Pamela White

Measuring ethnicity: Is ‘Canadian’ an evolving indigenous category?

Abstract Measuring ethnicity in any society is a challenge. Given world immigration patterns, many countries face a growing dilemma in determining the cultural antecedents of their populations. A further complication is the reality that such determination occurs within the political and nationalistic settings where ethnic‐cultural groups may be potent forces in their own right. As societies mature and evolve, there is an increasing tendency for populations, especially those with many generations of residence in the country, to see themselves as ‘indigenous’ to the society in which they live. Canada is not alone in having to deal with the fluidity of the concept, ‘Canadian’, ‘American’, ‘Australian’, ‘Yugoslav’, and ‘Soviet’ are parallel concepts in other countries of multiple ethnic composition. Using 1991 National Census Test results, the article explores some of the parameters of the indigenous category ‘Canadian’. In particular, the location in Canada and mother tongue of respondents reporting ‘Canadia...

Hidden from view: Canadian gestational surrogacy practices and outcomes, 2001-2012

Abstract This paper raises some troubling questions about the fertility treatments provided to Canadian gestational surrogates, women not genetically related to the child that they carry. Using information published between 2003 and 2012 by Canada’s Assisted Reproduction Registry, the paper traces the growing incidence of births to gestational surrogates. The transfer of more than one embryo increases the chance of pregnancy and the incidence of multiple births, and while the incidence of multiple births has declined overall since 2010, gestational surrogates consistently experience a higher proportion of multiple births and experienced higher levels of multiple embryo transfers. In 2012, just 26% of gestational surrogates received a single embryo transfer compared to 47% of other in vitro fertilisation (IVF) patients. The paper suggests that renewed attention needs to be paid to the counselling provided to gestational surrogates and treatment consenting mechanisms used by IVF clinics and that review of the 2007 Canadian Medical Association surrogate treatment guidelines is warranted. Finally, the paper describes the difficulties in obtaining accurate data about Canadian assisted reproductive medicine. Without good data, it becomes far more difficult to identify the possibility of potentially harmful practices.

“One for Sorrow, Two for Joy?”: American embryo transfer guideline recommendations, practices, and outcomes for gestational surrogate patients

In January 2016, Melissa Cook, a California gestational surrogate experiencing a multiple-birth pregnancy following the in vitro fertilization (IVF) transfer of three embryos comprised of donor eggs and sperm provided by the intended father, went to the media when the intended father requested that she undergo a fetal reduction because twins were less expensive to raise than triplets. Much of the legal interest in this case to date has centered on the enforceability of surrogacy contracts. However, the Cook case also raises troubling issues about fertility treatment practices involving gestational surrogates, twin preference, and third-party reproduction medical decision-making. This paper focuses on multiple-embryo transfers in the context of US surrogacy arrangements. Offering an original analysis of data obtained from the US national-assisted reproduction registry, it examines single- and multiple-embryo transfer trends over a 12-year period (2003 to 2014). Findings reveal that recommended guidelines were followed in fewer than 42% of the cases in 2014. The paper argues that ensuring equitable medical treatment for all recipients of IVF requires the adoption of treatment guidelines tailored to, and offering protections for, specific patient groups, and that, once in place, guidelines must be robustly implemented.