It’s had a long gestation. But ten years since the report of the Royal Commission on New Reproductive Technologies, Parliament is finally debating a bill on assisted reproduction that may actually become law.

Should we celebrate? Does Bill C-56 respond to the concerns that women’s groups and health advocates have raised? Will it prevent the practices that trouble us the most?

Human reproductive technologies provide ways for some women to circumvent biological causes of infertility. To do this, doctors remove sperm, eggs and embryos from the bodies in which they are produced — and put them into labs where they can be manipulated, changed, implanted or discarded in any number of ways under the control of physicians and researchers.

But their control cannot be absolute. Nor can it merely be regulated by a government licensing agency, by federal or provincial research funding bodies, or by research ethics review boards. Even more urgently, perhaps, we need processes that can address infertility “upstream” by eliminating its known causes — social and environmental causes in particular. Legislating assisted reproduction out of context takes attention away from what women need for their sexual and reproductive health: safe places to grow up, live, work and play.

There do appear to be some good features in the bill. But on a closer look, even these appearances start to seem deceptive. Government claims to the contrary, this bill is quite permissive on clinical and research practices that could lead to commercialization of human bodies and body parts. And there is nothing in this bill to ensure that any of this will be effectively and transparently controlled.

For instance, the bill is permissive about commercial surrogacy — carrying a pregnancy for a fee. The bill first bans it, then sets out conditions under which surrogates can have their expenses covered. How can someone be reimbursed for costs incurred through a banned activity? The bill should do what women’s groups have long demanded: it should ban the exchange of any money for contract pregnancies.

Stem Cell Research

Embryonic stem cell research has received lots of attention since the legislation was introduced. Basically, Bill C-56 would allow researchers to use embryos that were originally created to produce a pregnancy. These are the so-called “extra” embryos.

Of course, donors would first have to give written consent. And researchers would have to show that their projects are “needed,” and that there’s no other way to approach a problem.

Perhaps I’ve been working with biomedical scientists too long, but I have yet to find any research that could not be described as necessary. So we can expect to hear many reasons why “extra” embryos were needed for a given project. And when we doubt such claims, count on being shown photos and stories featuring sick children needing to be cured, or “desperate” women needing babies.

There is no moral imperative to do embryonic stem cell research now. Most illness and disability is not genetic. And the distress of childlessness does not require biomedical, reproductive or genetic fixes.

Ideally, this bill would ban all embryonic stem cell research. Ideally, this bill would limit how many eggs can be fertilized during infertility treatments to ensure there are no more “extra” embryos — no more opportunities for cloning behind closed doors.

However, even a three- to five-year moratorium on this activity would make me feel safer than leaving decisions about the “need” for this research to an agency.

During this time, we could finance adult stem cell research. We know very little about the potential of stem cells obtained from adult tissues. Let’s finance research to find out what these cells can do. And let’s provide citizen groups with the resources they need to participate in discussions about implications of embryonic stem cell work — including its potential for commercialization — before it gets even conditional approval.

Cloning

What about cloning? Here the bill seems to say “no” without qualification. But I am skeptical. The bill permits the regulated use of in vitro embryos for research. In practice, then, will cloning really be prevented? And are we not already being softened up to have this happen?

Lately, researchers have been distinguishing between “reproductive” and “therapeutic” cloning. And now they are pushing a new term for the latter: “human somatic cell nuclear transplantation.” This is about using words as sales pitches, muddying the issues that we need to see clearly. Distinguishing these types of cloning is artificial. The process is the same, no matter what the goal.

Human embryos must not be cloned — nor somatic cells transplanted to emptied oocytes — as a “resource” for medical experiments or to make a baby. Do we want human life and its various parts and processes to be mere research tools? Or to be manufactured commodities or products?

A Watchful Eye?

Am I being alarmist? Won’t there be a regulatory agency watching over everything — ensuring that only “good” things are done with eggs, sperm and embryos, and that women’s bodies and their health will be protected?

Yes, there will be an agency. But there is no clarity on who will do the watching and how.

We need an agency that can add to the current list of prohibited activities, not merely set conditions of use. One that will guarantee that if there is no long-term information on the implications of a practice, then it will be tightly regulated as research.

The legislation must ensure that everyone appointed to the agency’s governing board serves as an individual — not as a representative of any organization or group. It must ensure that no one with a possible conflict-of-interest can serve in a governance position.

Most important, public input into regulatory hearings and decision-making must be mandatory, and supported, so that the full range of these technologies’ impacts can be assessed in a democratic and participatory way. The “Bureau d’audiences publiques sur l’environnement” (BAPE) in Québec offers an interesting model for this.

Conclusion

Regulation of assisted reproductive, embryonic research and other genetic research must ensure that women are offered options that:

  • value them and their children;
  • are developed and approved in accordance with basic ethical principles of research and practice;
  • respect the precautionary principle (heeding suspicions that a practice may do harm, even when cause-and-effect relationships are not yet established); and
  • value diversity and scrupulously avoid discrimination against those with disabilities, before or after birth.

While Bill C-56 begins to move us toward these principles, it may also move us away.

This legislation must be amended to ensure it will sustain women’s health and reproductive rights. It must ban all commercialization of human bodies and biological material. And it must create a publicly accountable regulatory agency that listens to citizens, rather than to lobbyists from the biotech-university-industry complex.