The Canadian government announced its plans to establish a Royal Commission on Reproductive Technologies in the Speech from the Throne which opened the second session of the thirty-fourth Parliament (April 3, 1989). The Commission will inquire and report on current and potential medical and scientific developments related to new reproductive technologies. It will also consider social, ethical, health, research, legal and economic implications of these technologies.

Mandate

In accordance with its mandate it will examine the following:

–          implications of new reproductive technologies for women’s reproductive health and well-being;

–          the causes, treatment and prevention of male and female infertility;

–          reversals of sterilization procedures, artificial insemination, in vitro fertilization, embryo transfers, prenatal screening and diagnostic techniques, genetic manipulations and the therapeutic interventions to correct genetic anomalies, sex selection techniques, embryo experimentation and fetal tissue transplant;

–          social and legal arrangements, such as surrogate child bearing, judicial interventions during gestation and birth, and “ownership” of ova, sperm, embryos and fetal tissue;

–          the status and rights of people using of contributing to reproductive services, such as access to procedures, “rights” to parenthood, informed consent, status of gamete donors and confidentiality, and the impact of these services on all concerned parties, particularly the children;

–          the economic ramifications of these technologies, such as the commercial marketing of ova, sperm and embryos, the application of patent law, and the funding of research and procedures including infertility treatment.

Public hearings

The challenges dealing with each of these issues fairly and consistently are quite formidable. Consider the fact that the World Health Organization (WHO), for example, has calculated that “For the cost of one live IVF baby, it is likely that 100 women could be prevented from ever becoming infertile in the first place through programs to prevent sexually transmitted disease.”

The Commission has been meeting in Ottawa and is planning to start its public hearings in the spring of 1991. It hopes to wrap these up no later than October of the same year.

The public hearings, which will be held in a variety of cities throughout the country, offer opportunities for individuals – professionals or laypeople – to come forward and express their views about reproductive technologies and what implication they hold for Canadian society.

Dr. Patricia Baird, a professor in the Department of Medical Genetics at the University of Columbia, is the Commission’s chairperson. Dr. Baird has generated some controversy as a result of an article she authored which appeared in the B.C. Medical Journal, entitled “A cost-benefit analysis of prenatal diagnosis of Down’s Syndrome and Neural Tube defects.”

She discusses the economic benefits to extending the prenatal diagnosis program in B.C. to detect Down’s Syndrome and neural tube defects (primarily spina bifida) in the unborn. Dr. Baird and her co-author argue that the cost to the government of providing prenatal diagnosis for these disabilities is far lower than providing extra medical and social services for the disabled individuals over their lifetimes.

Other Appointees

In a radio interview, Dr. Baird was more pointed: “I can tell you in our prenatal diagnosis program in the last few years we’ve detected 62 abnormal fetuses [she is referring to unborn babies with spina bifida]. The parents have elected in every single case to terminate. SO that is 62 individuals who would have been seriously handicapped and a burden on the health-care system even if you figured they only lived on the average five years.”

The federal government also appointed to the Commission:

–          Mrs. Maureen McTeer, a board member of the Toronto Planned Parenthood Association and an honorary director of the Canadian Abortion Rights Action League (CARAL);

–          Dr. Suzanne Scorsone, a social anthropologist who is the director of the office of Catholic Family Life for the Archdiocese of Toronto;

–          Bruce Hatfield a Calgary doctor and bio-ethicist;

–          Dr. Louise Vandelac, a Montreal sociology professor and member of the National Bioethics Council on Research on Human Subjects;

–          Mr. Martin Hebert, a Quebec lawyer and ethicist;

–          Grace Jantzen, who teaches the Philosophy of Religion at King’s College, University of London;

The Commissioners have an extremely difficult task. They must relate the complex data involving reproductive technology to sound moral principles. At the same time they must hear, respect and reflect the views of Canadians. The tension is between ethics and politics. Politics is democratic; ethics is not. One hopes that the principles enunciated in the final report will be for the good of the people.

Dr. Donald DeMarco is professor of philosophy at St. Jerome’s College in Waterloo, Ontario.