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Canadian Women's Health Network Recommendations on Draft Federal "Legislation Governing Assisted Human Reproduction"

On Nov. 27, 2001, CWHN Co-Chair Dr Abby Lippman presented on behalf of CWHN to the House Standing Committee on Health. On May 3, 2001, Health Minister Allan Rock had asked the Committee to review the draft federal "Legislation Governing Assisted Human Reproduction". Below is a brief summary of the main recommendations made in Dr. Lippman's presentation.

(Please see also the CWHN press release of Dec 12, 2001 responding to the Standing Committee's Report, also released on Dec 12, 2001.)

General Organization and Intent
-strongly supports federal leadership on Canadian policies for assisted reproduction.
-applauds the Standing Committee on Health for its prompt review and report on the draft.
-urges the Federal Government to act swiftly and diligently to regulate assisted reproduction activities and to control development in this rapidly evolving field.
-recommends that the Government of Canada clearly state that absence of specific regulation or prohibition of an activity (such as related genetics technologies) in the current version of this Bill, does NOT indicate it is thereby an acceptable practice.
-stresses that the legislation requires an overarching framework based on the "precautionary principle"- that is, that the onus is on the practitioner to demonstrate, in advance, a lack of harm. CWHN encourages continued tight control and clear scrutiny of all assisted reproduction techniques, based on this principle.
-urges that the bill strongly recognize of the Charter of Human Rights commitment to equality, in particular that genetic technology must not contribute to discrimination against vulnerable groups, especially women and people with disabilities.

Consultation, and Education and Prevention
-urges that the governance body under the Act be mandated and funded to conduct much-needed public education and consultation about reproductive technologies, and not just act as a regulatory body.
-emphasizes that this bill be placed in the context of a renewed, broad sexual and reproductive health program.
-recommends that innovative techniques for ongoing public consultation and decision-making be included in implementation and management of this bill.
-emphasizes that research and education about prevention of infertility must be part of the mandate of the regulatory body to be created by this bill. The necessity to address safe treatment of infertility must not distract from examining and eliminating its causes, many of which are entirely preventable.
-points out that couples may choose IVF rather than adoption because IVF is, regrettably, less expensive than the long-term costs of adoption of already-born, parentless children, many of whom may be older, have a disability or have lived in numerous foster homes.
-recommends immediate attention to the multiple birth phenomenon, a frequent consequence of IVF, one which has health, economic and social risks to pregnant women and society.

Informed Consent/ Informed Choice
-emphasizes that regulations under the new Act must ensure informed choice as a fundamental principle.
-urges that counselling by a neutral party be a condition of informed consent for any decision related to assisted reproduction.
-recommends that individuals giving consent have the right to refuse re-use of health information for strictly research purposes, and that individuals be told of any potential or future commercial use of an embryo or its cells.

Disclosure of Health Information
-supports an open donor system whereby individuals born under assisted reproductive procedures have access to the identity of the donor, along with the necessary education and mechanisms to manage an open system.

Surveillance of Health Impacts
-recommends the set up of a tracking system, with explicit privacy safeguards, to monitor the safety and long term effects of assisted reproduction techniques, such as adverse reactions to drugs used in ovary stimulation, ovarian cancer, and strokes.

-strongly concurs with the complete prohibition of commercial use of human beings or their body parts.
-urges also the inclusion of strict regulation, perhaps prohibition, of products developed from cells or embryos obtained for assisted reproduction; and prohibitions on the commercial use of so-called "extra" embryos.
-recommends a ban on commercial relations between non- profit and for-profit entities with respect to body parts.

-urges that Canada immediately ban both reproductive and non-reproductive cloning, without waiting for enactment of the draft bill.
-urges that the Act clearly prohibit the cloning of embryos as a "resource" for medical experiments or to produce a baby. Lack of such a clear ban will contribute to increased market pressure for women's eggs and increased exposure of women to health-threatening treatments.

-strongly urges a ban on commercial surrogacy and, at the least, a moratorium on non-commercial surrogacy until clear and enforceable regulations are in place. CWHN is very concerned about distinctions between commercial and non-commercial pre-conception arrangements in the draft bill. The dangers to children, vulnerable populations and women are identical regardless of setting.

Regulatory Body
-urges a moratorium on all current activity that will fall under this future regulatory body, rather than "grand-fathering" acceptance of activities currently in place. If a moratorium is not possible, a short time limit should be set, within which those currently engaged in assisted reproductive activities must get a licence from the regulatory body.
-strongly recommends that the regulatory body must not include persons with any possible conflict of interest from the provision or development of technologies or activities, although such persons could be called upon for consultation or advice.
-strongly recommends that members of the regulatory body function as individuals, and not as representations of any organizations or groups
-that full disclosure is mandatory for anyone named to the regulatory body
-that a minimum of half the governance members be women.

Sex Selection
-emphasizes expansion of the draft bill to prohibit, not only the mentioned sperm-sorting technique, but also the use of any procedure to create or implant an embryo chosen on the basis of sex alone.

Pre-implantation Diagnosis
-recommends restrictions on pre-implantation diagnosis, (such as tests to determine medical problems in the embryo), until questions associated with it have had full and open public discussion, and until guidelines for its regulation are firmly in place.

Public or Private Payment
-believes that reproductive health technologies that have been approved as safe and effective should be covered under Medicare.


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