Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

Patchwork regulations likely outcome of reproductive technologies ruling

Laura Eggertson
CMAJ March 08, 2011 183 (4) E215-E216; DOI: https://doi.org/10.1503/cmaj.109-3792
Laura Eggertson
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

A Supreme Court of Canada decision that struck down key provisions of the Assisted Human Reproduction Act could increase medical tourism and risk to patients, experts in health policy fear.

“There is an absolute lack of protection for patients, and most especially women,” says Vanessa Gruben, an assistant professor of law at the University of Ottawa in Ontario.

The Dec. 22, 2010, split decision (4-4-1) upheld Quebec’s challenge to the federal government’s authority to regulate assisted human reproductive technologies, such as in vitro fertilization. Such regulation, as well as the licensing of fertility clinics, will now be left to provinces and territories. Each will have to draft legislation if it wishes to set standards in this area, Gruben says. Thus far, only Quebec has indicated a keen desire to do so.

A patchwork of provincial laws and regulations is likely to ensue, leading more women to seek treatment in provinces with regulations most favourable to their particular situation, Gruben says.

Dr. Patricia Baird, distinguished professor emerita at the University of British Columbia in Vancouver and chair of the 1989 Royal Commission on New Reproductive Technologies that spawned the federal legislation, concurs on the likely outcome. “I am disappointed about the legislation and concerned that it will lead to a patchwork of clinical standards, and reproductive tourism — if some provinces have little oversight,” she writes in an email.

For example, some provinces may decide to stipulate that fertility clinics can only implant one embryo at a time; others may leave the choice of single or multiple implantation — which increases the risk of multiple births — to the individual clinic and physician. Depending upon a woman’s age or the number of cycles of in vitro fertilization she can afford, she may opt to travel to a province that permits multiple implantations.

Figure1

A recent Supreme Court of Canada decision on the constitutionality of federal reproductive technologies legislation was caught up in 20-year-old rhetoric and fears about “cloning in the garage,” says Timothy Caufield, chair of health law and policy at the University of Alberta in Edmonton.

Image courtesy of © 2011 Jupiterimages Corp.

The Supreme Court also struck down the information provisions of the legislation that would have enabled the federal Assisted Human Reproduction Agency to create donor registries and compile information for people born from donated eggs or sperm. It did, however, leave in place prohibitions against human cloning, the creation of human embryos for research purposes, the mixing of human and animal genetic materials to form chimeras or hybrids, and the buying and selling of sperm, ova and embryos. Commercial surrogacy contracts also remain illegal.

But the agency will no longer have the authority to regulate such areas as pre-implantation diagnosis, including screening gametes for diseases such as Tay-Sachs or familial Alzheimer disease.

“That’s clearly something the provinces have to do,” says Timothy Caulfield, chair of health law and policy at the University of Alberta in Edmonton.

The ruling has left the agency in limbo and scrambling to determine how to carry out its adjusted mandate. A spokesperson refused comment, referring all inquiries to Health Canada, which said it is “studying the decision.”

Caulfield believes there’s a need for national standards in several areas, as well as a national discussion on the issue of pre-implantation genetic testing. “We’ve lost the ability to create a regulatory framework which I think ultimately would have led to a higher quality of care for Canadians seeking reproductive technology.”

He also believes there’s a need to reexamine the ethical, legal and social issues around cloning, genetic enhancement and stem cell research. Some of the justices got mired, in some of their discussions, around the fear of “cloning in the garage” and other things that were envisioned 20 years ago and haven’t happened, he says, adding that science has evolved in the area and the justices’ arguments did not reflect that.

Caulfield hopes provincial medical associations and national regulatory bodies governing physicians will step into the breach to develop standards governing such things as transparent success rates at fertility clinics, and policies regarding multiple embryo transplants.

Others fret about the absence of any kind of legislative or institutional check on the activities of fertility clinics.

For example, although the law prohibits the buying and selling of gametes, there are still no regulations that define what constitutes a “gift” to potential donors, says Dr. Renza Bouzayen. “It’s so hard to actually not pay a donor,” she says, and as a result, gametes are becoming scarce.

Bouzayen discontinued working with a patient who indicated a willingness to give a $10 000 “gift” to a donor at a Toronto fertility clinic. “I said, I’m not ready to take the risk” of defending the $10 000 as a gift rather than a payment, she says.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 183 (4)
CMAJ
Vol. 183, Issue 4
8 Mar 2011
  • Table of Contents
  • Index by author

Article tools

Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Patchwork regulations likely outcome of reproductive technologies ruling
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Patchwork regulations likely outcome of reproductive technologies ruling
Laura Eggertson
CMAJ Mar 2011, 183 (4) E215-E216; DOI: 10.1503/cmaj.109-3792

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Patchwork regulations likely outcome of reproductive technologies ruling
Laura Eggertson
CMAJ Mar 2011, 183 (4) E215-E216; DOI: 10.1503/cmaj.109-3792
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Unpacking “long COVID”
  • Canada’s long road to a vaccine injury compensation program
  • Health advocates want help handling online harassment
Show more News

Similar Articles

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of the resources on this site in an accessible format, please contact us at cmajgroup@cmaj.ca.

Powered by HighWire