Tuesday, December 26, 2006

New fertility panel is packed with conservatives

Critics troubled by new fertility panel


From Saturday's Globe and Mail

The federal government announced on the eve of the holiday weekend it has appointed a new body that could have a major impact on the way babies are made in fertility clinics and the future of stem-cell research in Canada.

The 10-member board will oversee Assisted Human Reproduction Canada, a federal agency with the power to influence both Parliament and medical practices in the most promising and controversial areas of health care and science — fertility treatments and research on human embryonic stem cells.

Both areas have traditionally divided liberals from social conservatives, and as word of the new board appointees spread among doctors and researchers yesterday, so did a chill of concern.

The board is to be headed by former Tory premier and family doctor John Hamm, with Dr. Elinor Wilson, a former CEO of the Canadian Public Health Association, as president.

The board's eight members include those who have in the past spoken out against abortion, embryonic stem-cell research and the way in which stem-cell scientists operate.

The board does not, however, appear to include any stem-cell scientists or fertility experts.

“They could steer this all in a very conservative way, and maybe that's what the federal government wants,” said Michael Rudnicki, scientific director of Canada's Stem Cell Network. “We will have to see whether the function of this board will be politicized and whether there is an agenda.

“This committee could make life very difficult for stem-cell research in Canada.”

No one was available yesterday afternoon in the office of federal Health Minister Tony Clement to comment on the new board. But one of its new members, Suzanne Rozell Scorsone, who has worked within the Roman Catholic Church for nearly 25 years, said, “One of the reasons the government has appointed as broad a group as it has is to ensure that all sectors of society have a voice in this, and that's fair ball.”

It remains unclear exactly what effect the new agency will ultimately have on access and availability to fertility treatments, which include such methods as donor insemination and in vitro fertilization. More than 300,000 Canadian couples a year turn to clinics and hospitals for reproductive assistance.

It was the royal commission on new reproductive technologies in 1993 that first called for a federal body to oversee fertility treatments in the country.

But not until 2004 did Parliament pass legislation on reproductive technologies that laid the groundwork for its inception. It is a sweeping law that, among other things, bans payment to surrogate mothers, sperm donors and egg donors beyond expenses; prohibits human cloning; and also restricts how scientists work with stem cells from human embryos.

Embryonic stem cells have the power to multiply indefinitely and grow into the various tissues that make up the human body. Many scientists believe they could be the keys to regenerative medicine, with the potential to treat everything from spinal-cord injuries to cardiac defects.

But because embryos are usually destroyed in the process of harvesting stem cells, the research has provoked condemnation from those who believe life begins at conception.

In Canada, the 2004 law permits researchers to work only on embryos that have been donated by couples who had them created through in vitro fertilization at fertility clinics.

The Assisted Human Reproduction agency, meanwhile, is now to play a key role in enforcing the law — with the power to inspect fertility clinics, and issue, suspend and revoke their licences to operate. It could also set rules for stem-cell research projects and make regulatory recommendations to the federal Health Minister.

The agency, based in Vancouver, was officially created in January of 2006, but until yesterday's board announcement there had been no word of its operations. The timing of the long-awaited appointments added to suspicions that the government hoped to dilute any criticisms the panel selection might raise.

“I think it's curious that they made this announcement so close to Christmas when everyone is so busy and not available to consider it,” said Tim Caulfield, director of the Health Law Institute at the University of Alberta.

“It's a little bit disappointing not to see a little more scientific expertise,” he said. “Other than a few names, these are not people who have had a lot to do with stem-cell research or stem-cell policy in Canada. Now on one hand, maybe that's a good thing because they bring a fresh voice. But they may not have the knowledge base to make decisions in the immediate future.

“On the spectrum, taken as a whole, this is a pretty conservative group,” Prof. Caulfield said. “The stem-cell community is right to be somewhat disappointed, but we'll have to wait and see what happens.”

Among the panelists, most of whom were unavailable for comment yesterday, is David Novak, a professor of Jewish studies at the University of Toronto, who has written of his opposition to abortion except in extreme circumstances in which the life of the mother might be threatened. In 2001, Prof. Novak's name was included as a signatory on an article in the Issues of Law and Medicine journal that called for the United States to continue its ban of federally funded embryonic stem-cell research.

Another board member is Joseph Ayoub, an oncologist at the University of Montreal, who in November of 2005 was billed as a speaker at a national pro-life anti-abortion conference in Montreal where he was slated to give a talk opposing euthanasia.

Dr. Rudnicki said he was troubled to learn that Françoise Baylis, a bioethicist at Dalhousie University in Halifax, would also be among the new board members.

Prof. Baylis was unavailable for an interview yesterday. But she has in the past called for a moratorium on scientists' use of “fresh” embryos for stem-cell research, preferring instead that frozen embryos be used.

But stem-cell researchers have argued that they have been unsuccessful in harvesting stem cells from years-old, frozen embryos.

“She has some extreme views that I would say are outside of the mainstream,” Dr. Rudnicki said. “She is very suspicious of the motivations of scientists.”

In public comments in the past, Prof. Baylis has argued for strong oversight of researchers and fertility doctors to ensure that that there is no coercion of couples to donate embryos.

Board member Ms. Scorsone, a social anthropologist who is currently the director of research for the Archdiocese of Toronto, would not discuss her views on embryonic stem-cell research or fertility treatments yesterday, saying only that, “My view is that every human individual is deserving of respect and of care and that would be true whatever the age of the person.”

In a past interview with The Globe, Ms. Scorsone said she has opposed the creation of extra embryos during fertility treatments, since they might be discarded.

Ms. Scorsone was also a member of the 1993 royal commission, and in that report she wrote her dissent on key areas that involved sex education, terminating pregnancies in response to a prenatal diagnosis and embryonic research.

Still, yesterday, Ms. Scorsone said she felt she had much to learn about the issues and how the board will function, and she looked forward to “constructive” dialogues with a “very interesting and stimulating group.”

“This is something that affects all human beings on the planet,” she said, “not just those directly involved.”

Albert Chudley, director of the genetics and metabolism program with the University of Manitoba, said he had just learned yesterday afternoon the identity of the other board members.

“I think it's an outstanding group, with a diversity of backgrounds,” he said.

Dr. Chudley stressed that he was not the official spokesperson but countered criticisms that the board lacks scientific expertise in the key areas. He said that the board may consult experts as needed. “I think the board will be taking all views into consideration . . . to ensure things are done in a safe manner . . . and to serve the needs of infertile couples.”

Under the legislation, the board is to meet at least twice a year and Dr. Chudley said there will be priorities to determine, among other things, how to set up the agency.

The board also includes Barbara Slater, a specialist on health policy in Ontario, Theresa Kennedy, a communications director with B.C. biotech firm ResVerlogix, and Ottawa lawyer Roger Bilodeau, who served as a deputy minister of justice in New Brunswick.

Under the 2004 law, three years after the creation of the oversight agency, Canada's stem-cell rules — which are among the most conservative in the world — are to be reviewed. Scientists have been hopeful that there would be a loosening around some of the restrictions, which include a maximum 10-year prison term if violated.

But Dr. Rudnicki worried yesterday that if the board takes a more conservative stand, it could influence the direction of that review.

Prof. Caulfield also pointed out that the board is likely to have an impact on far more than stem-cell research: “If this group does have a more conservative spin, it may impact the type of reproductive technologies that Canadians will be able to access in the future.”

Among those technologies is pre-implantation genetic diagnosis (PGD). This process, performed at fertility clinics, allows prospective parents to screen the embryos created for genetic diseases and implant only the healthiest embryos.

But many have argued that the method could be abused to screen for genetic traits in everything from sex selection to eye colour, neither of which would currently be allowed in Canada.

Still, there have long been calls for oversight of Canada's fertility clinics, where information and numbers on treatments and outcomes have often been difficult to access.

With a report from Editorial Research

The comments are interesting.

Government biographies of the members here.



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