In December 2022, the Supreme Court of Canada heard arguments in a reference case about the constitutionality of An Act respecting First Nations, Inuit and Métis children, youth and families (the Act). At issue is whether the Act infringes on provincial jurisdiction and changes the constitutional architecture by giving First Nations law governing child welfare the force of federal law. In this short Currents article, we argue that the Supreme Court's consideration of the Act marks a critical juncture in the ongoing relationship between Canadian and Indigenous law. Through an examination of the arguments made before the Supreme Court, we assert that it is essential that the Court move beyond its historical commitments to protecting the Constitution and umpiring jurisdictional disputes and toward a recognition of the failures of the constitutional framework to account for an expansive understanding of inherent rights and inherent jurisdiction, including child welfare.

The recognition of a health care service as medically necessary under the Canada Health Act is contingent on a variety of practical and political factors. This article examines how in vitro fertilization (IVF) came to be understood as a medically necessary service in Ontario, focusing on the establishment of public funding for one cycle of treatment. The article argues that the legitimacy of medical necessity in the contemporary period is tied to three interrelated factors: the recognition of a service as sufficiently “medical,” as efficient and as urgent—that is, something to be funded now and not later. By applying this framework to the case of IVF in Ontario, the article demonstrates not only the ongoing malleability of medical necessity but also how the government of Ontario has mobilized the three aspects of medical necessity to make a case for the public funding of a highly contested health care service.

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.