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Risky Business: Surrogacy, Egg Donation, and the Politics of Exploitation

  • Alana Cattapan (a1)
Abstract

This article examines exploitation as a policy rationale for the prohibition of paid surrogacy and egg donation in Canada, focusing on claims of exploitation in parliamentary transcripts and proposed legislation. Its main focus is challenging three assumptions long used to substantiate the prohibition of commercial egg donation and surrogacy, namely: that marginalized women are being exploited; that payment and exploitation are necessarily linked; and that prohibitions on payment are the best means to prevent exploitation in assisted human reproduction. By examining these assumptions, this article assesses the legitimacy of prohibiting payment on the basis of perceived exploitation and suggests that, though much has been done to protect surrogates and donors, little is known about their real-life experiences with reproductive technologies, that the relationship between exploitation and payment is tenuous, and that it remains unclear that prohibiting payment is not doing more harm than good.

Cet article examine comment l’exploitation sert à justifier l’interdiction de rémunérer la gestion pour autrui et le don d’ovules au Canada, en portant une attention toute particulière aux allégations d’exploitation au sein des transcriptions parlementaires et des projets de loi. Il remet en question trois hypothèses qui ont depuis longtemps été utilisées afin de justifier l’interdiction de la gestion pour autrui commerciale et du commerce des dons d’ovules, à savoir que les femmes marginalisées sont exploitées, que la rémunération est liée nécessairement à l’exploitation et que la meilleure façon de prévenir l’exploitation liée à la procréation assistée est d’interdire la rémunération. En examinant ces suppositions, cet article évalue la légitimité d’une telle interdiction sur la base d’une exploitation présumée. Bien que plusieurs mesures aient été mises en place afin de protéger les mères porteuses et les donneuses, peu est connu à propos des expériences réelles avec les techniques de procréation assistée. Le lien entre l’exploitation et la rémunération demeure précaire et il reste à savoir si le fait d’interdire le paiement cause plus de mal que de bien.

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1 Julie Murphy, “Egg Framing and Women’s Future,” in Test-Tube Women, edited by Rita Arditti, Renate Duelli Klein, and Shelley Minden (London, UK: Pandora, 1984), 68–75; Robyn Rowland, “Of Women Born, But for How Long? The Relationship of Women to the New Reproductive Technologies and the Issue of Choice,” in Made to Order: The Myth of Reproductive and Genetic Progress, edited by Patricia Spallone and Deborah Lynn Steinberg, Athene Series (Oxford, UK: Pergamon, 1987), 77; Elaine Hoffman Baruch, “A Womb of His Own,” in Embryos, Ethics, and Women’s Rights, edited by Elaine Hoffman Baruch, Amadeo F. D’Adamo Jr., and Joni Seager (New York: Haworth Press, 1988), 136; Janice G. Raymond, Women as Wombs: Reproductive Technologies and the Battle over Women’s Freedom (New York: HarperCollins, 1993); Susan Sherwin, “Some Reflections on ‘Surrogacy,’” in Misconceptions: The Social Construction of Choice and the New Reproductive and Genetic Technologies, edited by Gwynne Basen, Margrit Eichler, and Abby Lippman (Prescott, Ontario: Voyageur, 1994), 184.

2 Margaret Atwood, The Handmaid’s Tale (Toronto: McClelland and Stewart, 1985).

3 Allan Hutchinson and Derek Morgan, “Rent-a-Womb: Society’s Dilemma,” Globe and Mail, December 11, 1984; Daniel Drolet, “Wombs for Rent: The Dilemma of Surrogate Motherhood,” Ottawa Citizen, January 31, 1987; Derek Ferguson, “Ottawa May Ban Human Eggs Sale Minister Vows to End ‘Exploitation’ of Women in ‘95,” Toronto Star, December 13, 1994, Metro section; Penni Mitchell, “The Selling of Human Eggs,” Winnipeg Free Press, January 14, 1996, Editorial; Dennis Bueckert, “Plenty of Wombs for Rent: Surrogate Motherhood Phenomenon Growing in Canada, Advocates Say,” Winnipeg Free Press, May 31, 1999, Metro section; Hilary Stead, “Guelph Woman Has Womb for Hire: [Final Edition],” Expositor, July 31, 1999, Life section.

4 Gena Corea, The Mother Machine: Reproductive Technologies from Artificial Insemination to Artificial Wombs (New York: Harper and Row, 1985).

5 Murphy, “Egg Framing and Women’s Future,” 68.

6 Throughout this paper, the term “egg donation” is used to describe the provision of eggs (oocytes) both for pay and when no money is exchanged. “Commercial egg donation” is used to indicate that the “donation” occurs for payment. “Altruistic egg donation” is used to identify arrangements where no money is exchanged. The use of the term “donation” follows popular parlance, though some scholars use “egg provision” to indicate that the language of “donors” and “donations” is often inaccurate, as many donors are, in fact, paid. See, for example, Downie, Jocelyn and Baylis, Françoise, “‘Transnational Trade in Human Eggs: Law, Policy, and (In)Action in Canada,” Journal of Law, Medicine & Ethics 41, no. 1 (2013): 224–39.

7 Young, Alison Harvison and Wasunna, Angela, “Wrestling with the Limits of the Law: Regulating Reproductive Technologies,” Health Law Journal 6 (1998): 239–77.

8 Exploitation is not the only policy rationale used to legitimate the prohibition of commercial surrogacy and egg donation in Canada. The Government of Canada introduced the non-payment provisions of the Assisted Human Reproduction Act on the grounds that it would limit exploitation, and also limit the commodification of human life and reproductive capacity. Anne McLellan, [Assisted Human Reproduction Act], in Canada, Parliament, House of Commons, Debates, 37th Parl, 1st Sess, Vol 137, No 188 (21 May 2002) at 11523. Furthermore, Angela Campbell has argued that the use of criminal law to prohibit (rather than to merely regulate) matters such as payment for gamete donation and surrogacy served to identify the ethical importance of these matters to Canadians. Campbell, Angela, “A Place for Criminal Law in the Regulation of Reproductive Technologies,” Health Law Journal 10 (2002): 9698.

9 Reference re Assisted Human Reproduction Act, 61 SCR 457 (Supreme Court of Canada 2010).

10 Baylis, Françoise, “The Demise of Assisted Human Reproduction Canada,” Journal of Obstetrics and Gynaecology Canada 34, no. 6 (2012): 511–13;Baylis, Françoise and Downie, Jocelyn, “The Tale of Assisted Human Reproduction Canada: A Tragedy in Five Acts,” Canadian Journal of Women and the Law 25, no. 2 (2013): 183201.

11 Cattapan, Alana and Cohen, Sara, “The Devil We Know: The Implications of Bill C-38 for Assisted Human Reproduction in Canada,” Journal of Obstetrics and Gynaecology Canada 35, no. 7 (2013): 654–56.

12 Downie and Baylis, “The Transnational Trade in Human Eggs,” 229. See also Françoise Baylis and Jocelyn Downie, “Wishing Doesn’t Make It So,” Impact Ethics (blog), December 17, 2013, http://impactethics.ca/2013/12/17/wishing-doesnt-make-it-so/; Françoise Baylis, Jocelyn Downie, and Dave Snow, “Fake It ‘Til You Make It: Policymaking and Assisted Human Reproduction in Canada,” Journal of Obstetrics and Gynaecology Canada, forthcoming 2014.

13 Alison Motluk, “The Human Egg Trade: How Canada’s Fertility Laws Are Failing Donors, Doctors, and Parents,” The Walrus, 2010, walrusmagazine.com; Ubaka Ogbogu and Erin Nelson, “Trade in Human Eggs Not Unethical: Clear Rules Needed to Prevent Exploitation of Participants,” Edmonton Journal, May 16, 2012, Final edition, Ideas section; Tom Blackwell, “Illegal Surrogacy; Rare Fertility Charges Expose Lax Oversight of Baby Making Industry,” National Post, February 16, 2013, News section.

14 Campbell, Angela, “Law’s Suppositions about Surrogacy against the Backdrop of Social Science,” Ottawa Law Review 43, no. 29 (2012).

15 Egg donation is the practice of retrieving eggs from the ovaries of one woman for reproductive use by another. The process of egg retrieval takes place over the course of several weeks and involves a course of hormones that stimulates the ovaries, causing the maturation of more eggs than usual, followed by an invasive surgical retrieval of those eggs. While the short-term health concerns of egg donation are significant, the long-term risks of egg donation are largely unknown due to a lack of longitudinal research. Concerns about exploitation in commercial egg donation are thus often tied to the idea that women (most often young women, due to matters of egg quality) will be compelled to undertake significant (and unknown) physiological risks in exchange for pay. See for example, Gruben, Vanessa, “Women as Patients, Not Spare Parts: Examining the Relationship Between the Physician and Women Egg Providers,” Canadian Journal of Women and the Law 25, no. 2 (2013): 249–83. Surrogacy (i.e., gestational surrogacy) involves the implantation of an embryo into the uterus of a woman with the intention that she will not raise any resulting child and will, instead, cede guardianship to the intended social parent(s) at birth. Because the risks of implanting embryos, pregnancy, and childbirth are well known, understanding exploitation in surrogacy is different from egg donation, insofar as informed consent is not seen to be a primary matter of concern. Rather, concerns about exploitation in commercial surrogacy are bound up with the potential for bonding in gestation, and the idea that women’s reproductive capacity as well as their behaviors in pregnancy may be governed through relevant surrogacy agreements. See for example, Elizabeth Anderson, Value in Ethics and Economics (Cambridge, MA: Harvard University Press, 1995), 186.

16 Harvison Young and Wasunna, “Wrestling with the Limits of the Law: Regulating Reproductive Technologies.”

17 Anderson, Elizabeth S., “Is Women’s Labor a Commodity,” Philosophy and Public Affairs 19 (1990); Corea, The Mother Machine, 213–45; Raymond, Women as Wombs.

18 Peter Singer and Deane Wells, The Reproductive Revolution (New York: Oxford University Press, 1984); Satz, Debra, “Markets in Women’s Reproductive Labor,” Philosophy & Public Affairs 21, no. 2 (April 1, 1992): 107–31.

19 Wertheimer, Alan, “Two Questions About Surrogacy and Exploitation,” Philosophy & Public Affairs 21, no. 3 (July 1, 1992): 211–39;Hill, John Lawrence, “Exploitation,” Cornell Law Review 79 (1993–1994): 631–99; Martha A. Field, Surrogate Motherhood : The Legal and Human Issues, Enlarged edition (Cambridge, MA: Harvard University Press, 1990).

20 Hill, “Exploitation,” 699.

21 Hill, “Exploitation”; Wood, Allen W., “Exploitation,” Social Philosophy and Policy 12, no. 2 (1995): 136–58; Wertheimer, “Two Questions About Surrogacy and Exploitation.”

22 John Pierson, “Exploitation,” in The New Fontana Dictionary of Modern Thought, edited by Alan Bullock and Stephen Trombley (London, UK: HarperCollins, 2000).

23 Alan Wertheimer, Exploitation (Princeton: Princeton University Press, 1999).

24 Robertson, John A., “Embryos, Families, and Procreative Liberty: The Legal Structure of the New Reproduction,” Southern California Law Review 59 (1985–1986): 1023; Wertheimer, “Two Questions About Surrogacy and Exploitation.”

25 Heather Widdows, “Rejecting the Choice Paradigm: Rethinking the Ethical Framework in Prostitution and Egg Sale Debates,” in Gender, Agency, and Coercion, edited by Sumi Madhok, Anne Phillips, and Kalpana Wilson (London, UK: Palgrave Macmillan, 2013), 167.

26 Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 6th ed. (New York: Oxford University Press, 2009), 256.

27 Marina Strauss, “Surrogate Birth Acceptable, Medical Ethics Expert Says,” Globe and Mail, May 21, 1983.

28 Canadian Medical Association, Proceedings of the 116th Annual Meeting, Including the Transactions of General Council (1983), at 128, resolution 83-23; Ontario Law Reform Commission, Report on Human Artificial Reproduction and Related Matters (Toronto: Ministry of the Attorney General, 1985), 221; “Surrogate Parenting and the Right to Life Debated,” CMAJ: Canadian Medical Association Journal 130 (January 1, 1984): 65; Sarah Jane Growe, “‘Radical Report’ on Surrogage Mothers,” Toronto Star, June 27, 1985, Life/Classified section; Sarah Jane Growe, “Surrogate Mothers: Legislators Haven’t Decided Whether They’re Humanitarians or Prostitutes,” Toronto Star, March 23, 1985, Life section; Hutchinson and Morgan, “Rent-a-Womb: Society’s Dilemma.”

29 Ontario Law Reform Commission, Report on Human Artificial Reproduction and Related Matters, 1.

30 Ontario Law Reform Commission, Report on Human Artificial Reproduction and Related Matters.

31 Ibid., 231–35.

32 Ibid., 169.

33 Ibid.

34 Ibid.

35 Catherine Dunphy, “Surrogate Mothers ‘Threat to Equality,’” Toronto Star, March 3, 1987, Final edition, Life section; Jackie Smith, “Surrogate Birth Laws Demanded,” Toronto Star, January 12, 1987; Robert McKenzie, “Quebec Urged to Ban Surrogate Motherhood,” Toronto Star, April 29, 1988; Margrit Eichler on behalf of the Steering Committee (Canadian Coalition for a Royal Commission on New Reproductive Technologies), “Letter to Coalition Supporters and Friends,” letter, November 1988; Canadian Coalition for a Royal Commission on New Reproductive Technologies, “New Reproductive Technologies in Canada: Some Facts and Issues” (Canadian Coalition for a Royal Commission on New Reproductive Technologies, March 1988), Canadian Women’s Movement Archives.

36 Canada, “Speech from the Throne,” 1989. See also, Canada, Order in Council No PC 1989–2150.

37 Royal Commission on New Reproductive Technologies, Proceed with Care: Final Report of the Royal Commission on New Reproductive Technologies (Ottawa: Minister of Government Services Canada, 1993), 670.

38 Ibid. See also Eichler and Poole, The Incidence of Preconception Contracts for the Production of Children Among Canadians: A Report Prepared for the Law Reform Commission of Canada.

39 Royal Commission on New Reproductive Technologies, Proceed with Care: Final Report of the Royal Commission on New Reproductive Technologies, 592.

40 Ibid., 593–94.

41 Health Canada, “Health Minister Calls for Moratorium on Applying Nine Reproductive Technologies and Practices in Humans,” news release, July 27, 1995; Éric Montpetit, “Policy Networks, Federalism and Managerial Ideas: How ART Non-Decision in Canada Safeguards the Autonomy of the Medical Profession,” in Comparative Biomedical Policy: Governing Assisted Reproductive Technologies, edited by Ivar Bleiklie, Malcolm L. Goggin, and Christine Rothmayr, vol. 32, Routledge/ECPR Studies in European Political Science (London and New York: Routledge, 2004), 66–67.

42 Edward Greenspon, “Ottawa Backs Off Test-Tube Issues: Marleau Prefers Voluntary Curb,” Globe and Mail, July 28, 1995; “Policy Experimentation in a Petri Dish: Health Minister Marleau Dithers on Curtailing Reproductive Technologies (Voluntary Moratorium on Nine Controversial Fertility Practices),” Western Report, August 14, 1995.

43 Baylis, Françoise and Herder, Matthew, “Policy Design for Human Embryo Research in Canada: A History (Part 1 of 2),” Journal of Bioethical Inquiry 6, no. 1 (2009): 114; “Fertility Industry Defiant: Won’t Observe Ban on High-Tech Baby-Making Techniques,” Hamilton Spectator, July 28, 1995, Final edition.

44 Health Canada, “Health Canada News Release: Human Reproductive and Genetic Technologies Act—Prohibited Practices (June 1996),” in Governing Medically Assisted Human Reproduction, edited by Lorna Weir (Toronto: Centre of Criminology, University of Toronto, 1997), 121–23; Health Canada, “Comprehensive National Policy on Management of New Reproductive and Genetic Technologies Proposed” (Health Canada, June 14, 1996).

45 Bill C-47, Human Reproductive and Genetic Technologies Act, 2nd Sess, 35th Parl, 1996.

46 Monique Hebert, Nancy Miller Chenier, and Sonya Norris, “Bill C-13: Assisted Human Reproduction Act (LS-434E),” 10 October 2002, revised 16 April 2003, 1, http://www2.parl.gc.ca/Sites/LOP/LegislativeSummaries/Bills_ls.asp?lang=E&Parl=37&Ses=2&ls=C13; Baylis and Herder, “Policy Design for Human Embryo Research in Canada,” 114; Montpetit, “Policy Networks, Federalism and Managerial Ideas,” 66.

47 Standing Committee on Health, Assisted Human Reproduction: Building Families (Ottawa: House of Commons, December 2001).

48 Ibid., 12.

49 Ibid.

50 Ibid., 13–14.

51 Canada, Assisted Human Reproduction Act (SC, c 2, 2004).

52 Ibid.

53 Ibid.

54 Reference re Assisted Human Reproduction Act, 2010 SCC 61 457.

55 Harvison Young and Wasunna, “Wrestling with the Limits of the Law: Regulating Reproductive Technologies,” 269.

56 Cattapan, Alana, “Rhetoric and Reality: ‘Protecting’ Women in Canadian Public Policy on Assisted Human Reproduction,” Canadian Journal of Women and the Law 25, no. 2 (2013): 210.

57 Anne McLellan [Assisted Human Reproduction Act], in Canada, Parliament, House of Commons, Debates, 37th Parl, 1st Sess, Vol 137, No 188 (21 May 2002) at 11523. See also Campbell, “Law’s Suppositions about Surrogacy against the Backdrop of Social Science,” 45.

58 Ibid.

59 Eichler and Poole, The Incidence of Preconception Contracts for the Production of Children Among Canadians: A Report Prepared for the Law Reform Commission of Canada.

60 Ibid.

61 Royal Commission on New Reproductive Technologies, Proceed with Care: Final Report of the Royal Commission on New Reproductive Technologies, 664–65.

62 Ibid., 673–74.

63 Ibid., 670.

64 Hedy Fry, [Human Reproductive and Genetic Technologies Act], in Canada, Parliament, House of Commons, Debates, 35th Parl, 2nd Sess, Vol 134, No 94 (31 October 1996) at 5946; Andy Scott, [Human Reproductive and Genetic Technologies Act], in Canada, Parliament, House of Commons, Debates, 35th Parl, 2nd Sess, Vol 134, No 94 (31 October 1996) at 5969.

65 Canada, Parliament, Standing Committee on Health, Evidence, 1st Sess, 37th Parl, Meeting No 41 (2001), http://www.parl.gc.ca/HousePublications/Publication.aspx?DocId=1041184&Language=E&Mode=2&Parl=37&Ses=1.

66 Canada, Parliament, House of Commons, Standing Committee on Health, Assisted Human Reproduction: Building Families.

67 Campbell, “Law’s Suppositions about Surrogacy against the Backdrop of Social Science.”

68 Ann Muriel Fisher, “A Narrative Inquiry: How Surrogate Mothers Make Meaning of the Gestational Surrogacy Experience” (master’s thesis, University of Victoria, 2012); Shireen Kashmeri, “Unraveling Surrogacy in Ontario, Canada. An Ethnographic Inquiry on the Influence of Canada’s Assisted Human Reproduction Act (2004), Surrogacy Contracts, Parentage Laws, and Gay Fatherhood” (master’s thesis, Concordia University, 2008).

69 Busby, Karen and Vun, Delaney, “Revisiting the Handmaid’s Tale: Feminist Theory Meets Empirical Research on Surrogate Mothers,” Canadian Journal of Family Law 26 (2010): 80.

70 Yee, Samantha, Hitkari, Jason A., and Greenblatt, Ellen M., “A Follow-up Study of Women Who Donated Oocytes to Known Recipient Couples for Altruistic Reasons,” Human Reproduction 22, no. 7 (2007): 2040–50.

71 Ibid., 2047.

72 Winter, Alanna and Daniluk, Judith C., “A Gift From the Heart: The Experiences of Women Whose Egg Donations Helped Their Sisters Become Mothers,” Journal of Counseling and Development 82, no. 4 (Fall 2004): 483–95.

73 Motluk, “The Human Egg Trade”; Alison Motluk, “Wanted: Egg Donor in Good Health,” Sunday Edition, CBC, February 19, 2012; Alison Motluk, “Is Egg Donation Dangerous?,” Maisonneuve, 2012; Alison Motluk, “Egg Donor Sues Doctor after Suffering Stroke; Could Not Walk; Accuses Clinic and Doctor of Negligence,” National Post, March 28, 2013, A5.

74 Canada, Parliament, House of Commons, Standing Committee on Health, Sub-Committee on Bill C-47, Human Reproductive and Genetic Technologies Act, Evidence, 2nd Sess, 35th Parl, Meeting No 5 (1997), http://www.parl.gc.ca/ content/hoc/ archives/committee/352/srta/evidence/05_97-03-20/srta-05-cover-e.html.

75 For further discussion of how the surrogacy debate related to the AHRA addressed payment and exploitation together, see Campbell, “Law’s Suppositions about Surrogacy against the Backdrop of Social Science,” 46–48.

76 Joe Volpe, [Human Reproductive and Genetic Technologies Act], in Canada, Parliament, House of Commons, Debates, 35th Parl, 2nd Sess, Vol 134, No 89 (23 October 1996) at 5614–15.

77 Young, Alison Harvison, “New Reproductive Technologies in Canada and the United States: Same Problems, Different Discourses,” Temple International and Comparative Law Journal 12 (1998): 80;Lessor, Roberta, “All in the Family: Social Processes in Ovarian Egg Donation Between Sisters,” Sociology of Health & Illness 15, no. 3 (1993): 393413; Yee, Hitkari, and Greenblatt, “A Follow-up Study of Women Who Donated Oocytes to Known Recipient Couples for Altruistic Reasons.”

78 Ruparelia, Rahki, “Giving Away the ‘Gift of Life’: Surrogacy and the Canadian Assisted Human Reproduction Act,” Canadian Journal of Family Law 23 (2007): 1154.

79 Harvison Young and Wasunna, “Wrestling with the Limits of the Law: Regulating Reproductive Technologies,” 269; Harvison Young, “New Reproductive Technologies in Canada and the United States: Same Problems, Different Discourses,” 80; Ruparelia, “Giving Away the ‘Gift of Life’: Surrogacy and the Canadian Assisted Human Reproduction Act,” 30.

80 Ruparelia, “Giving Away the ‘Gift of Life’: Surrogacy and the Canadian Assisted Human Reproduction Act,” 14.

81 Canada, Parliament, House of Commons, Standing Committee on Health, Evidence, 1st Sess, 37th Parl, Meeting No 44 (2001), http://www.parl.gc.ca/HousePublications/Publication.aspx?DocId=1041199&Language=E&Mode=1&Parl=37&Ses=1.

82 Gruben, “Women as Patients, Not Spare Parts: Examining the Relationship Between the Physician and Women Egg Providers,” 256–62.

83 Leah F. Vosko, “Rethinking Feminization: Gendered Precariousness in the Labour Market and the Crisis in Social Reproduction” (lecture presented at the Distinguished Robarts Lecture Series, Toronto, April 11, 2002), 46, http://robarts.info.yorku.ca/files/lectures-pdf/rl_vosko.pdf.

84 Allan C. Hutchinson, “Surrogate Motherhood: Why It Should Be Permitted,” Globe and Mail, July 12, 1985.

85 Hill, “Exploitation,” 680.

86 Canada, Parliament, House of Commons, Standing Committee on Health, Evidence, 1st Sess, 37th Parl, Meeting No 44 (2001), http://www.parl.gc.ca/HousePublications/Publication.aspx?DocId=1041199&Language=E&Mode=1&Parl=37&Ses=1.

87 Health Canada, Workshop on the Reimbursement of Expenditures for Egg and Sperm Donors (Ottawa, 2004), http://www.hc-sc.gc.ca/hl-vs/pubs/reprod/2005-donors-donneurs/index-eng.php.

88 Anand, Sanjeev, “Clones, Controversy, Confusion, and Criminal Law: A Reply to Professor Caulfield,” Alberta Law Review 40 (2002–2003): 493.

89 Campbell, “A Place for Criminal Law in the Regulation of Reproductive Technologies.”

90 Caulfield, Timothy, “Clones, Controversy, and Criminal Law: A Comment on the Proposal for Legislation Governing Assisted Human Reproduction,” Alberta Law Review 39 (2001–2002): 331.

91 Caulfield, Timothy, “Bill C-13 The Assisted Human Reproduction Act: Examining the Arguments Against a Regulatory Approach,” Health Law Review 11, no. 1 (2002): 2025;Dickens, Bernard, “Do Not Criminalize New Reproductive Technologies,” Policy Options 17 (1996): 11; Harvison Young and Wasunna, “Wrestling with the Limits of the Law: Regulating Reproductive Technologies”; Harvison Young, “New Reproductive Technologies in Canada and the United States: Same Problems, Different Discourses”; Young, Alison Harvison, “Let’s Try Again...This Time with Feeling: Bill C-6 and New Reproductive Technologies,” UBC Law Review 38 (2005): 123–45.

92 For more about the evolution of morality policy and AHR, especially concerning the effects and outcomes of judicial intervention, see Christine Rothmayr Allison and Audrey L’Espérance, “Morality Policies, Legal Mobilisation, and the Canadian Charter of Rights and Freedoms: Does Policy Determine Politics and Patterns of Judicialization?” (paper presented at the Annual Meeting of the American Political Science Association, Washington, DC, 2010); Snow, Dave, “The Judicialization of Assisted Reproductive Technology Policy in Canada: Decentralization, Medicalization, and Mandatory Regulation,” Canadian Journal of Law and Society 27, no. 2 (2012): 169–88.

93 Since its passage in 2004, the Assisted Human Reproduction Act has been implemented on one occasion. Leia Picard, the owner of Canadian Fertility Consultants, was charged in relation to brokering surrogacy and egg donation and was fined (in conjunction with her company) a total of $60,000. Motluk, Alison, “First Prosecution under Assisted Human Reproduction Act Ends in Conviction,” CMAJ: Canadian Medical Association Journal 186, no. 2 (February 4, 2014): E7576, doi:10.1503/cmaj.109–4687.

94 Gruben, “Women as Patients, Not Spare Parts: Examining the Relationship Between the Physician and Women Egg Providers,” 279; Busby, Karen, “Of Surrogate Mother Born: Parentage Determinations in Canada and Elsewhere,” Canadian Journal of Women and the Law 25, no. 2 (2013): 213–14.

* Faculty of Medicine, Dalhousie University. I would like to thank the anonymous peer reviewers and the journal editor for their helpful comments. Thank you also to Miriam Smith, Margrit Eichler, Christine Michaud, Audrey L’Espérance, and Elizabeth Schwartz for their notes on earlier drafts.

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