Book Review: Fertility: 40 Years of Change

Several times each month, we are pleased to republish a recent book review from the Canadian Law Library Review (CLLR). CLLR is the official journal of the Canadian Association of Law Libraries (CALL/ACBD), and its reviews cover both practice-oriented and academic publications related to the law.

Fertility: 40 Years of Change. By Maureen McTeer. Toronto: Irwin Law, 2022. ix, 266 p. Includes glossary, bibliographic references, and index. ISBN 978-1-55221-637-8 (softcover) $39.95; ISBN 978-1-55221-638-5 (PDF) $39.95. <irwinlaw.com/product/fertility-40-years-of-change>.

Reviewed by Alexandra Kwan
Digital Services & Reference Librarian
Bora Laskin Law Library, University of Toronto

Fertility: 40 Years of Change is a retrospective look at the legal, medical, and research developments in assisted human reproduction (AHR) and in vitro fertilization (IVF) in Canada since 1978. This is reflected in the primarily chronological structure of the book, which is separated into short chapters focusing on significant developments in the history of AHR and IVF.

Author Maureen McTeer, an expert on health and medical law and public policy, was one of the original members of the federal Royal Commission on New Reproductive Technologies and is currently a visiting professor at the University of Ottawa. McTeer published a similar text 20 years ago titled Tough Choices: Living and Dying in the 21st Century (Toronto: Irwin Law, 1999). This expertise comes into play in several areas of Fertility marked with a “Comment” heading, under which McTeer provides her insight and analysis to help readers understand the significance of the legal and scientific developments in IVF and AHR. In her closing chapters, she makes brief suggestions on how to address the outlined public policy challenges in AHR and embryo research.

Fertility begins with a page-long prologue containing a fictional scenario of artificial insemination by a medical professional without consent. McTeer originally drafted this scenario as a teaching aid to challenge her students to identify medical, legal, and ethical issues. The text then continues in four parts. Parts 1 and 2 address the history of AHR and the work of federal, provincial, and territorial drafters to amend provincial family laws. Part 3 describes the research conducted on human IVF-created embryos. It also provides an overview of scientific concepts and legal aspects of stem cell research, genetic testing, and genome editing. Part 4 concisely outlines eight issues that policymakers should soon address.

The book has six appendices: a table summarizing what treatments and procedures are covered by each province and territory’s public healthcare plans; a section-by-section breakdown of the 2004 Assisted Human Reproduction Act (AHRA), showing amendments and in-force dates; a list of regulations that fall under AHRA and when they were in force; case summaries of two tax cases that address embryos and organs; provincial and territorial definitions of “tissue”; five case summaries pertaining to consent and refusal; and seven case summaries addressing the embryo as property.

McTeer is explicit about the intended audience for this book. She states in the preface: “It is written principally as an informational tool for the lay public, including the legislators who will decide future public policy and laws in these areas” (p. 1) [emphasis added]. The book concludes with a reminder of its intended audience and a call to action for meaningful participation by members of the public in public policy discussions on AHR: “I offer this book in the hope that the reader will feel informed enough to participate as an equal partner in the discussions about and resolution of these challenges” (p. 176).

Fertility would be a useful addition to public library collections. This slim, accessible volume is written in plain language and is punctuated with excerpts from pertinent legislation, highlights from report recommendations, and diagrams to illustrate biological concepts. The final third of the book contains an appendix, notes, a glossary, and citations for further reading, all of which provide entry points for readers to quickly get informed and start their research on AHR and IVF. However, for a more fulsome and scholarly analysis of AHR, researchers may turn to Trudo Lemmens et al’s Regulating Creation: The Law, Ethics, and Policy of Assisted Human Reproduction (Toronto: University of Toronto Press, 2017).

Fertility may also provide insight to family law practitioners and policymakers seeking an updated snapshot of the legal landscape, since there have been substantive changes since the publication of Glenn Rivard and Judy Hunter’s The Law of Assisted Human Reproduction (Markham, Ont: LexisNexis, 2005), notably the Reference re Assisted Human Reproduction Act, 2010 SCC 61, which struck down parts of the AHRA in 2010.

Fertility: 40 Years of Change offers a glimpse of the future of IVF. We can imagine that the next 40 years will be as eventful as the last.