The Commissioner for Health and Well Being, Robert Salois, was asked in 2013 by the previous Canadian Government to evaluate the medically assisted procreation programme launched in Quebec in 2010. He now recommends certain revisions. Deemed too costly and responsible for “ethical spin-offs”, Health and Social Services Minister, Gaétan Barette is considering abolishing it.
Current thoughts are centred on the financial issues raised with this MAP programme. It will have cost 70 million dollars between 2012 and 2014. In view of budgetary constraints, the State cannot meet this expenditure in full. Several hypotheses are being investigated including the possibility of making the MAP service “partly public”, or even private. The Commissioner believes that this service should be maintained and available to all (infertile couples, homosexuals and single women) but with “clearly recognised boundaries”, such as a psychological assessment, an age limit and a limit to the number of IVF procedures per person, etc. He also suggests putting an end to “medical tourism”: only people with medical insurance in Quebec will have access to this programme. In particular, women who chose “voluntary sterilisation as a method of contraception” should personally finance their MAP.
The ethical issues are also mentioned. The report highlights that the extended access to MAP is increasing newborn infant hospital admissions to intensive care units, the number of multiple pregnancies, which “always pose more of a risk” and premature infants. Furthermore, Robert Salois would like to see a debate on surrogacy. According to the Commissioner, vital “emergency” data are missing, such as follow-up of the repercussions on the health of the mothers and children involved.
Gaétan Barette wants intervention “between now and the autumn”.