By Tom Blackwell
It has triggered a boom in risky multiple births, created a generation of children with anonymous sperm-donor parents and spawned an underground trade in semen, eggs and surrogates.
Canada’s thriving fertility industry, however, will soon be left with virtually no official oversight, after the federal government decided this week to close down the oft-criticized regulatory agency for the field.
The government indicated in Thursday’s budget there is no point keeping Assisted Human Reproduction Canada (AHRC) open after a 2010 Supreme Court of Canada decision struck down much of the law it was supposed to enforce. The agency is slated to be shuttered by next March, its remaining functions taken over by Health Canada.
And though the court said large parts of the federal legislation fell under provincial jurisdiction, the provinces have shown little inclination to step into the breach.
Related
Meanwhile, the issues that a Royal Commission argued almost 20 years ago urgently required regulation continue to percolate: the commercial trade in sperm, eggs and surrogates; the multiple births generated by in-vitro fertilization; the effect on children of having unidentified donor parents; and the long-term health impacts of fertility treatment on women and their offspring.
“I think the whole debacle is shocking,” said Françoise Baylis, a Dalhousie University bio-ethicist and former member of the agency’s board.
“When you have a piece of legislation, you can choose to make it work or not, and I don’t see there having been any leadership,” she said. “There has been close to 30 years invested in terms of effort, energy and money [on the issue] and it’s all for naught.”
The problem is not just provincial inaction, she noted. Health Canada has yet to write crucial regulations under parts of the Assisted Human Reproduction Act the court left intact — eight years after the legislation came into force.
On top of all that, the RCMP now appears interested for the first time in investigating violations of the still-active sections of the law – a criminal ban on the purchase of eggs, sperm and surrogate-mother services – despite confusion about what the sections mean.
“It’s a mess,” said Sherry Levitan, a Toronto lawyer who specializes in the area. “The industry is just tied up in knots. Everybody is worried abut the next phone call. People are very nervous because nobody knows where the line is.”
Even the RCMP seem somewhat in the dark. Ms. Levitan said she received a phone call recently from an Alberta officer investigating an alleged violation of the Act, actually asking her for help in finding the relevant sections. The lawyer said she ended up giving the policewoman a primer on the topic’s hazy legalities.
If anyone steps in at the provincial level to regulate the fertility industry, it seems likely to be the regulatory agencies for the medical profession, said Juliet Guichon, a bio-ethicist at the University of Calgary.
In fact, the Alberta College of Physicians and Surgeons has already issued practice guidelines on in-vitro fertilization, but the terse document failed to address two key issues: multiple births caused by inserting more than one embryo in women, and keeping records on sperm and egg donors for the benefit of the future offspring, Prof. Guichon said.
Provincial governments — not just regulatory colleges — must get involved, she said.
“The law is sick here because where it’s being decided, where it’s being made, is not a forum that can take the broad public-interest view,” she said.
The human-reproduction Act came into force in 2004, the product of years of debate that started with the Conservative-appointed Royal commission on new reproductive technology. Its 1993 report recommended legislation and an agency to oversee it, saying there was “an urgent need for boundaries around the entire field.”
An agency finally opened its doors in 2006, but soon became a butt of complaints, seemingly achieving little of its mandate, while Prof. Baylis and two other board members quit in protest.
AHRC said it was hamstrung by the lack of regulations, while the government in turn said it had to wait for a Quebec court challenge of the law, which eventually resulted in the Supreme Court judgement.
The court said parts of the act dealing with the provision of fertility treatments and record-keeping by doctors fell under the provinces’ jurisdiction over health care and were unconstitutional, while other sections were still legal.
One former law-school dean called the confusing, 5-4 split decision the judges’ worst ruling of 2010.
National Post
Saturday, March 31, 2012
Canada Budget 2012: Government shutters agency that oversees Canada's fertility and assisted reproduction industry | News | National Post
Wednesday, March 28, 2012
Saturday, March 17, 2012
Thursday, March 15, 2012
Church in Quebec faces lawsuit on forced adoptions : Catholic World News
A Canadian attorney is bringing a class-action lawsuit against the Catholic Church in Quebec, charging that Church officials placed undue pressure on single mothers to offer their children for adoption.
Attorney Tony Merchant expects to file similar lawsuits against both Church officials and governments in other Canadian provinces. He argues that in the 1950s-60s, hospital staffers and social workers pressured single women to give up their babies. “The beliefs the Catholic Church had about premarital sex and the judgmental approach the Church had made it particularly aggressive in pressuring women into putting their children up for adoption," he charges.
Tuesday, March 13, 2012
Untreated depression and antidepressants may both affect unborn child - The Washington Post
THE QUESTION How might an unborn child’s development be affected if the mother takes antidepressants during pregnancy?
THIS STUDY involved 7,696 pregnant women, most of them 27 to 30 years old. Of the 669 women in the group who had symptoms of depression, 570 women took no antidepressants, and 99 took selective serotonin reuptake inhibitors (SSRI) antidepressants. During pregnancy, those in the SSRI group had fewer depressive symptoms than the other 570 women. All participants in the study had periodic sonograms to measure fetal growth, including body weight and head size, which is considered an indicator of brain development. Among the women with untreated depression, fetal growth overall was slower compared with the fetuses of all other study participants. Among women who took SSRIs, fetal weight gain was not different but head sizes were the smallest, on average; their babies also were twice as likely to be born prematurely. No link was found between symptoms of depression and below-normal birth weight.
WHO MAY BE AFFECTED? Pregnant women with depression. Among other concerns, women and their doctors have to balance the risks of not treating depression during pregnancy against possible side effects from the drugs.
CAVEATS Some of the data on SSRI use and depression symptoms came from the women’s responses on questionnaires. No antidepressants other than SSRIs were evaluated. Women taking SSRIs might have had more severe depression initially, which could have affected the results.
FIND THIS STUDY March 5 online issue of Archives of General Psychiatry (www.archgenpsychiatry.com).
LEARN MORE ABOUT women and depression at www.
nimh.nih.gov/health (click “publications,” then “women’s mental health”). For information about antidepressants, go to effectivehealthcare.ahrq.gov (search for “antidepressants”).— Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.
Tuesday, March 06, 2012
Lessons from the past – adoption isn't the answer to child protection
The release last Wednesday of the Senate’s Community Affairs Committee report on forced adoption resulted in almost unanimous condemnation of past adoption practices which saw young, unmarried women forced to give their newborns up for adoption. The question on everybody’s lips was how such cruelty could have been allowed.
One day earlier, an unrelated Victorian report was released that provides a very different take on adoption. The Protecting Victoria’s Vulnerable Children report recommends, among other things, the removal of barriers to adoption. This would allow more children to be placed for adoption, rather than being sent back to troubled families.
It’s ironic that two reports are released within a day of each other – one looking back critically at practices that promoted adoption and one looking forward that wants to increase rates of adoption. So is there a risk that the mistakes of the past could be repeated?
Parenting potential
The Victorian Inquiry argues adoption provides a child with a certainty foster care lacks. Therefore, in situations where there is no suitable family member to care for the child, he or she should be freed more easily for adoption.
If the adoption process was easier, the report suggests, more carers would be brought in to the system to fill the shortfall of foster parents.
But these recommendations assume that child protection workers can judge future parenting potential. And history shows this isn’t the case.
When legal adoption was first debated in the 1920s, politicians were well aware of the seriousness of the step they were taking. They conceded that circumstances could quickly change in the birth family or adopted family. The birth parents may come into an inheritance, or dramatically turn their lives around and be able to parent. On the other hand, the adoptive parents may fall on hard times.
These doubts disappeared over time. Social workers grew increasingly confident that they could predict who would make the best parent. By the 1950s, it was their view that young, single mothers were not in a position to support their children. It was therefore better to immediately separate the mother and child so the “girl” could “get on with her life”. And the child would find a home with a respectable married couple.
The Senate Committee heard convincing evidence that such confidence was sadly misplaced. What social workers saw as professional expertise, mothers condemned as injustice. People who were taken from an untested mother and placed in a family that turned out to be neglectful or abusive asked how adoption could have been in their best interests.
Apologising for past errors
The Committee was careful not to imply that such experiences were universal. Nevertheless, it recommended Commonwealth and state governments, church and community organisations apologise to those whose lives were harmed by adoption.
Counselling, memorialisation services, programs to improve records access and financial redress should be jointly funded by all those involved. These recommendations parallel services offered in the wake of previous apologies, although the government rejected financial redress.
The Committee’s report puts this alternative story of adoption onto the public record but argues that this history should not be confined to the past: “All those involved in current adoption practices … [should] take the findings … into account.”
The Inquiry notes that inter-country adoption (adopting children from abroad) is creating “supply chains” in some countries that are similar to those that operated in Australia. Adoption agencies have established maternity homes where single mothers have no choice but to relinquish their children. The Victorian recommendations, if implemented, have the potential to do the same.
Future risks
The Victorian Inquiry found no legislative barriers to increasing the number of children who adopted out, and could not understand why adoption was not more widely used. Perhaps the answer lies in an institutional memory of the practices condemned by the Senate report.
Our society produces very few children with no parents or extended family, even if their care is manifestly inadequate. What it does produce are families with multi-generational histories of poverty, neglect and abuse which leaves a legacy of the mental illness and substance abuse which lie at the base of most of the intransigent child protection cases.
And although these parents struggle with multiple problems, and are judged as a risk to their children, they don’t want to relinquish their parental rights.
A second danger is that freeing children for adoption would generate a demand, pressuring child protection workers to increase the supply.
Many of the problems of post-war new baby adoption arose from its very success. As more potential parents lined up at adoption agencies, social workers, consciously or unconsciously, increased the pressure on single mothers to consent to adoption. When mothers resisted, this pressure often moved towards coercion or even illegality.
We know that there is greater demand among adoptive parents for younger children. So what guarantees do we have that social workers will not succumb to similar pressure today? As the list of potential adoptive parents grows, it will not be easy to defend the right of a woman, whose other children are already in care, to have the chance to mother her new baby.
There’s no doubt that both children who cannot safely remain with their own families – and the substitute families who are prepared to offer them a home – need greater security than the child protection system is currently able to offer.
But does this justify the absolute break that adoption involves? Do social workers now possess the skills to decide unequivocally who will be the best parent for a child?
They certainly believed they did in the past, but the findings of the Senate report have shown conclusively that in too many cases they were wrong.