SCIENCE

Tinkering with Mother Nature

A controversial report on reproductivetechrlogies

MARK NICHOLS November 29 1993
SCIENCE

Tinkering with Mother Nature

A controversial report on reproductivetechrlogies

MARK NICHOLS November 29 1993

Tinkering with Mother Nature

SCIENCE

A controversial report on reproductivetechrlogies

She is 41 and has blocked fallopian tubes, a condition that normally makes it impossible for a woman to have a baby. Despite that, the Calgary art historian, who requested anonymity, and her husband are determined to have a child.

During the past two years, the couple have spent at least $25,000 for her to undergo in vitro fertilization (IVF) at Calgary’s Foothills Hospital. Last week, the woman completed her fifth cycle of treatment, which involves the use of drug to stimulate the production of extra eggs. Once that was done, her doctor pierced the wall of her vagina and drew out the eggs.

Laboratory technicians then used her husband’s I sperm to fertilize the eggs. After two days, up to three fertilized eggs, or pre-embryos, were ; inserted into the woman’s uterus. By week’s

end, she was waiting to see if, at last, she was pregnant. “We’ve got all our fingers crossed,” she said.

Until less than two decades ago, women unable to have children had only two choices: remain childless or try to adopt. But now, reproductive technologies ranging from IVF and artificial insemination to more complex techniques are allowing hundreds of infertile Canadian families each year to have babies. But the miraculous new techniques have raised troubling questions about medical science’s increasing ability to tinker with biological processes. On Nov. 30, Ottawa will release a report by the Royal Commission on New Reproductive Technologies that studied the techniques’ ethical, medical, legal, social and economic implications and will address the question of whether Canadian society should set limits on man’s ability to play God in the creation of human life.

The 1,328-page report, which makes 293 recommendations, is likely to urge the establishment of a government-backed central licensing

authority to oversee the work of fertility clinics and physicians who use the new technologies. As well, experts expect the report to suggest a ban or moratorium on some practices, such as commercial surrogate motherhood, in which women are paid to give birth to babies created from the eggs of infertile mothers. The document is almost certain to generate controversy, as did the commission itself, which took four years to complete its work at a projected cost of $28.2 million—making it the second-most expensive royal commission in Canadian history.

The commission, under Vancouver geneticist and pediatrician Patricia Baird, was also beset by internal feuding which in December, 1991, led then-Prime Minister Brian Mulroney’s Conservative government to take the unusual step of firing four dissident commissioners. Among them was Maureen McTeer, the high-profile lawyer and wife of then-Constitutional Affairs Minister Joe Clark. McTeer says that the trouble stemmed from Baird’s apparent belief that the commission’s task was simply to recommend how reproductive technologies should be managed. Other commissioners wanted to ask fundamental questions about the value of scientific developments that, said McTeer, “are challenging the very concept of what it means to be human.” According to McTeer, the dissenting commissioners were excluded from decision-making processes and denied access to information in the commission’s computer. But others insist that Baird encouraged a free expression of views. “Everyone was promised from the outset that they could express dissenting opinions in the final report,” said Suzanne Scorsone, a Toronto-based commission member. She added that the four commissioners who were fired were “seeking to control the administration of the commission, and that wasn’t their job.”

Now, a disparate array of interest groups, including feminists, disabled Canadians, pro-life groups and other organizations, are poised to denounce the report if its recommendations fall short of calling for strict controis on the use of technology that seems to promise flawless babies on demand and

challenge traditional concepts of parenthood. “These issues,” says Bernard Dickens, a professor of law who teaches in the University of Toronto’s Centre for Bioethics, “can be very emotional.”

Increasingly, scientists are using the new genetic and reproductive technologies to open up biological possibilities fraught with nightmarish ethical implications. Already, the new techniques make it possible for single women, lesbians and women in their 50s and 60s to have babies. Women in the United States and Italy have even given birth to their own grandchildren by carrying embryos formed from their daughters’ ovaries. Last month, research scien-

tists in Washington revealed that they had split 17 abnormal human embryos to produce 48 identical copies, or clones, of the originals. None of the human clones survived for more than six days, but the experiment triggered widespread debate

over the morality of such experiments—and opened up the prospect, among others, of women using stored frozen embryos to give birth to identical siblings years apart. Since the first in vitro baby was bom in England 15 years ago, the use of reproductive

technology has spread rapidly. According to a study released by the Baird commission in April, about 2,900 women were enrolled in IVF programs in Canada in 1991, resulting in 189 births, while 3,400 used artificial insemination in fertility clinics, leading to 360 births. The commission said that there was only one known case of surrogate motherhood in Canada in 1991. But experts say that private clinics in several Canadian cities quietly arrange for surrogate mothers to bear other women’s children. In its report, the commission is widely expected to call for legislation that would make it a crime for women to be paid for acting as surrogate mothers.

Its other proposals are expected to include a recommendation that Ottawa and the provinces back the establishment of a national supervisory body modelled on Britain’s two-year-old Human Fertilization and Embryology Authority, made up of doctors, scientists and government officials. Such a body could have responsibility for licensing fertility clinics, laying down operating rules and deciding what procedures could, or could not, be carried out. At present, Canadian clinics and physicians who use reproductive technologies are governed informally by guidelines laid down by professional medical associations.

The commission will also likely propose the establishment of regional IVF centres, with the treatment being covered by provincial medical insurance plans (currently, only Ontario pays part of the cost of in vitro procedures). The report will also contain proposals in several hotly disputed areas, including the growing medical use of fetal tissue in operations aimed at helping victims of Parkinson’s disease and other neurological illnesses, and the use of unwanted or damaged embryos for research purposes. In another controversial area, the commission is expected to propose that IVF and artificial insemination be made available to any woman who is medically and psychologically fit to have children, including single women and lesbians. Currently, clinics can make their own rules about whom they will help to have babies. Earlier this year, Edmonton’s gay and lesbian community criticized Dr. Josef Scott, the director of the University of Alberta Hospital’s infertility clinic, after he refused to artificially inseminate one member of a lesbian couple. Said Scott: “I’m not against lesbians, but I think a child should be brought up by a man and a woman.”

The report is certain to attract heavy fire if it ignores or brushes lightly over critics’ concerns. Many feminists argue that the technology reduces women to the status of mere child-bearers. They also question whether infertility should be considered an illness and covered by medicare—and whether millions of dollars should be spent on helping some women to have babies.

“There are so many other things we could be doing,” says Gwynne Basen, a Montreal writer and filmmaker who is a member of the Toronto-based National Action Committee on the Status of Women. “We could be providing more day care so that women could have babies earlier and looking into why so many women are infertile and why so many men have low sperm counts.”

Other critics worry that the growing role of reproductive technology and, in particular, the use of prenatal testing to identify flawed fetuses, which are often aborted, will have a dehumanizing effect on society. “What kind of society is it that wants us all to be blond-haired, blue-eyed and perfect?” said Joan Meister, a Vancouver-based

member of the DisAbledWomen’s Network of Canada.

In the end, the report is almost certain to disappoint some critics of reproductive technology by recommending that the most popular techniques be made more widely available, under more rigorous supervision. And it could be some time before Prime Minister Jean Chrétiens new Liberal government finds the time, or money, to act on some of the commission’s proposals. In the meantime, the would-be mother in Calgary—waiting to find out whether in vitro had finally made her pregnant—was unimpressed by feminist arguments against such techniques. “Some feminists,” she said, “claim that reproductive technology makes women into guinea pigs. I don't feel like a guinea pig. I feel fortunate that I live in a society where the medical profession may be able to make it possible for me to have a baby.”

MARK NICHOLS