It's not difficult to have an opinion about last week's birth of octuplets near Los Angeles.
The 33-year-old mother already has six children, aged seven and younger, one of whom is autistic. She is an unemployed student (ironically, with a degree in child and adolescent development) and lives with her parents (who recently filed bankruptcy) in a 1500 square foot three-bedroom house. All her children were conceived by IVF. She has hired a publicity agent, and seeks $2 million for an interview. Her mother, the grandmother of the babies, reports that her daughter is "obsessed with children" and was "just hoping for one more daughter." A friend mysteriously reported that the woman could afford the fertility treatments because she was paid for them.
Will the octuplets be the tipping point toward serious consideration of regulation for the assisted reproduction industry? Might the U.S. baby business be ready to leave its Wild West days behind?
Here are some comments reported in the media:
David Magnus, Stanford Center for Biomedical Ethics:
[I]f the octuplets were produced through in vitro fertilization, it would spotlight the poorly regulated infertility and reproduction field. "This is a huge problem," Magnus said. "You've got a virtually unregulated marketplace with tort law serving as regulation in the U.S."….The professional organizations should take a stricter line with doctors and clinics, he said. "They've been very loath to take that action." But "if you leave it up to the marketplace," he added, "there will be abuses."
Art Caplan, Center for Bioethics at the University of Pennsylvania (1, 2):
"She has a right to be left alone to decide for herself whether to have a baby. But that doesn't entitle you to the technology involved here."
"Anyone who transfers eight embryos should be arrested for malpractice."
Linda MacDonald Glenn, Women's Bioethics Project Scholar:
"Hopefully, this case will call attention to the need for regulation and oversight of Assisted Reproductive Technologies. Currently, we have a laissez-faire attitude towards ARTs and fertility clinics; we have trusted the doctors and clinics to regulate themselves, via the American Society for Reproductive Medicine - and this case demonstrates that we can no longer simply turn a blind eye."
M. Sara Rosenthal, bioethicist at the University of Kentucky's College of Medicine:
"[T]here's wide consensus from every single ethicist and fertility specialist that this was irresponsible and unethical to implant that many embryos. This is an outrageous situation that should not happen."
Dr. Geeta Swamy, assistant professor of obstetrics and gynecology at Duke University:
"But it really is still up to the individual physician. There aren't any laws or legal ramifications to it."
R. Dale McClure, MD, President, American Society for Reproductive Medicine:
"[T]ransferring eight embryos in an IVF cycle is well beyond our guidelines."
Sean Tipton, American Society for Reproductive Medicine spokesman (1, 2):
"While the early press coverage touted the successful delivery of the octuplets as a happy, joyful thing, high-order multiple births should never be considered a medical success story. A number of commentators are saying a woman with six kids should not be allowed medical treatment to have additional ones, and I think, at a common sense level, that makes good sense. However, to make that work, that means someone is going to start deciding for other people how, when and why they can have children. That's a very big step and one that we might not be prepared to take."
"We have no legal authority to stop someone from practicing."
Suleena Kansal Kalra, reproductive endocrinologist, University of Pennsylvania:
"It's a complete failure when something like this happens, a poor reflection of what we do...To put this many embryos back in a woman who is so young and had proven fertility is completely irresponsible."
Lynn Paltrow, Executive Director, National Advocates for Pregnant Women (via an email to Salon):
What I would check if I had the time is the extent to which coverage of this story - whether negative or positive - is framed as a question of ethics. When the pregnant woman is not brown or black and the drugs/technologies are provided by big pharma, the discussion focuses on questions of ethics. But if the issue is childbearing by low-income women of color, and the drug is homegrown/ illegal then the debate is a question of punishment through the criminal justice or civil child welfare system.... [W]omen who take fertility drugs and choose to carry three or more embryos to term often experience pregnancy loss and risk severe, lifelong harm to the children who survive."
Lisa Factora-Borchers at the blog of Bitch magazine:
"[I]f the feminist movements want to analyze her decision and talk about the ramifications of choosing this path of motherhood, I understand the need to pick the situation apart. What I don't understand is how her ability to choose is deemed wrong because she made a decision that most people would not have chosen. It's important to remember what women who came before us fought for and I'm pretty sure it was the right to choose not WHAT to choose. While we don't know all the circumstances, we know that she exercised a right that generations before us have fought so long for: accessible healthcare, reproductive health with knowledge, and, ultimately, the choice to make decisions about our own lives.
There's something to celebrate there."
Ann at the Feministing blog:
"That this was [the mother's] choice and she seems very happy, so that's that."
Richard Paulson, director of the fertility program at the
University of Southern California, who helped write the American Society for Reproductive Medicine guidelines:
"We're picking out this incredibly rare event, and all of a sudden, we
want to pass laws," says Paulson. "Would we write laws limiting the
size of someone's family to six? Would we write laws mandating
selective reduction?" he asks, referring to the option of aborting some
embryos if a high number successfully implant in the uterus.
"Restricting reproductive rights would be a minefield."
Brendan O'Neill, editor of Spiked:
"However, the implication behind the widespread denouncement of Suleman's doctors as 'irresponsible', 'negligent' and even 'criminal' is ominous indeed. Are we saying that doctors should decide which women are desirable for IVF treatment and which are not? That they should limit the choices of those women who are 'unmarried, unemployed' and who already have kids at home? And those who have 'no money, no job', too?"
Amy Tuteur, "The Skeptical OB":
"The "choice" is the decision to have an abortion, and it does not extend to any possible choice in reproductive ethics. That's why Nadya Suleman had a right to get pregnant, a right to terminate the pregnancy and a right to carry it to term. She had no right to deliberately conceive octuplets, however, and it is a misunderstanding of reproductive rights to claim that she did....
In the rush to protect abortion rights, people should not ignore the rest of medical ethics. The right to end a pregnancy does not confer the right to begin one using artificial means. The right to selectively reduce a multiple pregnancy does not confer the right to create a multiple pregnancy of any number of embryos. In fact, the right to control one's body does not confer the right to demand medical treatment of any kind if it is not medically indicated.
The "right to choose" is the right to choose to terminate a pregnancy; it does not confer a right to choose anything, even if it is a reproductive choice."
George Dvorsky, transhumanist:
Now, I'm a huge advocate of
reproductive freedoms and equal access to repro-tech, but something
clearly failed to happen here. In this case, the fertility clinic that
performed the procedure failed to exercise both restraint and common
sense. They also showed a complete disregard for guidelines - a strong
indication that, while regulation exists for repro-tech procedures,
it's not being enforced strongly enough. This needs to change...A
lassez-faire approach to repro-tech won't work to protect the interests
of those hoping to use these technologies and to protect those lives
that are created as a result.
Update: See more recent quotes (Feb. 10)
Posted in Jesse Reynolds's Blog Posts
CommentsAdd a Comment
Comment by watchdogonscience, Feb 5th, 2009 10:01am
Your comment section does not post public comments. Is this an software error or is this your policy? Please clarify or post so bloggers know what to expect.
Comment by watchdogonscience, Feb 5th, 2009 9:24am
Comment by Watchdog on Science
Why the IVF clinic gets to remain anonymous is just plain “bad medicine”. You can comment so much on the ethics of the situation, but without the facts, it is hard to know what to do or think about the situation. We need more transparency. The public should demand answers. The IVF clinic needs to come out of hiding. They have had enough time to rearrange their paperwork and get their eggs in a row. Come out, come out, where ever you are....
Comment by Debra Greenfield, Feb 4th, 2009 4:15pm
The comments are of interest for what they lack, a discussion of the per se IVF technology. I'm amazed by how much of the discussion is still about choice, not about medical safety or commercial motivations...and...
I'd love to know what Art Caplan believes should be the basis for the arrest of the practitioner, is he suggesting there should be a criminal statute?...does he know anyone else who should face arrest for "malpractice"....James Wilson???
Debra Greenfield, Postdoctoral Fellow
UCLA Center for Society and Genetics