Assisted Human Reproduction
Canada board of directors
-Dr Elinor Wilson (president),
former CEO of Canadian Public Health Association
-Dr John Hamm (chair), former
premier of Nova Scotia (PC) and family physician
-Dr Joseph Ayoub, hemato-oncologist
-Dr Franìoise Baylis,
bioethics professor
-Roger Bilodeau, lawyer and
former New Brunswick Deputy Minister of Justice
(PC)
-Dr Albert Chudley, geneticist
and pediatrician
-Theresa Kennedy, VP-Corporate
Communications of Resverlogix biotech company
-Dr David Novak, Jewish Studies
professor and rabbi
-Dr Suzanne Scorsone, Archdiocese
of Toronto director of research and social anthropology
PhD
-Barbara Slater, Ontario public
health consultant
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"No science is immune to the infection
of politics and the corruption of power," wrote famed
mathematician and philosopher Jacob Bronowski in 1971.
Over 30 years later, Canada is proving Dr Bronowski
correct: the dispute over Health Minister Tony Clement's
appointments to the Assisted Human Reproduction Canada
(AHRC) board of directors has largely left the purview
of medicine and entered the realm of politics.
CHIMERIC
UNITY
Established in principle in January 2006 in Vancouver,
shortly before the federal elections, AHRC is mandated
to "protect and promote the health and safety, human
dignity and human rights of Canadians who use or are
born of assisted human reproduction technologies, and
to foster ethical principles in relation to assisted
human reproduction and other related matters under the
[Assisted Human Reproduction] Act," according to the
description that accompanied Mr Clement's press release.
"Clearly the board could be very
influential," said Dr Edward Hughes, president of the
Canadian Fertility and Andrology Society. "The agency
was established to control all areas of reproduction
not just fertility clinics but also clinicians
in the community so it is very broad-reaching."
The 2004 AHR Act deals with three
important issues, according to Dr Hughes. It prohibits
10 ethically questionable activities like the creation
of chimeras (part-human, part-animal); it also bars
offering payment to sperm donors. The Act also safeguards
patient privacy by banning the gathering and centralization
of data on those using fertility services. Dr Hughes,
who did not apply to be considered for board membership,
stressed the difficulty of assessing the board's stance
on any of those issues before it has even met.
Dr Hughes pointed out that stem-cell
research is not prohibited by the Act nor will it be
governed by the AHRC board, although the board could
exert some influence in that matter. The board could
also potentially recommend that governments fund elective
single embryo transfer IVF (in vitro fertilization),
which Dr Hughes said would be a positive change in improving
access to safer alternatives to infertility treatments
like ovulation induction therapy the likely culprit,
he said, of the sextuplet birth in Edmonton in early
January that has already resulted in one of the infants
dying.
The board will likely consider
regulations on pre-implantation genetic diagnosis (PGD),
a screening technique to select healthy embryos to implant
that is already seeing limited use in Canada.
UNDER
THE MICROSCOPE
Asked if he had been surprised at the appointments,
Dr Hughes said, "Yes, deeply surprised." He had expected
there would be representation of patients, clinicians,
counsellors, researchers and nurses. "They are all important
and have insight and experience that the board members
won't have."
Beverly Hanck, executive director
of the Infertility Awareness Association of Canada,
recently wrote, "The current makeup of the board is
so narrow in outlook and conservative in nature that
the regulations will probably be too restrictive."
The prevailing criticism is that
too many of the board's members have political and philosophical
biases, as Ms Hanck wrote. Many of the people appointed
would not have been approved by the equivalent British
agency, which excludes anybody who was politically active
in the preceding five years a model that Dr Hughes
favours.
Among the problems cited by critics
are board member Dr Joseph Ayoub's 2005 speech at an
anti-abortion conference; Franìoise Baylis's
public support for a ban on using unfrozen embryos for
stem-cell research; Dr Suzanne Scorsone's 1993 testimony
against terminating pregnancies after prenatal diagnoses;
and David Novak's support of the United States' ban
on stem-cell research, all of which were reported in
late December in the Globe & Mail.
Dr John Hamm, the former Tory Premier
of Nova Scotia who chairs the board, told the Halifax
Daily News that he and his colleagues will be open-minded
and defended the board members' place on the board.
"I don't think that the duties of the board necessarily
require all of the experts in the world to be involved
at the board level," he said.
AHRC board president Dr Elinor
Wilson refused to comment for this story beyond saying
that there "has been a lot of misinformation" in the
media about the board and any politics behind the appointments,
and said that speaking about the board before its first
meeting would be premature.
FERTILE
GROUND
As the controversy began to heat up, moving quickly
in late December and early January from a simmering
argument into a rolling boil of a political battle,
the political rhetoric picked up. The criticism reached
new heights on January 11 when two Liberal MPs
Health Critic Ruby Dhalla and former Public Health Minister
and physician Carolyn Bennett held a news conference
in Ottawa to demand additions to the board, which has
only filled 10 of its 13 spots. "This government is
driven by right-wing ideology instead of trying to achieve
public policy that meets the needs of Canadians... their
tremendous insensitivity and lack of compassion is shameful,"
Dr Bennett said.
The Liberals have asked that the
three remaining seats on the board go to a patient representative,
a fertility doctor and a medical health professional
with experience in infertility counselling.
In an interview several days after
that press conference, Health Canada spokesperson Erik
Waddell said, "There is room for three more [board members].
At this point, we are not filling anything immediately.
In the future, if there is a need, we will." Mr Waddell
then shot back at the Liberals: "The previous government
didn't succeed in getting anyone appointed. We [the
Conservative minority government] have had a year and
we have appointed a board we have taken clear
action." Mr Waddell brushed aside claims of the members'
inexperience in medical matters, instead pointing out
"a rich diversity of perspectives." As for accusations
of social-conservative bias, Mr Waddell said, "The board
represents a wide range of interests, which is needed
to effectively reflect the views of Canadians on assisted
reproduction."
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