New reproductive technologies: The canadian perspective

Abstract

E ven though political and social institutions in the United States are not the same as in Canada and every society has to find its own way, both of our countries are faced with many of the same issues posed by reproductive technologies. The work of the Canadian Commission is of interest in this regard, but before it is described it is essential to set some context. Currently, we are in the midst of a worldwide knowledge revolution with regard to reproduction and to genetics, with knowledge and technology expanding rapidly. Reproductive technologies can now be used to monitor, to change, or to control many aspects of human reproduction. Some technologies permit reproductive methods that could not be undertaken by sexual intercourse. For example, a child can come from parents who have never met, from a parent who died years in the past, from a pregnancy of his grandmother, or indeed from a woman unrelated to him genetically. Prenatal detection of sex, and then selection by abortion, is now possible and, in fact, is widely used in some countries. How scientific knowledge about human reproduction is applied has the potential to change and affect how our societies view women, children, and procreation. Applying this knowledge to the human situation clearly raises many more issues than those related to health--it raises societal, ethical, legal, and economic issues as well. We cannot close our borders, we cannot set back the clock, and we are going to have to respond to this knowledge revolution. How we use these technologies, or indeed will not use them, will reveal what our priorities are, and what kind of societies we want to live in. Individual decisions regarding use of reproductive technology (such as in vitro fertilization or prenatal diagnosis) may be personally beneficial, yet have undesirable collective consequences. For example, if each couple can easily ensure that their first or only child is male, then a consequence in aggregate may be a very skewed sex distribution in the population. It is clear that scientific knowledge about human reproduction can be applied in many ways that may be in the interest of some individuals, but which may harm other individuals or groups. Reproduction and the formation of families is of central importance to © 1996 by The Jacobs Institute of Women's Health Published by Elsevier Science Inc. 1049-3867/96/$15.00 PII $1049-3867(96)00007-2