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37th PARLIAMENT, 1st SESSION

Standing Committee on Health

EVIDENCE

CONTENTS

Thursday, June 13, 2002

1135

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

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ)

The Chair

Ms. Suzanne Scorsone (Individual Presentation)

1140

1145

The Chair

Ms. Karen Murawsky (Director of Public Affairs, Campaign Life Coalition)

The Chair

Ms. Mary Ellen Douglas (National Organizer, Campaign Life Coalition)

1150

Ms. Karen Murawsky

Ms. Mary Ellen Douglas

1155

Ms. Karen Murawsky

The Chair

His Excellency Archbishop Terence Prendergast (Archbishop of Halifax, Canadian Conference of Catholic Bishops)

Professor Noël Simard (Professor of Ethics, St. Paul University, Canadian Conference of Catholic Bishops)

1200

Archbishop Terence Prendergast

1205

1210

The Chair

Mr. Bruce Clemenger (Director, Centre for Faith and Public Life, Evangelical Fellowship of Canada)

1215

1220

The Chair

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

Ms. Suzanne Scorsone

Mr. Bruce Clemenger

Ms. Suzanne Scorsone

Mr. James Lunney

Ms. Suzanne Scorsone

1225

Mr. James Lunney

Ms. Suzanne Scorsone

The Chair

Mr. Réal Ménard

Prof. Noël Simard

Mr. Réal Ménard

Prof. Noël Simard

Mr. Réal Ménard

1230

Ms. Suzanne Scorsone

Mr. Bruce Clemenger

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Paul Szabo (Mississauga South, Lib.)

Ms. Suzanne Scorsone

1235

Mr. Paul Szabo

Ms. Suzanne Scorsone

The Chair

1240

Ms. Madeline Boscoe (Individual Presentation)

1245

The Chair

Ms. Madeline Boscoe

1250

The Chair

Professor Abby Lippman (Individual Presentation)

1255

1300

1305

The Chair

Mr. James Lunney

Prof. Abby Lippman

Mr. James Lunney

Prof. Abby Lippman

1310

Ms. Madeline Boscoe

The Chair

Mr. Paul Szabo

Prof. Abby Lippman

Mr. Paul Szabo

Prof. Abby Lippman

The Chair

1315

Mr. James Lunney

The Chair

Mr. James Lunney

The Chair

Mr. James Lunney

The Chair

Mr. James Lunney

The Chair

Mr. Alcock

The Chair

Mr. Réal Ménard

The Chair

1320

Mr. Réal Ménard

The Chair

Mr. James Lunney

The Chair

Mr. Reg Alcock

The Chair

Mr. Alcock

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. James Lunney

The Chair

Mr. James Lunney

The Chair

Mr. Réal Ménard

Mr. James Lunney

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

The Chair

1325

The Chair

Mr. Réal Ménard

The Chair

Mr. Jeannot Castonguay

Mr. Réal Ménard

The Chair

Mr. Paul Szabo

The Clerk

Mr. Paul Szabo

The Chair

Mr. Paul Szabo

1330

The Chair

Mr. Paul Szabo

The Chair

Mr. Paul Szabo

The Chair

Mr. Paul Szabo

The Chair

The Clerk

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. James Lunney

The Chair

CANADA

Standing Committee on Health

NUMBER 090

1st SESSION

37th PARLIAMENT

EVIDENCE

Thursday, June 13, 2002

[Recorded by Electronic Apparatus]

Á (1135)

[English]

The Chair (Ms. Bonnie Brown (Oakville, Lib.)): Good morning. It's my pleasure to welcome you all to this meeting of the Standing Committee on Health.

The agenda says there is a motion we were given notice of 48 hours ago. However, the mover of that motion, Mr. Ménard, will now report that he is withdrawing it. Mr. Ménard, would you like to explain this to the folks?

[Translation]

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): I will do so very quickly, because I am anxious for us to hear the witnesses.

This morning, I met with the minister who told me that there had been some confusion, that she would be very happy to appear once more before the committee in September. Therefore, Madam Chair, if you would agree to take the necessary steps to invite her, I believe there would be no further need for my motion and that we could have her come in September.

[English]

The Chair: Thank you, Mr. Ménard, particularly considering the fact that it would have taken up 35 minutes of our meeting. It's good of you to do that.

We have two sets of witnesses this morning, and we were supposed to give each set one hour. We now have less than an hour and a half left in the time, so I'm going to suggest that we still cut it in half and give each group 45 minutes.

If there's any way the witnesses can make their points...and if you have a written presentation, please précis it just a bit to cut that back a little. If the members could be very precise in their questions instead of delivering long preambles, it would assist us in this process.

We'll begin this morning with a former member of the Royal Commission on New Reproductive Technologies, whose findings, you will recall, we leaned rather heavily on. Just to remind us about that, we have Suzanne Scorsone.

Suzanne.

Ms. Suzanne Scorsone (Individual Presentation): Thank you.

When I've had a chance to assimilate what happens today, I'll adjust my remarks and send the text in, so you will have anything I didn't get to say.

First of all, I'd like to say that I'm exceedingly glad that a bill has been introduced. I would like to see the legislation passed as soon and as effectively as possible. Only in this way will it be established in principle that this whole field, touching as it does upon the fundamental nature of human beings, their welfare, and the respect and dignity due to them, is in the final analysis the responsibility of all of society as represented by Parliament.

I'd rather see an incomplete or imperfect bill passed than no bill passed at all. People can work to ameliorate something that exists. A void is a void is a void.

Let me say, too, that there's much about this bill that I find very well considered and constructive. I'll cut to the chase and talk only about the things I'd like to see adjusted. But don't take that as negativity. It's just selectivity.

A key concern to me is that while there is prohibition of commercialization of certain activities, there's nothing in the bill prohibiting all commerce in human reproduction. Surely, if the provision of treatments found safe and effective for infertility is important enough to warrant all this--a bill, an agency, everything--it should be provided by medicare. It's not liposuction. So it ought to be provided in a non-profit setting.

The for-profit nature of many fertility clinics, with the complex sources of conflict of interest inherent in that, is unaddressed in the bill. This is a serious matter, and it should be remedied. Existing for-profit clinics are capable of converting to non-profit status. That commercial interests have entered the field in Canada in the decade of legislative void between the time of the Royal Commission on New Reproductive Technologies making its recommendations and the present legislation is not sufficient reason to permit activity that is today as incompatible with human dignity and Canadian health care policy as it was then. It's a stalking horse for two-tier health care, in my view.

It's also very important to note that we really won't know what is going to happen on the ground until we see the regulations. That's part of the process, but I just wanted to note that.

The wording of paragraph 5(1)(b) on the creation of an embryo does provide some protection, but it is incomplete. The human embryo is a human individual with a complete personal human genome and should be a subject of research, in my view, only for its own benefit. There is some protection there. But I think the wording “or improving or providing instruction in assisted reproduction procedures” should be omitted. While this would indeed limit the research that would be permitted to fertility-related areas, it appears that it would permit the creation of embryos for the deliberate purpose of research or teaching. The reasoning will be in the text you get. But it looks as though people could create embryos for the purpose of research on fertility. I don't think that's what is intended, but it's there.

Paragraph 5(1)(e), with its prohibition of sex selection, would accomplish something very positive as far as it goes, but the permission of post-conception sex selection on medical grounds still permits a fundamental form of discrimination against the disabled.

The prohibition of commercial surrogacy is very good. Even so-called altruistic surrogacy has many negative consequences for all parties, and I think that needs some attention.

I have problems with the wording about compensation. I'm glad that in line with your recommendation the wording “accepting services” has been eliminated. That's good.

But the allowing of receipts for expenses is still a problem. Receipts for what kinds of expenses? If it's a receipt for a maternity dress, that could be pregnancy related. If it's a receipt for a year's rent, it's equivalent to income. So I think there should be wording saying “nothing that would constitute an incentive”, or words to that effect.

The wording in the bill on the purposes of research on embryos is significantly more ambiguous than that in the committee's report. The committee's report specified that they should look for other forms of biological material that would be equally effective or would do the job. The legislative wording is vaguer, and it leaves it to the logic that is inherent in the proposal itself. As we all know, people can frame their proposal to make almost anything necessary. So I prefer the wording that the committee had in the beginning.

Paragraph 65(1)(z) presents a very serious problem, in my view, that regulations could exempt “controlled activities or classes of controlled activities, generally or in circumstances prescribed by the regulations, from the provisions of this Act”. That is a “get out of jail free” card. It vitiates the bill by subjecting all of its provisions for controlled activities to those creating the regulations. What is the point of legislation that can be bracketed out of existence without reference to the parliamentary process, and what would such action be saying about respect for Parliament?

Á (1140)

In subclause 16(2) there's reference to destruction of health information at the request of the patient, and that I think is fair and good. But there isn't enough, at least as far as I'm understanding the legislative wording, about control of other forms of destruction of information.

I would not want clinics to be able, at will, to destroy records on patients or their offspring without their explicit and prior consent. Here's also where a centralized registry is absolutely crucial. With all of these clinics all over the place doing different things--they can go out of existence, they can have different policies--it's important that there be this centralized registry for the sake of the offspring and for the sake of the women who have undergone the procedures.

With respect to gamete donation, I'm in full agreement with the committee's original recommendation that there be mandatory prior consent to release of identifying information. I would strongly recommend that the bill be amended to include that.

The bill includes, at the outset, saying that the priority, or a key priority, is the welfare and well-being of the offspring, the child who is born. Then how can we say that person should not have access to his or her identified progenitor just because someone else has decided that? There should be provision for asking the individual who is going to make the gamete donation to make that commitment, because they can. It's not, as with adoption, the rectifying of an already existing tragic situation. It's rather something people have a choice to go into or not. It's entirely fair to say that you leave a public record if the child wants it when the child has reached a mature age. It seems to have worked all right in Sweden.

I'm very glad to see the creation of the Assisted Human Reproduction Agency of Canada. What is key is that the functions be performed, and this is one way to do it. The bill seems to split the difference between those who wanted the agency to be within Health Canada and those who wanted it at arm's length. It's a very interesting structure the way it's put, that it's to be accountable to the minister, with the members of the board serving at pleasure. This means there are provisions that could keep it from being hijacked by any one particular group, one would hope.

The health information registry, provided for under the agency, looks to me like a very good thing, except for the fact--at least as I'm reading the wording, and correct me if I'm wrong--that there's no provision for ongoing future-oriented kinds of health care follow-up.

The clinics that bring about pregnancies may not even know whether the child was born or what the health status of the woman was shortly thereafter because the child and the woman have been handed on to other professionals by then, to an obstetrician and a pediatrician. So if it's limited only to the health information that's available at the time of conception, we're not going to know anything about long-term health effects equivalent to the DES causation of vaginal cancer in the offspring of women who took it during pregnancy. So I think there should be confidentiality maintaining long-term follow-up that people can consent to. Only in that way will patients in the future be able to be offered genuinely evidence-based medicine.

The committee recommended certain very constructive parameters for the selection of the members of the board of an agency. The bill does set up a structure that, in terms of size, terms, and the involvement of deputy ministers, is itself quite constructive, yet with respect to composition, the bill is much less specific, which to me is a concern.

There's no prohibition of conflict of interest. It's not clear what “a range of backgrounds and disciplines relevant to the Agency's objectives” means. It could be interpreted as including only that range of disciplines and interests directly involved in the provision of the activities under the agency's purview, which would be very unfortunate. If all you have is a geneticist, an obstetrician, a bioethicist, and a lawyer, you could have the board hijacked. It's the same thing with the advisory panels.

There should be adequate funding for the agency. If they are dependent for their income on the people they're trying to licence, there is an inherent conflict of interest. So cost recovery should not be the way to go. Government can tax the clinics, do whatever they like to make the thing come out as a zero sum, without making the committee or the agency itself dependent.

I would also like to see wording found that would have the effect of prohibiting patenting of human materials, as the committee originally recommended, or at least prohibiting the granting of a licence for any activity to any facility or persons seeking or holding such a patent.

Á (1145)

The Chair: Thank you very much.

We'll go now to Karen Murawsky, who is the director of public affairs at the Campaign Life Coalition.

Ms. Murawsky.

Ms. Karen Murawsky (Director of Public Affairs, Campaign Life Coalition): Thank you. I'm here with Mary Ellen Douglas.

The Chair: Yes, but you don't get two presentations.

Voices Oh, oh!

Ms. Karen Murawsky: I wish.

Ms. Mary Ellen Douglas (National Organizer, Campaign Life Coalition): Madam Chair and committee members, we wish to thank you for having us present to you this morning and also for your hard work and consideration of legislation on assisted human reproduction. The many hours of hearings and debate have given you a deep comprehension of the difficulties involved and of the pace at which science and medicine are moving in this new century. For this committee to undertake to examine and comment upon these issues merits congratulations.

It is true that we in Canada have been slow to create a legislative framework for reproductive technologies, and it is sorely needed. Bill C-56, in its objectives, is a step along the right path.

We are here today as representatives of Campaign Life Coalition, the national pro-life organization. We are pro-life and oppose embryonic stem cell research because it kills human beings. Our broad recommendation is that this research be banned and efforts be centered upon somatic stem cell research, which has shown such great promise.

You have before you today two very short ladies who have all the usual concerns--home, family, work, and community--but also a very strong respect for human life. We are not experts, but we have consulted with experts in our examination of Bill C-56, the assisted human reproduction act. One of the professionals with whom we have consulted is Dr. Diane Irving, and you already have her written comments.

Á (1150)

Ms. Karen Murawsky: We'll get to the points in the bill that we are most concerned about. The most obvious weakness of the bill is the lack of clarity in definitions. If definitions are not correct or scientific, the bill is flawed. The most obvious difficulty is the lack of a correct definition of “human being”. It's just not there.

The second definition we are concerned with is that of “cloning technique”. It's not there. We refer to Dr. Irving, who has stated that the really critical issue is that there are many forms of techniques of cloning, not just the somatic cell nuclear transfer cloning technique. This is a definition found lacking as well. All of these cloning techniques could produce a new, genetically unique, living human being, and all of these cloning techniques should be banned and prohibited. You have Dr. Irving's list in material you've previously received.

In the principles, we deeply regret the failure of Bill C-56 to recognize the human embryo as human life. This was recommended in the Canadian Alliance minority report, along with the inclusion of the phrase “respect for human life”. Failure to do so reflects an ethical weakness in the bill, wherein the principles have no firm base upon which to rest.

Ms. Mary Ellen Douglas: I'll just go through some of the concerns with the clauses, starting with subclause 40(2). The issuance of a licence for embryonic research “if the Agency is satisfied that the use is necessary for the purpose of the proposed research” presents a major stumbling block to all pro-life people. The purpose is neither explained nor listed: what purpose and what type of research?

We have had, for a number of years, the greatest difficulty in attempting to obtain a clarification on “medically necessary” in relation to the Canada Health Act. What does this word “necessary” mean in Bill C-56? To us it indicates an open door. In principle, the clause allows for embryonic research.

Concerning paragraph 5(1)(j), there have been a number of comments from other sources about the difficulty of protecting the use of hybrids for the hamster test used to determine male fertility. Care must be taken to include that this is an exception to the prohibitions.

Paragraph 5(1)(e) would prohibit identifying the sex of an embryo “except to prevent, diagnose or treat a sex-linked disorder or disease”. We believe this would most often lead to the destruction of the embryo. For example, in cases of muscular dystrophy or hemophilia, this would lead to eugenic practices and should be amended.

Paragraph 5(1)(b) allows, in other words, that the embryo can be used for providing instructions on the techniques of in vitro fertilization. There is no prohibition on destruction of the embryo in this circumstance. We ask that this part of the bill be considered for removal.

Regarding the issue of consent in subclauses 8(1), 8(2), and 8(3), and especially what should be free and informed consent, no person can give such consent without being provided with accurate scientific facts. This means the definitions in this bill must be clarified. The same clause refers to the consent of the donor. In our opinion, the donor in the bill should be identified as the parent, or the mother or father of the embryo. The same wording is found in paragraph 65(1)(a) and leaves the decision to the Governor in Council.

A human embryo is a living human being, the progeny of a human mother and a human father, no matter what his or her fate will be. In truth, the real donor is the embryo, who forfeits his life-giving stem cells where no full or informed consent is possible.

Clause 66 causes us much concern in that in subclause (2) we find the wording very weak, with only possible references to a committee of the House. We believe a committee should review new regulations, and it should likely be the Standing Committee on Health.

Subclauses 66(3), 66(4), 66(5), and 67(2) apparently mean that the minister would bypass both the committee and the House in a number of ways. We would recommend that these clauses be tightened considerably to make it necessary for changes to be reviewed, debated, and voted on. Considering the ever-changing scientific reality and the seriousness of these matters, we feel that accountability must be real and obvious to the public.

Á (1155)

Ms. Karen Murawsky: In summary, we see the problems of Bill C-56 to be centred on three particular areas: first, failure to recognize the humanity of the human embryo; second, definitions, which are absolutely critical, and it is very important to have these definitions correct; and third, the lack of accountability to Parliament and, in essence, to the Canadian public.

We quote from a letter from one member of Parliament about Bill C-56. That member said it speaks to the growing problems of infertility that approximately one out of eight couples suffer from infertility and are increasing reliance on assisted human reproduction.

We wish to pose just a few very short questions to the committee too.

What consideration was given to the root causes of this enormous problem of infertility? Was there any place in committee work for recommendations for such things as umbilical cord blood banks, or the perfection of techniques for freezing human oocytes rather than embryos? And finally, was consideration given to the related costs of embryonic stem cell research--for example, the expense of continued use of anti-rejection drugs that would be necessary?

We thank you for your attention.

The Chair: Thank you very much, Ms. Murawsky and Ms. Douglas.

We'll now hear from His Excellency, the Most Reverend Terence Prendergast, Archbishop of Halifax, and Mr. Noël Simard, professor of ethics at St. Paul University.

Archbishop Prendergast.

His Excellency Archbishop Terence Prendergast (Archbishop of Halifax, Canadian Conference of Catholic Bishops): Thank you.

The Canadian Conference of Catholic Bishops thanks the committee for the invitation to present its reflections on Bill C-56, the proposed assisted human reproduction act. In accepting your invitation to speak today, we are mindful that your committee is not starting at the beginning, but over the last year has already studied these technologies very carefully, with six months of public hearings and committee debate.

We had the opportunity to appear before you last November 26 and will not repeat everything that was said then. Instead, we will try to respect your request to frame our comments as a comparison between the provisions of the bill and your committee's recommendations with respect to the draft legislation that preceded it. Given the short notice for this hearing, we will not comment on all the provisions of the bill, but only those that interest or concern us the most.

Our comments are informed by Catholic teaching on the respect for human life from its very beginning, on respect for human dignity and integrity, on respect for the beauty and integrity of procreation, on concern for the most vulnerable, and on promotion of the common good.

I'll turn the floor over now to Dr. Simard.

[Translation]

Professor Noël Simard (Professor of Ethics, St. Paul University, Canadian Conference of Catholic Bishops): Hello.

With regard to the Statutory Declaration, we welcome the health committee's recommendation that the preamble of the draft legislation be replaced with a Statutory Declaration that would have more weight. The Bill seems to have adopted most of the committee's suggestions but would be better if it also included its stronger declaration against commodification and the recognition that persons with disabilities can lead full lives. From our perspective, the Declaration should also include a provision for the promotion and protection of human life, given that the Bill is concerned about the creation of human life.

The health committee's recommendation to supplement the Statutory Declaration with a purpose clause was an excellent one because it underlined that the interests of researchers must be subordinated firstly to the interests of children born from assisted reproduction procedures, followed by the interests of adults participating in the procedures. It would be even better if it also included protection for the interests of children before birth, that is for the embryos created by these procedures.

With regard to the definitions, in its report, the health committee found it offensive to include the embryo under the term “human reproductive material”. We are pleased that the Bill has removed the embryo from this definition because the embryo is a completely different reality from gametes.

With regard to prohibitions and human cloning, in its report, the health committee was strongly opposed to both reproductive and therapeutic cloning. The minister of Health, in speaking of the Bill, at second reading, said that it outlaws the creation of human clones whether for the purposes of reproduction or research.

We commend both the committee and the minister for respecting the strong consensus of Canadians on this point. Given the rapid development of science and the importance of getting this provision right, we hope that the definition of “human clone” captures all forms and possibilities of cloning. Furthermore, we are concerned that the phrase at the beginning of clause 5(1)(c) of the Bill that reads as follows:

c) for the purpose of creating a human being

may inadvertently open the door to therapeutic cloning.

With regard to the creation of embryos for research purposes, clause 5(1)(b) of the Bill states that:

5.(1) No person shall knowingly:

(b) create an in vitro embryo for any purpose other than creating a human being or improving or providing instruction in assisted reproduction procedures;

Clause 3(1)(d) of the draft legislation simply states that:

3.(1) No person shall knowingly:

(d) create an in vitro embryo solely for purposes of research;

We find the phrase “for any purpose other than creating a human being” puzzling because, from our perspective, the embryo is a human being from its very earliest beginnings. In our view, the drafters are confusing the nature of the embryo and its purpose. The human embryo simply cannot be other than a human being.

The Bill appears to have added the right to create an in vitro embryo for the purpose of improving or providing instruction in assisted reproduction at the request of the committee. While we understand that it is motivated, in part, by a sincere desire to research egg storage techniques that will ultimately reduce the number of embryos produced, we cannot support any research that results in the destruction of the embryo.

We prefer the wording of the draft legislation on creation of embryos for research purposes to that in the Bill and the Report of the Health Committee. It is clear and more ethically coherent.

Turning now to surrogacy, we welcome the continued prohibition in the Bill of commercial surrogacy.

Â (1200)

It recognizes that these arrangements contribute to the exploitation of women, especially those who are poor, to the objectification of children and the commodification of the process of reproduction from beginning to end.

The retention in the Bill of reimbursement of the surrogate mother's expenses could, however, open the door to payment for the surrogacy arrangement.

We also commend the committee for its efforts to discourage non lucrative or altruistic surrogacy. Even if there is no financial gain and the offer is made from a generous heart, there is still a risk of commodification of procreation, which is inconsistent with the dignity of everyone involved. Moreover, it violates the unity and dignity of marriage and separates genetic, “gestational” and social parenthood. It is, therefore, disappointing that the committee's recommendation for mandatory psychological counselling was not accepted.

As for the use of in vitro embryos without consent, the Bill maintains a provision that was in the draft legislation against using in vitro embryos unless the donor had given written consent. We would like to stress that one does not own an embryo; that while property can be donated, living beings cannot, and that consent is not sufficient unless it is for the good of the embryo.

[English]

Archbishop Terence Prendergast: I'd like to turn now to the controlled activities, particularly beginning with research on embryos.

Having appeared before the health committee, we know that you took the question of embryonic stem cell research very seriously and that you've made a point of getting up-to-date scientific information. It is clear that you tried very hard to protect human life, to give hope to those who are living with degenerative diseases, and to respect the deeply held convictions of witnesses.

Over the course of many months of testimony, the committee heard both scientists and ethicists define the embryo as a human being. Even those who consider the term “human being” more philosophical than biological would agree that embryos are human, that we all began as embryos, that human life unfolds as part of a continuum, and that in a very real sense the embryo is one of us.

Both reason and faith inform the Catholic position that the human being is to be respected and treated as a person from the beginning. This means that when it comes to treatment or research, the embryo must be treated as a subject and not as an object or as a means to an end. No treatment must be undertaken that does not benefit or respect the integrity of the embryo.

The problem with embryonic stem cell research is that while the research has the potential to benefit those living with disease, it actually harms the embryo, who dies in the process. Ultimately, the embryo is exploited for the benefit of others.

The provisions on embryo research contained in the bill and the recommendation made by the committee are quite different. Both are an improvement over draft legislation, which gave no protection to the embryo. The committee's recommendation is a well-motivated attempt to protect the embryo by making research on it a last resort. Recommendation 14 reads that:

Research using embryos be a controlled activity requiring a licence. Even if all other regulatory criteria are met, no licence may be issued unless the applicant clearly demonstrates that no other category of biological material could be used for the purposes of the proposed research.

The recommendation shows palpable concern for the embryo and is a serious attempt to address the ethical issues involved. Nevertheless, the recommendation is difficult for us to accept, either as a matter of principle or practice.

At the level of principle, one either accepts that the embryo is human, whose life must be respected, or one does not. There is no in-between. At the level of practice, it would be very difficult to maintain the limits expressed in the recommendation in the face of economic and scientific pressures. Experience with other significant moral issues shows that once the door is open, it is very difficult to shut.

The provision in the bill gives a nod to embryo protection, but the backgrounder to the bill, the positive reaction of researchers, and the plain working of the provision show that the green light has been given to embryonic stem cell research. It states:

A licence authorizing the use of an in vitro embryo for the purpose of research may be issued only if the agency is satisfied that the use is necessary for the purpose of the proposed research.

Some argue that the embryos who remain after fertility treatments will die anyway, so why not do some good? It's not necessary that we do something with these embryos so that some good or meaning will be given to their lives. There is good and meaning in their lives simply because they are intrinsically human. This also means from a faith perspective that they are known and loved by God. It is unnecessary to search for a meaning on their behalf, especially when such a search is really nothing more than a way of justifying the decision to release human embryos for research purposes.

A better approach is what is contained in recommendation 15 of the committee's report, that is, for people for whom in vitro fertilization is acceptable, to limit the number of embryos that may be created in the procedure.

We recommend that research in embryos, as well as any treatment that is not for their benefit, be prohibited. There is, however, a way forward that will enable both human life to be protected and degenerative diseases to be treated or cured, and that is through adult stem cell research, which, as the committee knows, is showing remarkable progress.

While some might argue that this approach will put our country behind its trading partners, we submit that it will put our nation ahead. Canada could become a leader in adult stem cell research, thereby promoting both scientific progress and respect for human life and dignity.

In terms of health information, in general we support the committee's clear call for the collection and maintenance of registries to facilitate accountability, transparency, and surveillance in the areas of assisted human reproduction. In particular, the committee's recommendation, which was not picked up in the bill, to require consent to release identifying information to offspring before gamete donation underlined the seriousness of what the donor was doing: creating a child.

Â (1205)

The committee's recommendation for a regulatory body that is “a semi-independent agency, directed by a Board that reports directly to the Minister of Health, and with mechanisms that ensure accountability to Parliament” seems to achieve a good balance between independence and accountability. In establishing the agency, the bill appears to have overlooked reporting to Parliament, or is it assumed that the minister will report to Parliament? Given what is at stake in the assisted reproductive technologies and related research, accountability to Parliament would seem to us to be essential.

In conclusion, we thank you for inviting us to speak with you today. As the new millennium begins, the Holy Father, Pope John Paul, has observed that among the urgent challenges facing the world and the church is our commitment to respect the life of every human being. A society's vision of human values, it seems to us, is most evident in the laws and protection it provides for those most vulnerable moments of human life.

The Pope also invited us to launch out into the deep. When you were invited to sit on this committee, you may have felt that you were launching out into the deep, but if you know the story from Scripture, the disciples were not asked to launch out alone but together. It's only by working together and trying hard to understand the convictions of others that we find a way forward that promotes the common good. We assure you that in your continuing deliberations, you are not alone in seeking creative and responsible solutions to the dilemmas posed by assisted human reproduction.

Â (1210)

The Chair: Thank you very much.

We'll go on to the representative of the Evangelical Fellowship of Canada, Bruce Clemenger.

Mr. Clemenger.

Mr. Bruce Clemenger (Director, Centre for Faith and Public Life, Evangelical Fellowship of Canada): Thank you, Madam Chair. It's a pleasure to appear before you. I appeared before you a year ago on the draft legislation. In that presentation I really overviewed the principles with which we come at this legislation, and they have a bit of a moral and philosophical context. I won't repeat that here today for the purposes of this presentation.

We read with interest your report, “Building Families”, and thought your report would make the draft legislation much better. We're concerned that not all of your recommendations were followed. We would like to see them...and wish that the legislation would have done that.

I have submitted my oral comments to the clerk, and along with that are about 34 recommendations. I won't go through all of them with you. We've also tabled a comparison where we look at the draft legislation, the new legislation--Bill C-56--the committee's recommendations, and then have in italics our old recommendations, so you can see them in context.

Some things have come up this morning that we hadn't thought of, so we will be amending that. If I trust you to read all that material, I will just skip through. I agree pretty well with much of what--really everything--has been said so far this morning, so I will try to pick through my comments and identify the things that have not yet been identified.

First of all, it was a great idea from the committee to have a statutory declaration rather than just a preamble. This is interpretative. It's important. Our only concern--a few of them--is that the ordering and wording of the declaration, unfortunately, in Bill C-56 does not follow the ordering and wording your declaration had.

One particular concern is the first point of the declaration, which in Bill C-56 places the pursuit of the protection and promotion of human health, dignity, and rights as a means to obtaining the benefits of assisted human technologies. This is similar to the wording in the draft legislation, and we objected at that time.

Our concern is that the respect for human health, dignity, and rights should be the focus and not the benefits that might arise from respecting these principles. Otherwise, we'd become utilitarian and reaffirm the basic principles only if they benefit us.

We also believe that the declaration should mention respect for human life. So where it says “dignity”, “individuality”, we would say “life”, “dignity”, “individuality”, etc.

Also, as was mentioned previously, you had a strong statement about the value of persons with disabilities. We think that should be re-included.

Also, you had a purpose clause that supplemented your statutory declaration, and the purpose clause is not in Bill C-56. One idea we have is that you may want to include it under the objectives of the agency in clause 22. It talks about ethical principles. It doesn't mention what those are. Why not just stick your purpose clause there?

As to definitions, again we agree with some of the comments about the concerns about the definition of human cloning--is it all-encompassing--the definition of human being, and the definition of a donor. Sometimes it's not pluralized. There are two donors leading to a human embryo, not just one. And the donor is really a biological progenitor or a parent. We'd recommend that kind of language.

Moving to prohibited activities, there are some important changes in the bill that could cause some of the prohibitions to be somewhat narrower in scope. This is our concern. For instance, the prohibition on cloning in paragraph 5(a) no longer contains the phrase “or participate in”. The committee should question its deletion and ensure that it does not narrow the scope of the individuals or activities that would be captured by the prohibition.

We affirm again our deep moral opposition to any research that causes the destruction of the human embryo. In this case we would side more with the Canadian Alliance minority report, calling for a three-year moratorium. Actually, we'd go further and say it should be prohibited.

Underneath the committee's decision to not allow production of embryos for research but to allow “spare” embryos to be used is this idea of a special moral status of the human embryo, which is identified in the tri-council policy statement and then repeated in some documents by the CIHR.

If we follow that line of reasoning, if we accept for an instance, which philosophically I don't, that we will identify the embryo as having special moral status, we are concerned that Bill C-56 itself undermines this special moral status by permitting the creation and use of embryos for research and instruction designed to improve IVF techniques. We would contend that this is inconsistent with even the special moral status--the limited moral status then--that the bill implies. So we recommend that the words “providing instruction in” be deleted from paragraph 5(b).

As recommended by the committee, the prohibition was added to ban the creation of animal/human hybrids “for the purpose of reproduction”. We would like to see this prohibition in paragraph 5(j) further strengthened to ban the creation of a hybrid for any purpose.

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We also agree with the committee about the concerns about the purchase, barter, or exchange of human gametes and embryos.

We move to subclause 7(2). We note that here the prohibition on the purchase and sale of embryos in the bill no longer contains the qualifier “or any part of one” that was in the draft legislation. We think that neither the embryo or any part of the embryo should be the object of trade or commerce.

Also, in subclause 7(1) and subclause 7(3), which deal with the purchase of gametes and reproductive material, again, if the committee is serious about trying to restrict the commercialization, we're concerned about the conclusion of the phrase “from a donor or a person acting on behalf of a donor”. Our concern is that this may still allow the purchase of gametes, of reproductive material, from third parties.

Some comments have been made about surrogacy and whether the commercialization of surrogacy has been really adequately captured in this bill or prohibited, and we don't think it has. Again, we compare the committee's recommendations to the bill.

Under “Controlled Activities”, we note that in subclause 10(1), which addresses the use of human reproductive materials, the phrase “or facilitating human reproduction” has been eliminated. This could narrow the scope of the application. It would allow unlicensed research using human reproductive material. It is our feeling that all such work should require a licence and be subject to the regulations in order to prevent abuse, even if the stated purpose of the research is not to create an embryo.

In subclause 10(2), in the use of in vitro embryos we are similarly concerned with the deletion of the qualifier “or any part of one”. The committee should examine whether this might not narrow the scope of the activities captured by the legislation and perhaps even whether any facility working with embryonic stem cells ought to be licensed and monitored by the agency.

It is also important to ask whether or not subclause 10(3) would allow the import of human reproductive materials and embryos from or export to jurisdictions that do not have the same restrictions on the commercialization of human reproductive material or that may allow cloning or the creation of human embryos for research activities under this legislation, which we ban in Canada. In other words, another jurisdiction could permit cloning, and this legislation may allow us to go and purchase embryos that have been cloned and use them in Canada.

So it's that export-import qualifier and whether the same rules we apply here will be imposed on any jurisdiction from which we obtain human reproductive material or embryos or fetuses.

The committee recommended that research using the embryos be a controlled activity requiring a licence. Again, given our objection to this research in the first place, we liked what you did, given your premise that you further narrowed the research by requiring that even if all other regulatory criteria were met, no licence might be issued unless the applicant clearly demonstrated that no other category of biological material could be used for the purposes of proposed research.

Again, we are opposed to any research. We appreciate the restrictions placed on this practice. We have further concerns, however, in clause 40, which deals with the use of an in vitro embryo, and we do not feel it adequately reflects what the committee desired. The wording would allow any research project if the use of the embryo was necessary to the project.

This does not restrict research to that which attempts to alleviate human suffering. Most of the justification for embryotic stem cell research has been public statements by groups like the Juvenile Diabetes Research Foundation, the Parkinson Society Canada, and so on, saying that we need this research to alleviate human disease. This legislation qualification would not limit that research just to alleviating disease; it could be used for all sorts of things, I imagine, such as cosmetics, etc.

If you're serious, again, about the special moral status of the embryo and really want to make allowance for alleviating human disease, then make that clear in the legislation.

I have two last comments. One, the bill includes a new clause dealing with what is referred to as transgenics. This is a new phrase; it wasn't in the old legislation. The old legislation talked about chimera and the management of hybrids. Anyway, this is a new category.

As we've surveyed the hearings that you undertook with the draft legislation, very few witnesses actually addressed the issue of hybrids, chimeras, and transgenics, especially since transgenics wasn't in the bill. We're not sure what all this means. I'm not sure that you know all that it means. Are you sure you want to allow something to be regulated, in a sense, in an open-ended system that you haven't examined?

One of the examples perhaps in transgenics is that it's really the mixing of genetic materials from different species, say, from human and non-human. This raises this question: How much human genetic material does it take to make a human and how much does it take to make an animal? And how do you make those distinctions?

It's quite an interesting area, and, again, we're not sure you've had enough information and study to actually comment on it and then to leave it to the regulatory agency concerned.

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In terms of the agency, again, we're not sure which way to lean, in terms of accountability to a minister or Parliament. We have a number of recommendations that split the difference and suggest, in a sense, that it do both: report to Parliament and the minister. Parliament can ask questions of it that the statute allows the minister to ask of it. There's concern, again, about the composition of the board, etc.

In conclusion, we urge Parliament, and, again, the relevant ministries, to consider the implications of using and further developing new reproductive technologies compared to other means available of supporting parenthood. These would include programs to promote the emotional, psychological, and physical well-being of those families already in existence; promoting adoption as a viable alternative for those couples who are unable to have biological children of their own; and focusing on restoring fertility, rather than bypassing it, which in some ways is what these technologies do.

We also encourage the government to promote practices and development of technologies that do not threaten or undermine human dignity or respect for human life, but encourage and foster ethical forms of research, such as research on adult stem cells and technologies that reduce the use of IVF and the number of embryos that are created for the purposes of reproduction.

Thank you.

The Chair: Thank you, Mr. Clemenger.

We'll begin the questioning. I must caution the committee to be as brief as possible because we still have two witnesses waiting to be heard.

We'll begin with Mr. Lunney, then Mr. Ménard, and Mr. Szabo.

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

Thank you to all the witnesses for their presentations. You've all done a lot of thinking on the subject and I certainly appreciate that.

Archbishop, with respect, we appreciate the concerns you raised regarding the embryonic research and the adult stem cells, and the very great promise that is shown in adult stem cell research in the last number of months in particular, and certainly in the last year.

Unfortunately, the committee was unable to come to an agreement on that particular issue, which resulted in the present state, and of course our recommendation in the minority report was that we have a moratorium. Be that as it may, that's where the debate is at this point.

Coming back to another issue here that was just raised about chimera and the hamster test, Suzanne Scorsone, you mentioned that, and Bruce Clemenger, you touched on that with transgenics.

I wondered, Suzanne, if you would comment on the chimera and the hamster scenario there and this whole issue of transgenics. Do you see a red flag and concerns about where the looseness of this language might be leading us?

Ms. Suzanne Scorsone: Why don't you start?

Mr. Bruce Clemenger: Actually, I believe you mentioned the hamster.

Ms. Suzanne Scorsone: Yes. I didn't mention it in my presentation.

Mr. James Lunney: I see.

Ms. Suzanne Scorsone: I'm familiar with the issue, but I didn't mention it.

Mr. James Lunney: I certainly wanted to acknowledge, Suzanne, your extensive--probably more extensive than anybody--experience in this issue going back to the Royal Commission on New Reproductive Technologies. I'm sorry, I attributed it to the wrong person.

We wondered, with your experience, if you would comment on that particular issue.

Ms. Suzanne Scorsone: It's a very difficult area because very often things are very undefined. Also, I find even the scientific information that's out there, the studies and so on, tend to use the terms in ways that shift. Sometimes what some people call transgenics is what someone else calls a chimera. So I think what Mr. Clemenger said about wanting to look more carefully at parsing out what all the definitions ought to be would be a very constructive suggestion, because what is being discussed is so unclear, even in the science itself. You could allow something and then have someone else interpret it in a way that was not intended by Parliament.

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Mr. James Lunney: Precisely. There are some concerns, again, about patenting when you're creating a new life form for research purposes. I'm wondering where you might go with that. Might you create something that is now considered a new life form that's patentable?

Ms. Suzanne Scorsone: I think we have here before the Supreme Court right now the question of the Harvard OncoMouse, for example, which is something I see as an issue of great concern. It's one thing to patent the intellectual processes by which you would insert a gene into an already existing creature, but it's quite another thing to try to patent the entire creature, most of which you didn't create. No matter what your theory of creation is, you didn't do that. And to claim a patent on that mouse and all of its progeny and descendants forever, and to make this subject to licence and commerce, strikes me as inappropriate for any naturally occurring creature, no matter what that creature may be.

I realize there are all sorts of commercial interests wanting a piece of the action here, but I think it's inappropriate. And when you consider there is so little genetic difference between us, and non-human creatures and the processes by which transgenic changes are brought about are exactly the same, if there were to be a precedent set with the patenting of non-human creatures of whatever sort, at what point does this begin to be applicable to humans?

I, myself, would prefer to see even the stem cell lines themselves, even if legitimately created from somatic adult stem cells and the rest of it, not subject to patent. Intellectual processes are fine, but no tissue itself.

The Chair: Thank you, Dr. Lunney.

Mr. Ménard.

[Translation]

Mr. Réal Ménard: I have two short questions, Madam. First of all, I believe that there is around this table quite a good consensus as to the idea that we should not be patenting human life and that human life and human embryos should be accorded the noble treatment they deserve. That is not being questioned here.

However, in the act, there are exceptions. I am addressing my questions here to my friends from the Canadian Conference of Catholic Bishops and the Evangelical Fellowship of Canada. Do you not believe that for the legislator, the granting of exceptions is a reasonable formula? The scientist will have to prove that he has no other biological material available to him to carry out his research.

We were given the example of people who in the 1950s were opposed to research on recombinant DNA, research which gave us insulin. Were we not prudent in setting up a general prohibition regimen which specific exceptions? That is my first question. I would ask you to kindly answer quickly in order for me to be able to ask you my second question.

Prof. Noël Simard: I believe there can certainly be exceptions to the law, but an exception can always open the door to a practise that might bring harm to the embryo. This is why it is very dangerous. If we start allowing research involving embryos or allowing individuals, researchers, to carry out work in this area, we may find ourselves opening the door to the creation of embryos for the purpose of research.

Mr. Réal Ménard: That is prohibited by the bill.

Prof. Noël Simard: Yes.

Mr. Réal Ménard: The prohibition will remain.

Prof. Noël Simard: But the exception may bring...

Mr. Réal Ménard: You are worried.

Prof. Noël Simard: Yes, that is it. We are worried by the exception.

Mr. Réal Ménard: I respect that. I have a second question.

Ms. Suzanne Scorsone: I would like to be well[Editor's note: Inaudible] for that.

Mr. Réal Ménard: Very well.

At the present time, the patent commissioner makes a distinction between inferior life forms and superior life forms. In Canada, we can patent cells, mushrooms, algae [Editor's note: Inaudible] and DNA strands. There is an organization called GeneWatch that has counted some 26,000 patent applications for genes tabled throughout the planet. In Canada, there have been 600 such applications.

Are you worried about the patent system we have today and would you like to see the committee make a recommendation in view of including in the Patent Act provisions under which the patent commissioner could, for reasons of public, moral or ethical interest, refuse to grant a patent? Would you like to see us have a moral and ethical clause similar to that which exists in the European Union and that the patent commissioner might call upon?

My question is addressed to all of the witnesses.

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[English]

Ms. Suzanne Scorsone: For my part, I would say yes. It should be possible for the commission to refuse a patent on something that is inappropriate, that is not in keeping with human dignity or with public policy, with respect to life of whatever sort is considered to be appropriate. I think higher life forms certainly would qualify there.

Mr. Bruce Clemenger: We were one of the interveners in the Harvard mouse case. Really, the routing of the case comes from a problem in the Patent Act itself. I use the analogy of new wine and old wineskins. It's from some Scripture, but the idea is that if you put new wine in old wineskins, the new wine is going to explode the skins. In a sense, what's happening is that now we're asking questions about biotechnology and transgenics, etc., of the Patent Act, which uses language that was developed in 1869, when it was first drafted. It talks about composition of matter and about invention. It's really a mechanistic model, and now we're putting organic questions to it.

The commissioner of patents and the lower court, the Federal Court, when asked whether they could patent a higher life form, both said no, the common understanding is that it can't apply. The Federal Court of Appeal overturned that and said we just have to apply the definitions across.

So I think it has to go back to Parliament. Parliament now has to really come back to this and ask whether we want to patent higher life forms. Actually, it's not just higher life forms; we patent single cells. Plants are actually addressed under several pieces of legislation, so we need to ask those kinds of questions.

The other thing that was raised with the Federal Court of Appeal was that even if we patent a mouse, we won't patent a human person because the charter will kick in. When that was raised before the Supreme Court, they weren't at all convinced that section 7 would necessarily limit the patenting of human life.

[Translation]

Mr. Réal Ménard: The best protection is clause [Editor's note: Inaudible].

[English]

The Chair: Excuse me. In actual fact, a report of patenting that has been explained to us is beyond the purview of this bill. I don't think it's uninteresting. As a matter of fact, it's fascinating, but it will have no impact on what we do with Bill C-56

[Translation]

Mr. Réal Ménard: No, you are mistaken, Madam Chair; there is a direct link between what we are discussing here and the Bill we have before us, and this link is the pre-implantation diagnosis. So do not try to...

[English]

The Chair: Yes, but we can't amend the bill to include the idea of patenting.

[Translation]

Mr. Réal Ménard: Yes. We made a recommendation in our report on...

[English]

The Chair: Yes, we did, which would suggest that if it cannot be within this bill, which is what the legislative lawyers have said, we'd have to do another bill that is about that subject matter. But today we're trying to finish up our testimony on Bill C-56, so I would ask that we not talk any more about patents.

[Translation]

Mr. Réal Ménard: Madam Chair, give me a break. The two issues are linked.

[English]

The Chair: Besides, you've had six and a half minutes. I think it's Mr. Szabo's turn.

[Translation]

Mr. Réal Ménard: Very well, but the two are linked. All of this is linked together.

[English]

The Chair: Mr. Szabo.

Mr. Paul Szabo (Mississauga South, Lib.): I have a question for Ms. Scorsone. Thank you all. I thought you did an excellent job in presenting your positions on short notice.

Ms. Scorsone, you said in your opening remarks that you were anxious to have this bill passed as quickly as possible, even if it was an imperfect bill. This bill includes generically two elements, one being the reproductive technologies, the other being the related research, which is getting a lot of attention. Is your position with regard to passing even an imperfect bill in relation to the whole bill or is your position specifically with regard to the reproductive technology provisions?

Ms. Suzanne Scorsone: In my view, although I haven't had the opportunity to parse that out and think about it for a long time, as it occurs to me now, I see them as intimately related because so much of the research is contingent upon the reproductive technologies. It is also my impression that although the reproductive technologies are where the rubber hits the road for the couples, for the patients, for the offspring, some of what is driving the pressure to make them widely available is not only the needs of people who are infertile but also people wanting to do research--companies wanting to do research--who want sources of the materials on which they would do this. So I would see it as two halves of the same whole, different takes on the same sphere. We have to control all of it at once.

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Mr. Paul Szabo: Thank you. There's no question they are intimately related, but Health Canada told us that once the bill is passed, once they get royal assent, certain things such as banning of cloning and genetic alteration are instantaneously in place. But the agency and all that other stuff is going to take two years before it would be implemented--two years before you do all that work.

Given that it's going to take two years to get the regs and the agencies and the fertility clinics and all the researchers on the same song sheet as to how business is going to be done, do you believe that since privately funded research could still get money to do some of this, whereas the public under the CIHR has a moratorium on the funding now, it would be advisable to have a moratorium on the related research--i.e. embryonic stem cell research--until such time that the agency is operational and able to consider licences?

Ms. Suzanne Scorsone: I think that would be within the purview of Parliament to ask that. The track record on moratoria up to now has been that they are anything but mandatory. People nod in their direction, and some people in good faith cooperate. Other people say I don't think so and go on with whatever they were going to do. I'm all for declaring a moratorium, so that everything can be done in an integral fashion, but I would definitely want to see the bill passed so that even if it takes two years to get things up and running, at least we won't have waited that much longer to do it in two chunks rather than one. We might as well get started and as soon as possible.

Mr. Paul Szabo: Thank you.

The Chair: Thank you, Mr. Szabo.

On behalf of the committee, it's my pleasure to thank all of you for coming on short notice, for being so well prepared and directing our attention to those specific facets of the bill where you would like to see it amended. So thank you for all that work you have done for us.

I would now ask Ms. Abby Lippman and Madeline Boscoe to come to the table. Thank you very much for your patience, ladies. We'll ask Dr. Lippman to--

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Ms. Madeline Boscoe (Individual Presentation): I was going to start first.

The Chair: All right, fine.

Ms. Madeline Boscoe: I'd like to read into the record the fact that I'm here on behalf of the Women's Health Clinic in Winnipeg. It's good to see some Manitobans at the table.

As the co-chair of the minister's Advisory Committee on Reproductive and Genetic Technologies, I will be drawing heavily on the brief we presented to you in December, which was rolled up into your excellent report.

I'm not going to repeat some of the earlier comments, other than where I would like to reinforce them, and then I'll go to the area that I think still needs some further elaboration.

I should say that the advisory committee was not consulted by the Department of Health in its preparation for this next version before you, due to the careful issues around legislation. I'm sure you understand some of these better than I do. So it's not for lack of interest but for lack of opportunity and capacity.

I would also like to mention that the Women's Health Clinic has been involved with this issue since 1983. I date it from my children--that's how I define my life so far. I understand social change takes a generation, but I didn't really believe it until I got into it.

We do want to reinforce the urgency around the passing of this bill and getting it through. There's a high state of anxiety in the community as we go forward, partly because we are normalizing things that shouldn't be normalized by our silence.

The legislative process here has been a very important clarification of values for Canadians, but I think we know what the message is; we had better get on with it. They actually think we're already regulating in the area, so it's even a little more urgent, in my view.

I would like to mention, though, that reproductive health is one of the big business lines in the agency I'm involved with. However, we do have a $20,000 debt in our free and low-cost birth control program. We can't get fertility services for women with legitimate needs because they're in the private sector, and we have big waiting lists for children who don't have parents. Big Sisters and Big Brothers are dying for people out there to come and help. So I think we do need to remember this is one tiny piece of the pie.

I spent yesterday in front of the medical officers of health helping them to understand that in fact poverty is the biggest number one issue for women's health in this country and that we have to get at this from a socio-economic process. We can't pretend that cells in dishes are going to improve the health and well-being of Canadians. That's not where the big problems are.

That being said, we do need quick action. I'm delighted to see the three-year comeback to the committee. I think it's very important that we're not going to get this completely right the first time in.

It's good to see the declarative principles. You were absolutely right, though, we want it to be stronger.

However, I think we do need to be much more overt on the issue of protecting the diversity of Canadians and the interests of people with disabilities in that wording. The disability community is very concerned. They don't have the capacity to be here.

I will forward to you a discussion paper called “The Ethical and Human Rights Implications of Prenatal Technologies”, prepared by Yvonne Peters, that calls for federal action in this area. This was funded by your very own Women's Health Bureau, the Centres of Excellence for Women's Health Program. Thank goodness they were there to help this community bring forward a regulatory framework. They're not suggesting it needs to go in this bill, but if we could at least put some language in the preamble, that would be a placeholder for people who come after us.

I will reinforce the issues around looking at the Patent Act. As you know, the insurance industry just announced yesterday that if you've had breast cancer genetic screening, you had better disclose it or you're not going to be insured.

So we have big problems that we're going to have to move forward on.

On the issue of surrogacy, we are still very concerned about the enabling tone. We're very ambivalent about the whole issue of altruism. We see the issue of the expense and a receipt as a great step forward. The only expense we could get our minds around was one related to counselling. Counselling should not happen in facilities that are regulated to actually provide their services, because those counsellors are fundamentally in a conflict of interest.

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I didn't have time between when I found out I was coming and last night to come up with brilliant wording, but I'll be glad to go back at it. But that was the only area we could think of as an allowable expense that would not end up reinforcing very vulnerable relationships.

I should let you know that my phone rings off the hook with sisters and friends who are being asked to provide altruistic surrogacy issues...and their issues of coercion are more about whether they can show up at Christmas dinner any more, or will they be invited to the bar mitzvah, because coercion has many forms, and families coerce as well.

The Chair: What is your conclusion on that?

Ms. Madeline Boscoe: My conclusion is that if we allow any kind of expense at all, it should be very contained, and the only one we could think of was counselling--and independent counselling. I can't stress that enough.

We realize we cannot require, nor should we require, anyone to go for counselling, but we need a system to do that. As an agency that has a two-year waiting list for social work counselling, I can tell you that our insured system is challenged in this area as well. But if you're writing your brief to the provincial ministers, I would much rather you say “You have to get this out of the private system”. I totally concur with Suzanne Scorsone on this issue, as does our advisory committee.

You could ask them to also support free access to counselling for women who are considering altruistic arrangements in the public sector, and that would get us out of some of those conflict issues.

Regarding sex selection, it's good it's in there.

On the issue of anonymous donation of gametes and embryos, we're very concerned that this piece did not get in. We understand the problems with family law and inheritance law, and all the other laws that need to be brought into place. However, I think it is possible now to say to people who are considering donating their gametes or embryos that we're going the way of open donation, and we should at least create, for those who come into the system now, a clear understanding, a line in the old policy sand, as Phyllis Colvin would say, to require this. And even though we don't have the rest of the infrastructure, that is, the parents and the children don't necessarily have that access, we'll have it sitting on our database, so we won't need to go back 18 years after the fact to somebody who had donated something and ask them for their consent.

The people who donate gametes and embryos are not like pregnant women who are dealing with adoption. Women don't get pregnant to adopt out their babies, but people donate gametes to do that, so I would like us to think very carefully about enforcing that in the legislation.

I'm not going to talk about research. I'm going to let my colleague, Abby, speak to this.

On the issue of the agency, because there's nothing much in the direction, we did spend a fair amount of time around this also. I'm quite concerned about the narrow definition of its scope, and I think we need to have language in there that says it will be actively involved in reviewing the regulations that come out of the department.

People are very concerned that this agency could evolve into a group of people who decide what temperature sperm are supposed to be kept at, and this broader, social ethics, consensus-building process is not clearly enough enshrined. Frankly, I would like to see the legislation redrafted in a way that would articulate that goal as the A job and the pieces on regulating the operational pieces as the B job.

And then, because I'm always interested in where the money goes, I would want to see that the budget would be appropriately allocated to those issues. I think too often we underfund consultation, education, and high-level scanning processes, and that's been what's been needed. If our other regulatory systems, like the doctors, had been able to pull this off, or the Canadian Council on Health Services Accreditation people could have pulled this off, they would have done it, but they cannot and will not--nor should they, I would argue--take on this higher-level function. I think that's what we at the advisory committee have been working towards, that vision, and I don't think it's clearly enough laid out in the act.

The other pieces that I think should be more clearly defined in the act in terms of their function are the issues around setting standards for informed consent, counselling standards, and guidelines. The act should specify that they have a transparent mandate from the get-go that lays out that their minutes need to be online...those kinds of activities. The act should specify that they have a community education component. The whole issue of setting up an open donor system seems to me to be exactly the task this group ought to take on. The act should specify that the consultation activities include synthesis and consensus-building, that we're not in the business of hearings, we're in the business of helping Canadians develop a shared vision and work on that. I think that's one of the failures I saw with the royal commission; it did not assume that Canadians can learn from one another and move forward, and we obviously can. We just need a mechanism to do that.

I won't go into too much more on the regulatory body, other than that I would repeat the issue that this should not be a partisan model. We need educated citizens at the event who represent stakeholders, but this should not include people who make money out of this system. Those people should be consulted, but they should not be at the decision-making table. They're in a conflict of interest.

There is an urgency to regulation. I'll send you the “to do” list, I think. I would like to reinforce the point around getting this out of the for-profit system and moving it into an insured system. If we think it's important enough to regulate, it has to be important enough for Canadians to have equitable access.

I'll stop now.

Â (1250)

The Chair: Professor Lippman.

Professor Abby Lippman (Individual Presentation): Thank you for having me back again. I will try to speak within a speed that the translators can manage, but given the time.... Fortunately, much has already been said.

I brought notes, but I'm not even going to look at them because of the time and some of the issues.

I want to clarify a few things. First, I think the most important thing this committee can do is to get back into the legislation some of the wording that was in the committee report, which I found less permissive than is in the law. I want to congratulate you as a committee for what you came out with as your report.

I'm delighted that there is finally a bill on the table. I think it is urgent that this bill be moved. I don't always agree with many of the things Suzanne Scorsone says. On this I think she was dead on. This has to move now. If this has to go back, and if there is even a thought that another committee might then have to deal with it after prorogation, I think you will lose everybody.

I was at a conference on human reproduction ten days ago in Montreal. I don't have very long hair, but it was standing on end at some of the things that were being done and some of the ways this was being described. These were not people talking about research in embryonic stem cells so much as they were talking about the reproductive technology techniques being done. There needs to be some control over what is happening. There needs to be a bill, although imperfect. No, I don't think anyone's going to agree, but it has to be moved rapidly.

In terms of some of the earlier discussion, I would just like to remind people here of this. I don't think you need me to say it, but I need to say it for my own sake. Don't get caught up in the definitions of words. That's a non-issue.

I've looked at some of the key words in the definitions and they generally cover a multitude of sins. There may be one or two that are left out, but remember that words are used for power. No word is neutral. Whoever defines the word has the power to use it the way they want to use it. I think you're fine. Don't trip up on redefining the words in the bill, because it will be a non-starter. You want to say what a chimera is. A chimera is a humpty-dumpty word. It means whatever I want it to mean. Don't get lost there.

In terms of some of the other issues against, I'm all in favour, as everyone knows, of a completely open donor system. I think some of the arguments I've heard used as to why it can't be done are non-starters, such as maybe there is not enough of a supply of sperm and eggs around. That's not an issue. There are enough around. It's the definition of infertility that's changing and making the supply-demand change. If people who are truly infertile are using these techniques, and if other people who are using in vitro fertilization to do pre-implantation genetic diagnosis are not in the ballpark, you'll have more than enough of what you need to go around. I think the supply-demand issue is not a thing....

I would hate to see any of this, whether it's the reproductive technology part to assist women who are truly infertile or even the research, used because it's being supported as an economic growth factor in this country. That is just unacceptable as an issue. I rarely agree with archbishops on things of this nature, but I think it was the archbishop who said that we can be a leader in the world if we develop adult stem cell work. There is good reason to think that even if you were to do all these supposedly miraculous cures with embryonic stems, it's not going to happen. It hasn't happened after 25 years of mouse research. Why we think it's going to happen in humans overnight boggles my mind.

The fact is that it probably is not going to work very rapidly. If it does work, it's going to be so costly that it is going to set up not just the two-tier system, but the kinds of distinctions that I think none of us, as Quebeckers, as Canadians, want to see in this country.

I think adult stem cells can make us into leaders. There are going to be problems, yes, but there is a lot of interesting research with money to be made, if people want to make money at it, figuring how to get around the immune system.

I think we also have a chance to be a leader in this, because there is a lot of stuff coming out of the United States now that says look at the Canadian draft legislation. They think we already have it in fact, so you have to slowly tell people it hasn't been passed yet. I think if we actually got that in place we would be seen as leaders. The Brits have something, but there are a lot of problems with the British enforcement. I think the Canadians should do it.

Â (1255)

What you should do is tinker very gently with the bill. I have to say this with reluctance, because there are a lot of places I'd like to say “You really have to do this because this is really going to make it a terrific bill”, but I am so concerned about there being nothing after so many years.

Earlier today someone said, where are all the women's groups? Why are they not mobilizing around this? Well, the women's groups have been worn out by attrition. First we fought for the royal commission. Then we fought to have something happen after the royal commission. Then we fought for the moratorium and to get it enforced. Then we fought for Bill C-47. Madeline talks about “your” generation. I feel it has been three generations, but I age rapidly, or faster than she does.

I'm willing to put all of my really serious things aside. I know I will be soundly chastised by some of my friends, but I think it's too important not to have that thread of criminal law out there right now.

As Madeline suggested, I would tighten up the preamble. I think you have to put back what the committee report said in terms of diversity and for people with disabilities. That is an important piece of the bill that has to be there, and then at least it allows for interpretation. If you've affirmed the life of a person with a disability, you then allow the legal interpretation to come into the prenatal genetic diagnosis parts of it. If you don't have that in the preamble, you don't give the law the space for interpretation.

Yes, there has been a lot of debate about a phrase I will use gingerly here. I would still like to see the precautionary principle. It's verified in there. But I won't go down that street, because I know it's a difficult one.

I think there should be something in the start about preventing infertility. That's where the action is to be made. That's also where there can be economic gains for this country. If you want to be very mercenary about it, look at preventing infertility as being a source of economic growth instead of just getting around it as being the source.

I would again like to see the word “choice” used wherever “consent” is used in the law.

I've said what I need to say about the open system. I'm not going to go back over that.

In terms of the expenses for surrogacy, I think there should be no expenses. I might go a little bit further than Madeline. We have not discussed this. We're friends, but we don't always compare notes on things. I think it might be possible, and I would respectfully suggest--I understand it was the use of counselling that made the expenses become a moot issue--that perhaps somebody who's good with words could figure out how to build in the counselling as part of the informed choice mechanism, because you say there must be informed choice. If the guidelines for informed choice ensure disinterested, separate counselling must be offered--you can never make somebody have counselling, I don't believe--at least it's there. They have to opt out of something that otherwise is not an informed choice. It might get you around having to reimburse the expenses, and then there are no expenses.

My concern is that the vulnerable woman who in a way is going to be pushed into being a so-called altruistic donor is not likely to run to the lawyers or to the social workers or to anybody else for this counselling. By leaving the expenses in there, you're allowing too many expenses for people without really protecting the vulnerable women who will be caught up in this. That would be my way around that.

In terms of the research on embryos, and I'm on the record on a website as saying you can't say it will be that the use “is necessary”. I have yet to meet a colleague in biomedicine who cannot tell me everything is necessary. I can make up why it's necessary too. This is the way they will give you it's necessary. There is a selling technique going on that's very troubling. The selling technique is the smiling baby on the front page of the newspaper who has been cured by this. Nobody wants to not cure babies. I certainly am not trying to keep babies sick.

So to get around the “is necessary”, I'd go back to what I think was the wording in the standing committee report. It should be something along the lines of “in vitro embryos may not be used for research unless it is first demonstrated that all other ways to address the question have been tried and/or have failed and/or are not appropriate, and that the question is essential”. I think it has to be two pieces of it--that there's no other material or approach that can be used and that there has to be a real proof that the question is important to answer. In the same way that research is necessary, the questions become equally necessary.

So I think the two pieces need to be tied together, and I think wording can get that. I would be very uncomfortable if it was just left as “is necessary” in subclause 40(2).

· (1300)

I've gone on the record regarding the agency. I have even suggested the model that comes out of Quebec. I think the agency must be open. I would go further than Madeline Boscoe did, in terms of posting its minutes. I think all of the hearings should be open. There is very little that is of a proprietary nature that would be discussed by the agency. There is no need for names of clinics or individuals to be mentioned. I think the hearings should be posted. They should be announced. They should be open.

For instance, just this week, I saw a posting from the Food and Drug Administration for a hearing that was held in May. The posting was about some research related to reproductive technology--the transfer of ooplasm into eggs--which would be banned by our law, apparently, but might get approved by the FDA.

Putting that aside for the moment, the agency should not just have no conflicts of interest, but be non-partisan. The people in the agency should not have vested interests one way or another. There are enough intelligent people around who can do the job. I think the model from BAPE, le Bureau d'audiences publiques sur l'environnement, in Quebec is a good model because of their postings. There may be things that need to be adapted, but all hearings should be open. There should be announcements, and people should be invited to hearings. I think I've spelled this out in a previous submission to this committee.

The other major point I wanted to make was that as much as I would like to see patenting addressed, I have been convinced to just let it be for the moment. I'm coming to accept that it cannot be put into this law without delaying the law. If I understood Mr. Ménard correctly, he was suggesting that there might be a recommendation from this committee that the patenters take action on this, but not that it go into the law. This is how I understood him. If I'm wrong, stop me.

So we would not put it into the law, but make a firm statement that there must be no patents on life forms. I would go beyond what the Canadian biotechnology group is recommending. I think their report is weak and not well justified. There should be no patents on any kind of life. If we are so concerned about patenting tomatoes, we should be worried about humans. There is some good stuff on this.

If anybody stays after we break, I will show you a wonderful spoof of the Harvard OncoMouse, which is on a website about patenting the scientist who created that mouse. The same justification for the mouse can be used for the scientist who created it.

Ms. Madeline Boscoe: I'm assuming that's his mother?

Prof. Abby Lippman: Yes, his mother. They did use technology.

I would like to see this committee come out with a strong statement about patenting.

The other thing that troubles me--and which I don't know how to get my head around, so I wrote an idea about it two minutes ago--is the whole notion of this bill not covering research on eggs and sperm per se. This has been left to the CIHR. The CIHR is a wide-open door to all kinds of things, even though they will have to get research ethics board approval. The tri-council statement about research with eggs and sperm, and so on, is pretty porous, as far as I can read. I have brought a copy with me. It doesn't stop you from doing much of anything in the standard way.

There's a lot of concern now in the research community and in citizen communities, or civil society, about research ethics boards. So my suggestion would be that there has to be a very close link between what is going on in the genetic component of things and what is going on in terms of the reproductive technology. The link should perhaps be at the agency level, and it must be put into law so that the agency is not left to figure out that it has to do this. They really have to have members going back and forth, or whatever, because there needs to be some formal link.

In my somewhat cynical, if not paranoid, way, it's too easy for me to envision that the research out there is playing with eggs, which can now be obtained very simply from women for research purposes. It's minor surgery to remove a piece of the ovary, to have access to a lot of eggs, to play with them in the laboratory or do all kinds of things in a lab, which is allowable to the CIHR. The only thing that's blocked is you can't play with them and then put them back into a women.

But I think if the researchers are going to advertise that they are able to do all of this with their techniques in the laboratory--and they get the bigger press--there is going to be enormous pressure on an agency to say, no, you can't really do it. I think the agency should, at least, know what's happening out there. It should be very well aware, so that it knows how to intervene and to make its voice heard.

· (1305)

As I say, I'm all over the place. If there are questions, I'll be happy to answer them. My message is to reinforce where you started with Suzanne Scorsone earlier, pass this bill, get this out of here as fast as you can, with some amendments to tighten up the places where there are really egregious things--not egregious but bad things--and then make sure we are on the road. I think we've all waited too long. You can be very proud of the legacy this committee will be leaving behind. You've actually got something done on this bill, which nobody who has gone before you will be able to say.

Thank you.

The Chair: Thank you, Dr. Lippman.

Dr. Lunney.

Mr. James Lunney: Thank you, Madam Chair. And thank you again to both presenters.

The first point is on the issue of speed, Mrs. Lippman. Given that the bill has already passed second reading and it can be reinstated at the same spot--there is a concern about proroguing the House and so on--in the legislative process it was at, at prorogation, and given that minimal time would be lost, do you still think we need to rush the bill through without hearing the remainder of witnesses and dealing with the amendments that need to be done to tidy this up?

Prof. Abby Lippman: I can be very selfish. I think the things I would like to see amended you should amend. I think they can probably be done rather rapidly. As to the notion of time, I don't know how much more you're going to hear. Quite honestly, I'm saying a lot of what I said at the end of November. Madeline is probably saying what she has presented to you before. The people prior to us, I've heard what they've said before. I don't think you're going to hear anything new. I think it's a matter of you all just biting the bullet and saying we're going to go for broke on something.

As I say, to me the major issues are an open system, surrogacy, payment, tightening up the wording about the embryo research, and fixing up the preamble. I can live with the rest and let it all go. Those to me are not a lot of changes and amendments to be made. Those to me are the big-ticket items.

Mr. James Lunney: I have two quick questions. One of them is in regard to the open system you just mentioned.

We've had others here. Dr. Librach yesterday gave a very impassioned plea that absolutely everything will be shut down if we take away anonymity. He said there won't be any donors and that will be the end of the game. Can you please explain if you're aware of other models and any other information that would be helpful to us?

The second question is regarding the agency. I think you both have said avoid people with direct financial involvement. There are people who can think in other realms and so on. You mentioned a model in Quebec. Perhaps you have some suggestions as to where we find these people, what type of people we might recommend, or language. Please, you might contribute in that area.

Prof. Abby Lippman: I'll let Madeline take that second piece and I'll supplement the first one, the donor.

There are more infertile women these days probably because the definition has changed, not because women are less able to conceive and have babies. There is good evidence that there has been some drop-off in the number of people who are coming forward as donors when the open system was instated, where it has been instated. I think, though, it picks up with a different group of people. I don't think there is necessarily going to be that backlog. I really don't. It's not going to come in overnight. It's going to come in more gradually. It's going to involve...which is why the agency is going to be important in terms of the educational work that is done to get people ready for this. That should be started now in terms of why this is.

I think Madeline made the point that this is not the same as adoption. Adoption is not a good model in this situation. It's a very different circumstance. If one is giving priority for these procedures to women who are truly infertile and who are not using them for reasons of childlessness per se or for pre-implantation genetic diagnosis, it will be okay. I'm not certain that there is that backlog.

· (1310)

Ms. Madeline Boscoe: I'll send up the writing we've done on characteristics of the agency, because I do think that in the legislation this piece is the piece that's had the least amount of public discussion. I think the characteristics and the job of this agency need strengthening in terms of what it's empowered to do. I'm not sure I want to be in a position as a member of that advisory committee to wait for the minister to always ask me for advice. I think we need to be able to push in. I'd love to see some wording actually saying, come before the health committee once a year and let us know what's going on, as part of your needs assessment consultation activity, if nothing else--things that would push it a little bit further.

On the characteristics of knowledgeable Canadians who have interest in the area without necessarily being paid in the area, or whose personal careers are on the line, I think there is some language there that we could develop. I'll send it up in writing. I know we're running late.

The Chair: Mr. Szabo.

Mr. Paul Szabo: On the issue of informed consent, have you considered what's there and maybe what should be there? How important is this aspect of full and informed consent?

Prof. Abby Lippman: Well, I have never felt other than that informed choice is essential. To get informed choice, you really need to have in many of these areas the meeting with the person who's not involved either in the research or in the practice, because as Madeline did say, they're there to give infertility treatment. My dream at one point many years ago, when I still had positive dreams instead of just nightmares about some of this, was to have this kind of thing done within the context, because I think this is really part of women's sexual and reproductive health.

My sense is that this should be done at women's health clinics, as a point of entry, but I do think informed choice is important. From what I understood from the two women who were sitting here, and I come back to the issue of the words, the words are there. The words are not the issue. The informed choice issue particularly came up with the surrogacy because it's built into all the parts, so I'm not touching there. But the one excuse, the one reason, that was given was why you had to cover expenses.

Mr. Paul Szabo: I have one last quick one. I'm very interested in this. I think you probably know this, and maybe you can advise us or tell us how we can find out. As to the question about immune rejection of embryonic stem cell therapies, how serious are anti-rejection drugs with regard to a regimen of a person? I know on the diabetes side what they do when they have an islet transplant. Are we talking about heavy drugs and consequences that are pretty serious?

Prof. Abby Lippman: I'm not a physician, so I can only tell you what I know. Immunosuppressive treatment is not a good thing to have to have, but there may be ways, if you're working with adult cells, which is why people were concerned about getting the embryonic cells, where you may be able to circumvent that. I really don't want to answer medical questions.

Mr. Paul Szabo: Okay. Thank you.

The Chair: If there are no other questions, I want to thank you so much. We have heard from you before, but we wanted you to come back to give your reflections on Bill C-56 as you did on the draft legislation. This process is--

Mr. Réal Ménard: I have two questions.

The Chair: Did you not have a turn?

Mr. Réal Ménard: All right, but I raised my hand.

The Chair: I'm sorry, I didn't see it. Can you talk after the meeting to them, Mr. Ménard? I'm sure they'll take a minute with you.

You can see the questions narrowing as we resolve certain of the issues. There is a question of speed, though, because we're not sure if the House is rising tomorrow or Tuesday. The committee has decided to move forward as quickly as it can with as much alacrity as it can. But the House could rise. Then I'm not sure of our status. I'm not sure. We could probably continue to meet, but I can't make any promises or guarantees.

Thank you very much.

On that same subject, committee members, I do not have any notion.... No one has told me whether we're rising tomorrow or Monday or Tuesday, so I'm in your hands. The fact of the matter is if we are going to amend it, as Dr. Lippman has said, in seven or ten places, that isn't very much. It's not the 220 we did the last time, in the last bill. I'm suggesting to you that if you want changes, they don't have to be in perfect legislative language, but they have to be in. They have to go to the drafters, and then to translation, and then to the clerk.

· (1315)

Mr. James Lunney: Do we have any more witnesses to hear on this issue?

The Chair: We've covered the seven areas where the bill.... That's what the committee agreed to, Dr. Lunney.

We had that lady on privacy. She was not very helpful, but the fact of the matter is the privacy commissioner refused to come.

Mr. James Lunney: On the imported gametes, I was looking for some input from the police officer who addressed that.

The Clerk of the Committee: We asked him. He couldn't come.

Mr. James Lunney: There's still no opportunity for anybody to give us input in that area. It's a very important area. That's a tremendous loophole.

The Chair: I thought your questions yesterday were answered well by the person who said we will not be importing them if in fact there is not proof that the creation of those gametes was not done according to our rules. In other words, if they're paying for them in Georgia, they can't come here.

Mr. James Lunney: But how are they going to determine that, Madam Chair? They could be from Costa Rica, Lithuania, or Latvia, or from anywhere--

The Chair: They would not send them to us, if they wouldn't be paid at this end. Which company in Costa Rica is going to send sperm here if they don't get some money for it?

Mr. James Lunney: All right, but there's the other issue then of people arranging for gametes, or even embryos, to come in from other countries. My gosh, with transactions through third parties, there's a loophole big enough to drive a cement truck through.

The Chair: I realize that, but pretty well all of our witnesses today--even though they disagree on some of the basic premises of this bill--are suggesting that we not get hung up on one detail. It will take two years. There will be an agency that can enforce things. It will receive information from us all the time.

But to stop the bill because we didn't hear from one policeman about import and export, to me, is not rational. I'm not saying you're not rational. I'm just saying that I thought the committee or the group as a whole had pretty well decided to go forward and get it done if they could.

Mr. Reg Alcock (Winnipeg South, Lib.): Particularly in light of the testimony.

The Chair: Particularly in light of the testimony. On all sides of the spectrum, everybody is saying do it.

Mr. Ménard.

[Translation]

Mr. Réal Ménard: I am leaving Monday for Europe with the special committee on non-medical drug use. According to the information we have been given, it seems that the House will be adjourning Monday or Tuesday, although that could change from one hour to the next. It depends upon the leaders and at the present time it is the Conservatives who would like us to stay here; the other parties want us to leave.

That being said, do you intend to hear further witnesses next week? In any event, I will not be here, but the parties that do not table their amendments here will be able to do so in the House. But was it your intention to pursue the work of the committee and to hear yet other witnesses next week or to table the report next week?

[English]

The Chair: No. About a week or so ago we decided there were seven areas where the bill diverged from our report and on which we wanted to hear witnesses. We have now done so. We have added Dr. Lippman and Ms. Boscoe to give us an overview of their reaction to the bill. They have now done this. So we have completed the process that we laid out last week. We are now ready to go to clause-by-clause. But there's no point in doing clause-by-clause unless you have thought about it sufficiently to put in a couple of amendments. Of course, the minister would love us if we just passed it exactly as it is, but it would be irresponsible on our part if we did not at least debate some of the key issues as a committee.

· (1320)

[Translation]

Mr. Réal Ménard: We will therefore do this in September, when we come back.

[English]

The Chair: I think we could do it next week.

Mr. James Lunney: A lot of members aren't going to be here next week.

The Chair: That will be their choice.

Mr. Reg Alcock: That's their responsibility.

The Chair: They will lose their right to vote on this.

Mr. Reg Alcock: That would be fine by me.

Mr. Réal Ménard: No, no. The government will not decide....

[Translation]

You are not going to decide alone on the tabling of the report. If you want to work on your own, we will simply go away and let you work by yourselves, but if we are working as a committee, you must take into account the reality of the committee.

Mr. Réal Ménard: First of all, there is no steering committee here, and in September, things will have to change.

[English]

The Chair: I understand, Mr. Ménard. If you have to go away next week with the drug committee to Europe, you're going to be working, aren't you? Madame Picard sat through all of these hearings with us. Could she replace you on this?

[Translation]

Mr. Réal Ménard: That is not the issue. I want to know if you wish for us to adopt the report next week. We could decide to adopt it, but I do not want to be told by the government members, especially those who have not necessarily participated in all of the discussions, that we will [Editor's note: Inaudible] the process because that is what you want. Either we work in committee or we do not work in committee. We could come back in the month of September and discuss this. We could decide amongst ourselves, just as we could decide next week to adopt the Bill, but it must be a decision of the committee. In certain instances, with regard to witnesses and questions, you have hustled us along a little bit, but upon our return in September, the first thing we should do is set up a steering committee. I find it unacceptable that there be eight witnesses at the same and that we only have three minutes. You have rushed us along, and I accept this, but if we want things to come to fruition... That is reality.

[English]

The Chair: Mr. Ménard, a week ago you said you had only a very few amendments. You said very clearly, in this committee, that you only had a very few amendments--

Mr. Réal Ménard: Oui, c'est vrai.

The Chair: --and that you would like to do it as quickly as possible--

Mr. Réal Ménard: Oui.

The Chair: --and you thought we could do it before the House rose.

Mr. Réal Ménard: Oui.

The Chair: But now you're giving me a completely opposite view. How can I operate with that?

[Translation]

Mr. Réal Ménard: No, not at all. Please understand me. What I am saying is that as far as hearing witnesses is concerned, the process has been extremely quick and not always fair. For my part, I was never consulted with regard to our hearing seven or eight witnesses at the same time. You were able to decide upon that because we have no steering committee. First off, in September, we will set up such a committee, and then we will work with all of the representatives of the different parties.

My other point is that I want us to pass the bill quickly, given that we are in agreement as to its content. I do not want us to stall. But if the House adjourns on Tuesday, will we move quickly on clause by clause to adopt the bill on Monday, or will we hold a discussion? It is wrong to say that we can hold a discussion... I indeed would like to see us pass the bill quickly, but I want us to do things properly.

[English]

The Chair: You wanted to move quickly. I'm telling you we can't move ahead without your cooperation. If you want to have amendments, you have to get them in. If the amendments come in, they're translated, they're in legislative language, and they're back to the clerk for presentation to the committee, and then we can do clause-by-clause. So everything will depend on the activity level of the members of this committee.

Mr. James Lunney: There are a lot of important issues we're going to have to discuss, like changes that have come up even today and in the last few days of witnesses, on the open donation system. We're going to have to consider that whole issue.

The Chair: We don't have to consider it. Somebody has to make an amendment and then we have to debate it as we do clause-by-clause.

Mr. James Lunney: Exactly, but it takes time to come up with the wording for those amendments and work that through. It's the same thing with discussions on the agency. Some very important discussions have come up on the composition of that agency. What we have in the bill right now is certainly not what we envisioned--even what we've heard today.

There's the other issue of the language in the preamble. It needs to be clarified in order to protect people with disabilities and the diversity of Canadians. These are important issues. Having come this far, if we rush it through in these last few days without adequate discussion, we won't be serving the interests of Canadians.

The Chair: There will be discussion when we go through clause-by-clause. There will be debate on those things, but the only way to debate them is to have amendments drafted by you people. You can say, you will do the preamble, and you will do this other thing. We can each take one, assign them, and come back to see if they fly. That's when we'll have the debate.

[Translation]

Mr. Réal Ménard: What will that change for the government?

[English]

Mr. James Lunney: That's not going to be possible here right now. Our health critic is out west right now, and I'm leaving this afternoon. It's not going to be possible.

The Chair: Dr. Castonguay.

[Translation]

Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.): Madam Chair, last week when we discussed this, we said that we would hear the witnesses we wanted to hear. Following that, and believing that we would be here until the 21st, we asked each member to prepare his or her amendments. Mr. Ménard told us that his party would not have very many, that he did not believe that there would be a ton of them.

We heard all of the witnesses whose names were on the list of witnesses we wanted to meet. I believe that we have reached the stage where each one of us must bring forward the amendments we wish to move. After that, we will have to begin our clause by clause study of the bill. If the House rises this afternoon, it is clear that we will not be here. How far will we be able to get? I do not know this any better than you, but this is my understanding of the agreement reached by us last week.

[English]

The Chair: We're not planning to hear any more witnesses.

Mr. Jeannot Castonguay: That's my understanding.

· (1325)

The Chair: We're finished. You will recall from the last time that it takes about three days to get amendments through the process. You have to give your wishes to the drafters.

If I had two things I cared about in this bill, before I went home for the weekend--probably tomorrow by noon--I'd hand my two ideas in to the drafters. If everybody did that, then there would at least be a chance.

[Translation]

A voice: But that is not possible.

Mr. Réal Ménard: But what will that change for the government? I am trying to understand. We will not be able to pass the bill at third reading between now and the end of the session. We all are in agreement on that. What is the difference between coming back in September with the amendments or passing them this week? In any event, we will not be able to table the report in the House next week if the House rises on Tuesday. There must be 48 hours notice in order to table a report in the House. What is the difference for the government, whether we do it now or in September? We are in favour of the bill; there is no problem there. But what will that change? We will not be able to pass the bill.

[English]

The Chair: It doesn't take 48 hours if they can get consent.

Mr. Szabo.

Mr. Jeannot Castonguay Just to answer that,

[Translation]

Madam Chair, we could find ourselves in September with new people around the table. I believe that that is a serious problem.

Mr. Réal Ménard: I will be here.

[English]

The Chair: Exactly. Even one new member makes a huge difference on this committee.

Mr. Szabo.

Mr. Paul Szabo: We have not heard from Dr. Nancy Irving, and I assume we've attempted but she can't come. Is that the idea?

The Clerk: It just wasn't practical.

Mr. Paul Szabo: Okay. But her recommendations were submitted at the request of the committee. I don't believe Mr. Ménard got them. They were to be translated, but it was going to take some time. Since the committee asked for it, all members should at least have the benefit of that clause-by-clause analysis and suggestions for changes. There was some work done on it.

The second point is that in today's testimony, many of the witnesses indicated they didn't have a chance to put on the record their full recommendations, but they were submitting to the clerk their information. I think it would be useful for the committee members to at least receive the written testimony before they were asked to consider amendments, because it is part of the testimony.

The Chair: But it is our second round with these people. They told us the same thing before.

Mr. Paul Szabo: But this is specific. I think Mr. Clemenger, Ms. Scorsone, and Ms. Boscoe spoke to specific clauses, and their thought processes and wording would be useful.

Finally, I have a feeling Health Canada is considering some changes as well. I think it would be helpful to committee members if Health Canada indicated the areas in which it would consider changes, because I think this committee did such a darn good job on the draft report--and so many people here said they wished the legislation reflected more of the draft report. It would be important for this committee to know where Health Canada is prepared to move, so this committee could take credit for making appropriate amendments to better reflect that report.

Given that this is the case, Madam Chair, I really think it would be helpful to the committee to once again, as one last kick before anybody starts doing a lot of work on amendments, at least to be aware of where there is a concurrence or consensus with regard to an area where changes could be made.

I personally have about ten amendments I would propose. I would like clarification on the calendarization of when I have to have them in so they would be in order before this committee in time for clause-by-clause.

The Chair: They would need to be in tomorrow.

Mr. Paul Szabo: Tomorrow?

· (1330)

The Chair: Yes.

I think your idea about trying to get Health Canada to decide...if Health Canada wants to submit some amendments, it will do so. If you want to, you have to. I'm not going to try to get into some negotiation with Health Canada. It has a position; it's called Bill C-56.

Mr. Paul Szabo: I understand. You have to take the line. I respect that.

Could I get an idea of when I can receive the material submitted by the witnesses today?

The Clerk: We probably can have the blues distributed by tomorrow.

An hon. member: Don't assume that this committee passes things just because--

Mr. Paul Szabo: No, no, but it was testimony. I just want the benefit of--

The Chair: You can get the blues by noon tomorrow.

Mr. Paul Szabo: No, no. They couldn't read it into the record.

The Chair: She said she wasn't going to, but she actually covered all her points.

Mr. Paul Szabo: Mr. Clemenger had pages.

The Chair: He had 31 points.

Mr. Paul Szabo: And I don't know what they are.

The Chair: Did he hand them to you, Mr. Clerk?

The Clerk: He did, yes. But the translation is going to take a while.

[Translation]

Mr. Réal Ménard: Madam Chair, will we not begin clause by clause tomorrow?

[English]

The Chair: Not tomorrow. I'm saying if you want the chance of doing it, you can have it.

Suppose we sit until the twenty-first--which is the only indication I have as yet--and suppose by Tuesday evening we could begin clause-by-clause. This would require that people who heard some of this testimony twice and have read information on it put on paper what it is they want. I'm just asking. Everybody has staff.

[Translation]

Mr. Réal Ménard: What we are telling you, Madam Chair, is that there are represented on this committee two parties that would prefer to do clause by clause when we come back in September. If you do not take that into account, you will have problems further down the road.

[English]

The Chair: That's not what you said last week.

[Translation]

Mr. Réal Ménard: Yes, but, Madam Chair, we are now Thursday. The passage of the bill is not a problem for us: we have five amendments. But given that we risk seeing our work interrupted as of Tuesday, it is not true that we will be passing the bill in the course of one day.

[English]

The Chair: Every step we get closer to the process brings this bill to fruition sooner.

[Translation]

Mr. Réal Ménard: But what is the difference? Answer my question.

[English]

The Chair: I can't deal with you giving me one set of ideas last week and a new set this week.

[Translation]

Mr. Réal Ménard: No, we have not changed our minds on this. In any event, if I want to change my mind, that is my business, not yours. What I am trying to tell you is that we are in favour of the bill and we want to work towards it quick passage. But if the House rises on Tuesday, it is not true that we will be able to adopt 56 reports in committee between Monday and Tuesday. What will that change for the government, given that it will not be possible to report this to the House next week? We will in any event not be able to table the report in order for it to be in the House next week. Whatever the scenario, that will not be possible. So why not resume our work in September and work more quickly.

Even if we worked in committee, I am convinced that the Canadian Alliance will not give its consent for the tabling of the report. So what does that change as far as the work of the committee is concerned? What is the difference for the government? We will not be adopting this on third reading next week. I do not want you to have the impression that we are against the bill. On the contrary, we are in favour of it. I have four amendments that I know by heart and that I could quickly explain, but as far as the government is concerned, there is no difference between our doing this next week or in September. This is what I fail to understand in your logic.

[English]

The Chair: We're not going to resolve this today. The clerk and I have to go to the committee to submit the budget. We were supposed to be there at one o'clock. If we don't, we can't pay the bills, so we have to go.

I'll have to check again with my House leader. As I said, I have no indication we're rising on Tuesday. We did the last bill with 220 amendments in exactly one work week or five working days. This one with, say, 20 amendments total, or even 25 or 30, we could do in one day, in my view.

Mr. James Lunney: Madam Chair, it is really not possible to adequately prepare our amendments until we've heard all the witnesses. We are not ready at this stage to proceed on Tuesday. We won't be ready to go that quickly into clause-by-clause.

With all due respect, I would like to move that we delay the continuation of the clause-by-clause until--

The Chair: We can't move anything; we don't have a quorum. That's why I'm going to adjourn the meeting. There's no quorum, and we can't have any final motions. I was just hoping for some cooperation.

This meeting is adjourned.