HEAL Committee Meeting

37th PARLIAMENT, 2nd SESSION

Standing Committee on Health

EVIDENCE

CONTENTS

Tuesday, November 26, 2002

¹

1530

The Chair (Ms. Bonnie Brown (Oakville, Lib.))

Dr. Alan Bernstein (President, Canadian Institutes of Health Research)

The Chair

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1535

Dr. Jack Kitts (Member, Association of Canadian Academic Healthcare Organizations)

¹

1540

The Chair

Mr. Rob Merrifield (Yellowhead, Canadian Alliance)

Dr. Alan Bernstein

¹

1545

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

¹

1550

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

¹

1555

The Chair

Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.)

Dr. Alan Bernstein

º

1600

Mr. Stan Dromisky

Dr. Alan Bernstein

Mr. Stan Dromisky

Dr. Jack Kitts

Mr. Stan Dromisky

Dr. Jack Kitts

Mr. Stan Dromisky

The Chair

Dr. Alan Bernstein

Mr. Stan Dromisky

The Chair

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ)

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1605

Dr. Alan Bernstein

Mr. Réal Ménard

Dr. Alan Bernstein

Mr. Réal Ménard

Dr. Alan Bernstein

Mr. Réal Ménard

Dr. Alan Bernstein

The Chair

Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.)

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1610

Dr. Jack Kitts

Mr. Jeannot Castonguay

Dr. Jack Kitts

Mr. Jeannot Castonguay

Dr. Jack Kitts

The Chair

Dr. Alan Bernstein

Mr. Jeannot Castonguay

Dr. Alan Bernstein

Mr. Jeannot Castonguay

Dr. Alan Bernstein

The Chair

Mr. James Lunney (Nanaimo—Alberni, Canadian Alliance)

º

1615

Dr. Alan Bernstein

Mr. James Lunney

Dr. Alan Bernstein

Mr. James Lunney

Dr. Alan Bernstein

The Chair

º

1620

Ms. Hedy Fry (Vancouver Centre, Lib.)

Dr. Alan Bernstein

Ms. Hedy Fry

Dr. Alan Bernstein

The Chair

Dr. Alan Bernstein

The Chair

Dr. Alan Bernstein

The Chair

Dr. Jack Kitts

The Chair

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP)

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1625

Dr. Alan Bernstein

Dr. Jack Kitts

Ms. Judy Wasylycia-Leis

Dr. Jack Kitts

The Chair

Ms. Carolyn Bennett (St. Paul's, Lib.)

Dr. Alan Bernstein

Ms. Carolyn Bennett

Dr. Alan Bernstein

Ms. Carolyn Bennett

º

1630

Dr. Alan Bernstein

Ms. Carolyn Bennett

The Chair

Ms. Hélène Scherrer (Louis-Hébert, Lib.)

Dr. Alan Bernstein

º

1635

Ms. Hélène Scherrer

Dr. Jack Kitts

Ms. Hélène Scherrer

Dr. Jack Kitts

The Chair

Mr. Paul Szabo (Mississauga South, Lib.)

Dr. Alan Bernstein

Mr. Paul Szabo

Dr. Alan Bernstein

Mr. Paul Szabo

º

1640

Dr. Alan Bernstein

Mr. Paul Szabo

Dr. Alan Bernstein

Mr. Paul Szabo

Dr. Alan Bernstein

The Chair

Mr. Rob Merrifield

Dr. Alan Bernstein

º

1645

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

Dr. Alan Bernstein

Mr. Rob Merrifield

The Chair

Mr. James Lunney

Dr. Alan Bernstein

Mr. James Lunney

Dr. Alan Bernstein

Mr. James Lunney

Dr. Alan Bernstein

Mr. James Lunney

Dr. Alan Bernstein

Mr. James Lunney

Dr. Alan Bernstein

º

1650

Mr. James Lunney

Dr. Alan Bernstein

The Chair

º

1655

Mr. Rob Merrifield

Mr. Réal Ménard

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

»

1700

Mr. Réal Ménard

The Chair

Ms. Hedy Fry

The Chair

Ms. Hedy Fry

Mr. James Lunney

The Chair

Ms. Hedy Fry

Mr. James Lunney

The Chair

Ms. Hedy Fry

»

1705

The Chair

Ms. Hedy Fry

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. Stan Dromisky

The Chair

»

1710

Mr. Stan Dromisky

The Chair

Mr. Stan Dromisky

The Chair

Mr. Stan Dromisky

The Chair

Mr. Stan Dromisky

The Chair

Mr. James Lunney

The Chair

Mr. Réal Ménard

»

1715

The Chair

Mr. James Lunney

The Chair

Mr. James Lunney

»

1720

The Chair

Mr. Paul Szabo

The Chair

Mr. Paul Szabo

The Chair

Mr. Paul Szabo

The Chair

Mr. Paul Szabo

The Chair

Mr. Paul Szabo

The Chair

Ms. Hedy Fry

The Chair

Mr. James Lunney

»

1725

The Chair

Mr. Jeannot Castonguay

Mr. Réal Ménard

The Chair

Ms. Judy Wasylycia-Leis

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. James Lunney

The Chair

Mr. Paul Szabo

»

1730

The Chair

Mr. Paul Szabo

The Chair

The Clerk of the Committee

The Chair

Mr. Rob Merrifield

The Chair

Ms. Carolyn Bennett

The Chair

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CANADA

Standing Committee on Health

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NUMBER 006

l

2nd SESSION

l

37th PARLIAMENT

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EVIDENCE

Tuesday, November 26, 2002

[Recorded by Electronic Apparatus]

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[English]

    The Chair (Ms. Bonnie Brown (Oakville, Lib.)): Good afternoon, ladies and gentlemen. It is my pleasure to welcome you to the Standing Committee on Health and to introduce to you the witnesses. Two are from the Canadian Institutes of Health Research and one is from the Association of Canadian Academic Healthcare Organizations.

    We will begin with Dr. Alan Bernstein, who is the president of the Institutes. I'm not sure if Patricia Kosseim is going to present or answer questions.

    Dr. Bernstein, you have the floor.

    Dr. Alan Bernstein (President, Canadian Institutes of Health Research): Thank you very much. Patricia Kosseim is a colleague at CIHR in CIHR's Office of Ethics. She is with me here today.

    First, thank you very much again for the opportunity to be in front of the health committee. This is my third appearance relating to Bill C-13 on the Assisted Human Reproduction Act. I decided to make my comments extremely brief.

    As you know, at least I hope you know, CIHR and Canada's health research community welcome the legislation and fully support the intent, content, and spirit of the provisions of the legislation. We look forward to the passage of the act for the much-needed guidance and framework it will provide for Canadians and for Canadian researchers.

    I'm not telling you something you don't already know, but the bill will establish a consistent national approach to research in both the private and public domains. I think it's a key aspect, obviously, of the bill. It will ensure that research is conducted in accordance with a coherent regulatory framework that respects the ethical, social, and cultural values of Canadians.

    At my last appearance before the committee in the spring, I made a commitment that no new funds from CIHR would flow for embryonic stem cell research until, at the earliest, April 2003. We have lived up to the commitment.

    I again encourage the committee and Parliament to continue to work, as you are, towards the passage of Bill C-13. I believe its balanced approach sets the right tone and direction for all stem cell research conducted in Canada. Your leadership as a committee in addressing this difficult issue should be applauded. I acknowledge it is a difficult issue.

    I believe that timely passage of the legislation is critical if Canadians are to be, on the one hand, confident that important, potentially life-saving research is going forward by Canadians, for Canadians and for the world, within an ethical and acceptable framework, while at the same time balancing the ethical and social concerns we're all aware of.

    I'll stop there, Madame Chair. I'll be pleased to try to answer any questions.

    The Chair: Does Ms. Kosseim have anything to say? No? Thank you.

    We'll move on to Jack Kitts, who is the president and CEO of the Ottawa Hospital, and is here today as a member of the Association of Canadian Academic Healthcare Organizations.

    Mr. Kitts.

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    Dr. Jack Kitts (Member, Association of Canadian Academic Healthcare Organizations): Thank you, Madam Chairperson and honourable committee members.

    I have left copies of my text at the front. I apologize, I didn't have the opportunity to provide them in both official languages today.

    As indicated, my name is Dr. Jack Kitts. I'm a physician and president of the Ottawa Hospital, one of Canada's largest teaching hospitals. Thank you very much for providing me the opportunity to speak with you on this very important legislation dealing with reproductive technologies.

    There are many aspects of this legislative package that impact on health care, education, and research. I am here today representing the Association of Canadian Academic Health Care Organizations. Before moving to the substance of my remarks, let me say a few words about the association.

    The Association of Canadian Academic Health Care Organizations, known ACAHCO, represents more than 40 teaching centres and regional health authorities who have jurisdictional responsibilities for teaching institutions. Members range from single hospital organizations to multi-site, multi-dimensional regional facilities that provide clinical programs ranging from primary care to highly specialized tertiary and quadrinary health care services.

    The distinguishing characteristic of the association is that its members represent all of the principal teaching and health research sites for Canada's health care professionals. The mission or mandate of members of ACAHCO is threefold. First, it's to provide Canadians with timely access to quality specialized health care services. Second, it's to provide the setting where the next generation of Canada's health care professionals receive their hands-on education and training. And third, it's to be the engine of innovation through ongoing health research, medical discovery, and knowledge creation.

    As president of the Ottawa Hospital, my mandate, like that of my colleagues across Canada, is to ensure that the patient population served by our hospital is provided with the best possible health care. The Ottawa Hospital is a teaching hospital affiliated with the University of Ottawa. In partnership with the university's faculties of medicine and health sciences and the Ottawa Health Research Institute, we constitute an academic health science centre where patients with the most complicated and difficult diseases are cared for.

    My role and that of my colleagues is to ensure that the care we provide in treating these complex disorders in our hospitals is at the leading edge, taking advantage of the latest in research results from around the world. But an academic health science centre is responsible not only for providing the best possible care today, it is also responsible for carrying out research to ensure that we provide our patients of tomorrow with innovative therapy based on research.

    As president of such a centre, I have a major role to play to ensure that the appropriate environment is in place to support a constant flow of innovation. I must also make sure that my institution facilities a rapid bench- to-bedside process so that discoveries in basic science today lead to better treatments and cures at the patient's bedside tomorrow.

    A major component of this enabling environment is ensuring that the right policies and procedures are in place to support the highest standard of scientific integrity, including proper ethical conduct on the part of researchers. A major challenge I have is ensuring that the field for scientific inquiry remains as wide as possible, for we can never predict when or from where the next groundbreaking medical discovery is likely to arise.

    One of the most exciting developments in the future will be in the area of regenerative medicine. In our hospitals today patients suffer from many common diseases that are caused by tissue degeneration or destruction. Today, these diseases are not adequately treated. Such diseases include Parkinson's disease, where specific neurons and brain degenerate; diabetes mellitus, where islet cells in the pancreas disappear from the body as the result of an auto-immune disorder; cerebral vascular accidents or strokes, where the oxygen supply to parts of the brain has been cut off, causing localized degeneration of brain tissue; and cardiovascular disease such as heart attacks, where reduced blood supply to the heart results in degeneration of cardiac muscles.

    Regenerative medicine is a new branch of medical science dealing with the regeneration and repair of damaged tissue in diseases such as these, leading, for the first time, to hope for an effective treatment or even a cure for patients with severe permanent disabilities.

    Underpinning research in the field of regenerative medicine is the concept of tissue regeneration and repair by stem cells. Stem cells, as you know, are primitive cells that are capable of extensive cell division and specialization to create the 200 or more different cell types that are found in our tissues and organs. Recognizing the importance of stem cells in regenerative medicine, the Association of Canadian Academic Healthcare Organizations applauds the federal government for including in Bill C-13 a provision that allows research on embryonic stem cells to be provided from frozen embryos that are not being used for reproductive purposes.

    We understand that there is significant controversy surrounding the use of embryos for research, but we believe that these embryos that would otherwise be discarded or destroyed, or even left forever in the freezer, should be made available for scientific research, subject to the appropriate consent and approval by the proposed regulatory authority.

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    We also understand that stem cells derived from adult tissues have great potential for therapeutic use and that in recent experiments, especially the recent work of Dr. Catherine Verfaille, it has been shown that a rare population of stem cells from mouse bone marrow have properties very similar to embryonic stem cells. This raises the question as to whether or not research with embryonic stem cells needs to continue. Indeed, we understand that some members of Parliament, including members of this committee, have expressed the view that research with embryonic stem cells is no longer necessary because of the promising results observed with adult stem cells.

    To better understand this argument, there was a meeting on November 9, 2002, in Ottawa attended by the research directors and vice-presidents of research of the various academic health science centres across Canada. These are the scientific leaders within our teaching hospitals and the people we look to for advice on matters relating to research and innovative patient care. After extensive discussions they concluded that it would be a serious error to stop doing research on embryonic stem cells at this time simply because the research on adult stem cells looks promising. Their unanimous recommendation was that research on all forms of stem cells is still warranted at this time and that through the study of embryonic stem cells we will gain new insights into the fundamental differences between an embryonic stem cell and the various forms of adult stem cells. Understanding these differences may be critical in obtaining the optimal performance from any stem cell population in a therapeutic protocol.

    As I mentioned previously, I, like my colleagues across the country, am very concerned about the proper conduct of research in our institutions and insist that patient care and research be carried out according to the prevailing national and international ethical standards.

    On the advice of our vice-presidents of research, we support the idea that continued research on embryonic stem cells is important for the future development of innovative therapies in the field of regenerative medicine. We therefore support the provision in Bill C-13 that allows research to be conducted on embryonic stem cells. We believe this is in the best interests of the citizens of Canada, particularly for those patients who currently suffer or will suffer from any of the common devastating degenerative disorders we see in our hospitals every day.

    We also understand that this support is consistent with the view of the mainstream scientific community and stem cell researchers across the country. Indeed, this is also consistent with the view of Dr. Catherine Verfaille, whose important work on adult stem cells has generated some of the current discussion about the need to work with embryonic stem cells. I am aware that in a recent review Dr. Verfaille indicated that she does not advocate ceasing work on embryonic stem cells; on the contrary, she strongly supports the view that research on embryonic stem cells must continue in order to maximize the opportunity for innovative therapy.

    In closing, I want again to thank the committee for the opportunity to present a viewpoint on the issue of stem cell research from the presidents of Canada's teaching hospitals. As a group we have the mandate to foster the development of important and effective research in Canada and to bring the fruits of this research to the bedside of the patients we serve. We are pleased that the current legislation allows research on all forms of stem cells, including those of embryonic origin, and we believe that this will be important in providing our patients with innovative treatments in the field of regenerative medicine.

    Thank you.

    The Chair: Thank you, Dr. Kitts.

    We'll move to the question-and-answer portion of our meeting. I'll begin with Mr. Merrifield.

    Mr. Rob Merrifield (Yellowhead, Canadian Alliance): Thank you very much for coming, Dr. Bernstein. This is the third time.

    I appreciate your keeping your comments short so that we can get in more questions. One of the difficulties we're having as a committee is actually getting into the questions and answers, which is where we learn the most and get an opportunity to clear up some of the ideas we have and to question where you're at on certain issues.

    For Dr. Bernstein, I'd like to go back to your comments the last time we met. You committed to April 1, 2003, for no embryonic stem cell research. Your intent, if I interpreted it correctly, was that this bill would be passed and you would have comfort in knowing that this legislation was there supporting some limited embryonic stem cell research, depending on what you define as necessary. Is that where you're coming from on the April 1 date?

    Dr. Alan Bernstein: To make sure I understand your question, Mr. Merrifeld, and just to rephrase it, if I may, I made a commitment the last time I was here that no new dollars would flow from CIHR for embryonic stem cell research until at the earliest April 1, 2003. As I said in my brief remarks, we've honoured that commitment. There are some applications in this round that are currently being peer-reviewed for scientific merit in this area. We are obviously watching very closely to see what is the outcome of your deliberations and what Parliament ultimately does about the bill, and based on that iterative process, we will decide what our proper role is in terms of moving forward together with you.

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    Mr. Rob Merrifield: Would you move ahead regardless of where we're at and regardless of the outcome of the piece of legislation before us?

    Dr. Alan Bernstein: No, we won't move forward regardless. As I said, I think we need to monitor very closely where Parliament is at in terms of your own deliberations. It is very important that we have a framework in place. I think this committee expressed that fairly strongly the last time I was here. I agree with that. It is very important. And we'll need to make a decision based on where things are at with this committee and in Parliament, and on what our proper response should be to those four applications.

    Mr. Rob Merrifield: Okay. So can I take it that if we have not completed our work, you would not proceed until that time?

    Dr. Alan Bernstein: We're continuing to move forward.

    Mr. Rob Merrifield: So are we.

    Dr. Alan Bernstein: I know that. And we're anticipating that the bill will be passed for April 1. We've been charged by Parliament to conduct research that will improve the health of Canadians in an ethical framework. As you will appreciate, I have been from the beginning trying to balance those two things in the absence of any national legislative framework for Canada, and hence our guidelines last March.

    So we as an agency need to be ready, depending on where Parliament is at, to ensure that the law is followed, first of all, and to make sure that the research community understands where Parliament is at both in terms of process and content. And that's been, I think, our proper role at the moment. So I'm waiting to see what Parliament will do.

    Mr. Rob Merrifield: We've asked other researchers this question. Can you explain to me why you feel, let's say, retarded with regard to embryonic stem cell research when you can continue it right now on animals, and I assume that's taking place?

    And last time you were here you suggested that you have imported the embryonic stem cell lines from the United States and you are continuing research on that.

    So can you tell me what research you cannot do that you would be doing if this piece of legislation had passed?

    Dr. Alan Bernstein: Well, there's a whole lot of research that is not going forward now that I know some researchers in the country would like to do. You'll appreciate that these stem cell lines are rather special and unique. There's a huge controversy in the scientific literature about how many of the lines that the NIH have grandfathered, if you will, will be of any use either for research or therapeutic purposes.

    So there's constant pressure to derive new stem cell lines. For example, there is one project that I think is of great relevance to Canada, given our historic strengths in this area. We were talking about the Edmonton protocol just before the meeting started. Is it possible, for example, to induce embryonic stem cells to make islet cells and to make insulin?

    Mr. Rob Merrifield: Wouldn't you be doing that in the animals, prior to humans?

    Dr. Alan Bernstein: No. These can go on simultaneously. That is, one could do research on both mouse embryonic stem cells, for example, to work out conditions, and also on human embryonic stem cells in a Petri dish to see whether or not they could be induced to either make insulin or more broadly to become islet-producing cells.

    Mr. Rob Merrifield: So you wouldn't have to make sure that the procedure is even possible in animals before moving into embryonic stem cells. Is that what you're saying?

    Dr. Alan Bernstein: That's right. I think there's good scientific reason for wanting to do this research in the Petri dish immediately.

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    Mr. Rob Merrifield: Okay. I understand that.

    I have a magazine here. I'm sure you're familiar with it--BIOTECanada Insights. I believe you're quoted in there. There's an article on embryonic stem cell research, and I'd just like to quote one line. It says that “Canada already has new human embryonic stem cells growing in a manner that is not possible in other countries at this time.”

    Can you tell me what stem cell research is being done that is not being done in other countries right now?

    Dr. Alan Bernstein: I'm not aware of that quote. I'm having trouble with that.

    Mr. Rob Merrifield: I think it's on page 28, Dr. Calvin Stiller.

    Dr. Alan Bernstein: Oh, it's a quote from Dr. Stiller? I thought you implied it was a quote from me.

    Mr. Rob Merrifield: No.

    Dr. Alan Bernstein: As far as I know, the Canadian research community in universities and hospitals is respecting the commitment that I made. We are not aware... and we have asked of any research going on in universities or hospitals that lies outside either the proposed legislation or our guidelines. Indeed I am aware of several groups that are holding back, waiting for the passing of the legislation.

    Mr. Rob Merrifield: So what you're saying is you're not aware of what he's talking about?

    Dr. Alan Bernstein: No, I'm not aware of it. I can't comment on it. You'd have to ask Dr. Stiller.

    Mr. Rob Merrifield: Maybe that's what we'll have to do. I hope our researchers take note.

    Dr. Alan Bernstein: The other comment I would make that's relevant to that, Mr. Merrifield, is of course--and it was one of my comments at the outset--our guidelines do not cover research going on in the private sector, and I'm not aware, one way or the other, if any of this research is going on in the private sector in this country.

    Mr. Rob Merrifield: We had Dr. Worton in here, one of the researchers, I believe just the other day, and we had others at other times, suggesting that therapeutic cloning is something they would encourage us to consider. This piece of legislation does not allow it, it's under the prohibitions, but really what we're doing with this piece of legislation is drawing lines. I think we're fighting over where we're drawing the lines. Is that a line that you would draw, that you agree with, not moving down towards therapeutic cloning?

    Dr. Alan Bernstein: Our guidelines also do not allow therapeutic cloning or somatic cell nuclear transplantation. So in that sense, yes, I agree with it. But this is a rapidly changing area of science. I'm comfortable certainly with where both the legislation and our guidelines are at the moment. I think the challenge for you at some point in the future is to decide if that is a position Canada's not going to be comfortable with. Would we want to change the law, in other words, to allow somatic cell nuclear transplantation? It's easy to change guidelines.

    So I think that's the issue. Whether the committee wants to in some way, in the regulations that go along with this bill, consider that or not is something you might want to think about.

    Mr. Rob Merrifield: Why are you having discomfort with therapeutic cloning at this time?

    Dr. Alan Bernstein: I think the ad hoc working group that considered this had two issues. The first was scientific. There was grave concern in regard to reprogramming the nucleus or genome and going from a somatic cell, an adult body cell, back into an embryonic cell, that the evidence wasn't there yet at all that this was doable.

    Secondly, I think there was concern from a public perspective. The word “cloning” is in there, and the concern was that the public is not comfortable at all with therapeutic cloning, although it is really somatic cell nuclear transplantation, a much more neutral kind of phrase. So I think the committee was both anticipating the scientific concerns and the public's concerns about this thing for today.

    Mr. Rob Merrifield: You're right, in that the public is very confused. It's a complex subject, and I would suggest that most people around this table are somewhat confused at different times.

    I want to bring up an example of what happened about a month ago with the lady who was cured from umbilical cord stem cells. The program on TV that evening showed that 76% of Canadians agreed with embryonic stem cell research. It talked all about embryonic stem cell research, and then went on to show how this lady was cured from umbilical cord stem cells, which are, as you know and I know, and everyone in this room knows, adult stem cells.

    So the confusion is something that is very difficult, and we need to clear that up as we move forward in debating this nationally, so that Canadians know what this piece of legislation is truly and actually doing.

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    The Chair: Thank you, Mr. Merrifield.

    We'll move on to Dr. Dromisky now.

    Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.): Thank you very much, Madam Chair.

    I had several small questions, and a couple of them have already been answered very clearly by both you and...is it Dr. Kitts? I'll address you as Dr. Kitts. You earned that title.

    Bill C-13 prohibits the creation of embryos solely for the purpose of research. This morning we listened to witnesses who've gone through the experience of trying to either enhance the size of their families or have their first born. They talked about embryos, the numbers that were required, how many eggs had to be produced, saved, fertilized, and so forth.

    Anywhere from 25 to 35 are used by one person, and there is no guarantee whatsoever of a positive result because so many different factors affect those embryos, and they might have to try again and again. However, maybe number three, four, five, or six is successful. Most of them voiced the opinion that they were going to preserve what was left because they might want a second or third child, if possible. You can see where I'm heading. People indicated there was a vast supply of embryos in storage. And then we heard these stories about the number that were required in order to get the results people desired.

    I'm concerned there won't be enough embryos for research. If the demand is great and is increasing on a yearly basis because of umpteen factors that are involved in this society of ours--infertile women--the demand could be so great that we could do certain things. Through the underground market, we could get private research centres--not the ones you're talking about within your jurisdiction--to produce them. They could be available on the black market. Or we could buy them. We could import them from the United States or some other country that had them available for sale.

    It could get to the point where all institutions that were doing research would have to start producing embryos for not only research, but possibly even for reproductive purposes. Will we ever reach that stage, do you feel? Do you think any of those kinds of things could really happen?

    Dr. Alan Bernstein: You're absolutely right that the process of generating these fertilized eggs is still less than 100% efficient, in terms of their successful implantation, so embryos are always generated in excess of what is needed, certainly for the first rounds of assisted human reproduction. The remainder are frozen down.

    I think it's safe to say we do not have an accurate number for how many embryos are actually frozen down in this country. I'm only aware of the guesstimate Dr. Baylis made. She may have talked about it when she was here last week. You have those numbers, so I won't go through them again. By her estimate, there are 500 to 1,000.

    I think it's safe to say that the procedure will get more efficient with time and experience, but how quickly and how much I don't think anybody knows. In the U.K., as you know, the human fertilization authority, by law, says those excess embryos can either be used for research purposes, under appropriate informed consent conditions, or they have to be discarded after five years.

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    Mr. Stan Dromisky: Do we have any regulation, rule, or law preventing us from importing them? We import sperm, and we have a hold cell in Toronto for sperm donations. Couldn't we or the private sector do the very same thing?

    Dr. Alan Bernstein: I'm not aware there's any law restricting that, but I'm not the expert in this.

    Mr. Stan Dromisky: Okay.

    Dr. Kitts.

    Dr. Jack Kitts: I think it's a very good question, because I asked our vice-presidents of research the same thing--how many embryos we were talking about. The number was somewhere around 300 to 500, from what I understood.

    It's clear that these are embryos that were generated by couples who indicated they were not going to proceed with any further attempts to have children, and agreed they could be discarded or remain frozen. So these are only excess embryos.

    If the number is as small as we think, it's very important that the stem cell researchers across the country agree on where the expertise lies, and use the small amount of specimen appropriately. Everybody can't do it.

    Mr. Stan Dromisky: You are a professional researcher and a member of a professional group, and you have certain aims, goals, hopes, dreams, and expectations. If the demand is of such a nature and the supply is not there, would you then turn around and say that there are limitations to the rules, regulations, and laws of this country and they must be re-examined and possibly altered in order to meet what researchers and the medical field in particular are demanding? In other words, we're short; the supply is not there.

    Dr. Jack Kitts: I'm a physician, not a researcher, but in terms of your question, I think it's an important next step, because as of today we don't know whether embryonic stem cells or adult stem cells are going to be the superior therapeutic treatment. All we know is that if we can help these patients with massive strokes, heart attacks, and diabetes, that's what we want to do.

    I think the researchers are saying that the adult stem cells show a lot of promise, but we don't know that this is the answer, and we shouldn't stop looking at embryonic stem cells, because they may be the answer. I would hope that a year from now our researchers will find that adult stem cells are the answer. If not, we shouldn't have neglected embryonic stem cells, this for the sake of our citizens who suffer from these very common diseases. If we find that the embryonic stem cells are the answer, I think we will probably be back around the table as we are now, debating the merits of generating these things for the good of Canadian citizens.

    Mr. Stan Dromisky: Thank you very much.

    The Chair: Thank you, Mr. Dromisky.

    Dr. Alan Bernstein: I would add one comment, which goes back to the question Mr. Merrifield asked me. It's just for the committee to keep in mind that once these embryonic stem cell lines are generated, if it's a good stem cell line--by good, I mean if it retains its potency to differentiate into many different cell types--those cells, that line, can be shared among different laboratories. Indeed, in our guidelines we require that. That is, if you expect to generate cells with public funds, they have to be shared, because this is a precious resource with ethical issues around it. As long as they stayed totally potent in terms of their differentiation capacity, I could use them in my lab, I could ship them to you, and you could use them in your lab.

    Mr. Stan Dromisky: Thank you very much.

    The Chair: Thank you, Mr. Dromisky.

    Mr. Ménard.

[Translation]

    Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): I will be brief, as some of my questions have already been answered.

    We are confronted here with a certain ambiguity. I have seen some reports, amongst others, on science programs, and on the TV program Enjeux with which some of you are perhaps familiar. Earlier, Mr. Bernstein led us to believe that no stem cell research is currently being carried out in State laboratories, in universities or in laboratories subsidized by public funds. He also led us to believe that no such research had been carried out in these places in the recent past. I was under the impression, however, that at Laval University, and this will undoubtedly please some of my colleagues at this table, doctors have carried out research after having received subsidies, and that there are research protocols in force which involve stem cell manipulation.

    Tell me clearly if, to the best of your knowledge, over the course of the past two years, stem cell research has been carried out in State laboratories or teaching establishments.

º  (1605)  

[English]

    Dr. Alan Bernstein: I'll try to be as clear as possible.

    There are various classes of stem cell research. There is human and non-human research, mostly human and mouse, and then there is adult and embryonic research. In this country at the moment there is a lot of research going on with mouse stem cells, both adult and embryonic, including at Laval University--on mouse.

    At the moment there is also human stem cell research going on. I'm not aware offhand of such research at Laval, but there might be. Certainly at the University of British Columbia, the University of Toronto, the University of Alberta, and McGill University there is research going on with adult stem cells of the umbilical cord kind Mr. Merrifield mentioned, adult bone marrow cells, and adult skin cells. But as far as I'm aware, there is no research going on with human embryonic stem cells--that is, with deriving new stem cells from human embryos.

[Translation]

    Mr. Réal Ménard: Regardless of whether one is for or against this bill, we all want it to be adopted quickly. From your understanding of the bill, tell me what route an agency such as the Canadian Institutes of Health Research would be best to take, once the bill is passed, in order to get ministerial approval? How do you understand the requirements to which you must adhere? What the witnesses told us was not clear. I want to compare my understanding to yours; this will give me the pleasure of comparing myself to a doctor for the first time in my life.

    Dr. Alan Bernstein: I am not a doctor of medicine; I am a doctor of genetics.

    Mr. Réal Ménard: The comparison is all the more noble.

[English]

    Dr. Alan Bernstein: If the scenario is that the bill is passed, once the bill is passed, the way I read the bill, what is contemplated is the creation of this agency. The agency then will be in the position to issue or not issue a licence to individual investigators working in universities, hospitals, or industry across this country. It's not something that CIHR would have to do. The people who want to do the research directly would have to do it.

    Then, in a world where the bill is now passed and the agency is up and running, if an applicant came to us to apply for a grant, we would, of course, review its science. We would also ask that there be a local ethical review from Laval University's ethics review board. We would also ask, either before or after, if the national agency contemplated by this bill has given you a licence to do the research you're contemplating and if they approved the particular application.

[Translation]

    Mr. Réal Ménard: That was not the answer that I was expecting from you. When the officials appeared before the committee, I understood that, in order to get ministerial approval—at the end of the day, it is the minister who will give approval—it has to be proven that no other existing genetic material could be used. I thought that such proof was key to being allowed to carry out research using stem cells. But perhaps I am mistaken.

[English]

    Dr. Alan Bernstein: The wording now on the legislation is that a licensing authority authorizing the use of an in vitro embryo is satisfied that the use is necessary for the purpose of the proposed research. You would have to demonstrate, as a researcher, the necessity of using embryo-derived stem cells for the research that you were proposing to do. It's the way the bill is written right now.

    The Chair: Thank you, Mr. Ménard.

    Dr. Castonguay.

[Translation]

    Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.): Thank you, Madam Chair.

    On a practical note, what is done with embryos that have been created for the purpose of reproduction but which the parents no longer require? What is the current practice regarding these embryos?

º  (1610)  

[English]

    Dr. Jack Kitts: My understanding is there are two choices. They can currently remain frozen for an indefinite period of time or they can be discarded and destroyed.

[Translation]

    Mr. Jeannot Castonguay: So, currently, in the real world, those are the two choices: some are frozen and others are destroyed.

    Can they be kept frozen indefinitely or do they become non-viable after a certain time?

[English]

    Dr. Jack Kitts: My understanding is that in the thawing process you don't know whether they're going to be viable or not. It comes back to the question about why it takes so many to have one fertilization. I think there are a lot of pitfalls in terms of the freezing and the thawing process. It's why they take a lot at any given time.

[Translation]

    Mr. Jeannot Castonguay: Would it be fair to say that, the longer they remain frozen, the higher the chance that they will be non-viable when thawed?

[English]

    Dr. Jack Kitts: I don't know.

    The Chair: I think Dr. Bernstein wants to comment.

    Dr. Alan Bernstein: I have two comments here, Dr. Castonguay. One is that there is the risk of those embryos accumulating damage, which increases with time. That's why in the U.K. there's a five-year rule.

    The second thing is--and I know this from talking to people who run these in vitro fertilization clinics--that it costs money to keep these embryos frozen. I don't recall how much offhand, but the clinics will keep the embryos frozen as long as the couples are paying the cheque every year to keep up the cost of maintaining the embryos. There's an attrition rate. That is, now in this country once a couple has had their baby, they don't want to come back, and they stop paying, the embryos are discarded.

[Translation]

    Mr. Jeannot Castonguay: It is sometimes said that embryonic stem cells are immortal, that they can be renewed indefinitely. Is that correct?

[English]

    Dr. Alan Bernstein: Embryonic stem cells? There are cell lines that can be grown in a Petri dish. They can be frozen, but again, if they're frozen for long periods of time, more and more cells die off. The difference is--not to get too technical--when you freeze down an individual fertilized egg, you're freezing down a single cell or a small number of cells, four to eight cells. When you freeze down these embryonic-derived stem cells, you're freezing tens of millions of cells. So even if you lose 50%, you have 5 million instead of 10 million, and you still have lots of cells that can be recovered to grow with.

[Translation]

    Mr. Jeannot Castonguay: Do you know if, currently, intensive research is being undertaken to freeze ova with a view to thawing and fertilizing them?

[English]

    Dr. Alan Bernstein: Not that I'm aware of. It doesn't mean there isn't, but there's none I can think of offhand.

    The Chair: Thank you, Dr. Castonguay.

    Dr. Lunney.

    Mr. James Lunney (Nanaimo—Alberni, Canadian Alliance): Thank you, Madam Chair.

    I'm picking up on the stem cells. On committee we are concerned about and interested in this debate, as we're all interested in delivering cures to Canadians, whether it's heart disease or stroke or whether it's Parkinson's disease, Alzheimer's, or whatever. We're interested in making sure that the best treatments are delivered in the most ethical way, and that's part of the discussion we've been having here.

    Now, we've had Dr. Worton and others here to discuss this issue, and Dr. Bernstein, we've had some interesting discussions on this subject already. But on the issue of embryonic versus adult stem cells, in fact I believe I've seen you quoted in the paper after some of the breakthroughs here with the increased plasticity of adult cells. I think you're even quoted as saying that perhaps we need to revisit the necessity of using embryonic cells.

    In that direction, one of the things we are concerned about on committee is commercialization. You mentioned here that a good embryonic stem cell line, perhaps one that produces islet cells to produce insulin, could be shared and so on. We had some discussion the other day on this line. It seems as if industry would like to have a line of stem cells that's good for pancreas problems, a line that's good for Parkinson's patients, a line that's good for heart patients, and so forth, each one with a patent attached to it with funding for research and big dollars in profits in the therapies and interventions.

    On the other side of the coin, with the adult cells, if we're talking about autologous transplant.... I talked just the other day in Toronto to a patient who had multiple myeloma. Of course, they had extracted stem cells from his marrow, grown them in vitro, killed his cancer with potent chemotherapy, and then reintroduced his own stem cells, and he's doing fine.

    We also had a cardiac cell breakthrough recently--I think it was Italy, wasn't it--with the immature skeletal muscle cells that were growing in cardiac tissue. And with the adult cells that are extracted from the same patient, we understand they can be stimulated by chemicals to be released from the bone marrow. You can stimulate the marrow to kick out stem cells. They can be extracted intravenously, grown in vitro, and put back into the general circulation. They will actually find tissue that's undergoing regeneration, whether it's cardiac or elsewhere, and they will attach and identify to the tissue grown there.

    Now, there's a minimal intervention here. The cells come from the patient, and they go back into the same patient. There might be a patent for a drug to stimulate the marrow to kick it out, but there's minimal opportunity for patenting or commercialization, whereas there's maximum benefit for the patient. We're avoiding anti-rejection drugs, which would have big profits attached to them, presumably, if the patient receiving embryonic cells had to take those for the rest of their life.

º  (1615)  

    With a huge financial windfall on one side for commercialization, all on one side of this equation, can we have confidence that the research community and the industry will in fact put the emphasis on adult stem cells that show such promise but minimal promise for commercialization?

    Dr. Alan Bernstein: That's a very good question. I would say that if one knew that adult cells would work in therapeutic settings, and I could take my own cells and use them to treat my nascent Parkinson's condition, or what have you--I don't have Parkinson's, but imagine--then there's no question that this would be the preferred route of treatment, as opposed to using embryonic stem cells, where one doesn't know about the transplant rejection situations and all that.

    Even if one admits that there might be a profit motive or profit possibility for a company to patent a stem cell line--and I'll come back to that in a moment--I think from a health care provider and patient's perspective, using one's own cells, autologous transplant, is far preferable to an antologous transplant situation because of the rejection issues.

    The issue is we still don't know which cells will actually work, embryonic or adult. But I think most people would prefer if it were adult, which is why I was so excited about those papers I'm quoted about.

    Mr. James Lunney: Along the same line, you have some people in this debate saying that embryonic stem cells are in fact immortal. Perhaps it could be suggested that this is disingenuous. I wonder if you'd comment on that. And in fact, because you've taken them out of an embryo that's on its way to becoming an 80- to 100-trillion-cell human being, that usually takes 18 to 21 years, but because you can grow them for a few years in a Petri dish hardly qualifies them for immortality. Would you agree with that?

    Dr. Alan Bernstein: Yes and no. This is just based on mouse experience, but you can take embryo-derived stem cells and grow them for a long period of time in a Petri dish and at any one point, months and months or even years later, reimplant them and they will generate a mouse. Indeed, a group in Toronto have really shown that without any feeder cells of any kind they are totally potent. So if you extrapolate that, if they are totally potent after a year, why wouldn't they be totally potent after two or three, or four, or infinite years?

    I think, in an operational sense, which is what science is all about, they are effectively immortal.

    Mr. James Lunney: One year is immortal?

    Dr. Alan Bernstein: No, but operationally, a year is like infinity in terms of practical things, which is all I'm talking about here now at the moment.

    And don't forget that although we have trillions of cells in our body, all our cells, by and large, are differentiated. What we are talking about here is propogating cells for years at a time that retain their total potency. There's a difference.

    The Chair: Mr. Lunney, your time is up.

    We'll move now to Dr. Fry, please.

º  (1620)  

    Ms. Hedy Fry (Vancouver Centre, Lib.): It's actually quite difficult, because when you came to me most of my questions had already been asked. But I had a question on one of the things that's there just for practical purposes with this legislation, which is that we're talking about requiring the explicit consent of the donor as defined in the regulations. Could you explain the process a researcher would go through to get that explicit consent?

    Dr. Alan Bernstein: We're just checking in the legislation. I know that in the CIHR's guidelines--and I'm sorry I can't recall now what the wording is in the legislation--we were very careful to say that no member of the research team could be part of the clinical team that was actually doing the assisted human reproduction, so that there was not even a chance of coercion by the researchers on the couple to donate their embryos for research purposes. I don't recall offhand what's in the legislation. It may be identical. I just don't recall.

    Ms. Hedy Fry: So you are suggesting basically that the person in the infertility clinic would get that consent beforehand and then you would be able to go via that route of the intermediary.

    Dr. Alan Bernstein: Exactly. So if Dr. Kitts is the physician and I am the researcher, he would do the assisted human reproduction with the couple, the embryos would be generated, some would be frozen. As a researcher, I would then approach the couple and ask for their informed consent to use some of those embryos to generate stem cells. So the couple doesn't feel they have to say yes to get Dr. Kitts' attention.

    The Chair: Excuse me. You've mixed me up. A minute ago you said it's done in the clinic by the clinical person or the physician, ahead of time. In your second description you said that after they have that permission, you would then approach the couple. Why wouldn't you approach Dr. Kitts, if he's already gotten--

    Dr. Alan Bernstein: Because it's the couple who has to give the informed consent. It's their material, it's not Dr. Kitts', in this example.

    The Chair: If Dr. Kitts had their permission to use excess embryos for research, it's not good enough. You would have to do it again.

    Dr. Alan Bernstein: We wanted to be very careful that there was no possibility of coercion by the clinical team to the couple: “We'll help you generate these eggs if you donate some for research purposes. We'll help you jump the queue or we'll give you special attention.” There really had to be a complete separation of the two teams.

    The Chair: Okay, Dr. Kitts.

    Dr. Jack Kitts: That's what the research ethics board is all about. It's a consent to ensure that there's absolutely no feeling by the patient that there's any pressure to do so.

    I haven't given it a lot of thought, but I would like to see that the physician ask the patient, when they come to the end of therapy and they are no longer involved in the fertility clinic, whether they would consent to being approached by a researcher, who would then give them fully informed consent on what they would do in terms of research on the embryos. And that's where the informed consent would occur, after the treatment is all over and there's no concern on the patient's part that they should take part in it to perhaps get better care or whatever.

    So I would see it as a two-stage process. When you initially come to the fertility clinic, the consent should ask if you agree to be approached after the end of therapy by a researcher who would talk to you about embryonic stem cell research.

    The Chair: Thank you, Dr. Fry.

    Ms. Wasylycia-Leis.

    Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Thank you, Madam Chair.

    Sorry I missed your presentations.

    I think I really should hand over my time to Mr. Lunney, who has such an in-depth knowledge of this whole area.

    I want to ask the question that still bothers me around the scientific research community's response to this whole process. The way in which we've prohibited certain aspects of reproductive technologies is going to deny our society the benefits of scientific research that would help humankind.

    I know we've made a conscious decision through the draft bill and then through this process to maintain prohibitions. I want to know what you think. Are we doing a great disservice to the possibilities of scientific exploration and innovation by approaching it this way? Or do you think we've found the right balance?

º  (1625)  

    Dr. Alan Bernstein: My personal view is that with the one exception perhaps of the difficulty of changing legislation, of changing science, of changing societal values, with that one proviso, I think this legislation is a model for the world. It balances the ethical and social concerns that you all have expressed with the potential or promise of these cells to cure disease.

    If I look at our nearest neighbours, the U.S., and the U.K., I think most people would say the U.K. has gone too far and the U.S. has not gone far enough. I'm simplifying a complicated debate. Canada, I think, has it just right. So I applaud you for the legislation that's in front of you.

    Dr. Jack Kitts: The message we get from our vice-presidents of research in the teaching hospitals is that this legislation is excellent. They support it fully. It doesn't go too far. It goes far enough.

    And based on the current knowledge we have today in terms of stem cells, if the adult stem cell were known scientifically to be equivalent or superior to the embryonic, we wouldn't have to have this discussion. The scientific community says that they do require more studies to validate which stem cell line is superior. And hopefully it will be the adult stem cell.

    Ms. Judy Wasylycia-Leis: Is there anything you would change in the bill?

    Dr. Jack Kitts: Not from the advice I've been given by the vice-presidents of research.

    The Chair: Thank you, Ms Wasylycia-Leis.

    Dr. Bennett.

    Ms. Carolyn Bennett (St. Paul's, Lib.): Thank you, Chair.

    This is along the same lines as Judy's questioning. There was a view that the committee had found this balance between the English approach and the American approach. My understanding is that the American approach we're comparing ourselves to is just for those that are publicly funded. Can you tell me what's happening in the private sector in the United States?

    Dr. Alan Bernstein: There are companies in the United States, a small number, that are going forward, because there are no guidelines for the private sector in the U.S.

    In one sense I think what you are doing here is the more honest, open approach, which is it's one rule for all. If it's not right in the public domain, it shouldn't be right in the private domain, and vice versa.

    The other comment I would make, which goes back to Madam Chair's comments, following on what I said earlier about somatic cell nuclear transplantation, for the areas of research where the landscape is always changing, I think your challenge is to write laws that take that into account. One example--but it is just an example and an important one--is therapeutic cloning or somatic cell nuclear transplantation. What if five years from now somebody in France shows that the best way to cure Parkinson's disease is to use somatic cell nuclear transplantation? Will we regret having written in stone in this legislation, and is there some imaginative way of revisiting it that doesn't take years and years? I don't have a concrete solution for you. I'm not a lawmaker. But that's the one area where others have commented that it would be nice to think of a way with regulations of allowing changes to be made that Parliament accepts in the face of changing science.

    Ms. Carolyn Bennett: We had a witness last week who thought it was probably easier to amend the legislation by changing the regulations.

    Dr. Alan Bernstein: Is that true?

    Ms. Carolyn Bennett: I think that has happened on occasion.

    Some hon. members: Oh, oh!

    Ms. Carolyn Bennett: Dr. Bernstein, with regard to what you were describing in terms of the sharing of the good stem cell lines, is that along the same lines as what the U.K. calls its embryonic stem cell bank?

º  (1630)  

    Dr. Alan Bernstein: In brief, it is along the same lines. Again, I'm referring to CIHR's guidelines. The regulations have yet to be written for this legislation, but assuming they're along the same lines, we would require that any cell lines generated with public funds be registered in this virtual bank, if you will, and be freely available to other researchers that are approved by us or that have a licence to do that. It's for general public reasons but also particularly because I think one doesn't want these embryos being used frivolously or unnecessarily.

    Ms. Carolyn Bennett: Thank you.

    The Chair: Thank you, Dr. Bennett.

    Next is Madame Scherrer, followed by Mr. Szabo and Mr. Merrifield.

[Translation]

    Ms. Hélène Scherrer (Louis-Hébert, Lib.): Thank you very much, Madam Chair.

    I too am sorry to have missed your presentation. I am trying to focus my mind on what is at the heart of this debate. What started many of our discussions was the question of the potential of adult cells as opposed to embryonic cells. The problem that we are facing at the moment is that we have to legislate here and now. Had this bill been drafted 10 years ago, we would probably not even have raised some of these issues. At that time, skin grafts, for example, did not exist. Science has undergone major developments over the past 10 years, and that presents us with something of a dilemma. We have to say that there is potential for adult cells and potential for embryonic cells.

    At the moment, it would appear that embryonic cells work better, or offer more potential than adult cells. We all know how quickly research is going to evolve. If we could wait 10 years to take into consideration these developments, the bill that we would draft would perhaps be completely different to the present one; however, we have to work with the current facts. We do not know the full potential of adult cells and embryonic cells, but do we have any concrete facts regarding their limitations? Are you certain that there are significant limitations in terms of adult cell potential which would mean that, at a given time, you will have to invest in one field or another? Has research been carried out to back this up? Has it been confirmed that there are limits to the research that can be done with adult cells?

[English]

    Dr. Alan Bernstein: I wish I could give you a clear-cut, black-and-white answer. Ce n'est pas possible. This area of biology is still an experimental science, and the theories are made up after the observations. So all we know is what the results are of the latest experiments. I think it would be foolish for me or anybody to say here are the hard facts forever.

    Five years ago or less we would have said that adult cells do not have the potency of embryonic cells. I think we definitely can say that totally potent adult cells have the greatest potential still, both proliferative and developmental potential. On the other hand, I think it's clear from the Verfaille paper from Minnesota and also from Freda Miller's work here in Canada, which CIHR funds, that adult cells are much more pluri-potent than would have been thought two or three years ago. How far that will extend in the future remains to be seen. We just don't know at the moment.

    We know intuitively that if you cut off a finger, you don't regrow another finger. So we know that there are limits to what our body is capable of doing. If you have a damaged spinal cord, the nerves under those conditions don't regrow. Maybe they can be induced to regrow under certain conditions we have yet to discover, and that's where a lot of research is going on.

    I think one of the arguments for continuing to do embryonic stem cell research is we know that those cells can give rise to neurons, fingers, etc. If we can discover the factors, the molecules, that will convince those embryonic cells to do those things, maybe those same conditions or factors will also induce adult cells to do so under certain circumstances. So that's sort of the logic, if you will. But this is what research is all about.

º  (1635)  

[Translation]

    Ms. Hélène Scherrer: I would like to come back to a question that my colleague asked regarding freezing embryos. This morning, the witnesses were almost unanimous in telling us that using frozen embryos gave fairly mediocre results. It seems that their experience has taught them that using fresh embryos is far more effective. Could Dr. Kitts please tell me why, then, we freeze embryos? Why not restart the process each time a couple wishes to fall pregnant? Are they frozen in the interest of sparing the woman another operation? Is that why it is preferred to keep them frozen for five years?

[English]

    Dr. Jack Kitts: The process by which you harvest the egg and the sperm and cultivate the embryo is very expensive, time-consuming, and difficult. So when the patient ovulates, they remove as many ova as they can safely do, so that they don't have to go back in and do that procedure each time they try for fertility. My understanding is that it's from a dozen to twenty ova at a time, which are then fertilized with the sperm, and those embryos are frozen and available for implantation without going through the harvesting procedure each time.

    Ms. Hélène Scherrer: If it were proven that it's better to have a fresh one than a frozen one, why wouldn't you repeat the procedure? I know that if it were me and my husband, I'd say let's do it again and get some fresh ones and have some more chances.

    Dr. Jack Kitts: I don't think that's proven. My understanding is that they fertilize it and then freeze it at five days for then implantation. When they thaw, they go up to 14 days. It's a timing thing. You can't just remove and implant and go from there.

    The Chair: Thank you, Madam Scherrer.

    Mr. Szabo.

    Mr. Paul Szabo (Mississauga South, Lib.): Thank you, Madam Chair.

    In her lead-off speech on May 21 on what was Bill C-56 at the time, the Minister of Health said that embryonic stem cell researchers would need to obtain approval from a reputable ethics board for any project proposal and demonstrate that no other source would be adequate for their needs. Under the CIHR framework, would the CIHR be relying on REBs for the ethical determination? Who would be dealing with the other parts that are necessary?

    Dr. Alan Bernstein: Within the CIHR framework we had contemplated a two-stage ethical review. One was the usual local REB review, which involved any research involving human subjects. In addition, for really the first time ever in Canada, we had envisioned this national oversight process for all the reasons that I've discussed in my previous visits.

    Mr. Paul Szabo: Dr. Bernstein, the CIHR guidelines are comprehensive and integrative and go right from the beginning to the end of the process. Would it be your view that this legislation should incorporate, either in the legislation or in the regulations, substantively all of the guidelines developed by the CIHR?

    Dr. Alan Bernstein: I'm quite proud of the guidelines. I think I tried to indicate that in my previous two visits. So I would certainly encourage this committee to look at them very carefully.

    For example, let me go back to the informed consent issue. The committee thought long and hard about the right mechanisms for getting informed consent in this area, and they are laid out in our guidelines. I would encourage this committee, when you're developing regulations, to have a look at that as one example. I wouldn't say holus-bolus adopt them or not, but I certainly would look carefully at different components of the guidelines in terms of what you can learn from what work's already been done.

    Mr. Paul Szabo: Okay. From our discussion before the hearings, perhaps you could advise the committee what your preference would be with regard to where those guidelines would be included--in the legislation or in the regulations.

º  (1640)  

    Dr. Alan Bernstein: Well, I would encourage the committee to move forward as quickly as possible and as responsibly as possible to get this bill through the House. If it means changing the bill, I would say put it into the regulations. Time is of the essence.

    Mr. Paul Szabo: Most people have said to us that they just don't know how many embryos there are in fertility clinics. This is astounding to me that we have legislation before us that is prescribing to license fertility clinics, and nobody, but nobody, either in Parliament or in the industry, has any clue what's going on in the fertility industry. Do you think we should do a little work to perhaps educate ourselves about the different disciplines or standards in the fertility industry before we opine on licensing?

    Dr. Alan Bernstein: I'm very mindful of time, so I would say it's one of the first things I would ask the agency to look into. In other words, not slow down the work of the committee...

    Mr. Paul Szabo: The final question is with regard to therapeutic cloning. On May 16 I happened to catch your participation in a panel that was more money or financially oriented. There was a substantial discussion on commercialization of biomedical research. I'm not sure if you recall this. It was a week after the bill was first tabled at first reading and a few days before the minister gave her speech.

    During that exchange, you made, I thought, a really interesting intervention with regard to the rejection issue and the fact that therapeutic cloning would be something to look at. As I recall, at that time, your view was that the legislation should be changed to permit therapeutic cloning, which is what you stated on that interview.

    Are you suggesting that the legislation or the regulations be tweaked or morphed in a way that would permit therapeutic cloning down the road if the values of society should change?

    Dr. Alan Bernstein: I am quite comfortable at the moment with where both our guidelines and the legislation are at, which is not to allow therapeutic cloning for the reasons I stated earlier. I also feel, and again I've stated this, that if there's a way of allowing that to be revisited in the light of changing science or changing values, etc., of course we should re-look at it.

    On the one hand, the great promise of therapeutic cloning is it avoids the rejection problem because it's your own nucleus. On the other hand, it raises another whole set of scientific issues around reprogramming somatic nuclei. So it's a scientific saw-off as well as an ethical saw-off.

    So I'm comfortable where we are now. We may not be there five years from now, so I think that's a challenge for this committee. How do you revisit if you need to revisit?

    The Chair: Thank you, Mr. Szabo.

    We'll now go to Mr. Merrifield.

    Mr. Rob Merrifield: I'd like to pick it up where I left off on the therapeutic cloning. I concur with Mr. Szabo. I heard you suggest that therapeutic cloning may be all right, and you've explained that somewhat. I'm just trying to get an idea of the ethical standard or moral compass with which you're approaching this whole subject. You said earlier that it's a matter of where we're going to draw the line. My question is more specific so that you can grab a handle on where we're going. What makes you oppose reproductive cloning and yet be somewhat soft on the therapeutic? It starts out exactly the same way. One is destroyed at 14 days or prior, and the other one continues on.

    Dr. Alan Bernstein: Just for the committee to be clear, although both have the word “cloning” in them, the procedures are really--

º  (1645)  

    Mr. Rob Merrifield: Just clear this up, because I'm going to get cut off. They start the same. The only difference is that for one the stem cell is taken from it prior to the 14 days, and the other is allowed to grow into adulthood. Is that not true?

    Dr. Alan Bernstein: It's true, but there's another major fundamental difference, which is intent. The intent of one is to try to cure disease by therapeutic cloning or somatic cell nuclear transplantation. The intent of reproductive cloning is to try to clone yourself or the subject at hand, not to cure disease. So there's an ethical--

    Mr. Rob Merrifield: Let's say that a clone was to grow for nine months and then be frozen so that we could perhaps take some cells from it later to cure something. Could the argument not be made that the intent was to cure? I'm just talking about ethics, and I'm stretching the envelope to see exactly where we're going with this.

    Dr. Alan Bernstein: I'll go back to the initial framework in our guidelines, which was a very strong statement that embryos should not be generated for research purposes. So I think in a clear sense that would violate that guideline.

    Mr. Rob Merrifield: So that's where you're at. Embryos should not be generated for research purposes.

    Dr. Alan Bernstein: That's right. The primary purpose should be reproductive.

    Mr. Rob Merrifield: Okay. Thank you. I think that reflects Canadians' values, from the limited information they have on the subject.

    Let's get back to the word “necessary” and the definition. We don't have it in the definitions. That's one of the problems. The intent of this committee was that we allow embryonic stem cells to be used only if no other biological material could be found to do that research. It was changed in this piece of legislation to “necessary”. What would not be necessary under the definition as you understand it? What would you not allow?

    Dr. Alan Bernstein: I'm trying to think through scenarios. What would I not allow? I'm sorry, I can't think of a particular example offhand.

    Mr. Rob Merrifield: That's exactly my point and the point of our discomfort with the word “necessary”. It's very difficult to define something we cannot allow.

    Thank you.

    The Chair: Mr. Lunney.

    Mr. James Lunney: On the therapeutic cloning, which of course the bill would disallow, the notion would be that with somatic cell nuclear transplantation you would extract the nucleus from the adult cell, put it into an ovum, and then treat it. Ovum from a donor would replace the nucleus in the ovum. That would supposedly be genetically equal to the body, and then the cells produced would go back in and wouldn't be subject to immune rejection. I want to raise the question about genetically identical, because certainly there's mitochondrial DNA in the cytoplasm of the ova. So in essence you wouldn't be genetically identical to the somatic cell donor. Is that correct? Are there known or unknown consequences of having two types of DNA perhaps battling it out in the same cell?

    Dr. Alan Bernstein: There are some unknowns there, but it's not likely to be a problem from what we do know. The mitochondrial genome does not encode for any transplantation rejection, so-called antigens, things that would be recognized as foreign on the outside of cells and would therefore be a cause for rejection, as far as I'm aware. It's a theoretical issue. But the mitochondrial genome is small, as I said, and not likely to code for these transplantation antigens.

    Mr. James Lunney: You use mitochondrial DNA in forensic medicine.

    Dr. Alan Bernstein: Yes.

    Mr. James Lunney: Might that create problems for forensic medicine, for example, with tissue samples and so on?

    Dr. Alan Bernstein: Well, it might, but so does bone marrow transplantation from another donor. Remember we're talking about people with very serious diseases, so I think it would be hard to argue, on the basis of the recipient potentially being a criminal, “We're not going to cure you of your disease because one day you might be a criminal”. We're getting into scenarios here.

    Mr. James Lunney: Okay, thank you. I just wondered whether that might be an issue.

    Let me ask you something more practical. Is it correct that the budget for CIHR is somewhere in the neighbourhood of $600 million?

    Dr. Alan Bernstein: It's $562 million.

    Mr. James Lunney: Can you give us a rough ballpark idea of how much money is currently being invested in adult stem cell research?

    Dr. Alan Bernstein: I can get back to the committee with a real number, with a hard number. My guestimate is that it would be in the order of $5 million to $10 million. It's roughly 2%. If one also includes the money for the stem cell network, which Parliament approves and flows through CIHR, that would add all of that money to the budget as well.

º  (1650)  

    Mr. James Lunney: Given the tremendous potential there is in this area, I wonder why it represents such a small portion of the current CIHR budget.

    Dr. Alan Bernstein: It's a reflection not of the importance of the research but of the breadth of our mandate. Our mandate goes from biomedical research in all diseases and all areas of health, from Parkinson's disease, to spinal cord injury, to arthritis, to aging, etc. And we also now, as you know, fund a lot of research that never goes near a lab. We fund a lot of health services research, a lot of population health, a lot of clinical research, and a lot of knowledge translation research, given our broadened mandate. So it's a measure of how broad our mandate is in any one area. Actually it's only a small percentage of the total budget.

    You are now hearing a pitch for our budget, you realize.

    The Chair: Thank you, Dr. Lunney.

    Seeing no further names on the list, it's my pleasure to thank the witnesses for their generous allocation of time to our purposes and for sharing their wisdom with us.

     Ladies and gentlemen, we have come to part two of the meeting now, which is on a set of process issues.

    Apparently the clerk sent us all something in mailing two. I don't know when that happened, but it is all about the legislative counsel attached to the committee. They're the people who write our amendments for us so that they're in good legal language. I don't remember that particular mailing, but I guess we have it. In any case, I want to tell you at least verbally today that the legislative counsel attached to this bill is a man called Richard Denis, and his phone number is 943-2601.

    If possible, it is preferable to give the clerk of the committee and the legislative clerks enough time--that is, 48 hours--to prepare the amendment package in advance so that the members of the committee can also receive the package in advance, about 24 hours ahead of clause-by-clause, to consider what their colleagues are proposing.

    Say you decide to put one amendment in. That amendment is, at that point, a secret between you and the legislative clerks, unless you care to share it with a couple of your friends. Essentially, all these submissions to the legislative clerks are secrets. I can't find out and my clerk can't find out what it is you've put in. Therefore it is only when the package comes out--you'll recall the package we had on the pesticide bill--that we can begin to see the thinking of some of our colleagues and we can make some decisions about what we think is valid and what we plan to vote for and to vote against.

    So knowing that this whole thing takes at least 48 hours, and knowing that other committees are heading in this direction as well, I'm wondering if you would agree, this being Tuesday, that we have our amendments in by Monday, December 2. If that is your wish, perhaps we could lock that deadline in with a motion if someone would like to make that motion.

º  (1655)  

    Mr. Rob Merrifield: We're not interested in a motion. Anyway, it takes 48 hours before you can get a motion through here.

[Translation]

    Mr. Réal Ménard: I would like us to discuss the schedule for committee business because there's a problem. I would like to start the clause-by-clause study as quickly as possible even if it means proposing a motion on the subject. I do not think that it is worth seeing all these witnesses on Monday and Tuesday. We will not learn anything new.

    I am in the process of writing a proposal. First of all, we cannot sit from 9:00 a.m. to 8:30 p.m. We cannot work on the Romanow Commission Report in the evening after having spent all day working on something else. There is a limit to how much we can do if we want to do things properly.

    So, I appeal to our colleagues in the Alliance. We are against the bill. I have said very clearly that we will not vote in favour of this bill, and if the committee wants to hear people who have already appeared before us a third time, we are not making the best use of our time.

    Furthermore, on Monday, in theory, we are not here. We are in our constituencies.

    Madam Chair, I would like us to have a discussion on this, and I would like to introduce a notice of motion to bring an end to our debate. We could vote on the motion on Thursday. I am against continuing to hear witnesses who are not telling us anything new about the bill. Our duty is to undertake the clause-by-clause study. If our colleagues want to move amendments, they will do so.

[English]

    The Chair: Mr. Merrifield.

    Mr. Rob Merrifield: I have a point of order, namely that you're discussing an issue that goes against a motion that has been made by this committee. We made a motion, one that was approved by this committee, to deal with Mr. Romanow for the first two weeks in December in four meetings, four regular meetings. That was approved and agreed upon by this committee. The intent was very clear before we made the motion that we deal with the Romanow report and not mix this bill with the Romanow report. That was the intent of the motion, and that was the preamble just prior to the vote.

    That there would be four meetings was there. We had talked about it just prior to the vote; that was the preamble. If you check the blues, you'll find that we are to have four meetings and that we are not to mix these two issues.

    The Chair: Unfortunately, Mr. Merrifield, this is not a point of order because you are incorrect. We voted on a motion, and the motion said “That this committee demonstrate its commitment to the future of our universal health care system by immediately reviewing upon its release the Romanow report for a period of no less than four meetings.” The word “regular” is not even in the motion, so no matter what the preamble says--there were lots of people who talked in that preamble period and suggested various things--the motion itself says four meetings.

    Mr. Rob Merrifield: Yes, but the intent of the “four meetings” was for four regular meetings of this committee, and we did discuss that.

    The Chair: John Bryden was here and he raised the question of evening meetings, and no one said--

    Mr. Rob Merrifield: Yes, we did talk about the evening meetings, and we said just prior to the vote--to clarify that motion--that the intent of that motion was that we deal with just the issue of the Romanow report and not mix these two issues. I agree with Réal Ménard that we're only human and that we can't be going from nine in the morning until midnight on two separate issues as we go through this week. That's unrealistic.

    The Chair: Well, I think your point of order is invalid, because while you have an opinion about it and you described a preamble as you heard it, as the chair I can only go by the words of the motion that was passed in that meeting.

    Mr. Rob Merrifield: And the intent of the words of the motion is that they be regular meetings--that means the meetings of this committee--which are two meetings a week, are they not?

    The Chair: You should have said “four regular meetings”.

    Mr. Rob Merrifield: No, that's the intent. If you go against the intent of the motion, that's exactly what you'd be doing by--

    The Chair: The intent of the words is what they say.

    Mr. Ménard.

»  (1700)  

[Translation]

    Mr. Réal Ménard: Madam Chair, I would like to give notice of a motion that might enable us to attain the two objectives. I know that the rules do not allow us to discuss it today. I will give it to the clerk and we can discuss it on Thursday. I will read it slowly because I wrote it in just one language.

    I move that the committee begin clause-by-clause study on Tuesday, December 3, that it continue on Wednesday, December 4, Thursday, December 5, and Monday, December 9, and that for each of these days, it sit from 9:00 a.m. to 11:00 a.m. and from 3:30 p.m. to 6:00 p.m., with a view toward completing clause-by-clause study on Monday, December 9. I also move that on Tuesday, December 10, Wednesday, December 11 and Thursday, December 12, the committee study the Romanow Report.

    If we start on Tuesday—and we won't have to work day and night— we can complete clause-by-clause study. If our colleagues have 75 amendments to table, they can table 75. That is democracy. There is no need to recall witnesses. Let's aim to finish studying the bill by Monday, December 9, and then on Tuesday, Wednesday and Thursday we can work on the Romanow Report. That is my motion and I hope that common sense will prevail and that the motion will be carried.

[English]

    The Chair: Are you giving that as a notice of motion for Thursday? I just want to say that if people are going to consider this, because we would vote on it on Thursday, you should be thinking about whether or not you're willing to give up the witnesses who are scheduled for Tuesday the third. I might say they're pretty expensive witnesses: one from Philadelphia, one from Indiana, one from Minnesota, one from Calgary, one from Alberta, one from Maryland.

    I got the money through stage one of the budgeting process today, which is called the liaison committee. There is no guarantee that when the House leaders meet they are going to approve it, and I might say that Tuesday has the set of the most expensive witnesses. The other witnesses who are far away are the people from the U.K. That's set-up as another one of these interactive television things such as we had this morning, so they aren't that expensive.

    Okay, let's open it up now. Dr. Fry.

    Ms. Hedy Fry: Madam Chair, with regard to the discussion of meeting with and listening to witnesses, I would like to agree with what Mr. Ménard said earlier on. I do not see any earthly reason why we should meet with people we have already met with. That's the first thing I would like to say. We agreed to that. And therefore, anybody on these lists that are presented here to us whom we have met with before I would like us to scratch off the list. That's the first thing I would like to suggest.

    The second thing is---

    The Chair: Do you mean those we have met ever before, or on the bill? The people on this list whose names you recognize we didn't meet with on the bill; we met with them on the committee's study of the draft legislation.

    People like Barry Stevens are terribly interesting, but I can remember him quite clearly from the previous set of hearings, prior to our committee report. Do you want to get rid of them too?

    Ms. Hedy Fry: I think--

    Mr. James Lunney: Why are we even having this discussion? I mean, really—

    The Chair: These are the witnesses—

    Ms. Hedy Fry: That's why it's on the table to be discussed, Mr. Lunney. May I finish, and you intervene then, please, when I've finished?

    Mr. James Lunney: Yes.

    The Chair: Go ahead, Dr. Fry. You have the floor.

    Ms. Hedy Fry: I think that although it's not on the table, Mr. Ménard's proposal is a very good one. It tends to give us a very clear set of timelines and tends to make sure we will get the work done in the prescribed time. It's one thing to suggest we're going to work in the evenings, only to find we don't even get a quorum sometimes, because people come, then leave halfway through. And then you come the next day--and I'm speaking from experience of having had a committee in which we did exactly that--and you discuss the same thing all over again because they weren't there the night before and therefore want to discuss it again. It becomes almost inefficient.

    So I think that by deciding and discussing now, which I hope we will do, who the people are we need specifically to hear from and who we believe can clarify stuff we need to know, then we can fit them in between now and the Tuesday when Mr. Ménard is suggesting we begin our new schedule for clause-by-clause.

»  (1705)  

    The Chair: Perhaps I can respond to that. The problem is, Dr. Fry, I don't particularly need to hear from any of these witnesses at this point, having lived this life, as have a few of us, for almost two years now.

    The fact is these represent individuals whom different members around the table felt they needed to hear from. I did not, nor did the clerk, nor did the researchers, discriminate and say “Madame Thibeault's witnesses are more valuable than Mr. Lunney's witnesses”. We took them all. If you handed them in, they were on the list.

    Now, there are a few who aren't, and I can tell you about them. If in fact you put in Wesley Smith from Seattle or Michel Lévesque from Celmed, these people have said no. They are not free.

    Ms. Hedy Fry: I'm not making a subjective comment on the witnesses. I'm suggesting we find a way to talk about this among all of us. Do we need to see everybody here? Could we condense the list, take off the people who are going to be repetitive in the things they're going to say? Could we decide what we specifically need to hear to help us to deal with the clause-by-clause when we begin it on December 3? Could we focus, as we discuss around the table, on the ones we take off the list? We'd all like to have the people we'd love to hear. I think we have to be more efficient in the way we do our work. That's all.

    The Chair: Yes. Mr. Merrifield.

    Mr. Rob Merrifield: Well, take a look at the witness lists. It's totally inappropriate not to hear some of these individuals who talked not about a piece of legislation, but actually about the draft piece of legislation, which was significantly different, particularly coming out of our report as a committee. If we're going to start condensing these or throwing them off the list we are in trouble of receiving the accusations of not doing our job appropriately as a committee. And that would be justified, because these people are very keen on having their information brought up to speed and to have their input on the actual piece of legislation that is before us.

    An example would be David Prentice, who was a terrific witness when he was here. He's an expert in his field on adult or non-embryonic stem cells. So much has happened in the year between the time that we heard him until now. It is absolutely essential that we listen to this individual's perspective on it at the present time.

    I could go through each one of these and suggest that they are very valid, and I think they are. And if we fail to do our job appropriately we'll be accused of that.

    Now, I don't see where the deadline of the Christmas break is written in stone anywhere. I don't understand where the logic is in saying that this is a deadline that we have set. It's much more important that we do our job and do it appropriately, especially after the energies that we've put into this, than it is that we rush to a false deadline or someone else's deadline.

    If we are a committee that is struck to do the job before us, then I think it's appropriate that we do that job as effectively as we possibly can. And I think to limit this would be a terrible mistake.

    Also, when it comes to the motion of this board to put these evening meetings in with the Romanow report, I think this is totally inappropriate. Many of us have other engagements in those evenings. I know for one we have our Christmas party.

    The Chair: It will become a moot point if Mr. Ménard's motion carries, because he's suggesting study in the daytime of the Romanow report.

    Mr. Rob Merrifield: Yes, but that would go against the motion that is already here before this committee that we've already approved.

    The Chair: Dr. Dromisky.

    Mr. Stan Dromisky: I know the motion is coming before us on Thursday, and really what it's saying is to shorten that whole list of witnesses or get rid of all the witnesses on Tuesday alone. It doesn't make any difference which plan you choose, you're going to get rid of some people who are on this list.

    From a professional viewpoint and from what I think is proper and ethical, you don't contact people like this to get cracking on some kind of presentation, and then two, three, or four days later you tell them, “Sorry, we don't want you any more”. We have no idea how much effort and time and energy has been put already into making a presentation.

    I don't know when they were notified and asked.

    The Chair: In actual fact, it was suggested to them that it was possible we might want to hear from them on Tuesday, December 3. The problem was, we did not have the money at this point, so nobody on Tuesday is confirmed, not one person. It has been suggested to them that it might be helpful if they set aside some time on Tuesday in case we had the money.

»  (1710)  

    Mr. Stan Dromisky: So no one on Tuesday has been confirmed.

    The Chair: No, because we couldn't and we still can't. We can't until Thursday, and that's another thing I was going to say. If in fact we can't confirm Tuesday until possibly Thursday after the House leaders have met, then this whole discussion is a moot point. In other words, we will have more information when we come to the Thursday meeting. Mr. Ménard's motion will be on the floor, and I will have found out from the House leaders whether our money is available to us.

    We can't even confirm with these people till Thursday anyway. I could have more information for you on Thursday about the money situation, and then you could decide whether or not you wish to eliminate the witnesses on Tuesday and start the clause-by-clause, as his motion is suggesting.

    Mr. Stan Dromisky: So in essence, if Ménard's motion is defeated, we're going to turn around on Thursday afternoon and start phoning these people and inviting them. That's what's going to happen?

    The Chair: Yes.

    Mr. Stan Dromisky: This will be after your meeting with whatever committee to see whether you've got the money or not.

    The Chair: Yes. I'm sorry about this, but this whole money thing is screwing everything up.

    Mr. Stan Dromisky: We'll start Thursday night or Friday and Saturday, working on whatever document they're going to work on to make a presentation here on Tuesday the third.

    The Chair: I have to assume that these people have been suggested by members of the committee because they are experts, because they have strong opinions. Almost everyone is from a university, so almost everyone, I would assume, has published something on stem cells and stem cell research, wouldn't you think?

    Mr. Stan Dromisky: You're asking people who are used to reporting to groups of people for anywhere from an hour to three hours at a time, and you're asking them to make a report to a parliamentary committee in a five- or ten-minute presentation. That takes a hell of a lot more effort than preparing a lecture outline for three hours. I think the demand is unreasonable, and I would reject your request to come here on Thursday night or on Friday if you phoned me.

    The Chair: As half the witnesses on that Tuesday already have, even though they were asked last week if they could set aside the time for ten days hence. They said no, I don't have the time to do that, I'm too busy teaching. So some of them already have said no.

    The point is, we're discussing this now. If we could get the Romanow meetings into the daytime, that would please Mr. Merrifield, although he wants to stop everything about the bill to do Romanow. I think I'm reading the committee by suggesting that they're not willing to do that. In fact, if we're going to do Romanow, we're going to do Romanow in concert with the bill or after we get the bill through. Is that correct?

    Some hon. members: Yes.

    The Chair: We'll vote on it. You'll find it is.

    Mr. Lunney.

    Mr. James Lunney: Madam Chair, it seems to me that the issue here is that we have Canadians who have something to say about this bill who are informed and knowledgeable and concerned about it. And it's important, even as it was important that we hear the witnesses this morning, because they are concerned about it and they want their voice heard. It's going to affect their future, and it's going to affect the future of a lot of Canadians. The issue here is not one of efficiency and pushing a time limit. We have to hear these witnesses in order to do a job and so we can adequately satisfy Canadians that we have heard their concerns on the issue.

    That's more important than an artificial timeline. With all due respect to the member opposite here who thinks we can drop witnesses, I will point out that some of us have been here to hear all the witnesses from the beginning--or at least the lion's share. You're a relative newcomer on this committee, and to rush this thing through at the last minute is to me a big mistake. We need to do the job properly. We need to finesse it, and I would recommend that we take the time to do the job properly.

    The Chair: Mr. Ménard.

[Translation]

    Mr. Réal Ménard: Madam Chair, with all due respect, we have been studying this bill for a year and a half so you cannot claim the committee is being rushed. We have been studying it for a year and a half. As a member of the opposition, I am not here to make life easy for the government. If people were told we would be paying for a second round... I would be curious to know who will be here Monday.

    Secondly, I keep an eye on regulatory activities. There has already been a round table with people from the United Kingdom, and the bill has hardly changed since then. What new information can they give us?

    The names of 20 witnesses have been put forward. Would our colleagues from the Alliance be willing to reduce that number to 10 and try to finish on Monday? For example, you can be for or against the use of stem cells. There are ideological and religious issues. But are the people going to tell us anything new? Our task as legislators is to collect information. I am available for that, but this afternoon I did not learn anything I did not already know. That is not because I think I am more intelligent than the others, but because I was assiduous in my committee work.

    So are our Alliance colleagues willing to hear all the witnesses on Monday, with a view to starting clause-by-clause study on Tuesday? They can move their amendments at that time. I find it hard to believe that after a year and a half, they do not know what they like or don't like about the bill. We can't tell Canadians or Quebeckers that we've studied the bill for a year and a half and that we want to start the process all over again because we are unfamiliar with the bill. That is ridiculous.

    Last Monday we all attended a meeting on mental health. Mr. Merrifield was there and I was too. Some people want us to discuss mental health, the cost of drugs and the Romanow Report. There is no shortage of work, and when the time comes to make the government's life difficult, we will do so. We've been studying this bill for a year and a half now.

    Madam Chair, could you ask our colleagues whether they would be willing to hear all the witnesses on Monday for one final hearing?

»  (1715)  

[English]

    The Chair: I think that's a very practical suggestion.

    Is there anyone here who put a name forward? I mean someone who submitted one of these names and who is willing to suggest that we don't have to hear from that particular witness. We can't remove other people's names; we can only remove our own suggestions.

    Who put forward the Brits? I think there has been a change over there, and that's why we wanted to hear from them. They've had some change of heart about certain things, which came up in the paper this summer, a change of heart around their agency and some of the rules therein. I understand that it's still not set up.

    Who put forward Catherine Clute? Maybe she wrote, did she? Who put Pratten forward?

    A voice: Pratten is from my riding.

    The Chair: Irene Rill. Barry Stevens; he wrote in. Graham Myers. Paul Muldoon. This is about equivalency with provinces, something we're not really up on. Mark Winfield. I think it's about the same thing, equivalency, isn't it? This 6 o'clock to 7:30 thing is all about how to deal with the provinces, etc., and we have probably only had a couple of sessions on this. It's pretty tricky.

    Who put in Lorraine Iacovitti? Mr. Merrifield. Who put in Clement Persaud?

    Mr. James Lunney: I believe I put his name in. He's from Victoria.

    The Chair: Who put in David Prentice? Mr. Merrifield did. Catherine Verfaillie? Tim Caulfield? Dianne Irving? Jackie Jeffs? She put herself forward.

    The Catherine Clute group, is that confirmed?

    A voice: None of them are confirmed.

    The Chair: None of these are confirmed. I'm wondering if they have similar views. For example, Paul Muldoon and Mark Winfield are going to speak about a similar thing. I wonder if we could have two instead of four and above that two instead of five. We could try to hear the different topics but get it done on the Monday, as Mr. Ménard is suggesting.

    Mr. James Lunney: With all due respect, I feel it's kind of nitpicky to go through and try to say which ones of these we can knock off when we're this close to completion. What's another day or two?

»  (1720)  

    The Chair: Well, you'll have a motion that will clarify this before you on Thursday.

    Mr. Szabo.

    Mr. Paul Szabo: Madam Chair, it's a very difficult situation. I'm sure that this will evolve as your milestones are reached and you know what you're able to do. There are a few people on this list who I hope the committee will see, but that's according to the committee's wishes.

    My concern is this. I've considered some amendments for report stage purposes in the House and have gone to the legislative counsel to see how long it would take. It's been a week and a half before, and I won't be getting them until tomorrow.

    The Chair: Yes, 24 hours is questionable.

    Mr. Paul Szabo: I'm a little concerned that members haven't already got their proposed amendments together, about whether or not they're properly worded, and whether or not they're in order, which is what the legislative counsel does for you. There may be a little bit of difficulty actually getting them to meet this timeline. I know that you would like to have--

    The Chair: Do you mean getting the counsel to meet the timeline or getting the members to meet the timeline?

    Mr. Paul Szabo: If you work back from Thursday the fifth and if you are hoping that anybody who was prepared to share them would assemble them to be put into a package--I think that's what you were alluding to--that those who were prepared to say here are the Canadian Alliance amendments, one through 20 or whatever, that they would be.... The 48 hours was--

    The Chair: No, the 48 hours was so the legislative counsel people, who have received yours and who will receive others, can put them in a package. Then they are shared with everybody at the same time, all of them.

    Mr. Paul Szabo: Well, I raise it from this standpoint. It appears that there is this flurry of activity going on around that office--

    The Chair: I'm worried about that too, Mr. Szabo.

    Mr. Paul Szabo: —and I'm a little concerned that the committee will be faced with a situation where members don't get their matters dealt with by the committee and therefore cannot sponsor them at clause-by-clause simply because they aren't there. I don't know how this gets accommodated, but I—

    The Chair: I think, considering your caution, it might be a good idea if we tried to get our amendments in by this Friday. Then if they're overwhelmed, maybe they can keep some of their staff working over the weekend. They did that the last time for us.

    Dr. Fry.

    Ms. Hedy Fry: Madam Chair, I would like to make a suggestion. I think that with regard to the issue we were discussing on the witnesses themselves, I would like to suggest that we give each member present at the moment who is a member of the committee the opportunity to pick a maximum of two people, and then that's it. I don't think it's appropriate, fair, or reasonable for members who feel that they have heard enough to have to have one member bring in six people or whatever.

    It's a fairness issue, Madam Chair, I'm discussing here. If we can, let's each have a maximum of two people we can pick. If some of us have no people, well then, we'll say nobody, but let's have a maximum of two people on this witness list we can each pick based on the premise that they will bring to the issue some sort of extra information people currently don't have. I would like to suggest that, Madam Chair.

    The Chair: Do I have any takers for that?

    Voices: No.

    The Chair: You might want to put a motion together for Thursday and get it on the wire tonight. Get it to the clerk tonight, because then if Mr. Ménard's motion fails, or even if it passes, and we only have Monday to hear witnesses, it would give the clerk a bit of time to decide which witnesses we'll hear on the Monday.

    Hearing nothing new—

    Mr. James Lunney: I have something new. I wanted to make another suggestion here, one I think is more reasonable. I think we need to appeal for some reason here.

    Given the importance of what we're dealing with here, both the witnesses and the clause-by-clause, we need a little bit of time to do it properly, to get the clause-by-clause in and to get the money to get our witnesses here. I'd like to make a formal notice of a motion that we will take next week's meetings and commit them to the Romanow report, this to be followed by the witnesses after we've done or wherever that takes us. With the witnesses coming the following week, this will give us time to sort out the money to get our witnesses here in due course, and then as soon as we've finished with the witnesses, we'll start our clause-by-clause. We'll be able to submit the amendments in time for the legislative clerks to deal with them so they're properly worded.

»  (1725)  

    The Chair: And it successfully uses up the time and keeps the bill out of the House, I might add.

    Dr. Castonguay.

[Translation]

    Mr. Jeannot Castonguay: Madam Chair, I take issue with that approach. Let's call a spade a spade: the process is being stalled so that we can deal with this bill again in February. I am getting fed up, Madam Chair.

    The House has asked us to study this bill. A motion was passed to study the Romanow Report and we will do so, but our priority is still this bill. I think that is how the situation should be approached. I commend my colleague Mr. Ménard. He does bother us whenever he can, but he is being very reasonable by saying we should stop stalling the train. It has to get to the station. And that is our job.

    Mr. Réal Ménard: Can we discuss the motion on Thursday and adjourn for today? Those who want to table motions can give us notice now and we will vote on Thursday. There were two motions. If our colleagues from the Alliance want to give us notices of motion, we can receive them. We are already running late, Madam Chair. We were supposed to adjourn at 5:00 p.m.

[English]

    The Chair: Yes. Can you write yours out so you can read it aloud before we leave?

    Mrs. Wasylycia-Leis.

    Ms. Judy Wasylycia-Leis: I've heard what Mr. Castonguay has said about his priority being the bill. My priority, once Romanow has reported, is to at least honour the motion that was passed, and have four good sessions on the Romanow report. Whether it's the proposal before us or Mr. Ménard's motion, as long as we have four sessions I'll be happy. I think that would honour the decision of this committee.

    I give notice of a motion for Thursday that we invite, as witnesses for those four sessions on Romanow, Roy Romanow, the Minister of Health, the provincial governments, the CMA, the CFNU, the CNA, the CHA, the CHC, and the CLC. So I recommend we hear these, as a minimum, in our four hearings.

    That's not a long list of witnesses. It's a bare-bones set of individuals and organizations, to give us some comments on the Romanow report. I think it's workable. I give that as a notice of motion now.

    The Chair: Make sure the clerk has the wording you want before you leave.

    Do you have one, Dr. Fry--I think we're going to adjourn in a minute--knowing what's coming up at the Thursday meeting? The Thursday meeting isn't a video conference. I think we'll do the motions first. So I hope you'll have made up your minds before you come, so we don't have to debate it. We'll hear from one speaker on each side and then vote, if we can.

    They're pretty easy. It's not exactly complicated to decide what each individual wants. So the only way to clarify it is to vote. Long speeches--

    Mr. Rob Merrifield: I thought we clarified it the last time.

    The Chair: We did. Your interpretation of some of the preamble and your intent was not in the words of the motion, therefore I can't enforce it, Mr. Merrifield.

    Mr. Rob Merrifield: I think you can bend intent the way you like it.

    The Chair: Mr. Lunney has a motion he wants to read to give us notice.

    Mr. James Lunney: The motion will read that the committee take four meetings beginning Monday to hear about the Romanow commission, followed by a return to Bill C-13 to hear witnesses, and then proceed to clause-by-clause in an orderly fashion.

    The Chair: We've now had notice of a different view on how to proceed. Mrs. Wasylycia-Leis is writing up her motion for the clerk. There's one here from Dr. Fry. She moves that the committee allow each member to name a maximum of two witnesses to present their findings to the committee on Monday the third, finances permitting. So that will be another motion you'll deal with on Thursday when we get here.

    Mr. Szabo.

    Mr. Paul Szabo: Madam Chairman, vis-à-vis what we've discussed earlier about the drafter, could the committee presume that whatever is decided it will respect the members' right to get a response or a return from the legislative counsel on their amendments, prior to going into clause-by-clause?

»  (1730)  

    The Chair: We can't go into clause-by-clause if we don't have a package of amendments. But if people are late getting their amendments in, the first package may be the early amendments.

    Mr. Paul Szabo: Is somebody going to inquire about the situation in that counsel office and instruct the members? I don't know if they have to go through the clerk, or if they should go direct...

    The Chair: For example, the clerk has told me that on this whole thing about the members having it for 48 hours and 24 hours, we had that much time last time, they told me. We can't do this. So I need you to go to your boss and ask him to guarantee that if we get amendments in, say by Friday, we'll be able to start clause-by-clause on Tuesday.

    The Clerk of the Committee: The 48 hours starts when the amendments have already been drafted and returned to the members.

    The Chair: Yes, but it's that earlier stage I'm worried about. We need to find out if they are going to work this weekend. They did the last time. At the end of the session, they often work all weekend.

    We've heard most of these witnesses.

    Mr. Rob Merrifield: We haven't heard all the witnesses here. There are 20-some here that we haven't heard.

    Dianne Irving---

    The Chair: We have about 25 pages from Dianne Irving, and I think we can all read.

    Dr. Bennett.

    Ms. Carolyn Bennett: Just on the work plan for this committee, I think Commissioner Romanow's availability to this committee will seriously change how we decide to schedule our meetings. So maybe this afternoon we could get consensus to invite Commissioner Romanow to come, and schedule meetings around his availability, rather than carve something out like this and then realize he isn't available.

    Thank you.

    The Chair: That's just common sense, Dr. Bennett.

    I think we have some motions coming. Please be ready to vote when you come in on Thursday.

    This meeting is adjourned.