Health and safety of Canadians

Updated - 2004

One of the key goals of the assisted human reproduction (AHR) legislation is to protect the health and safety of Canadians, particularly those undergoing AHR treatments in Canada, and children born from such procedures. The legislation will ensure that Canadians who walk through the doors of fertility clinics anywhere in Canada do so knowing that a rigorous system of licensing, monitoring, inspection and enforcement is in place.

Protecting Canadians

There are many aspects of the AHR legislation which will ensure the health and safety of Canadians.

The prohibited activities (listed in sections 5-9 of the Act) are those activities considered ethically unacceptable and/or which may pose significant human health and safety risks to Canadians. These activities will not be allowed anywhere in Canada. Prohibitions include human cloning, genetic alteration and the commercialization of reproduction. The Act contains significant penalties for the contravention of any of the prohibitions.

The legislation also establishes controlled activities - activities that are prohibited unless carried out pursuant to a licence and in accordance with the regulations. The Act creates the Assisted Human Reproduction Agency of Canada (AHRAC or "the Agency") which will oversee the area of AHR and related research in Canada. The legislation requires anyone performing procedures to obtain a licence and follow the regulations.

Section 2 of the Act sets out the broad principles on which the Act and future regulations are based. Under the Declaration of Principles, the Parliament of Canada recognizes that:

• The health and well-being of children born as a result of AHR technologies must be given priority in all decisions respecting their use.
• Assisted human reproduction technologies and related research can benefit individuals, families and society but only if appropriate measures are taken to protect and promote human health and safety, dignity and rights in the use of those technologies and related research.
• While all persons are affected by AHR, women are more directly and significantly affected by these technologies than men, and women's health and well-being must be protected in the application of these technologies.
• Free and informed consent must be promoted and applied as a fundamental condition for the use of these technologies.
• Persons who seek to undergo assisted reproduction procedures must not be discriminated against.
• The health and ethical concerns inherent in commercializing the reproductive capacities of women and men, as well as in exploiting children, women and men for commercial purposes, justifies prohibiting such trade and exploitation.
• Human individuality and diversity, as well as the integrity of the human genome, must be preserved and protected.

Protecting the health and safety of users of AHR technologies and their children

There is currently no national reporting mechanism to collect information on AHR treatments and outcomes. Through the legislation, the Agency will be now be able to do this, providing information to those considering undergoing AHR procedures so that they can make more informed decisions.

There is a growing understanding of the role parental medical histories and genetic information can play in predicting, preventing and treating medical conditions. At the moment in Canada, there is no consistency as to what information, if any, individuals undergoing procedures using donated gametes (sperm or eggs) or embryos are provided about the donor. The AHR legislation will ensure that, in cases where donor sperm, eggs or embryos are used, individuals undergoing treatment must be provided with the donor's non-identifying health reporting information. Any child born from such treatment would be able to access this information. Identifying information would only be released with the written consent of the person to whom it relates.

A growing concern amongst physicians and health care policy makers is the increasing number of multiple births (birth of more than one baby from a pregnancy) associated with AHR. The Agency will work with relevant stakeholders to develop guidelines to reduce the risks of multiple births and will ensure that information be made available to prospective patients outlining the risks of multiple pregnancy and multiple births.

As new AHR technologies are developed, it will be important for the Agency to understand any potential risks posed to women and their children. The Agency will ensure that untested medical procedures do not become common medical practice without the scientific data to support their safe application. For example, despite the development of improved egg freezing techniques, little data exist as to the safety of this procedure for women and any resultant children. Much research is required before this becomes clinical practice.

Protecting against the commercialization of human reproduction

The Government of Canada recognizes the health and ethical concerns inherent in the commercialization of the reproductive capacities of women and men, including the exploitation of children, women and men for commercial ends. As such, the AHR legislation prohibits the commercialization of human reproduction.

The legislation prohibits the payment of a woman to become a surrogate mother, and to any person willing to arrange the services of a surrogate mother. Allowing commercial surrogacy arrangements might lead to the inducement of women to enter into a surrogacy agreement purely for financial gain. The legislation does not, however, prohibit altruistic surrogacy arrangements and it allows for the reimbursement of reasonable expenses, including compensating the surrogate for loss of work-related income during the pregnancy if continuing to work may pose a risk to her health or to that of the developing foetus.

The AHR legislation also prohibits the purchase of sperm or eggs from a donor, and the purchase or sale of an in vitro embryo. Altruistic donation is in keeping with the Canadian tradition and practice whereby human organs or tissues are donated, rather than sold or purchased, for the use of those in need. The Act will allow for the reimbursement of receipted expenditures incurred in the course of making a sperm or egg donation (section 12), in accordance with the regulations and a license.