you is going to proceed?

His Excellency Archbishop Terence Prendergast (Archbishop of Halifax; Representative, Canadian Conference of Catholic Bishops): I would like to begin first, Madam Chairperson, and Father Mercier will intervene partway through my presentation.

The Chair: Go ahead.

[Translation]

Archbishop Terence Prendergast: Good Morning. The Canadian Conference of Catholic Bishops would like to thank the committee for an invitation to present its reflections on the draft Assisted Reproduction Act.

The Conference is the national association of Catholic Bishops who are the pastoral leaders of approximately 12,5 million Catholics in seventy-one dioceses across the country.

Since our presentation comes almost at the end of your public hearings, we have decided to limit our comments to identifying in a general way some parts of the draft legislation that we can readily support and to focusing in a very specific way on our major concern with the legislation.

[English]

I'd like to begin with a few general affirmations. The first is the relationship that we see between faith and science. The quest for knowledge is very much at the heart of Christian faith. Far from being in conflict, we believe faith and science have much in common, awakening wonder in the mysteries of creation and coming from and leading to the same God. As Pope John Paul II said in a recent encyclical, “Faith and reason are like two wings on which the human spirit rises to the contemplation of truth”. There can be no real conflict, we believe, between faith and science, except where there is either bad faith or bad science.

The Catholic Church supports scientific research and technology when it respects the inherent dignity and value of human life, preserves the richness and diversity of creation, promotes responsible stewardship, cares for the vulnerable, and serves the common good. Science and faith are not irreconcilable, we believe, but can nourish and inform one another. As Einstein said, science without religion is lame, and religion without science is blind.

At this point we'd like to mention some positive elements we see in the legislation. First of all, the preamble contains several significant affirmations, such as the need to protect the best interests of children affected by the application of the technologies; the recognition that women are particularly affected by these technologies; the fundamental importance of free and informed consent; and the importance of protecting human individuality and the integrity of the human genome.

The Government of Canada we believe should also be strongly commended for prohibiting cloning, the creation of embryos for research purposes, commercial surrogacy, germ line alteration, and the marketing of gametes and embryos.

Now our major concerns. First, the major concern we have about this draft legislation is that while it deals with the beginning of human life, it does not define the human embryo as a human being or protect it with full moral status. The Catholic Church believes human life is God's most precious gift to us; each human being is created in the image of God; and each human being has inherent worth and dignity. Therefore, each human person must be respected and protected as a person, however small and fragile.

• 1045

We believe the human being exists from conception, and our position is shared by medical and other professional opinion. In their April 2001 response to the Canadian Institutes of Health Research discussion paper on human stem cell research, the Canadian Physicians for Life said:

It is an objective scientific fact that human life begins at conception/fertilization. This is not a “faith” position or a “belief”. We are human beings even at the one cell stage. A human embryo is not a “potential human being”. It is a human being. It is precisely what a human being looks like at that point of his or her life.

The Law Reform Commission of Canada, in its working paper “Crimes Against the Fetus”, more than ten years ago affirmed that a human being exists from conception. They said:

True, the present Code has a curious provision in section 206 to the effect that a child doesn't become a human being until it has proceeded completely from its mother's body. This, far from being a proper definition of the term, runs counter to the general consensus that the product of human conception, in the womb or outside, is a human being.

Dr. Françoise Baylis, an associate professor in the Department of Bioethics at Halifax's Dalhousie medical school, said in testimony before the Standing Committee on Health on May 31 of this year:

The first thing to recognize in the legislation and in all of our conversations is that embryos are human beings. That is an uncontested biological fact. They are a member of the human species.

There would appear to be no longer any question that the human embryo is a human being. It is what makes the human embryo so fascinating and valuable to researchers. The debate is no longer about the facts but about how to respond to those facts. The fact that the embryo is a human being combined with the principle of Catholic teaching that human life must be protected from its earliest existence has obvious ramifications for our response to certain provisions of the draft legislation.

With regard to the definitions in the draft legislation, we recommend that “embryo” and “fetus” be defined as human “beings”, not as human “organisms”, as in the draft bill. We also recommend that embryos be removed from the term “human reproductive material”. As legislators, you know how important it is to get the definitions right, because their meaning determines what follows. If Parliament is going to allow research on embryos who remain after fertility treatments, then it should not be glossed over that this research is being done on a human being. Legislation that is grounded in science and has such ethical import should make it evident that it is dealing with human beings when making provisions for embryos.

Those who have different positions on abortion could find common ground on the definition and treatment of the human embryo in the context of this legislation. This is because the embryo is not within a womb and there are no conflicting rights and interests between the child and his or her mother.

At this point I'd like to invite Father Mercier to proceed.

Father Ron Mercier (Dean, Regis College, Toronto School of Theology, University of Toronto; Representative, Canadian Conference of Catholic Bishops): On the matter of embryonic stem cell research, the act would permit, under licence, embryonic stem cell research on embryos who remain after fertility treatments, embryos called “spare” or “surplus”. Scientists tell us that embryonic stem cells are capable of forming virtually any tissue in the human body, and can be used to repair tissue that has degenerated or been destroyed. This has understandably excited scientists and raised the hopes of people who live with a variety of degenerative diseases such as Parkinson's, Alzheimers, muscular dystrophy, and spinal cord injury.

While we would like to support research that has the potential to do so much good, we cannot in this case, because scientists also tell us that deriving stem cells from the embryo destroys the embryo. Other alternatives can produce the same good without destroying the embryo.

Stripped of its cells and destroyed, the embryo is reduced from a subject to an object, from a human being with dignity to a source of organic material. No amount of public benefit or healing could ever justify the deliberate killing of a human being. No human being, including the embryo, should ever be used as a means to an end. No human being, no matter how tiny, can be killed to help another. No human being should ever be considered spare or surplus.

• 1050

Some will argue that the embryo who is not implanted will die anyway, so why not do some good? A better question for people for whom in vitro fertilization is acceptable would be, why create more embryos than are needed for implantation? Why not spend time researching ways to do this procedure that are not dependent on using powerful, costly drugs and creating additional embryos who are put at risk either through freezing or experimentation? By allowing stem cell research on the embryos who remain after fertility treatments, are you not inadvertently encouraging the creation of extra embryos, subverting the very welcome prohibition against creating embryos for research purposes?

On therapeutic cloning, we strongly support the provision in the draft legislation that would prohibit therapeutic cloning and urge you to resist the pressure coming from some groups to permit this procedure. This type of cloning has a misleading name, because it results in the death of the cloned embryo at an early stage for the purpose of retrieving stem cells. The embryo is produced solely to be destroyed for his or her stem cells. Legal, medical, and religious leaders in Australia recently said that therapeutic cloning “produces a laboratory embryo with no parents or guardians, in fact no one concerned to protect his or her interests”.

Therapeutic cloning is supported by some of the organizations searching for a cure for degenerative diseases. While it is easy to understand their deep desire for a cure, this method would result in human beings being used as nothing more than industrial raw material, which is dehumanizing for us all. There are also serious ethical questions about the many women who would be required to donate eggs, a procedure that is painful, risky, and invasive.

In regard to adult stem cell research, while the initial focus in the media and scientific community has been on embryonic stem cell research, there have been remarkable developments in adult stem cell research. Adult stem cells, or non-embryonic stem cells, have recently been found to have surprising plasticity and versatility, with stem cells from bone marrow giving rise not only to blood cells but also to muscle, liver, and neuron-like cells. Neural stem cells can give rise to blood and other cell types, and this summer researchers in Montreal found stem cells from the skin of mice and humans could grow into complex brain cells, smooth muscle, and fat. Stem cells have also been found in fat, the blood of umbilical cords, and human placentas.

Adult stem cell therapy would be preferable to embryonic stem cell therapy, because there are no problems of tissue rejection and no ethical problems. We suggest that the government focus on allowing and funding research on adult stem cells, because it would not involve the destruction of human life. This would be a way forward that would facilitate scientific progress while respecting human dignity, and it is something we could all agree on.

[Translation]

Finally, I would like to speak of the embryo's moral status. The background information around this legislation suggests that the government's inclination to regulate embryonic stem cell research has been influenced by the Discussion Paper released by the Canadian Institutes of Health Research this spring.

The CIHR accepted the middle ground granting the human embryo a special moral status by limiting the source of embryos for research, prohibiting commercialization, requiring free and informed consent and insuring confidentiality. With respect, when it comes to human life there can be no middle ground and a status that permits a human being to be killed is not special but meaningless. Surrounding the research with what can only be considered secondary ethical guidelines masks the fact that the ultimate ethical decision has already been made that research will be permitted that results in the destruction of the embryo. The desire to help and heal others is deeply human; there are ways that it can be done without harming another human life.

Members of the committee, may I say, by way of a conclusion, that you have undertaken an enormous task that affects the health, safety and life of Canadians, particularly women and children. You deserve our appreciation because these issues are scientifically complex and the ethical dilemmas profound.

• 1055

The last few years have seen some truly stunning scientific achievements and evoked some wonderful responses. Last February, when the announcement was made about the first draft of the human genome, politicians and scientists spoke of “the language in which God created life”. To that we could add:

The humble and persevering investigator of the secret of nature is being led, as it were, by the hand of God in spite of himself, for it is God, the conserver of all things, who made them what they are.

Thank you very much.

[English]

Thank you very much.

The Chair: Thank you, Your Excellency, and thank you, Father Mercier.

We'll now proceed to phase two of our meeting, which is questioning of the witnesses by the members.

We'll begin with Mr. Manning.

Mr. Preston Manning (Calgary Southwest, Canadian Alliance): I'd like to say thank you to each of the witnesses for your presence this morning. I think all committee members feel it's very timely, particularly your presentations on embryonic stem cell research. As this announcement from the U.S. about the successful therapeutic cloning of an embryo is ostensibly for the purpose of producing stem cells to treat disease, your remarks are certainly relevant.

I'd like you to imagine for a moment that we are the regulatory tribunal that has been set up by this act, and I'd like to ask Mr. Soler, first of all, how you respond to the one moral dilemma in granting what you asked, the concern that embryonic stem cell research involves the destruction of the embryo, the one big moral obstacle, I think, to going along with your argument. I'd like you to address that moral dilemma as if we were the regulatory body trying to decide what weight we should give that.

Then I'd like to ask the Catholic faith representatives how you respond to the obvious concerns of the parents and the children who feel that we have also a moral obligation to heal, and if embryonic stem cell research were the best hope for their children, how do we balance the moral concern about the status of the embryo with the moral obligation to heal and the potential that embryonic stem cell research appears to grant?

Mr. Soler, maybe you can go first, and perhaps one of the others can respond to the other side. Mr. Windwick can be the lawyer in this.

Mr. Lawrence Soler: I would say there's no question that there are deep moral issues and challenges here, and there's no question that when you derive an embryonic stem cell from a human embryo the human embryo is destroyed. Those are facts, and I think we all agree on that.

I would just stress a few points. One is that the human embryos that are going to be used for this research have already been created for another purpose, which is for in vitro fertilization to produce a child, and as was mentioned, as part of the in vitro fertilization process, that process involves creating more embryos than are needed to initiate a pregnancy. You can have up to 10 or more embryos created for one pregnancy, and you're going to have embryos discarded for that purpose. Our point is that they're going to be discarded, they're not going to be saved, so let's use them to save lives.

The other point is that once you derive an embryonic stem cell from a human embryo, they have an ability to self-perpetuate and grow indefinitely in the laboratory dish. So we don't believe in the long term there's going to be a never-ending need to go back and use new human embryos for this research. Once embryonic stem cells are perfected and derived from human embryos, they will grow in the laboratories and they will be able to use...

So our hope is that there will be a time where you will have insulin-producing cells growing in the laboratory that can be given out to clinicians, and they continue to grow. One scientist described them as growing like weeds in a research laboratory, and then they can be transplanted. So we don't continue to foresee a need to go back to human embryos as a source tissue in the long run. I think this is going to be a short- or medium-term step to get us from here to there.

Mr. Preston Manning: Okay.

• 1100

Dr. Mary Lou Cranston: I guess the first thing I would want to say—there are a couple of things—is that at this point perhaps the embryos are the best source, but I'm not sure we haven't got a lot of information suggesting other cells could be an equally good source. So one of the things is that we need to decide where we're going to put our energies in terms of developing a source.

Linked with that, I guess I strongly believe that if we really accept that the embryo is a human being, we can never in principle use one human being—and destroy one—for the other human being. I think that would be my bottom line to that.

As I look at even things like the Edmonton Protocol, which is what you were referring to in terms of Dr. Shapiro's work in diabetes, we could put an awful lot more energy into doing the next steps of that kind of research in developing the number of... or whatever the eyelets are we need to do that kind of thing. So I guess it's a matter of where we're going to put our energies.

The other thing I need to say is that I hear that we have all these spare embryos. I'm afraid that what happens is we say, well, we have them all, so we have to use them. But we don't question why we have them all. We just keep doing one thing, doing the next, doing the next, and then we start saying, well, it's accepted that we have all these extras. Why do we have all the extras? We might have the extras now, but we don't need to have them as we go forward.

I think there are some fundamental questions, but the most fundamental for me is that I would never use one human being to help another—kill one in the process of helping another. That would be my bottom line.

The Chair: Thank you.

Mr. Manning.

Mr. Preston Manning: Okay, I have a second question related to this. If this regulatory body is created, regardless of the shape of it one of the concerns will be to ensure standing before the tribunal for all the big, major perspectives—the scientific perspective, the public perspective, the faith community perspective. I wonder whether you feel that what you're perhaps solely looking at from the research and scientific standpoint, and the others from the faith perspective—that your particular perspective has the standing it needs to make its arguments and be credible in front of this regulatory tribunal. Perhaps Mr. Windwick might even comment on other things we have to do to make sure all the relevant perspectives have standing.

In saying that, I'm conscious I'm not just talking about technical standing to get through the door and be in a hearing room. I recall when the Sharpe case on pornography was being looked into by the B.C. supreme court; although the faith communities were allowed in the door, their arguments on pornography based on faith were virtually dismissed as not being relevant—even though technically they were present.

I'm asking about real standing. Does the act create real standing for all the major perspectives and ensure things that have to be done to ensure that your perspective or others have that standing before the regulatory tribunal?

Mr. Lawrence Soler: I would say we honestly don't know for sure until we approach it, but we have a very strong confidence that we would have that ability and standing and would work very closely with the body to ensure that our views are heard and that they understand our needs. We feel comfortable in moving forward in that process.

Dr. Mary Lou Cranston: The one thing I'd like to contest is I'm not sure it is a “faith” perspective that we don't kill one human being for the sake of another human being. What I'm trying to argue is I think it's a fundamental “human” perspective. We have to be careful we don't start labelling stuff faith perspectives, and therefore of only a certain group of people, when there are fundamental human values at stake.

I'd just like to put that in the mix.

The Chair: And the need for standing in front of an administrative body; could you respond to that, please?

Father Ron Mercier: At present, as a number of the groups who have appeared before this committee have noted, much will depend on the form of the ultimate advisory body as it is set up. It would be critical that there be a wide spectrum of ethical voices, including religious, certainly, and faith-based communities, but also the ethics community generally.

Given the current shape of the legislation, it is unclear what role such an advisory body would have, or whether any such advisory body would have a wide spectrum of opinions, including faith-based. So it would be a matter of concern for us.

• 1105

Mr. Preston Manning: Mr. Windwick, in your view, more from the legal standpoint, are there things that have to be done to assure adequate standing for the various perspectives that have to be brought into account here, or are you satisfied that using the conventional techniques it can be achieved?

Mr. Brent Windwick: I think it was just mentioned that this is very uncertain, because the shape of the oversight authority is still uncertain. It would seem to me it would be important to look at this issue of having a proper cross-section of views at two levels.

One is in the representation on the oversight body itself, whether one is talking about the actual decision-makers or about an advisory body to the decision-makers. I think the views that have been expressed this morning are all views that really belong in at least an advisory capacity if not as participants in the decision-making of this oversight body.

The other level at which I think it is important is that once an oversight body is established and given certain rules to work with, it needs to establish protocols or policies that would mandate a certain level of representation and a certain quality of representation from all the interests that need to be engaged in the process. They may not necessarily be exactly the same interests in every single circumstance, but I think one could easily envisage a core group—not just of scientists, but of philosophers, the faith-based communities, policy-makers.

All of those need to be represented in some way. It seems to me if they aren't represented in the oversight body itself, then there should be some sort of standard set of rules that would govern standing for others. And I think that's quite feasible.

The Chair: Thank you, Mr. Manning.

May I just say, ladies and gentlemen, we have a good turnout this morning. We have 55 minutes left, so in order that everyone who wants a turn gets it, I'm going to limit you to five minutes. If at the end some people didn't want to participate, we'd then have time to begin a second round.

Mr. Merrifield.

Mr. Rob Merrifield (Yellowhead, Canadian Alliance): Thank you very much. Since I have only five minutes now, I guess I'm going to have to make my first question go a little faster.

Mr. Windwick, I was actually quite interested in what you were suggesting. If I caught what you said aright, you're suggesting that prohibition should be under, or should make it into, the regulatory framework because it's a little more responsive. Then you suggested the only way you could pull a prohibition from that would be to have a negative vote... by Parliament?

Mr. Brent Windwick: That's one of the options we're putting forward as a way of ensuring there's adequate flexibility and responsiveness of the part of the oversight agency but at the same time ensuring there is democratic accountability and transparency in the process.

There seem to be a number of ways this can be done. One of them is to have some sort of mandatory consultation process following any decision taken by the oversight body to change the prohibition list in any way. That's one option. Another option put forth in our submission is to actually make it subject to essentially a veto by a majority—perhaps not a simple majority, but some majority—of members of Parliament. The ultimate accountability and responsibility for changes in these prohibitions, although it doesn't require full parliamentary debate for a legislative amendment, would still be there and would still be effective.

Mr. Rob Merrifield: What that in effect would do is make an issue that was prohibited come forward in a much smoother and easier way when it is proposed to come off the prohibition. Is that your intent?

Mr. Brent Windwick: Arguably, that would be so, and it could work the other way as well, obviously. If three years down the road something that was a licensed activity turned out to be causing significant safety and health risks to the population, then a decision could be taken to add it to the prohibition list that's in the regulations, and the same process would unfold.

Mr. Rob Merrifield: I'll be going through your draft in more detail, but obviously it's the accountability of that regulatory body that is of great concern to this committee, so that we may have enough faith and trust in the decision-making about what is prohibited or not. It also throws up questions in my mind as to provincial jurisdiction and federal jurisdiction—and under the criminal law, which is federal—in that relationship.

• 1110

I have only five minutes, and I don't think I'm going to get the answers there anyway, so I'd like to put another question from a different angle, that of the faith communities.

What you're suggesting—and I concur—is that human life and dignity are threatened by using an embryo. Is there an ethical dilemma at all in non-embryonic uses of stem cells, from a fetus or anything else? You've said not to go down this path because there's a lot of danger there; go down this one because it's adult or non-embryonic. Are there any ethical concerns down this other path?

Dr. Mary Lou Cranston: From the perspective of the fetal tissue, the one question we would ask is the source of the fetus. In other words, if we paid people to be pregnant for three months and then took the fetuses, it would be an abortion question. That would be an ethical issue. If on the other hand we were using the fetal tissue from spontaneous abortions, miscarriages, then I don't see a problem with that. It would be no different from using a dead human body.

Father Ron Mercier: The one significant concern that's arisen in a number of areas is that the question of consent for the use of the cells would be a critical issue in the long run. For example, with certain forms of genetic research, cells or gene lines have been taken without the permission of the people from whom they are derived. So an informed consent for the use of the cells would be important in the long run.

Mr. Rob Merrifield: Before the chair cuts me off—and if you go too long, she will—I want to ask Mr. Soler a question. Perhaps you can answer both at the same time, because she'll allow that.

You mentioned, Mr. Soler, under the regulatory body, that perhaps the destruction of embryos is appropriate. You also used the word “safeguards”, that there should be some some safeguards in the regulations. I'm quite intrigued by what you see as a safeguard in regulation that would find the destruction of an embryo okay.

Mr. Lawrence Soler: I think the embryos we're talking about are going to be destroyed no matter whether this research is permitted or not. That's issue number one.

But, yes, I think safeguards would be an integral part of this—for example, on issues like informed consent, that you cannot make payments to purchase embryos, or that the decision to begin in vitro fertilization is separate from the decision of what to do with the surplus eggs. All those are the types of ethical safeguards I think many people would support. So those are the things I'm talking about.

Following up on the issue about spontaneous abortions and miscarriages, I think it's important for people to remember that the National Institutes of Health funded a major study of this in the early 1990s, awarding a major grant to see whether tissue from spontaneous abortions and miscarriages would be available and useful for research purposes. The research did not pan out well at all. It turned out those tissues were defective in most cases. So keeping that in mind, it's probably not going to be a good alternative.

The Chair: Thank you, Mr. Merrifield.

Madam Sgro.

Ms. Judy Sgro (York West, Lib.): It's interesting, we've had several months of meetings and we all seem to be coming to a lot of the same conclusions or specific areas of interest. Some of my questions have been grabbed very quickly by Mr. Manning, so I think you can get a feel that the committee is struggling with an enormously difficult issue.

We appreciate you coming today, but we have to make decisions over this next little while. And the more we hear, the more difficult it becomes. I think I started to feel I was going in one direction, and then there were some other issues raised that brought them back to the minds of most of us. We have to try to deal with that balance.

To Reverend Prendergast, as someone I've known for a long time, how do we deal with that? How do we get that balance? It would be one thing if the whole world were in agreement with the question of the 14 days, the fetus, and all of those other complicated issues, but given the fact that we represent a country that is very multicultural, very multi-faith, how do we do our jobs as parliamentarians and find a balance to ensure the safety of these issues and to recognize the other needs and the science that's moving so quickly ahead of us?

• 1115

Archbishop Terence Prendergast: I don't think there's any easy answer, but I think Dr. Cranston raised the position of whether there are some fundamental issues on which we can agree—that is, not to do evil so that good may come. That's a very difficult statement, but I think one of those fundamental principles is that one should not take life, even if it's to benefit another person's life. I believe those are not only faith-based convictions; they are convictions that human beings generally agree on, whether they have faith or not.

So I think, first, principles have to be one of those bases for the conclusions you will draw. Whether it's possible for you to do that, I don't know. I don't know how your committee works or how you'll actually come to draw a consensus.

I think one of the difficulties we had is that you can set up these extremes and then come out in the middle position, but in a way, the middle position doesn't please anyone. Sometimes it actually undermines one of those basic convictions.

I guess we simply have to urge you to do the best you can according to your conscience and according to the data you've received. As well, see if you can't articulate the fundamental principles on which you are basing this. I guess that's why preambles are important.

That's the best I can suggest. Maybe someone else would have a comment.

Ms. Judy Sgro: Regarding the issue of having a regulatory body at arm's length to try to deal with this legislation, rather than Parliament, which avenue gives you the most feeling of security and comfort, if those are words we can use?

Archbishop Terence Prendergast: Personally, I feel a body that is somehow responsible to Parliament would be a better vehicle. I think sometimes regulatory bodies that are not accountable can take on an independence and move in directions you yourselves would not want. I think that's the way I would prefer it, that somehow there be an accountability to Parliament. I don't know how that would be structured, but that would be my preference.

Ms. Judy Sgro: In regard to violations of the legislation, we're looking at putting things into the Criminal Code, looking for a way we can get as much enforcement of this legislation as possible, once a decision is made. There are some people who think we are criminalizing women and others who are attempting to do something for the good of mankind. Should we be doing that?

Archbishop Terence Prendergast: Again, the question is, what is the purpose of the law? Does the law teach as well as enact punishments or penalties? I think there's a normative character that comes from the law. And we don't have any question about “Thou shalt not kill”. That's part of our vision of society. Can we see this as somehow entering into this field? That's the nub, isn't it. I don't think we would have any question about any other vision of killing another person. But if the person seems to be unseen, or invisible, or in a petri dish, or somehow distant, then it becomes less a person, and I think that's where you'd have to go back to your fundamental principle.

Ms. Judy Sgro: Thank you.

The Chair: Mr. Ménard.

[Translation]

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): Thank you, Madam Chair.

This is without a doubt one of the most interesting panels we have heard from since the start of our deliberations. The worst thing for Canadians would be our failing to think out as clearly as possible these various issues. I will tell you quite frankly that in caucus I intend to argue that an embryo that is only a few days or a few hours old is not yet a human being.

I would like one of our witnesses to indicate to me whether any court in Canada has decided otherwise, since I believe that Canadian courts have taken a very clear legal stand on this issue: the foetus is a human being from the moment it leaves the mother's womb and is deemed to be living and viable. That is the legal standpoint and I submit, in all due respect, that it is from the legal point of view that Members of Parliament should consider the issue.

• 1120

I believe, furthemore, that it would be a very grave error with respect to future generations if we were not to come down clearly in favour of the right to engage in stem cell research. As you know, the Canadian Institutes of Health Research have outlined an analytical framework which was, on the whole, well received by the scientific community.

But all this gives rise to the following issue. On one hand, the ecclesiastical community and, more broadly, the people who focus principally on the ethical dimension, affirm that human life must be respected. I agree, but believe that this concern must be balanced by respect for the human condition. There is suffering. There are people suffering from degenerative diseases. If we want the research into such diseases to bear fruit in the short term—and I don't mean 50 or 60 years from now—we must authorize stem cell research without delay.

That, I believe, is the ethical or moral framework for determining the issue.

You stated that it was possible to use adult stem cells, adding that research has already been undertaken along those lines. We have heard from researchers in Massachusetts and within the next few days we should also be hearing from scientists working in London, England. We have also heard from researchers funded by the Canadian Institutes of Health Research who told us that it was difficult to use adult stem cells, and that in order for research to reach its full medical and scientific potential, it was absolutely necessary to use cells found in the embryonic pouch. It was clearly stated that the four or five day-old embryonic pouch contains approximately a hundred stem cells crucial to the regeneration of adult tissue.

You could perhaps outline a perspective the committee has not yet heard. I myself consider that we should decide in favour of the use of embryonic stem cells. Do you agree that adult stem cells do not, for research purposes, have the same regenerative potential as that pool of a hundred embryonic stem cells? Is there common ground on that point?

[English]

The Chair: Mr. Ménard, I want to alert you to the fact that you've used 3 minutes and 19 seconds. Therefore, you probably will only get one answer.

[Translation]

Mr. Réal Ménard: Let us love one another.

[English]

The Chair: Who's going to respond to that?

Mr. Lawrence Soler: I'll respond.

Particularly in the case of diabetes, you can look at specific issues on adult stem cells versus embryonic stem cells. While there has been research to find certain adult stem cell-like structures from the pancreas, none of them have definitively been able to be called a stem cell. They have problems growing, they don't produce insulin in the same ways, and the numbers aren't there. We've been doing adult stem cell research for more than 20 years. For the human embryonic stem cell research, which has only been going on for three years, researchers have already been able to show, in three different studies, expressed markers of early pancreas and the ability to express insulin. That's on top of the reports from the National Institutes of Health and the National Academy of Sciences. Even in America, President Bush's own statement basically recognized that human embryonic stem cell research is important and valuable. Even with his own strong pro-life views he has decided it's best to move forward.

The Chair: Is there anybody else?

Father Ron Mercier: Part of the issue is that while it is true we have been researching on adult stem cells for some years, the rate of development in terms of research and results in adult stem cells has been markedly growing within the last few years. The recent discoveries in Montreal, at Montreal Neurological, have been extraordinarily important and unexpected. In August, I think, the finding of the ability to regenerate some of the most complex cells within the body came forward.

In some ways, then, while embryonic stem cell research in the United States and in the United Kingdom have shown possibilities, it remains unclear whether, with sufficient investment of resources, adult stem cell research would not provide the same kind of results.

The Chair: I'm sorry, Mr. Ménard. You're over. You can ask again in a second round.

Mr. Dromisky.

• 1125

Mr. Réal Ménard: You don't love me?

Some hon. members: Oh, oh!

The Chair: Those who are witnesses to this committee on a regular basis know that Mr. Ménard and I have an ongoing love-hate relationship. As a matter of fact, some people might even think we were married.

Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.): Madam Chairperson, could you restart the clock, please?

The Chair: Yes, Mr. Dromisky.

Mr. Stan Dromisky: Going through your document this morning, many of the pragmatic concrete dos and don'ts are there, but I would like to switch the discussion to the philosophical level here. The Most Reverend Father Prendergast has already given me some information this morning.

On a very pragmatic, self-serving level of morality, there isn't as much mental anguish personally—and I think for most people that's true—but on a philosophical level of morality, we could drive ourselves crazy. There's no doubt about it, the personal anguish level is extremely high, the anxiety level is high, and that's what this committee is going through. We've been going through it for quite some time.

From the pragmatic level, the self-serving level, a group of cells called an embryo potentially has a great benefit. There you have an adult, a full-grown adult, who potentially can benefit society. The embryo doesn't carry a gun or drop bombs; the grown adult drops bombs and carries a gun. Yet there's this dichotomous situation we find ourselves in today where, philosophically, it's all right to kill. It's all right for adults to kill. We even bless those adults to go in to make sure they kill more efficiently and more rapidly before they get killed themselves.

A harmless embryo, which potentially has a great deal of benefit, possibly, for mankind, does not carry a gun, and we're doing everything in our power... or we're dealing with this problem of trying to stop it from doing any good whatsoever.

This is the philosophical, psychological level of anguish we're going through at the present time. When you start comparing those kinds of situations and scenarios, how can you justify stopping research from going on when we're doing all these other horrible things that are going on in the world today?

Voices: Hear, hear!

The Chair: Does anyone have a comment on that?

Archbishop Terence Prendergast: There are several ways we can look at it. One of them is that this potential human being, this embryonic cell, could become a great scientist, could become another Beethoven, could be another famous painter or dancer. If we simply treat it as material from which we can extract raw data to create a scientific conclusion, then we have really objectified it. We've made it a thing rather than a person. And I think that's the problem.

The other thing is that with adults, even though they can throw bombs around or have guns, we try to regulate that. As human beings, we want them not to carry bombs or to gun people down. We want them to be sources of life. We're arguing today, some of us, that this potential life that is here cannot be objectified, should not be objectified, but must be respected.

To do no harm is a great principle. How to do it in this particular instance is very, very difficult, and I don't envy you your task. You need to hear everything that's been said and weigh all the various things in the balance, but I think the issue of the protection of life and the respect of the individual is key. We can say we respect the dignity of every human individual, but we don't see the embryonic stem cell as a human individual, we see it as a thing. And when we do that we're less than human. So it's a painful thing.

I think that while we see that adults do evil things, we try to prevent and to curb that. We try to convert hearts and we try to bring people to their dignity, as human beings, to see that killing is not right.

• 1130

In a way, our own reflection in the Catholic Church has led us to argue—and I know this is not a popular vision in some centres in Canada—that the taking of capital punishment is not appropriate anymore. We can so restrain an individual now that there's no need to put a person to death.

Obviously people in the United States don't share that view. Many people in Canada don't, but to me, that respect of the dignity of each individual goes that far. So I'm glad you've raised the philosophical issue and so on, but you've not given us an easy choice, and I pray for you. I offer you not only my encouragement and my support but also my prayers that you will know what's right and wise.

Mr. Stan Dromisky: Thank you very much.

The Chair: We don't usually have applause in committee rooms.

Mr. Lunney, please.

Mr. James Lunney (Nanaimo—Alberni, Canadian Alliance): Thank you, Madam Chair.

I would like to pick up on some of the comments on stem cells. First, my colleague Mr. Ménard, who has disappeared on us, said that the courts have decided that an embryo is not a human being, and we have no alternative. Therefore, using embryonic stem cells was a way he went...

Of course, we've had medical doctors and researchers as witnesses. There really isn't any contest about when life begins. Certainly if we leave it to the courts to decide on scientific issues, perhaps we're not looking at the best evidence.

We've had witnesses here who stated that life is, of course, a continuum, beginning with conception. There is no other scientific way to explain this. You can come up with political ways of rationalizing, but life is certainly a continuum.

I'm interested in the remarks of Mr. Soler, on behalf of the juvenile diabetes association, that it's impossible to predict which type of cell will provide the most benefits.

You say the embryonic have two distinct advantages—that they are able to grow indefinitely in a laboratory and that they are able to grow into any cell type. Well, you haven't listed, in balancing that, the problems with embryonic stem cells. While it's certainly true that embryonic cells are rapidly growing, they're destined to become a full-blown human being, 80 trillion to 100 trillion cells, which all of us in the room here represent. Their rapid growth is, of course, in terms of their destiny.

The tremendous breakthroughs that have been mentioned here with adult stem cells present new opportunities for us. But I'd just like to mention that if we were to take these cells and transplant them... And the fetal cells have been quite a disappointment in regard to diabetes. Just to quote from one testimony before Congress, “Fetal cells are too immature to produce much insulin”.

By the way, the American Diabetes Association is not on board in supporting your comments. In their paper Unproven Therapies, they talk about proposers often providing exaggerated, unrealistic claims about these modalities.

But with your fetal cells, if they were transplanted, or your embryonic ones, you'd have the problem, of course, of rejection. You're going to be on anti-rejection drugs the rest of your life. You have the risk of rejection to begin with, the risk of anti-rejection drugs, the risk of viral diseases, and the risk of genetic diseases. We've had researchers, medical researchers, admit here that the gold standard is going to be adult stem cells, if we can harvest cells from your own body. Because then you have an autologous transplant and you don't have all these complications.

So that has been certainly acknowledged here. I don't know where Mr. Ménard was when this testimony came before committee, because it's quite clear that we can predict which is the best outcome; we're just not quite there scientifically to deliver. But the promise out of Montreal and other researchers with adult-based cells is showing that indeed the genetic code is in every one of our cells to produce an entire human being, and therefore to harness the cells... That's what we hope to be releasing, and a lot of our researchers do.

As a first comment, did you know that the American Diabetes Association is not on board in supporting embryonic as enthusiastically as you do?

Mr. Lawrence Soler: Actually, respectfully, sir, I was at the hearing you refer to where that fellow testified, and he had his facts incorrect. The American Diabetes Association is part of the Coalition for the Advancement of Medical Research, which does support embryonic stem cell research, and I'd be happy to provide, for the record, their policy statement stating their support, if I may.

On the issues of rejection, those are good issues you've brought up. There are a few different ways of looking at this. There are some differences about juvenile diabetes versus some of the other diseases we're talking about—Parkinson's, ALS, and others. Juvenile diabetes is an autoimmune disease, which means the body's own self destroys its insulin-producing cells, unlike Parkinson's disease, where it's not an autoimmune disease but some other type of destruction that takes place.

There are some scientists who actually believe using your own cells, because they have that genetic autoimmunity problem, could be less helpful for the transplantation.

• 1135

There are some scientists who actually believe using your own cells could be less helpful for the transplantation because they have that genetic autoimmunity problem. We don't know yet, because we haven't gotten to the clinical trials for this research. It could turn out that using cells from another person for juvenile diabetes, multiple sclerosis, lupus, some of these autoimmune diseases... There are over a hundred autoimmune diseases. It actually could be more helpful to use cells not from your own self. So it's hard to know.

We do support and fund adult stem cell research. Our foundation funds them. As I've mentioned, they've been going on for many years, and I agree that there has been more progress in the last few years on adult stem cell research. Frankly, we don't really care where we get the cure from versus these two different areas, adult stem cell research or embryonic cell research; we want to see a cure, and that's why we support both.

In fact, it may turn out that we need to do research on embryonic cell research and learn things from that to figure out how to make adult stem cells work better for people in transplantation. That may turn out to be what happens. But as a matter of science, looking at the NIH, the National Academy of Sciences, and 80 Nobel laureates who wrote a letter earlier this year, I think it's pretty clear that, with current thinking, embryonic stem cell research seems to have more hope for most of the diseases, from my research.

Mr. James Lunney: That's very interesting, because we did have other witnesses from the scientific community who have all acknowledged that if we can harness adult stem cells, there's no contest, because of the compatibility genetically.

But as a comment, in terms of this legislation, it purports to create children. It's draft legislation on assisted human reproductive technology. The purpose of the legislation is to produce children. As far as the excess ones are concerned, you said they're going to be destroyed anyway, therefore we should use them. But in reality, not every child that is conceived or every attempt at conception is successful, even naturally. There are many conceived embryos that people never know about. They're just not successfully implanted, and they're lost.

If the purpose of our legislation is to help people produce babies, then perhaps we should look at making sure that the embryos created for this purpose either fulfil their destiny or they would pass the way many millions go—that is, they either fulfil their destiny or they don't. But using them, because you say they're going to be wasted anyway—

The Chair: Mr. Lunney, you're well over your time. Can you quickly phrase your question and we'll get an answer?

Mr. Réal Ménard: Ah!

The Chair: Yes, it's my fault.

Mr. Réal Ménard: In French, we say “chouchou”.

Mr. James Lunney: Perhaps someone will have an opportunity to comment on that. Using them because they're going to be wasted doesn't have to be a legitimate argument.

The Chair: We'll make a mental note about that idea and maybe fit it in with another answer, because we're moving on to Madame Thibeault.

[Translation]

Ms. Yolande Thibeault (Saint-Lambert, Lib.): Thank you very much, madam.

I would now like to address a completely different issue, if I may. I would like to speak of surrogate mothers. How do you deal with something like that. As a lawyer, you are saying the pregnancy contract should not be enforceable and so on. By the same token, you also assert these contracts should not involve any financial transaction. Several witnesses have stated that where, for example, a woman is incapable of bearing children but where her sister can, and everything remains within the family, they don't really see on what basis you might want to prevent that sort of agreement.

I wonder how the Catholic Church views surrogate motherhood under such circumstances. I also wonder where the line might be drawn from the legal point of view. You have stated that a woman who is employed should, during her pregnancy, continue to draw her full salary, etc. Where do you draw the line?

• 1140

[English]

The Chair: Father Mercier.

Father Ron Mercier: In terms of the question of the Catholic position on surrogacy, the issue for us, of course, is that at this point, on a couple of issues, it is morally problematic. First, it does significantly move outside the familial context. The process for us, the linkage between procreate reproduction and the family context, is a critical one. Introducing the third element, for however good a reason, is already a seriously problematic issue.

Second, it inevitably leads to the question of commercialization, precisely because it's contract law. Trying to draw any line, the moment you move outside of pure altruism, would be exceedingly difficult. What falls within acceptable remuneration? It is very difficult to draw that kind of line.

So on the two issues, in principle, we don't accept it. Even if it's accepted, it is very difficult not to make it a commercial transaction, as has been recognized in law in a couple of American states—New Jersey, for example.

Mr. Brent Windwick: I would certainly echo what Reverend Mercier said about the difficulty in drawing a clear, bright line between what is commercialized and what is not. Nevertheless, I think there are many people in this country who feel they have no other option, or have determined this is the best option. The position we take is the key to this is not whether there should be surrogacy or not, but it is trying to draw the line between relationships that are exploitive of one party where the balance of bargaining power is not appropriate.

It seems to me that within general parameters one can make the distinction between surrogacy arrangements that are commercial and surrogacy arrangements that are not. Within those broad parameters, I would acknowledge there is an area of ambiguity when you get to the point of saying someone should receive money or assistance for any reason whatsoever. The draft legislation, as it stands, contemplates certain kinds of medical and counselling assistance. In our submission, it seems to be a reasonable thing to offer.

I don't think anyone in our section of the Canadian Bar Association or in the family law section would promote the idea of a fee or any sort of consideration for a surrogacy agreement, or as part of a surrogacy agreement. However, the idea that a surrogate mother bears certain extraordinary expenses because of her status as a surrogate mother bears consideration in terms of whether the expenses should be reimbursed.

We are suggesting the draft legislation perhaps doesn't pay enough attention to at least that little part of the grey area. But just to be absolutely clear, we are not in any way suggesting that a true commercial arrangement, where a fee would be paid for the service, would be appropriate or would belong in this legislation.

The Chair: Thank you, Madame Thibeault.

Mr. Manning, do you have another round?

Mr. Preston Manning: I have one question for Mr. Windwick.

In looking at this legislation overall, do you have any concern about the jurisdictional question? I think some of us on the committee feel, particularly as you get into the regulation of human reproduction procedures, you're really getting into medical practice. When you get into the operation of information, health information systems, and regulations that pertain to family law, you are getting into the provincial jurisdiction.

Do you have any concerns about it, or any suggestions where the line should be drawn, so we don't end up in endless litigation?

• 1145

Mr. Brent Windwick: It seems to me the line between federal and provincial jurisdiction in this area is not an easy one to draw. I think a reasonable analogy is environmental law, where the Canadian Environmental Protection Act was subjected to the same judicial scrutiny.

This draft legislation, as it is framed, will meet the appropriate legal test for the federal government to assume jurisdiction over the activities it seeks to regulate. We would certainly encourage legislative harmonization with the provinces. The Canadian Bar Association has passed a resolution to this effect. As in the case of the Environmental Protection Act, it is extremely important for there to be consultation between the federal government and provincial governments about the regulation of activity like this.

Can the federal government legitimately legislate in this area? I know there have been different views expressed about the level of risk for challenges to legislation like this. Our view is this legislation, and in fact the legislation as we would suggest it be framed, would meet the test for federal jurisdiction.

It does not in any way minimize the importance of trying to get the provinces on board as well. The best solution would be a harmonized regime of federal and provincial legislation that would permit the activities to be regulated nationally.

The Chair: I believe Mr. Ménard is next.

[Translation]

Mr. Réal Ménard: Madam Chair, you are too kind.

[English]

The Chair: Try to ask the question, Mr. Ménard.

[Translation]

Mr. Réal Ménard: Madam Chair, give me a break.

There are two questions I would like to ask. Do you urge us to affirm, in the bill, that the embryo is a human being? Do you feel that position would be compatible with the decisions handed down by the courts up to now? I know that you would not be asking us to assert in draft legislation something that has not been accepted by the courts.

And then, we will be hearing, this afternoon, from witnesses who feel that persons living on their own, either single mothers or lesbians, should have access to fertility clinics. Are you in favour of this?

[English]

Archbishop Terence Prendergast: I'd like to answer the second one.

From our perspective, we would prefer to see conception within the marital unit, the family unit, and not single people. I know it is not a position shared by everyone in society. We believe it's the best context in which to raise a child. It's the position we would take. It should be restricted in that way. It's our view.

Would you like to comment on the legislation?

Father Ron Mercier: On the first question, as the Canadian Institute for Health Information pointed out, the question isn't necessarily a factual one. The recognition is certainly there that an embryo is a human being. The question is the moral status one attaches to it. It is often talked about as “personhood”. The analogy in the United States would be, at what point does personhood attach to the embryo?

We would certainly, on behalf of the Catholic community, strongly urge that the human embryo at its earliest stage be treated as a human being, a human person.

[Translation]

Mr. Réal Ménard: But that is not what the courts have said. You do agree, do you not, that this has not been the position of the courts. You are asking Parliament to state in the preamble something which is not congruent with current law.

[English]

Father Ron Mercier: I would have to say I don't know the judicial history.

Mr. Brent Windwick: I could perhaps respond briefly.

I don't think there is anything in the preamble that is inconsistent with the way courts have defined where life begins or what personhood is. In order to accomplish the kind of objective that has been suggested, in terms of changing the definition of what constitutes status as a human or legal person, I think something would need to be put explicitly in the legislation to accomplish the objective.

• 1150

[Translation]

Mr. Réal Ménard: My question is the following. The courts have very clearly stated that an embryo is not a human being, since human life commences upon leaving the womb.

The bishops urge that we recognize the embryo as a human being. I myself am trying to think things through. The issue could be debated on the moral level but, as Members of Parliament, we are subject to the rule of law. You know what the legal tradition is concerning this issue. Can anyone indicate whether the Supreme Court or a court below has ever held an embryo to be a human being?

[English]

Dr. Mary Lou Cranston: I'm not sure of this, but I would wonder whether it says it's not a human “being” or whether it says it's not a human “person”. I think the difference is there. Even if we look at the preamble, we talk about human “individuality”, etc. We have several ways of talking about this. And I think it's the basic philosophical question.

If we go back to the abortion laws, to a case in Quebec, I think it was human “person”, not human “being”. It then becomes a philosophical question of how we understand “being”. It's the same as if you were to talk about a dog “being”. In other words, a dog exists. That's where the distinction has to be, I think.

Now, I'm not positive on that, but I'm pretty sure. The Chantal Daigle case is where that came from, if I'm not mistaken. That's what we'd have to look at.

If you look in your present text in the preamble, one of the points you affirm there is the “individuality”. So the text to me seems to keep playing with different concepts, and we're going to have to start doing some definitions of what they really mean.

The Chair: Thank you, Mr. Ménard.

Mr. Lunney.

Mr. James Lunney: Thank you, Madam Chair. I'll try to get a question in this time.

I want to go a different way, back to the surrogacy issue. The draft legislation, as you know, would ban commercial surrogacy. However, coming back to the question of reasonable expenses, we've had witnesses here testify reasonable expenses might be $2,500. I think I heard up to...

The Chair: Up to $36,000 a year for one pregnancy. So it isn't just some little token.

Mr. James Lunney: Right.

Is it conceivable that you could have a professional woman—a lawyer, say, one of Mr. Windwick's colleagues, or a doctor—earning $250,000 a year who wants to help someone with surrogacy who would be able to argue, under this “reasonable expenses”, loss of income, in order to supplement that kind of income to take a year off and enjoy having a baby for someone?

Ms. Yolande Thibeault: Spoken like a man.

Voices: Oh, oh!

Mr. James Lunney: Ouch.

Mr. Brent Windwick: I think that argument is certainly available to anyone if you accept as a principle that someone should essentially not be out of pocket by virtue of taking on this role and this responsibility. Practically, whoever is going to set these rules will have to look at a number of policy considerations, including not just the amount of income that a particular woman earned the previous year. I know there have been some views expressed that the equivalent of unemployment insurance benefits would be one standard to use. I'm not sure that's a view that's accepted by everyone.

It seems to me there's certainly a spectrum of numbers that one could talk about, and I think a lot of considerations would have to be taken into account in deciding what that number is. The key from our perspective is accepting the principle that someone who assumes extraordinary expense or financial burden by taking on this role should, in some way, be reimbursed or compensated for those expenses, and that would not make it a commercial transaction. Beyond that, I honestly don't have enough of a sense of the views of our members to offer a comment as to what level would be appropriate.

Mr. James Lunney: So the short answer is, yes, you think it would be all right for a lawyer to argue for $250,000, in essence, if that's what they wanted.

• 1155

Mr. Brent Windwick: I think it would be all right that they could argue for it, but whether they could get it or not, taking into account various other considerations, I don't know.

Mr. James Lunney: Would the Bar Association take the same view of the sale of gametes? Some fashion models have been offered up to $175,000 to superovulate and produce ova for people. Would the Bar Association support that?

Mr. Brent Windwick: I would say that's jumping quite a bit over the line into commercial transactions—the selling of gametes. What we're talking about is a situation in which a family member or somebody for purely altruistic purposes assumes the responsibility of carrying the fetus to term and perhaps because of unforeseen complications in her condition during her pregnancy is unable to work. We're not looking at this as an intentional money-making proposition for anybody.

Mr. James Lunney: Perhaps you're not, but if we leave the door open—

The Chair: Mr. Lunney, I think we've followed this enough. We have a picture of where Mr. Windwick stands on this. He's painted it clearly.

Ms. Wasylycia-Leis, very quickly, please.

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Thank you, Madam Chair. I appreciate you allowing me this question. My plane just arrived. I apologize for missing the presentations.

I trust the issue I'm about to raise may not have been addressed in full. It's part of the appendix to the Canadian Bar Association's presentation on jurisdictional issues. In many ways, much of this area has become a jurisdictional football with some areas not touched on at all in this legislation, and other areas touched on with less than the full force of the law or use of prohibitions and so on.

To the Bar Association, is there anything constitutionally or within other federal legislation, such as the Food and Drugs Act, to allow for the federal government to have clear standards and guidelines that provide a framework for provincial action as opposed to simply leaving it to harmonization and goodwill and cooperation between jurisdictions? Is there anything you can tell us that would help us push for national standards and guidelines and broad regulatory provisions to allow for leadership from our federal government, and thereby lead to harmonization across the board?

Mr. Brent Windwick: I have to preface my remarks by saying that I'm by no means an expert in environmental law or food and drug law or some of these areas you've talked about. Having reviewed some of the Supreme Court of Canada cases that evaluated these kinds of regulatory regimes, I would say first of all the federal government can take a leadership role in this area by this kind of legislation. It sets out principles, important principles, that will certainly have a persuasive force in any provincial regulatory regime.

I don't agree that getting into provincial jurisdiction is something the federal government can do. Obviously you'll be met with political resistance and probably legal challenge. However, the Canadian Environmental Protection Act, for example, presents an interesting example of a situation in which a federal-provincial joint body exercises a certain degree of discretion and can do a lot of good things in terms of standard-setting and harmonizing different regimes. Looking at an oversight regime under this sort of legislation, I think one might do well to consider what the federal government has done in concert with the provinces in terms of standard-setting.

In the Canadian Environmental Protection Act, if I remember correctly, the list of toxic substances, which was actually the subject of a Supreme Court of Canada case that was decided a few years ago, was something that required input from this federal-provincial advisory body before it could be finally decided upon.

There seems to be a lot of opportunities, I think, for consultation and for getting input and consistency between the provincial jurisdictions and the federal jurisdiction. In those areas in which the federal government is going to legislate and use the criminal law power to do so, obviously the federal government can exercise that power legally without provincial consent. But it seems to me quite important to make sure there is buy-in from both the federal government and the provinces.

• 1200

I don't know if I've answered your question, though I think I've rambled on a bit.

The Chair: Thank you, Ms. Wasylycia-Leis.

I did have two questions for Mr. Windwick, and one has to do with the fact that you have a regulation of surrogacy list of things the Bar Association would agree to. You say surrogacy arrangements should be rendered unenforceable, but you don't tell us how to do that. What would we say, any contracts are invalid? I'm wondering if you could think about that, looking at the proposed legislation, and send us comments as to where you would put that in the act and what wording you would use. Thank you.

I have a second thing I'd like you to consider, though it may be outside your area of expertise as well. Some of us are very concerned about the commercialization possibilities that arise through this draft legislation as to the application of patent law. I think a lot of us would like to have something in the act that also says there can never be patents issued for any of this and that patent law is not enforceable either. I thought we might slide that in where we say that contract law isn't enforceable. Could you think about that and maybe ask someone who chairs the patent section of the Canadian Bar Association to think about it and perhaps send us some possible wording?

Mr. Brent Windwick: Sure. I'd be happy to take both of those questions under advisement.

The Chair: Thank you. We are trying to report before Christmas, so if you could do that in the next few days...

Mr. Brent Windwick: It's well understood.

The Chair: Thank you very much.

On behalf of the committee, I'd very much like to thank our witnesses today. I'd like to thank you for the work you put into preparing, for the thinking you've done about it—not just in the past month, but for some of you over so many years—and for sharing your wisdom with us.

I think you'll agree with me that the members here are pretty terrific at taking it pretty seriously—more than seriously, as somebody put it; it's driving us crazy.

We would welcome your suggestions on paper and, may I say, your prayers as well as we come to the conclusion. Thank you very much.

This meeting is recessed until one o'clock.

• 1202

• 1309

The Chair: Good afternoon, ladies and gentlemen. I'd like to call the second session of this meeting to order.

This afternoon we have witnesses from four organizations. The first organization is REAL Women of Canada, and its representative is Ms. Landolt, the national vice-president.

Ms. Landolt, welcome. You have the floor. Ms. Landolt?

Ms. Gwendolyn Landolt (National Vice-President, REAL Women of Canada): I'm sorry, I didn't hear you, Madam Chairman. I apologize.

• 1310

The Chair: I'll take advantage of this minute to tell my committee members that this morning we had two breaches of committee protocol. One was the fact that there were children introduced as, one could say, “props” to an argument. We won't let that happen again. The second is that this magazine was distributed without any prior clearance. All materials that are distributed at committee are supposed to have clearance. So you may disregard this magazine.

Mrs. Landolt.

Ms. Gwendolyn Landolt: We are delighted to have the opportunity to be here, Madam Chairman, because we regard this as one of the most serious issues to face Canada today. There are many issues, but this is one of the most serious, with long-range ramifications.

In dealing with the new medical technologies, however, we must bear in mind these technological issues do not exhaustively or even primarily deal with medical and scientific matters. They also involve basic issues of social, legal, moral, and ethical considerations. Therefore, we can't afford to view these technologies in the narrow, shortsighted, and limited terms of the individual's defeat of infertility or the hope of a cure for a disease. We have a responsibility to view these technologies in their broader social and cultural terms with regard to their moral, ethical, legal, as well practical long-range implications to society.

The first thing we want to bring up is the question of informed consent. The preamble of the proposed legislation correctly recognizes that women more than men are directly and more significantly affected by these technologies. Further, it also provides that a free and informed consent is a fundamental condition of the use of human reproductive technologies. An informed consent, therefore, is a very core principle and a fundamental condition governing the use of these assisted reproductive technologies.

Although experimentation in these technologies may serve the researchers, it may also be a very serious exploitation of the psychological and emotional needs and desires of women to bear children. Women are not set free from the limitations of their fertility, but rather become living laboratories for trial and error experimentation by medical authorities. Regretfully, in this age of animal rights, women provide cheap, experimental material, where the cost of buying and maintaining laboratory animals for research is prohibitive.

Informed consent, therefore, in such situations is very difficult, because it leaves women open to manipulation and exploitation. They want a child desperately and therefore the details, the full significance of the experimentation, may not be appreciated by the women whose bodies are the subject of research.

Our organization has further concerns about the impact on the embryo created as a result of these medical procedures. At the present time, the interests of would-be parents, donors, and scientists appear to have priority over that of an embryo, who in many cases is regarded merely as an end product, a consumer item to satisfy the needs of others. But the embryo has rights and is not owned by others. All children at all stages of development are gifts, and adults are merely their stewards, guarding them and guiding them. For that reason alone, all research on embryos must be prohibited.

We have concerns again about surrogacy with regard to women. I know it's allowed for altruistic reasons under this proposed legislation; however, have we in fact looked at the long-range detrimental effect on the surrogate mother? In this regard, science is now only beginning to explore the awesome mystery of prenatal bonding. What about the child? What's going to happen to them? We have to look at the mother. Although she may enter into the agreement with the best of intentions, this procedure can lead to misunderstandings and legal challenges with regard to the contract and with regard to the child born of that contract.

• 1315

We would also like to raise the issue of the use of embryo stem cells for research. According to the media, the issue of stem cell research is just a question of whether society will permit embryonic stem cell research so the curse of illnesses such as Alzheimer's and Parkinson's may be eliminated.

We wish it were that simple.

To start with, we must all agree it is critical for any public policy, but especially public policy dealing with the issue of new medical technologies, to be based on universally acknowledged and scientifically accurate facts. It is a fact that an embryo is a human being—not a potential but an actual human being—requiring only time and nutrition in order to grow and develop.

The embryo represents the transmission of human life from one generation to the next. Because it is a genetically unique living entity, it should not be used in research. We do not need human victims to end other human suffering. It is for that reason REAL Women of Canada is utterly opposed to embryonic stem cell research.

Of course, it goes without saying that we object to the 14-day limitation. The proposed legislation says it's permissible only to 14 days after its development. That is simply no excuse to do experimentation. Any research on embryos is objectionable and unethical at any time in their development.

Further, it strikes us as intensely curious that intense pressure is now being placed on the potential of experimental embryo stem cell use when there is already proven alternate sources of stem cells from bone marrow, umbilical cords, placenta, human fat, tissues, skin, and even the brain cells of deceased adults. In fact, 20 hours after an adult has died, they still retain usable stem cells.

These stem cells from adults have proven to work. In fact, just in August at McGill University they used stem cells from the skin to implant in the brain, and it worked remarkably well. The use of adult stem cells removes the difficult problem of the rejection of foreign material by the body created by embryonic stem cell implantations. In contrast to the successful use of adult stem cells, human embryonic stem cells have never been used successfully in clinical trials.

It seems clear that embryonic stem cells have been oversold to the public, understandably eager for cures for some of our most devastating diseases. Yet such research will be at the expense of full and fair acknowledgement of the uncontroversial, ethical, and successful alternatives.

For example, there are 11,000 births a day in the United States that provide placenta and umbilical cords that can be used safely without any of the problems of embryo stem cells. One of the problems of the embryo stem cells that has never been satisfactorily resolved is the rejection in the body, as well as the fact that they proliferate and create tumours.

REAL Women therefore is fully in support of the use of alternate stem cells. We recommend most strongly that the federal government generously fund research using these alternative sources.

I think it's fair to ask why there is such pressure for embryo stem cells. The answer would seem to be that many of the prominent scientists in the U.S. are members of reproductive organizations and companies. I refer you to page 11 in our brief, where we give just a few examples of outstanding scientists who are on the boards of embryo research companies.

We also object to the concept of extra embryos for research. That to us is absurd. Physicians should be permitted to retrieve only the number of embryos required for implantation. If there are extra ova removed, they should not be fertilized so they will not then become embryos, and, therefore, begin life.

One of our major concerns above all our other concerns is that we are totally devastated by subclause 12(1) of the proposed legislation. It's referred to in our brief at page 13. Subclause 12(1) is alarming because there are no restrictions in regard to that which the minister may license.

• 1320

In other words, apart from the absolutely prohibitive procedures, it gives the minister sweeping powers to override the control practices set out in the legislation from clauses 8 to 12. It allows carrying out, at the minister's sole discretion, highly dangerous and unethical experimentation without limits. Such a licence can, and will, be issued in secret with no provisions whatever for a review.

It seems to us that in subclause 12(1) it is imperative that the permission for the minister to issue licences at his sole discretion must be eliminated from the legislation.

We propose, on page 14 of our brief, regulatory bodies that will be set up to make the whole process of experimentation open and transparent. The regulatory body should include a broad range of views, including ethicists from faith-based groups.

In this regard, for the proposed regulatory body for new medical technologies, it may be very useful to adapt the model used in research on human subjects, as set out in the 1998 policy statement by the tri-council consisting of the Medical Research Council of Canada, the Natural Sciences Engineering Research Council of Canada, and the Social Science and Humanities Research Council of Canada. They have a policy for reviewing experimentation. It seems to be an excellent model for new medical technologies.

It's not sufficient for this regulatory body to merely authorize the project in the front end. The regulatory body must also monitor the progress of any research, and follow up on projects after they have been completed. In short, the regulatory body should not approve protocols before the research begins. They should monitor the research before, during, and after it is completed.

It is absolutely imperative that this regulatory body be required to report annually, directly to Parliament through the Minister of Health, so the research remains transparent and the researchers are accountable to the public that has so much at stake in carrying out these technologies.

Under this proposed legislation, the minister acts in secret. He can propose anything. He can do anything he wants, apart from the prohibited policies. Anything with regard to reproduction or the cure of disease is within his power. It is far too unreasonable to allow in this day and age, when the proliferation of medical technologies is already out of control.

Therefore, we would like to make one final comment. Much of the proposed legislation will be settled by regulation. I can give you examples, such as subclause 9(2) and clause 23; they all say regulations. It is imperative that whatever is to be allowed to take place not be put into the regulations, because no one will know. It is much better for the provisions now set by regulation to be put in the act itself. People will know what is being permitted and what will not be permitted.

Those are our major concerns, Madam Chairman. I particularly want to emphasize the thrust of subclause 12(1), which gives all the power to the Minister of Health. No minister and no department can possibly understand all the medical, ethical, and legal complications involved with these technologies. It should never be put in the hands of one man, no matter how wonderful the individual is. We don't know what will happen in the future. We cannot stress strongly enough that there must be a regulatory body that is transparent and open to the public.

Thank you very much.

The Chair: Thank you, Ms. Landolt.

We will now have the representative of the Lesbian Mothers Association, Ms. Mona Greenbaum.

Ms. Mona Greenbaum (Coordinator, Lesbian Mothers Association): I am the founder and coordinator of the Lesbian Mothers Association of Quebec. My partner, Nicole, and I are also the mothers of two young sons. I am here today representing the more than 500 women who have joined our group since its beginning in 1998.

The association's members include mothers with children of all ages, as well as couples who are beginning to think about starting families. Lesbian motherhood is a growing reality across Canada. Our 500 members are only a small fraction of the total number of lesbian mothers in Quebec.

• 1325

Our interest in the new bill on reproductive technologies arises from the fact that many of us have or are planning to have children by insemination. I'm here to describe our current exclusion from the system, the health risks associated with this exclusion, and our concern that under the new law we may become even more marginalized.

We have read Health Canada's website. Health Canada says a pan-Canadian approach is needed to regulate reproductive and genetic technologies. Currently some women, including lesbians and single women in Quebec, are excluded from the mainstream system. We believe that without a guarantee of equal access to fertility services in the new law, these groups will continue to be excluded, leading to health risks.

As an organization we support the main points of this proposed law, including the 12 prohibitions. Indeed, I'm not here to recommend sweeping changes to the bill but to argue for the inclusion of one very important principle—that, under the law, all women in Canada must have equal access to fertility clinics and sperm banks, regardless of their sexual orientation, marital status, or fertility status.

As a Quebec-based organization, we are naturally most familiar with the situation for lesbians in Quebec, so that is what I will describe. But this is not to suggest that unequal access to services is unique to Quebec. There are other provinces as well that do not allow lesbians access to their fertility clinics. There are some provinces, such as Ontario or British Columbia, that do provide access to single women and lesbians, but in Quebec the policy of every single fertility clinic is to bar access not only to lesbians but to single heterosexual women as well.

A woman can't get through the doors of a Quebec fertility clinic for testing, let alone for insemination, unless she is a wife. As coordinator of the association, I have had phone calls from single heterosexual women who are amazed that they are discriminated against and turned away from these clinics. There is nothing in our Civil Code that prohibits lesbians or single women in general from having access to these clinics, but in Quebec it is the case.

Yet the existence of organizations like our own is proof that lesbians are making babies. It's not a miracle but the result of reproductive tourism. Barred from using clinics in our own home province, many lesbians obtain semen samples from banks in Ontario or British Columbia. If a sperm bank in Toronto has spread its seed far and wide in this country, it's not because Canadian women believe in the superiority of Toronto sperm; it is a direct result of unequal access caused by the restrictive policies of individual clinics.

In order to obtain out-of-province sperm, a Quebec lesbian must first find a doctor in Quebec who's willing to receive the samples and perform the insemination. She can pretty much rule out finding a fertility specialist, since virtually all of them are associated with the restrictive clinics. If she is lucky, she will find a sympathetic family doctor who's willing to educate himself or herself on insemination practices. At present, we know of only a handful of doctors who perform this service, and their practices are rapidly filling up.

Although there's nothing illegal about this parallel system, it is far from ideal. It not only discriminates against lesbians but also creates health risks. Because of the difficulty in finding doctors to help us, as well as the extra expense of having to ship the frozen sperm, many lesbians turn instead to known donors. “Known” in this context can mean anything from a trusted friend to an acquaintance to a complete stranger—even through a personal ad.

Regardless of how well the woman knows the donor, the risks with using fresh sperm are the same as those associated with having unprotected, unsafe sex. If Quebec lesbians are not given access to the system where donor semen is rigorously tested for sexually transmitted diseases and other conditions, we believe sooner or later someone will contract HIV from a known donor and pass it on to her baby as well.

Health Canada has stated that all Canadians must be protected with respect to health and safety. One of the guiding principles of the draft legislation is supposedly to protect and promote the health, safety, dignity, and rights of all women and children. In the current situation, lesbians and single women in Quebec, as well as their children, are not protected.

Our first recommendation is thus that all Canadian women be assured access to fertility clinics and sperm banks regardless of sexual orientation, marital status, or fertility status. To underline this, we suggest that one of the conditions a clinic or practitioner must meet in order to maintain a licence would be not to bar access to any woman based on her sexual orientation or marital status. Many Canadian provinces have granted full legal rights to lesbian parents, officially and publicly recognizing our families. British Columbia, Alberta, Saskatchewan, Ontario, and Nova Scotia have all given legal rights to non-biological mothers in lesbian-headed families.

It is ironic that while many Canadian provinces have accepted our families, there are still medical clinics that refuse to see us and thereby jeopardize our health. We feel that a new law must make a strong statement against this type of discrimination. The health risks are too important to be ignored.

• 1330

Because individual provinces can and will opt out of the federal law in order to write their own, we are asking that the inclusion of the principle of equal access, regardless of sexual orientation, marital or fertility status, be made a condition for acceptance of any provincial equivalency agreement. This is our second recommendation. Otherwise, lesbians in Quebec will likely find themselves no better off, or even worse off, than they are now when it comes to accessing services. We are concerned that some, in desperation, would engage in risky behaviours in order to become pregnant.

Lesbians and single women in Quebec don't have access to the same health care services as women in other provinces. In some provinces there is equality; lesbians and unmarried heterosexual women are treated like any other Canadian citizen. But in Quebec, if a single woman or lesbian discovers she is infertile, she must travel to another province to access treatment.

Despite the fact that most Canadians believe women should have the right to control their own bodies, in some provinces a woman can still not get through the door of a fertility clinic if she does not have a husband on her arm. That is the situation as we are living it today. Ensuring access to fertility services for all Canadian women in a new law would immediately solve many of these problems and reduce health risks.

Some women don't want to have an unknown donor. They prefer to ask a friend to be a sperm donor. For these women, in at least two other provinces a sperm bank will provide the service of testing the semen for disease and banking it for future use. A similar policy across Canada would eliminate the health risks to mothers and their babies of using known donors.

This brings me to our third recommendation. We believe individuals and couples who use sperm banks, as well as the children born of assisted reproduction techniques, should have access to as much information as possible about their donors. As an organization we support the creation of information registries and Canada-wide licensing criteria for doctors who practice assisted human reproduction techniques. For our sake and the well-being of our children, we feel it is imperative that our data be kept according to the same system used for other Canadians.

We would welcome a new system that allowed “yes” donors—that is, sperm donors who agree to meet with the resulting offspring at a later date should the child so wish. We feel it is important for children to be able to have access to their biological roots if they so choose.

For our fourth recommendation—since donor insemination is a simple procedure, we feel it does not need to be in the exclusive control of fertility clinics—we recommend that private practitioners who may already be versed in these techniques should be eligible to apply for licences. Obviously, to obtain those licences, these individuals would have to follow the same guidelines and meet the same standards as the clinics.

Why should doctors outside fertility clinics be eligible to obtain licences? Because many women live outside of big cities and are far away from fertility clinics. For simple inseminations using sperm from a sperm bank, a family doctor can do the procedure.

I have not come here to defend the right of lesbians to become mothers, but this might be the appropriate time to mention that children in lesbian-headed families are as well adjusted as kids with heterosexual parents. Study after study has shown that our children are as emotionally and psychologically fit as other children. Boys and girls show the same gender-specific behaviours whether their parents are gay or straight. I can attest to that myself, with my own house full of toy cars and trucks and the rough-and-tumble climbing and wrestling that goes on every day with our two young sons.

Many people ask if our kids are teased. Well, let me tell you, all kids get teased. If it's not for their hair colour, or the colour of their skin, it's their weight, the clothes they're wearing, or the wrong pair of sneakers. Our kids don't get more teased than the average, and if they do confront homophobia, we are able to provide them with the same tools and resources we ourselves have used in the face of prejudice—the same tools that people of various ethnic, racial, and cultural origins have used throughout time.

I'd like to add that among the women in our association there are no unwanted pregnancies. Our children are loved and cherished all the more for the difficulties we've been through to form our families.

In our brief, we make four recommendations to the committee.

One is that sperm donors be allowed to consent to having their identity revealed to any persons born of their donations.

The other three recommendations all have to do with access.

First, we want an explicit provision in the law that all Canadian women may have access to fertility services regardless of sexual orientation, marital status, or fertility status. I respectfully remind you that access for all women was a recommendation of the 1993 Royal Commission on New Reproductive Technologies and should therefore be included in the proposed law. It is a question of safety and health.

Second, we ask that should individual provinces develop equivalency agreements for controlled activities, inclusion of the same guarantee of access be a condition for acceptance of the law as equivalent.

• 1335

Third, we recommend that private practitioners in their own offices be eligible to apply for licences to practice simple procedures such as donor insemination.

Canadian society has come a long way in my lifetime. From the decriminalization of homosexuality in 1969 to the introduction of the Charter of Rights and Freedoms in 1985 to last year's Bill C-23, granting common-law status to same-sex couples, our country has been on a steady course toward greater openness and acceptance. One of the reasons we need an act regarding assisted human reproduction at this specific time in history is that Canadians today are fulfilling their desire to create families in numerous ways, many of which were unheard of a decade or so ago.

Lesbian-headed families are not just a reality in Canadian society but a growing one. We are asking the committee to take the health and well-being of lesbians as seriously as that of any other group of women in this country. We believe in a system that uses new reproductive technologies wisely, and we want to be part of that system, for our own well-being and that of our children.

Thank you very much for your time.

The Chair: Thank you, Ms. Greenbaum.

Our next presenter is from the Campaign Life Coalition, with Dr. John Shea, the consultant to that organization.

Dr. Shea.

Dr. John Shea (Consultant, Campaign Life Coalition): Thank you, Madam Chair, and ladies and gentlemen, for the opportunity to speak on behalf of the Campaign Life Coalition, an organization interested in being involved in the political defence of the dignity and human rights of every human person, from conception to death.

You have heard many facts put before you in the last while. I wish to outline the facts that I believe are relevant to the proposals for the legislation governing assisted human reproduction.

First of all, this act would allow a person under the authority of a licence issued by the minister to perform what is called a controlled activity—that is, to use reproductive material, which is defined as sperm, ovum, other human cell, or in vitro embryo, and includes any part of them. It allows them to do the following: first, to create an embryo, or to facilitate human reproduction; second, to make use of any in vitro embryo, or part of one, for the purpose of research or prevention or diagnosis of treatment of disease, injury, or disability; and third, to create a chimera. In ordinary parlance, that's known as a monster.

A chimera is defined in the act in two ways. First of all, it is defined as a human embryo, or fetus, into which a cell of any non-human life form—now, that goes the whole way from virus to vegetable to animal—has been introduced. Secondly, it is defined as any non-human embryo or fetus into which a cell of a human being or of a human embryo or fetus has been introduced. This creation of a chimera is allowed for any purpose, including research.

As well, the proposed act allows for any person to combine any part or any proportion of the human genome with any part of the genome of any animal specified in the regulation. The genome is defined in the draft bill as the totality of the nuclear DNA sequence of a particular cell.

• 1340

The draft bill therefore—despite the fact, I might add, it is paraded up front that there are prohibited activities—allows, with ministerial permission, embryo splitting, nuclear transfer cloning—and I repeat, nuclear transfer cloning is allowed—recombinant DNA transfer, and germ cell alteration, which is the technique used for eugenic enhancement.

Germ cell alteration is the use of embryonic germ cells. Germ cells are usable at the eight-week stage. They are the cells that reproduce to become ova or sperm, as distinct from the other from of adult stem cells that produce all of the 200-plus tissues in the body. These cells are the ones used for eugenic enhancement. But more about that in a moment.

This legislation allows the retrieval of cells from blastocysts, otherwise known as stem cells, or more appropriately called blastomeres. These cells are taken off the embryo at the five- to seven-day stage when implantation would normally occur on the inner cell mass, and as a result the embryo is killed. This bill also allows, therefore, a parthenogenesis, a process that has been perfected in frogs but has not yet been done in human beings—as far as I know, but it may have been—whereby a human ovum is electrically stimulated and can produce a female human being.

It also allows and causes, if these cells are retrieved from the embryo in the first three weeks, some of these cells of the embryo to undergo a process called regulation. The cell that is retrieved from the embryo—plucked off from the embryo, usually in a bunch to start with, a few of them at once—has the capacity to die, first of all, and many do. Secondly, it may be cloned into a tissue. Thirdly, it can spontaneously become an identical twin of the first embryo.

Dr. Mithat Erenus, an expert on in vitro fertilization, has recommended this as a method, and I suspect it's already being done. He recommends it in the circumstance where a woman has been filled up with estrogen to superovulate and cannot produce the usual ten to fifteen ova but maybe has only three. In this case they split the embryos to give her six. This gives her a higher chance of having a successful implantation. When they use these cells for research rather than for in vitro, the result is that some of these cells are cloned into tissues and some become further embryos, which subsequently may die or subsequently form yet more embryos, which subsequently are cloned or die, and so on and so on.

I'd like to draw your attention to some facts with regard to these embryonic cells and adult stem cells. There have been no—I repeat, no—successful clinical trials of embryonic stem cells. There have been few successful animal model research successes. Tissue rejection is the order of the day, either rejection of the recipient by the tissue or rejection of the tissue by the recipient. This is of particular relevance to diabetes, because you have to take cortisone-like drugs that cause the same symptoms as diabetes.

With regard to that, the proponents of nuclear or embryonic stem cell research are therefore keen on nuclear transfer cloning. The idea—and it has been done, because you read it in the paper today—is that if you take a nucleus, or in the case of the recent issue take a whole cell from an adult and put it into an ovum, from which the nucleus has been removed, and then treat it chemically, you can develop an identical twin of the person who donated the cell.

There's a problem. As Leon Kass has pointed out, there is DNA in the cytoplasm of the ovum, called mitochondrial DNA, which is still foreign protein and has the same chance of producing tissue rejection.

• 1345

Embryonic stem cells are extremely primitive. We don't know the tissue they are going to become because they have the potential to become any tissue, including another twin. So they're very hard to regulate. A Chinese who had Parkinson's had neural cells from an embryo at eight weeks injected, and developed skin, hair and teeth, that is, a teratoma in the brain, which killed the patient.

There is a report in the clinical literature in the last year in which they did extensive research on Parkinson's patients, younger and older, and they had some success by injecting similar cells, neural cells, from an eight-week embryo in Parkinson's patients. The older patients, 15%, developed dyskinesia tardive, which means they got much worse—a wild thrashing of the arms and legs, chewing of the mouth, and moving of the fingers that could not be alleviated by medical therapy at all.

These cells, despite what is said, are somewhat hard to grow and maintain, but it can be done. The use, of course, of the transfer cloning involves the death of the identical twin. The use of these cells therefore is, to put it quite fairly, I think, hypothetical. Possibly they may be of use in the future, if all these things can be overcome.

Some of the facts with regard to the use of adult stem cells, on the other hand, are that, first of all, they've been used for 20-plus years in the form of marrow transplants. They've been used for 12 years as adult stem cell therapies. The overall number of successful patients treated or somewhat improved over the years of various diseases is in the hundreds of thousands. Diseases that have been alleviated or cured by these cells include diseases of blood, bone, kidney, and cancers of the brain, breast, ovary, testes, retinoblastoma, as well as some success—and remember, this is just beginning, so I believe the future is magnificent in this area—in stroke, diabetes, heart disease, multiple myeloma, leukemia, muscular dystrophy, and Crohn's disease.

Adult stem cells are available from multiple sources. Some sources, like the placenta, umbilical cord blood, neural cells, and fat cells, have been shown to be able to turn into almost any cell of the body, of which there are over 200 kinds. They can be grown quickly. Over a period of weeks they can produce billions of cells by special techniques. They have the ability to travel to the relevant area of the body for which they're needed. They do not cause tissue rejection, and their use involves no ethical problems that any other form of medical therapy does not involve, such as informed consent and so on. Basically, they are without major ethical problems. And their promise is not hypothetical; it is real and it is remarkable.

The Chair: Dr. Shea, you are three minutes over.

Dr. John Shea: I'll read the rest quickly, if I may.

The status of the human embryo, scientifically, first of all, as a member of the human species, created of fertilization, was established in the 1850s by Wilhelm Roux, father of embryology, and accepted into scientific literature ever since.

As to the moral status, a whole human being is present in the first cell. That cell continues a unity that is the cause of further cells occurring in a specific, orderly way. This unity is maintained at all later points of development of that human being. Even though at first not all parts of this unity are fully emerged, the embryo will grow these parts on its own in a coordinated way.

The fact is, the embryo, from the moment of fertilization on, through all its development stages, is a unitary, integrated, whole being. Without a whole being there and present from the start, a further development of the so-called bunch of cells could never take place in a way that is ordered and geared to a specific biological end.

• 1350

This fact precludes arguments offered in favour of the use of embryonic stem cells, such as their use on utilitarian grounds for the potential benefit of research. Such arguments would support any act or justification by which certain individuals could benefit others.

Finally, validity of consent. The proposed act accepts the consent of the donor of an in vitro embryo as a necessary precondition to allow controlled activities. For any donor to give valid informed consent, it will be necessary for her to have been fully informed by a competent person as to what will happen to the embryo. This information, if it is to fulfil all of the requirements of the act, would have to include one or all of the uses listed in the act. Is it likely this kind of consent will really be obtainable in practice? What kind of legal complications does it lead to when donors realize the full biological, ethical, and legal ramifications?

The final point is that the confused terminology is a concern. A definition for human “beings” is not provided in the act. A definition of human “organism” is provided by inference as either an embryo or a fetus. At birth, a fetus, it is implied, remains a human organism, but in paragraph 9(3)(b) a chimera is defined as a non-human embryo or fetus into which a cell of a human being, or of a human embryo or fetus, is introduced. In regard to the humanity of the embryo, this is neither philosophically nor scientifically correct; the embryo and fetus have been defined out of the human family.

I have supplied two references, one with regard to the moral status of the embryo and one with 228 references to the scientific literature on embryonic and somatic stem cells.

Thank you.

The Chair: Thank you, Dr. Shea.

Our next witness, Ms. Micheal Vonn, is representing the British Columbia Civil Liberties Association. She is from the executive committee of the board of directors of that organization.

Ms. Micheal Vonn (Member, Executive Committee, Board of Directors, British Columbia Civil Liberties Association): Thank you, Madam Chairperson.

Thanks to the committee for the opportunity to make submissions on the draft legislation on assisted human reproduction on behalf of the B.C. Civil Liberties Association.

Our 1996 position paper, which I understand has been distributed to members of the committee, continues to be our position generally on the issues raised by the proposed legislation. In these remarks, however, I would like to outline our general opposition to the use of the criminal law as a means to effect policy in these areas, and discuss specifically the problems raised by the contemplated prohibition on commercial surrogacy.

Our concern that criminal law is not an appropriate means to deal with the issues addressed in the draft legislation echoes the concerns of several other presenters. We concur with many points previously raised, including that the criminal law is a blunt instrument not conducive to the type of ready amendments likely to be required to address areas where scientific advancements are rapid; that the use of the criminal law is highly problematic relating to subject matter on which there is a lack of social consensus; and that criminal prohibitions relative to research activities into specific areas would almost necessarily generate uncertainty and fear in those whose research interests might be seen to border on those areas, and prevent many areas of beneficial research from flourishing in Canada.

In general, we favour the use, where necessary, of other forms of regulation to address the types of conduct the draft legislation simply criminally prohibits.

I would like to make some specific comments on the proposed prohibition of commercial surrogacy. There are three rationales given for the proposed prohibition—one, protecting those potential surrogates who are vulnerable to exploitation because of their economic circumstances; two, commercial surrogacy treating children as objects; and three, commodifying female reproductive capacity impairs the dignity of women.

We believe regulation would be more effective than criminal prohibition as a means of guarding against the exploitation of economically vulnerable women. We agree with the prior submissions of Alison Harvison Young and others regarding the demonstrated tendency for criminal prohibition to drive activities underground, where the vulnerable have no protection or recourse.

In our view, the legislative distinction drawn between commercial surrogacy and what is termed “altruistic” surrogacy is unprincipled, untenable, and unworkable. The beliefs, circumstances, and conditions that may lead a woman to choose to act as a surrogate mother are likely to be highly complex and intensely personal, and will necessarily vary from woman to woman.

• 1355

In our view, it is not appropriate for the state to constrain women's choices as to whether to enter into such agreements on the basis of whether we think the rationales for their choices are good or bad. In few other areas would we consider the inclusion of an economic rationale, as part of a decision-making process, so inappropriate that it ought to be subject to criminal sanctions. Thus, in our view, there is no principled basis for denying women the opportunity to decide for themselves whether they wish to be paid for agreeing to act as a surrogate while permitting women to do so for altruistic purposes.

Further, so-called altruistic surrogacy, if left unregulated, provides no protection to women who may be pressured into such arrangements by family pressures, family pressure being potentially just as oppressive and often linked to economic pressures. Additionally, it is impossible to draw a bright line between expenses, which are permissible in altruistic surrogacy, and consideration, which is impermissible, and seen to pertain only to commercial surrogacy.

The difficulty in defining the scope of these two types of payment raises the serious concern that criminal sanctions may be imposed on the basis of a law that is vague and uncertain.

In regard to the second rationale, the concern that surrogacy that includes a commercial transaction treats children as objects, it is notable that a commercial aspect is present in many if not most adoption arrangements. As mentioned in our position paper, people who have paid large sums of money to adopt children, who in that sense have been commodified, manifest no tendency to treat their children with any less dignity or respect because they have, in point of fact, been bought. It is evidently not the case that commercial exchange in itself is determinative of whether children are afforded proper care and concern.

Third, the characterization of human dignity that is used as a rationale for prohibiting commercial surrogacy does not take sufficient account of the inherent importance of the capacity to exercise autonomy. People's choices are necessarily legally constrained to avoid demonstrable harm to others. But to have choice constrained where there is no demonstrable harm to others is to have one's dignity impaired, not enhanced. In essence, it is to infantilize the people so constrained, as their choice, their freedom, and their ability to act according to their own assessment is curtailed.

If this is done under the auspices of protecting the people whose choices are so constrained, then it is clearly, regardless of the laudable aims that may motivate those imposing the constraints, paternalistic, and tantamount to characterizing the people so constrained as unfit to make their own decisions about an intensely personal matter. This, I have no doubt, was not the intention of those who drafted the proposed prohibitions, but it is an inescapable consequence of the policy proposed.

Elsewhere in the draft legislation and its preamble much emphasis is put on the importance of informed consent as a means of ensuring that people are making choices reflective of their own free will. We agree wholeheartedly. In the introduction to the draft legislation it describes informed consent as a core principle and states that consent regulations would be developed to help ensure that women choosing altruistic surrogacy do so of their own free will. It is inconsistent with the draft legislation's very proper objective to empower people to make informed choices to have this principle implicitly rejected in the case of commercial surrogacy.

The consent regulation alluded to in regard to altruistic surrogacy is in fact an example of how policy to address these issues requires a detailed and nuanced approach. What, for example, constitutes written informed consent? What information is required to be disclosed by and to the parties? What governs withdrawal of consent? These are crucial questions best addressed through thorough and detailed regulatory mechanisms.

To conclude our position on commercial surrogacy, it is a matter of serious concern for any civil rights group that public policy may be employing an argument, grounded in a notion of human dignity, that undervalues human autonomy. In the absence of demonstrable harm resulting to persons such as children or others who have not consented to the conduct in question, the harsh instrument of the criminal law cannot be justified. It is undoubtedly the case that the idea of commercial surrogacy offends some people's sensibilities. But the mere causing of offence is not grounds for legal sanctions in a free and democratic society. In our submission, there is insufficient indication of demonstrable harm to society to justify the proposed limitation of individual rights and autonomy in the matter of commercial surrogacy.

Those are my submissions. Thank you.

• 1400

The Chair: Thank you very much, Ms. Vonn.

We'll move on to part two of the meeting, which is questioning of the witnesses by the members. We'll begin with Mr. Lunney.

Mr. James Lunney: Thank you, Madam Chair.

Thank you to all of the witnesses for your very interesting and informative presentations.

I would like to direct the first question to Dr. Shea. You mentioned that you find the creation of chimeras for research objectionable. Can you tell us why? What concerns do you have about the creation of chimeras? Where would researchers want to go with this?

Dr. John Shea: The chimera is a combination of the human embryo with animal or vegetable, or even viral. This is treating a human being as a means. And who knows what the means are? It might be for research, it might be therapeutic, it might be anything. But it treats a human person, a human being, as a product, and it treats a person as a means towards another end. A human person is entitled as a human person not to be used as a means. That's the generic reason. Apart from emotional reasons, that's the basic reason.

Mr. James Lunney: We have a rich resource of human genetic material available to us with six billion humans on the planet, but you might wonder why researchers would want to mix animal and human genes, what they would hope to derive from that. How are they going to improve upon us by borrowing from animals?

Dr. John Shea: I can only speculate. Science is so vast and technology is so vast that I can't even imagine the number of uses there could be. There could be the production of proteins, there could be the production of therapeutic agents. For instance, people have suggested that one could mix spider DNA in with the human being's so that athletes would have stronger tendons so they could jump higher, etc. It's unending.

Mr. James Lunney: Thank you.

Let's go in another direction here. You mentioned, with the whole cell nuclear transfer, the problem of mitochondrial DNA. Now, how many parents would be involved if you left behind DNA from a donor ovum and you include now a nucleus mother's cell, another person? Can you explain that a little further to us?

Dr. John Shea: How many people might what?

Mr. James Lunney: Well, that you'd have genetic material from different beings, obviously related, mixed in the nuclear transfer because of mitochondrial DNA being left behind.

Dr. John Shea: Mitochondria are those structures that actually perform the respiratory function. They are, as it were, the energy producing organisms or parts that produce the energy, the ATP system that produces energy for the cell, uses oxygen, etc., and produces energy. They're like little electronic batteries.

These structures are sited not in the nucleus but in the cytoplasm, but they contain DNA, and that is DNA of the mother, of the ovum. And in the transfer of a nucleus into that ovum, they still remain. So they are foreign protein, as it were, for the person who receives any material, any tissues, that were derived from it, so you do not get rid of the question of rejection of protein by this means.

Mr. James Lunney: You end up with a form of civil war in the cells as you get DNA really from two different beings.

Dr. John Shea: It's a good question. What they are doing now is putting a full cell with its cytoplasm into an ovum. Whether there's a war between the mitochondrial DNAs or not, God only knows. The point I was trying to make here was on the question of protein rejection, on that rejection phenomenon, tissue rejection.

Mr. James Lunney: With the adult cells, you referred to a lot of the advantages and the successful use of adult cells in the last number of years, 20 years for bone marrow transplants and 12 years with adult stem cell research. You mentioned that they can grow quickly in culture, and one of the issues they say is that we have problems growing adult cells. Are you aware of research that's shown successful culture—

Dr. John Shea: There are methods they can use to speed up cellular reproduction, and over a period of about eight weeks I believe they can get billions of cells.

Mr. James Lunney: Where is this being done?

Dr. John Shea: I can't recall from memory, but in that document I gave you, with the 228 references, you'll find it in there somewhere.

• 1405

Mr. James Lunney: I have another comment, going back to something Mrs. Landolt mentioned. One of the recommendations from REAL Women was that they would prefer the federal government to generously fund adult stem cell research.

Would you agree with that conclusion, Dr. Shea, and could you expand?

Dr. John Shea: Absolutely.

I don't want to give the impression we're against research or against stem cell research. Research is one of the greatest things since sliced bread. It's wonderful. But it has to be done in a moral way and for moral reasons, in a just way.

We've had evidence for many years... and incidentally, on the market in New York more money is put into adult stem cell research, because the people who put money into things know where they get the results. The results are starting. There is a huge future to it. They're quite remarkable. This is out there, for anybody who wants to look at the literature. I think it is to be greatly encouraged. For all these terrible diseases like diabetes and Parkinson's, this is probably where the future is.

Mr. James Lunney: That's in adult stem cells?

Dr. John Shea: In adult stem cells.

Mr. James Lunney: Because of the reasons you listed here—for instance, the risk of rejection isn't there?

Dr. John Shea: The risk isn't there.

By the way, I don't know whether you understand this, but stem cells from the embryo are totally potent in the first three weeks—the first week, really. That is, they can become anything, including another embryo. After that, they become progressively less potent—pluri-potent and not so pluri-potent. But the germ cells are usually taken from aborted embryos—the germ cell eugenics research—whereas the rest of it usually comes from children or adults themselves, and harms nobody.

Mr. James Lunney: Are you aware of the recent research by Dr. Freda Miller at McGill with skin precursors, as she called them, and could you give us some examples of what they were able to turn those skin cells into?

Dr. John Shea: I am trying to recall now. There are so many articles along the same lines. They were nerve cells, were they?

Mr. James Lunney: They started with skin cells, and I understand they were successfully able to grow neurons and muscle cells.

Dr. John Shea: Neurons and muscle cells, that's correct.

Mr. James Lunney: And some bone or blood cells.

Dr. John Shea: There are so many examples like that. This is just one. There must be maybe 20 articles about similar achievements, with other cells—placental, embryonic, and umbilical-cord blood. The latter, by the way, have the advantage that they are quite primitive and are not rejected. If you do transplants, for instance, there's an 80% rejection of adult stem cells. But if you take them from umbilical-cord blood or placenta, they are so relatively primitive there's a much lower rejection rate. There's also an advantage in that they're very rarely contaminated by cytomegalovirus, which also occurs in adult stem cells.

So they have great advantages. And there are 4 million placentas a year in the States, and probably 400,000 in Canada.

The Chair: Thank you very much, Mr. Lunney.

We'll move on to Mr. Ménard.

[Translation]

Mr. Réal Ménard: Thank you, Madam Chair.

I have two questions. The first one is for Mona. There is, according to you, discrimination in that people living on their own, single mothers, singles, as well as lesbians, do not have access to fertility clinics in Quebec. Do you have reason to believe that this is also the case outside Quebec? Am I right in saying you wish us to clearly state in the preamble that there can be no discrimination on the basis of sexual preference or marital status?

I would then have a question for Ms. Vonn.

Ms. Mona Greenbaum: You ask whether this occurs only in Quebec. I do not think so. I think that this may also occur elsewhere. I am not really familiar with the situation in the other provinces. I know that it is legal and I know that it is being done in Ontario and British Colombia, but I do not know if that is also the case in the other provinces. In Quebec, there are clinics in Montreal, Quebec City, and Sherbrooke, and I know for a fact that they do not admit single women.

Mr. Réal Ménard: It happens in British Columbia as well as in Ontario. Is it so, then, that a single woman, with no man in her life, or who is a single parent, can obtain an insemination treatment in a private clinic?

Ms. Mona Greenbaum: Yes, that's right.

Mr. Réal Ménard: And you are urging us to state in the draft legislation's preamble that there can be no discrimination on the basis of marital status or sexual preference.

• 1410

Ms. Mona Greenbaum: Yes, and also on the basis of fertility. What we are currently told in Quebec is that we cannot have access because we have no fertility problem, but that always happens with women living on their own. It is a sort of loophole that is being used to deny us access to these clinics. It is important to include such a provision in the act. Without it we are creating a great health risk for single women.

Mr. Réal Ménard: I had asked officials from Health Canada to draw up a list of cases presently before the courts in matters relating to section 15 and access to fertility clinics. It would be useful to have such a list.

Ms. Vonn, you do not feel we should be using criminal law provisions to prohibit various activities outlined in the draft legislation. But how could we ensure that certain practices, such as human cloning, are indeed prohibited without resorting to criminal law provisions? What might the alternatives be?

[English]

Ms. Micheal Vonn: In terms of regulatory bodies, I believe it has been suggested by numerous other presenters that the model in the U.K. is a good one in that it provides for an expert regulatory body and also allows for criminal sanctions where licences have, in essence, been defied, as the regulatory bodies have access to a broad range of sanctions.

We believe the initial thrust of the regulatory activity is best ascribed to an expert body, and the Criminal Code is not the place where we should find the actual provisions. The degree of sanctions for criminal activity here seems to me, as we've suggested, to be simply not called for, or not across the board, in any case. We were suggesting that what can be regulated in terms of a regulatory body be undertaken in that guise. The stigma attached to criminal sanctions in particular does not seem appropriate for all the current prohibitions.

[Translation]

Mr. Réal Ménard: All right.

[English]

The Chair: Thank you, Mr. Ménard.

Ms. Sgro.

Ms. Judy Sgro: Thank you, Madam Chair.

I have a couple of questions for different people. Ms. Landolt, I was reading through your brief and following your comments. Just to give me a bit of background, when I read the first several pages of this... I guess the reason for the question is based on your organization, called REAL Women of Canada. Excuse my lack of knowledge of you other than the fact you're listed there. You're here, and I believe I've heard a little, but I don't know enough about the organization.

When I read the first several pages of your brief, as I am the mother of two young professional women already, what jumps out to me is a feeling that women aren't capable of making decisions. I would have thought the title, “REAL Women of Canada”, would be indicative of an organization that would be very much promoting strong, healthy women in society. Yet in the first several pages it clearly comes out and sounds as if women are very weak and unable to make really good decisions, so we must ensure that we have legislation that will protect them because they're not capable or smart enough to make those decisions. That's what comes out to me when I read the first several pages of the brief, so evidently I'm missing something because I don't think that's what you intended.

Ms. Gwendolyn Landolt: In REAL Women, “R” stands for realistic, “E” for equal, “A” for active, and “L” for life. We do believe in equality of women. We are suggesting and believe that women are competent and capable and that they don't need special legislation to protect them, except in that there are problems with new medical technology.

• 1415

The problem is that when women desperately want a child, right now we already know they're subjecting themselves to a lot of hormone treatment. They're so desperate for it they're willing to subject themselves, when animal treatment should be the first experiment. But they're experimenting on women's bodies because of the desperation. As well, women undergo great psychological problems when they finally can't conceive even under all these technologies.

Often women are being exploited by scientists and physicians, who know their great vulnerability in this particular area of wanting children. It's a perfectly normal concept most of us have. Women are being exploited in their desperate need. We have to balance the rights. What we're finding, unfortunately, in many cases, is that scientists and physicians in pursuit of fame and fortune will use the bodies of women. Women are so desperate to have that child that they are willing to go through that process of being experimented upon. That is what is actually happening.

We're wondering now about women who have these hormone injections with the multiple release of ova, because of the long-range ramifications with regard to cancer. Many women are willing to risk that to get a child, but they're not even told of the risk. We don't know the risks. Because women are exceptionally vulnerable, we want there to be, in this particular thing, some way to restrain some of the physicians and scientists.

I must say, one of the problems is that physicians are really in a conflict role. On the one hand they're caring for the woman, and on the other hand they're researchers. There's often a conflict of interest, and women are not getting the full story. One of the problems is the question of consent. How do you know what the consent is when women don't know the long-range ramifications? How do you get a consent from the embryo? Nobody knows what they're going to be used for. If the basic principle of this proposed legislation is that there must be a full and complete consent, it would appear that this is not going to happen.

It's not that we're saying this artificially, or making it up. Many women have told us they've been used and abused in their desperate need for children and their wanting of children. They're asking why money isn't spent on learning to deal with their infertility rather than using their bodies for experimentation purposes. These are real women who've really endured this. We're suggesting that there has to be some controls on what goes on sometimes in new medical technologies. It's not that women are not equal, and are not competent and capable; it's just this extraordinary situation of desperate need for a child, of wanting a child.

And 90% of women do have children. It's a normal, natural thing. If you can't have one, it's a terrible burden that many women carry. In this particular circumstance, we are saying, look, let's make sure women are not exploited in their desperate need by physicians in this conflict of interest position they hold over them.

The Chair: Thank you, Ms. Sgro.

Ms. Judy Sgro: Do I have any time left?

The Chair: It's been 5 minutes and 27 seconds.

Ms. Judy Sgro: All right, put me down in the next round.

The Chair: Yes.

Mr. Dromisky.

Mr. Stan Dromisky: I have two questions.

First of all, to Mona Greenbaum, your presentation pertains to what I consider to be more or less a sociological factor and situation in terms of the increase, as you said, in the number of women who would like to bear children. Is that because of a natural desire to be child-bearing mothers, to be mothers, or is it because now, at this stage in our society, the lesbian organization is much more prominent, more visible, and transparent than it's ever been in the history of mankind, and as a result we have organizations like yours? You have clubs and social factors coming into the picture. Is it because one is stimulating another?

In other words, one woman says she's going to have a child, and then another says she's going to have a child. Is this a sociological, cultural phenomenon within an organization?

• 1420

Ms. Mona Greenbaum: I wouldn't say it's a club mentality. I think, as you said, it's a natural urge—

Mr. Stan Dromisky: It's evolved.

Ms. Mona Greenbaum: No, I wouldn't say that. I would say that probably throughout history lesbians have wanted to have children. There's been an interest. As with heterosexual women, there's an interest in having children. It's not for everybody, but some people, many people, do want to have children.

I think the reason it's an increasing phenomenon is that it's becoming a possibility in our culture. Women are seeing that you can have children. There are role models there where they see there are families with lesbians who have children. They're very happy families, and the kids are turning out great. It's possible now for us. It's just as you see now an increase in interracial families; many years ago you didn't see that very much. It's not that the urge wasn't there, or that a club was formed and people from different races got together and it became the social “in” thing to do. It was because the culture opened up enough and our laws accepted people who didn't fit into what was the norm before.

Mr. Stan Dromisky: It would be interesting if someone did a study of that whole area, comparing the kinds of problems directed to the medical profession for assistance with what's happening right now in Montreal because of organizations such as yours. Has there been a great increase in demand for...

Ms. Mona Greenbaum: As our culture becomes more and more tolerant, I think women see that they can potentially do this. Before, you'd be so stigmatized, but now we live very happy lives. We have occasionally a bit of friction with people, but for the most part we're normal families like everybody else. Things are okay for us. Lesbians see that it's possible to form a family now.

Mr. Stan Dromisky: Thank you.

My other question is about comments made earlier by REAL Women of Canada. We can't avoid this situation we find ourselves in. The woman is the focal point of our deliberations here. We know that most doctors have 8, 9, 10, 11, or 12 pills in their stable of cures or aids for their patients. They say, well, try this pill, and if it doesn't work, try that one, and so forth. This is very common in the medical profession.

We went to fertility clinics and discovered that there are women who, as you indicated, are very desperate. If it doesn't work—perhaps rejection is taking place—the doctor will recommend another chemical, maybe, or a pill, or something to prevent rejection from taking place.

To me, this is experimentation. In other words, the attitude is, if this doesn't work, let's try this. If this doesn't work, let's try this. So women automatically become research vessels. I can't see how we can avoid that, simply because of the nature of the practice and what is available. If there are 10 pills available that are being used all over the world to prevent rejection, a doctor will try, try, and try again to see what will work on Miss Brown, or whatever.

Do you understand what I'm driving at?

Ms. Gwendolyn Landolt: Yes, but the difficulty is that the medical profession is trying to develop an artificial way of conceiving the child, not by medical technology. They're pushing away from working with the problem, which is a lack of fertility. This money is going into this research, not necessarily because it's in the best interests of women but because it's in the best interests of the medical profession and the researchers.

They'll try a third something on a woman, and say, yes, she's conceived; then they can write a paper on it and make their fame and fortune. That's what the concern is. There must be more emphasis on controlling our infertility.

The emphasis should be getting at the basic problem, not dealing with what will artificially create a child for you. Our whole emphasis has been switched because of the medical research. They want this angle; it's more exciting and all sorts of things. But dealing with the basic problem, which is a woman's infertility, is where our money, and our effort, and our research should go. That's where there's a big mistake going on here. We're concentrating on the result of a child, which is a commodity, when we should get to the problem of a lack of a child, which is the infertility.

Mr. Stan Dromisky: Very good.

Thank you.

• 1425

The Chair: Thank you, Mr. Dromisky.

We'll go on to Ms. Wasylycia-Leis. Oh, she was here.

Ms. Judy Wasylycia-Leis: I have to be in too many places at once.

The Chair: Poor you.

Ms. Judy Wasylycia-Leis: I would like to raise a question to Mona and Micheal around the dilemma we have in terms of balancing women's right to choose and the need to ensure health protection for women. Where that shows up the most, based on the testimony of our witnesses to date, is with respect to the whole issue of artificial insemination and fertility clinics.

How do we put in place a system where your concerns as a lesbian mother are addressed and your concerns about civil liberties are addressed, while still putting limits on the degree to which these private clinics can extract eggs for the purposes of making them into embryos and for the purposes of dealing with the needs of many different Canadians in many different circumstances? The consequences are significant in terms of the ill-health consequences for women, the possible connection between fertility drugs and ovarian cancer, and the fact that all of these operations don't ensure informed consent. I'm struggling for some advice on how we do both.

[Editor's Note: Inaudible]

Ms. Mona Greenbaum: ...lesbian mothers in Quebec where, if anything, we can't be in a less informed situation than we are in now. We're working in a parallel system that's outside a system. We don't know very much about new fertility treatments or new drugs or defects, because we're being treated by family doctors who are sympathetic to us and want to help us but are not trained in anything having to do with fertility.

In our situation, it's quite simple: either we're accepted into a system that's better or we're put in a situation where our health is at risk, because lesbians are going to have babies whether or not the law includes us. So for us, any new information is going to be positive.

I read a little bit on the website about registries that follow different treatments. The more openness there is, the more information we're given about drugs, the more we can make our own choices. That's what we need to be able to do, just decide for ourselves.

It's like any type of medicine. Almost every medicine has potentially positive effects and potentially negative effects. We have to be able to choose. People will take many risks to have certain results for their health or for child-bearing, and that should be our choice. I know there's a potential for abuse there, but the alternative of not allowing us access at all and not giving us any information, of just saying we can't access these services, is much too negative for me. We're smart enough to be able to ask questions, listen to information, and draw our own conclusions.

Ms. Micheal Vonn: My comment is that this is medical research, and in medical research, we count on a balancing of two things traditionally: the ethical review committee making sure that certain ethical standards are adhered to and the informed consent of the participants.

I'm concerned that this situation is being considered somewhat sui generis, as completely unique. I'm going to speak just briefly from my experience, which is in the realm of HIV-AIDS. That's where I work professionally.

I do not consider the argument completely salient that we have here people who are in desperate straits, and therefore their rational capacities cannot be trusted. We conduct HIV clinical trials on people who are facing a life-threatening illness in situations where there is much emotional duress, and we count on this balance of ethical review and informed consent.

The civil libertarian perspective would be that we would ask for as much disclosure as feasible for the participants. Where this sperm is coming from is certainly the issue with my co-presenter here, Mona. Absolutely, disclosure is a key element, or the consent is not informed.

• 1430

I outlined in my submission what governs withdrawal of consent, for example. If we consider these absolutely critical issues, the thoroughness and the detail with which we can flesh these out are going to be the balance in the tension, as with all medical research, that keeps these things balanced for the best result, in my submission.

The Chair: Thank you, Ms. Wasylycia-Leis.

Ms. Sgro.

Ms. Judy Sgro: Thank you.

To Ms. Vonn, we've been talking about the issues of criminal law and the difficulties we have before us of dealing with something that's an extremely complex and difficult piece of legislation, and our desire to have it set in criminal law, which makes us feel good. At least we know we're going as far as we can—I should speak for myself—and that we'll at least have some teeth in some regulation, because I don't have as much confidence in regulatory bodies as evidently some other people do.

So I want to know, if someone breaks down a difficult piece of legislation, we can deal with them within our criminal system. It makes it stronger. It shows how serious the government is about protecting the people we have to protect and allowing science to do what it needs to do as well.

Have you had a lot of experience with regulatory bodies that give you a feeling of confidence that this regulatory body would be in a position where it would enforce the legislation?

Ms. Micheal Vonn: My understanding—and I won't say it's informed by a terrific amount of experience in my own personal life, being only a law student and not in fact a lawyer who works with regulatory bodies—is that the regulatory body has exactly as much teeth as the empowering legislation gives it. It's my understanding from reading prior submissions, because this is a little bit of a unique realm, that the model that has been proposed time and time again is that of the U.K., and there was no submission I can recall that suggested that regulatory body is without bite.

As I suggested prior, the sanctions in terms of regulatory bodies are wide-ranging. I think the suggestion here from our association is that there is a range of activity here that has been looking to be controlled, and that criminal sanctions are not equally appropriate to all. So where it's feasible, we feel that the regulatory body would in fact have teeth, provided the empowering legislation gives it teeth.

Ms. Judy Sgro: You have more confidence than I have.

To Ms. Greenbaum, in many of the presentations we've had we've tried to put the well-being of the child as the number one issue in trying to deal with couples who want to have a child. Based on the knowledge you have... and I think when we're trying to deal with something that's supposedly going to assist families to be traditional—a man, a woman, and a child—in the presentations that come to us, that's how we look at this. It's almost as if you're going to create a family that isn't there by allowing a child to come into being with a couple.

But you raised different sets of issues today, because you're talking about going in a whole different direction. Evidently you don't feel that way, that if we're going to start creating things we should attempt to create the model, or at least a model that we believe or have believed is the family unit.

With regard to the raising of your own children, how old are they, and have you not had significant difficulties on some of those issues with the children?

Ms. Mona Greenbaum: I should tell you our kids are young. The older one is three and a half and the younger one is just two. But I'm also the coordinator of quite a big association, with hundreds of families, so I've seen kids of all ages. And I have to say that in Quebec—the same might not be true in smaller places or different places in the world—it's certainly true that our families do very well. Apart from the whole body of research that shows that our families do well and that our kids do well, from my own personal experience I can say that the kids are doing fine, and not confronting any major problems. In my own case, my kids are young, and they're doing great.

• 1435

In Canada it's been only over the last ten years or so that lesbians have started to use sperm banks to start their families, so it's relatively new. In the States, however, it's been going on for decades. There they have a whole body of research, long-term research, that shows that the kids are okay. They've looked at them in terms of psychological and emotional development, gender identity, sex role identification, and all types of ways. Our kids are doing fine. They're also not confronting a ton of prejudice. To me, it's analogous to kids from other races who grow up in a setting where... you know, there's racism in our culture.

So it's sometimes difficult, sure, but our kids do fine. We give them the tools to face homophobia when it is there, but I've spoken to a lot of women and seen a lot of families, and I feel very confident about this.

I think I should emphasize that we're here to talk about a health issue. Regardless of whether or not we're going to have access to fertility clinics, we're going to keep making our families, and the more we're placed outside the mainstream system the more our health is going to be at risk. And it's often unknown risk. Many women don't know that if they ask a friend for a donation of sperm they're putting themselves and their future child at risk. They're just not aware of it. We're worried that at some point someone is going to contract something, whether it's AIDS or some other sexually transmitted disease.

So it's important for us to have access to the same system as everybody else.

Ms. Gwendolyn Landolt: Madam Chairman, can I just make a comment?

The Chair: We're actually well over our time, but if you can do it in about 30 seconds, go ahead.

Ms. Gwendolyn Landolt: A longitudinal study that looked at 23,000 children was done by Stats Canada, and they found that children thrived best, by far, with a mother and a father. As well, in April of this year the American pediatric journal came out with the fact that children who come from same-sex arrangements do not thrive as well.

So there's a whole body to contradict that, and I want to put that on the record. We should look to Stats Canada, which is certainly neutral... that children are much better off with a mother and a father than in any other situation.

Thanks very much.

Ms. Mona Greenbaum: I didn't know Stats Canada did research. I thought they did surveys.

There's also a whole body of research by the American Psychological Association—I have a full bibliography here, and could make photocopies for anybody who's interested—by very prestigious researchers from well-known journals that—

The Chair: I have to cut you off there. Obviously there's a body of research backing the opinions of both sides, and I don't think we're going to resolve that.

Ms. Mona Greenbaum: I do think it's a question of health and not whether you fall on the side of our family or against.

The Chair: Okay, Ms. Greenbaum.

Dr. Lunney has one last short question, to which I'm hoping there will be a short answer. There being no other names on the list, we will then adjourn the meeting.

Dr. Lunney.

Mr. James Lunney: Thank you, Madam Chair.

I want to go back to something Dr. Shea had said earlier about embryonic stem cell research, particularly germ line research, as related to concerns about eugenics. I wonder if you could develop what you were indicating there. Are you concerned that the use of embryonic stem cells in research could lead to an enhancement of, or further attempts at, eugenics experimentation?

Dr. John Shea: Yes, indeed. That is probably...

I was president of the ultrasound society of Toronto and Hamilton, and for 30 years I did ultrasound studies that doctors used in order to kill off babies they thought were defective. Sometimes they were wrong.

The other side of the coin is going to be what I call the ultimate shopping experience—namely, the perfect baby purchase. I have downloaded from the Internet some information on a group of people in San Francisco who already have set up an association whereby they, deeming themselves to be superior intellectually, etc., have decided to set about improving on evolution. Evolution is too slow for them. They think they're better. They know there'll be other groups contending with them. They know they'll be against everybody else, and they don't care.

So it is coming. It is here. Eugenic enhancement, the Hitlerian motive, the master race—it is here, and it will be big.

• 1440

The Chair: Thank you very much, Dr. Lunney and Dr. Shea.

Thank you to all our guests. We thank you for not just the work you did to prepare for this meeting but also the work you've done for years on this and related topics. And thank you for sharing it with us. Our researchers may want to call you to ask for further information. I hope that's all right. In the meantime, we'll take all your comments into consideration as we finalize our report.

This meeting is now adjourned.