Saturday, March 14, 2009 - Posts
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sponsorship
Holly's eloquent post is a testament to the difficulties that beset legislators and ordinary people when it comes to thinking through the ethics involved in making policy regarding human embryos, stem cells, IVF treatment, and reproductive freedom. Congrats on your twin boys, Holly, and I sympathize with the difficulty of figuring out what to do with those frozen embies. Studies have shown that disposition of embryos is difficult and even agonizing for IVF patients, who at the end of it all want to do the right thing by any leftover embryos, often feel quite attached to them and/or responsible for their welfare, aren't quite sure whether to think of them as tissue, future children, wards, or what, and up to now, at least, have found it often logistically hard to donate them for research, because so few labs could take them. That's why there are about 500,000 frozen IVF embryos in storage around the country. I love the Georgia bill's title, "ethical treatment of human embryos." Given the evolution of that bill, ethical here seems to be a concept that can accept editing.
The bill seems mostly to be part of a periodic conservative effort on the state level to pass some kind of law that will equate embryos with people. I think this particular bill must be the result of two tides washing together. One impetus of course is octo-mom Nadya Suleman, whose eight premature babies are the result of an IVF treatment in which six embryos were transferred. (That eight babies were born is a result of the curious fact that IVF embryos split in two more often than other embryos do.) The other was the Obama administration's loosening of rules on federal funding for embryonic stem-cell research. Talking to people who follow this closely, I gather that in Georgia the Senate tried to put significant restrictions on in vitro fertilization, with some of the limitations that alarmed Holly, most notably a directive that would have essentially done away with embryo freezing, all of which which seems to me a confused attempt at defeating both the Sulemans and stem-cell researchers of the world by forbidding the creation of excess embryos. Infertility patients protested; the bill was modified to direct that (as near as anybody can tell) embryos can only be created with the intent of growing them into children, not using them for research. Meanwhile the Georgia House passed a bill entitling human embryos to the same adoption status children have. The two bills are not identical, and it's not clear they will get resolved. Both endeavor to secure elevated, person-y status for an embryo. I think Holly is right to be confused, because when vague measures are passed equating embryos with children and permitting (but not, I think, compelling) embryo "adoption," it raises a host of questions about the pesky details. MUST embryos be adopted, if they are "children?" CAN embryos be frozen, if they are "children?" If Georgia does pass a law, those details might have to be resolved through litigation.
It should be noted that is yet another bill in Missouri, before the House. It would direct IVF doctors to adhere to the American Society for Reproductive Medicine's guidelines on how many embryos may be transferred. This is a sane proposal. I think infertility patients should have the freedom to freeze embryos and decide what to do with the leftover ones—I also think they should be counseled in advance on how hard it might be—but I don't think they should have the freedom to choose how many are transferred during IVF. Or maybe they could choose within a very narrow range—like, one vs. two—but they shouldn't be able to treat the petri dish like some kind of all-you-can-use buffet.
Holly, your post raises an interesting question. You point out that Suleman is a single mom, but not infertile. This implies that people who aren't infertile but want to use reproductive technology may be in a different ethical category than people who are infertile. Should the non-infertile people be regulated differently? Suleman is a persuasive case if anybody is (though some articles have suggested that her many issues actually include infertility) but this is difficult ethical terrain. What about single women who sense that they are on the verge of infertility and use sperm donation, maybe combined with IVF, to conceive before it's too late? Are they not legitimate patients? Then again, 67-year-old IVF moms (or whatever the world's record is, now) are technically infertile. It's hard to draw the line, which is probably why we've found it so difficult to regulate this arena. Nontraditional patients, who include single women, gay men, and lesbians, sometimes are leery of any government involvement or laws or whatnot, for fear they could be excluded. They probably aren't wrong to worry.
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