Event Review: Administrative Review of Assisted Human Reproduction Canada

Last Tuesday, the embattled head of the Canadian federal assisted human reproduction agency, Assisted Human Reproduction Canada (AHRC), returned to defend herself before a Parliamentary committee.

This Parliamentary grilling was different from the one Dr Elinor Wilson experienced in June. Then, she deftly passed off a request for 'detailed budgets for 2007-08, 2008-09, and the current year' to the AHRC Board of Directors' Chair, Dr John Hamm. Dr Wilson, the current President of AHRC, also attributed her numerous trips on Canadian holidays to Vancouver, where her daughter reputedly lives, to the fact that the Agency is headquartered there.

Three former Board members spoke first at Tuesday's Parliamentary meeting. They each claimed to have resigned with great regret and only because they could not meet their responsibilities. They alleged that the Agency undermined its governing statute, the Assisted Human Reproduction Act, by funding research contrary to its aims, failed to provide the Board with the 2008-2009 budget, and offered insufficient information about the costs of an international conference and the award of consulting contracts in 2009-2010 valued at more than $2 million.

Professor Francoise Baylis, Canada Research Chair in Bioethics and Philosophy at Dalhousie University, who resigned in March this year, accused the Board of failing to abide by its stated values, 'excessive, unnecessary secrecy that undermines the public trust', and claimed that with the loss of members expert in law, ethics, policy and patient experience, the Board could not fulfil its mandate.

Professor Baylis, together with former members, Barbara Slater, a health policy analyst, and patient representative Irene Ryll, claimed that Dr Wilson acted in a domineering way. They said she engaged in acts of intimidation in board meetings including eye rolling, hand waving, 'tskying' and dismissive body language. They believed the Board could not learn, for example, what percentage of the budget was spent on board governance, why minutes were not posted online and why votes were not being recorded.

Though the Board had been in existence three years, Professor Baylis said: 'We never were at the point of debating any matters of substance'. Barbara Slater detailed allegations of Dr Wilson blocking substantive input by Board members into regulations. Ms Slater also spoke of her persistent resistance to input from Board members on matters of substance and process. Irene Ryll summed it up by saying: 'the Board is broken and is managed by the President'.

The Chair seemed only to add credibility to that claim. Dr Hamm, a respected former Conservative Premier of Nova Scotia and family doctor, said that he often receives emails two days after they are sent. He chairs two other boards and sits on yet two more. As a busy man without instant access to AHRC communication, the Chair must rely unusually heavily on the professionalism, ability and integrity of his President.

But the Agency President did not acquit herself well. Dr Wilson asserted: 'I have never disrespected my board members', whilst conceding that her friends find her expressive and that she does wave her hands. She had no strong answer to Member of Parliament, Ujjal Dosanjh, who wanted to know why she referred in a Board meeting to a user group - Lesbian, Gay, Bisexual, Transgendered and Queer people - as the 'BLTs' (a term that usually refers to a bacon, lettuce and tomato sandwich).

An investigation is underway into allegations that the Agency she manages shredded documents after the June Parliamentary Committee meeting. Mr Dosanjh is now calling for an independent investigation into the Agency itself.

So where does Tuesday morning's Parliamentary hearing leave Canada now, 17 years after the Royal Commission on New Reproductive Technologies' recommendation that a Canadian agency urgently be established to license and monitor the use of assisted human reproduction and enforce the law? In a very sorry state just when we need it most.

Canadian headlines announce almost weekly new problems created by assisted human reproduction. These include a British Columbia legal action to disclose the identity of a sperm donor; a Vancouver 'surrogate' forced to abort a Down's syndrome fetus; two Ottawa women demanding that their fertility doctor's DNA be tested to rule out him as the father; and a 60-year old woman who gave birth to twins in Calgary.

Canada needs ethical and effective leadership in this brave new world. It is not enough for the Agency leaders to lament the continued wait for a Supreme Court decision on constitutional issues. The unchallenged law that bans the purchase of sperm, egg, embryo and gestational capacity is simply not being enforced.

The Agency and its diminished Board must attempt to regain public trust by improving its practices, communicating those improvements and not engaging in misstatement. Can they do so?

After last Tuesday morning's testimony, the odds look poor.