Gingrich on IVF: Bad for Families, Bad for Bioethics
Scientists, reproductive specialists and andrologists had better prepare. If Newt Gingrich has his way (and wins the Presidency), he will have a whole new world in store for science and medicine.
Newt has revived the embryo debate in Republican politics, giving bioethicists a "walk-on role" as Michael Cook explains it. How successful he will be on keeping it on the radar is another issue altogether. It is just as likely that Newt may have just been pandering to the audience at the Exciting Idlewild Baptist Church in Florida, trying to secure votes that clearly were not enough to win the Florida Primary. Perhaps his views on IVF have been informed by his Catholic conversion.
Yet, Gingrich doesn't seem to have a well thought out plan for how to tackle the wild west of IVF research. His bold move? Appoint a commission about the ethics of assisted reproductive technology. My prediction: like other Republican appointed bioethics commissions before it, their recommendations will result in little change to actual practice or policy. This does not bode well for bioethics in the Gingrich administration.
His goal: to have more federal control over IVF clinics. Well that shouldn't be hard since there is virtually none now. Most people agree that IVF clinics should be more closely regulated. That is not what is concerning about his proposal.
His primary goal seems to be reducing the number of excess embryos created in the lab and prevent their disposal after the couple has conceived because, as Gingrich puts it, it amounts to "the use of science to desensitize society over the killing of babies."Never mind that the embryos sitting in excess storage for years eventually cannot be used by anyone. But Gingrich doesn't see it that way: "If you have in vitro fertilization you are creating life. And therefore we should look seriously at what should the rules be for clinics that do that because they're creating life," he says.
Get ready for Snowflake babies and increased demand on freezer space, if Gingrich wins the nomination and the general election. At last count nearly 400,000 excess embryos were sitting in freezer storage around the US. And that was in 2003. IVF procedures have only increased in frequency since then. Gingrich's position would only exacerbate that problem.
Another problem that Gingrich hasn't considered is the fact that if procedures involving the creation of embryos are changed with the goal of reducing the number of excess embryos IVF is likely to become even more costly for couples trying to conceive, pricing many couples out of the market. With IVF success rates being in the range of 20-30 percent (approximately one in four fertilized eggs results in a pregnancy), this may mean that the average cost of one IVF cycle ($12,000) should have be paid for 2, 3 or 4 times before a woman can conceive. The only sensible way to reduce the number of embryos left over is to create less of them in the first place. Making embryos one at a time would be even more costly for the to-be parents and prolong the agony of waiting to learn if one can have a child.
Gingrich's stance on IVF clinics would make it harder for couples to conceive through IVF generally. It would become more agonizing, more expensive, and likely more rare that women could conceive using ART. Some regulation and oversight (more than we have now in the US) would be ideal. But making the process of creating a family in the lab shouldn't be any harder and emotionally draining than it already is. For a candidate who espouses family values, it is more than ironic that Gingrich would try to stand in the way of those who would do anything to have a child. It's just wrong.
Summer Johnson McGee, PhD
Gingrich on IVF
Scientist, reproductive specialists and andrologists had better prepare. If Newt Gingrich has his way (and wins the Presidency), he will have a whole new world in store for science and medicine.
Newt has revived the embryo debate in Republican politics, giving bioethicists a "walk-on role" as Michael Cook explains it. How successful he will be on keeping it on the radar is another issue altogether. It is just as likely that Newt may have just been pandering to the audience at the Exciting Idlewild Baptist Church in Florida, trying to secure votes that clearly were not enough to win the Florida Primary. Perhaps his views on IVF have been informed by his Catholic conversion.
Yet, Gingrich doesn't seem to have a well thought out plan for how to tackle the wild west of IVF research. His bold move? Appoint a commission about the ethics of assisted reproductive technology. My prediction: like other Republican appointed bioethics commissions before it, their recommendations will result in little change to actual practice or policy.
His goal: to have more federal control over IVF clinics. Well that shouldn't be hard, since there is virtually none now. Most people agree that IVF clinics should be more closely regulated. That is not what is concerning about his proposal.
His primary goal seems to be reducing the number of excess embryos created in the lab and prevent their disposal after the couple has conceived because, as Gingrich puts it, it amounts to "the use of science to desensitize society over the killing of babies."Never mind that the embryos sitting in excess storage for years eventually cannot be used by anyone. But Gingrich doesn't see it that way: "If you have in vitro fertilization you are creating life. And therefore we should look seriously at what should the rules be for clinics that do that because they're creating life," he says.
Get ready for Snowflake babies and increased demand on freezer space, if Gingrich wins the nomination and the general election. At last count nearly 400,000 excess embryos were sitting in freezer storage around the US. And that was in 2003. IVF procedures have only increased in frequency since then. Gingrich's position would only exacerbate that problem.
Another problem that Gingrich hasn't considered is the fact that if procedures involving the creation of embryos are changed with the goal of reducing the number of excess embryos IVF is likely to become even more costly for couples trying to conceive, pricing many couples out of the market. With IVF success rates being in the range of 20-30 percent (approximately one in four fertilized eggs results in a pregnancy), this may mean that the average cost of one IVF cycle ($12,000) should have be paid for 2, 3 or 4 times before a woman can conceive. The only sensible way to reduce the number of embryos left over is to create less of them in the first place. Making embryos one at a time would be even more costly for the to-be parents and prolong the agony of waiting to learn if one can have a child.
Gingrich's stance on IVF clinics would make it harder for couples to conceive through IVF generally. It would become more agonizing, more expensive, and likely more rare that women could conceive using ART. Some regulation and oversight (more than we have now in the US) would be ideal. But making the process of creating a family in the lab shouldn't be any harder and emotionally draining than it already is. For a candidate who espouses family values, it is more than ironic that Gingrich would try to stand in the way of those who would do anything to have a child. It's just wrong.
Summer Johnson McGee, PhD
Canadians have Bieber Fever...For Organ Donation
Yes, it's true. Bieber Fever has spread far and wide. But it isn't just tweens who are following the pop star, Justin Bieber's, every move. Apparently his Twitter feed has quite an effect on his fellow Canadians in regard to organ donation.
Capitalizing on the young star's success, Helene Campbell, 20, asked him to Tweet about the Trillium Gift of Life Network to incentivize signing up for being an organ donor, says Canada's National Post.
And shockingly, it worked. More than 500 people signed up to be organ donors after Bieber's tweet. All it takes is just a few words from a celebrity to make a difference. It was as easy as a 140 character plea for help in response to Campbell:
"@alungstory i got the word .... You have amazing strength. I got u. #BeAnOrganDonor.""
No, we got u, Bieber. Way to take a stand for your fellow Canadians waiting on the transplant list and to encourage others to put themselves on the transplant list.
If only now we could get you, Avril Lavigne and Alanis Morrisette to tweet about the virtues of the universal healthcare system in Canada. Our Canadian celebrity pals just might make us sit up and take notice to other health care issues as well.
Summer Johnson McGee, PhD
Caplan: Say No to Sterilization, Forced Abortion
Art Caplan discusses a troubling case regarding a 32-year-old pregnant woman known as "Mary Moe" who is pregnant for the third time and who suffers from schizophrenia and bipolar disorder.
Can the court require her to have an abortion? Ought someone prevent Mary from having sex?
These questions and more are raised by Caplan's provocative piece on MSNBC. To read it click here.
Summer Johnson McGee, PhD
Rallying Around Amelia: A Debate on Disability
The blogosphere and the airwaves are filled with indignation regarding what has happened to Amelia Rivera, a three year old who has a rare genetic disorder called Wolf-Hirschhorn syndrome. Amelia needs a kidney transplant, but physicians at Children's Hospital of Philadelphia have denied her access due to her mental impairment. The discussion held in a conference room at the hospital is recounted in detail by Amelia's mother, Chrissy, on her blog.
Parents of special needs children around the world are outraged not only for Amelia but at the notion that health care providers, even at one of the best children's hospitals in the world, might arbitrarily decide to deny children treatment on the basis of their mental status. According to USA Today, as of last night the following had happened:
•More than 16,000 signatures have been added to an online petition at change.org demanding the hospital allow the transplant.
•Hundreds of complaints -- along with some supportive comments for hospital staff -- have been left at the CHOP Facebook page.
•More than two dozen bloggers, many of them parents of other children with disabilities, have put up posts supporting the Riveras and criticizing the hospital.
•Tweets using the hashtag #teamamelia continue to spread the story.
But the story is not just "potentially very disturbing" as David Magnus has described it. But very disturbing indeed. It is hard to believe that anyone would cite "quality of life" arguments to parents of a toddler who will die without the transplant. Furthermore, worries about "who will care for Amelia 30 years from now" are irrelevant. Her survival is at stake. Her need for a second transplant is neither morally or practically relevant to the decision about the first transplant.
Either a person, old or young, disabled or not, is medically suitable for a transplant or they are not. Psychosocial factors such as social support are relevant, but that is not the same as mental status being a deciding criterion.
Whether there exist other factors in her medical history that make her unlikely to be a successful candidate for transplant has not been disclosed. But one would think that if there were any other reason to deny a three-year-old a transplant, it would have been mentioned first by the physicians. None were discussed.
CHOP has come under significant fire for its physician's decision receiving an online barrage of complaints. As it should have. It strains credulity for this hospital to say it does not discriminate 'in any way'. Perhaps hospital policy does not, but at least a few of its employees clearly do. Whether these staff will be enlightened and/or reprimanded remains to be seen. But someone needs to do something. Or the life of a very sick little girl will be lost due to prejudice against those with mental disabilities.
Summer Johnson McGee, PhD
Get Fit, For Your Corpse's Sake
Art Caplan reminds us in his column on MSNBC.com that its good to be skinny, whether dead or alive. The negative health consequences of obesity experienced during life linger on well into death, especially for those who want to donate their bodies to science. Does this create a moral obligation to shed pounds? Perhaps. If we want medical students to have cadavers and crash-test dummies.
To read more about Art's position on the issue, click here.
Summer Johnson McGee, PhD
In Memoriam--Bernard Gert
We sadly note the passing of philosopher and bioethicists, Bernard "Bernie" Gert. Bernie was also a member of American Society for Bioethics and Humanities and received its Lifetime Achievement Award in 2006. He will be missed by all.
His obituary is below.
Summer Johnson McGee, PhD
Bernard Gert, Stone Professor of Intellectual and Moral Philosophy, Emeritus, died on the evening of Saturday the 24th of December at the UNC Hospital. He was 77.
Bernard - Bernie to his friends and family - was arguably the greatest moral philosopher of the 20th century. He taught at Dartmouth College for fifty years, from 1959 to 2009, making him the longest serving faculty member in the school's history. He was also a giant in the fields of Hobbes scholarship and bioethics. A founding member of the Ethics Committee at Mary Hitchcock Memorial Hospital, Bernie continued as a consultant to the Ethics Committee at the UNC Hospital until his death. His first book, The Moral Rules, was published in 1970. Retitled Morality in 1988, it has undergone major revisions during the last 35 years, but has remained continuously in print. In 2006 he was awarded an honorary doctorate from the University of Cincinnati, his alma mater. That same year he also received a Lifetime Achievement award from the American Society for Bioethics and Humanities. At the time of his death he was at work on a book on Human Nature, and his book on Hobbes has just come out in 2010. Bernie lived and breathed philosophy and could not be outlasted in philosophical discussion.
Bernie is survived by Esther, his wife of 53 years and sweetheart of 70 years, by his daughter, Heather, his son, Joshua, his son-in-law, John Roberts, his daughter-in-law Victoria Costa, and his granddaughter Susanna. He also leaves behind his sister, Ilene Wolosin, and brothers-in-law Sam Wolosin and Jerry Rosenstein, as well as many nieces and nephews, and great nieces and nephews. He often remarked, with pride, that all of his children, including his son- and daughter-in-law, were professional philosophers. He was a loving husband and a wonderful, wonderful father and grandfather. He lived by the common moral code that his work helped to clarify, and he taught it by example.
There will be a memorial service late in the summer of 2012, in Hanover, NH, where Bernie and Esther spent most of their lives. The date is not yet fixed. Those who wish to honor his memory may plant a tree in Israel or make a donation to the ACLU. To plant a tree, please send your donation to: Jewish National Fund, 2 Reservoir Circle, Suite 204, Baltimore, MD 21208. Please indicate in the memo line of your check that your gift is in memory of Bernard Gert. This will allow gardens dedicated to his memory to grow over the years.
Why Fat Cannot Make You Unfit to Parent
An eight-year-old Cleveland Heights, Ohio boy has been taken away from his parents by Child Protective Services. An unfortunate, but routine occurrence in the world of CPS--but this time the case has an usual cause---this third grader weighs more than 200 pounds and in the judgement of some Cuyahoga County officials his parents are the cause of his abuse to his health and well-being.
But as the Cleveland Plain Dealer asked this week, "Is Obesity Cause Enough To Take Kids From Parents?" My answer is absolutely no.
Of course, it is a tragedy that an 8-year old third-grader weighs as much as a major league baseball player and that is is almost certain that he faces a life of serious and life-threatening co-morbities of obesity such as diabetes, heart disease, depression and others. The issue is serious and has consequences that will effect this child throughout his lifetime. On this I agree with Art Caplan who has said, "A 218-pound 8-year-old is a time bomb." From a health perspective that is true. But will his health status be improved when he is yanked from his family and put into foster care? Almost certainly not, as studies have shown multiple negative mental and physical health consequences from being in foster care including 35% of children increasing their BMI while in foster care. Will the state ensure that his nutrition and physical activity will be better in his foster home than his previous one? They haven't said they will and it's impossible to see how they could.
Childhood obesity, no matter how severe, is no reason to take a child away from his family, whom we must assume love and care for him and provide for him well. Why this assumption? No other justification was provided for removing him from his family except for his BMI. But some may argue that his parent(s) are putting him in harms way, allowing him to eat and not to exercise in ways that certainly damage his health. This may be true, or it may be the result of socioeconomic and structural factors that are beyond this family's control. Perhaps they live in a "food desert" and cannot get easy access to fruits and vegetables and perhaps even more likely they live on a meager income in a society where they are bombarded by commercials and billboards for 99 cent Value Meals.
Moreover, if Child Protective Services is going to get in the business of taking away children from parents who expose them to health risks repeatedly and with serious detriment to their health, the "stereo cops" had better start surveying every house to ensure that the volume knobs on teenage stereos are turned down, lest the parents allow them to get permanent hearing damage from their iPhones or car radios. Or the "tanning police" had better make sure that every child in America never gets a sunburn, because a parent who allows their child to be sunburned exposes that child to a significantly greater chance of malignant melanoma, just from one burn. I could go on and on, but you get the point.
Furthermore, there exist a wide range of details in the case not provided to us via the media: what is the BMI of his mother and/or father? Is obesity a problem throughout the home? Could education, behavior modification, or other interventions far short of taking away a child from his home help ameliorate this problem? Did authorities try these methods and warn the parents prior to taking away the child?
This case, as extreme as it is, does shine a light on an important issue in our society: childhood obesity. There are clearly better and worse strategies to deal with it. The worst would be to traumatize a child by removing them from their home solely because they struggle with their weight. The better strategy would be to have public health and social services unite to help children and their families who live in food deserts and who are the products of a society manipulated by food lobbies find ways to improve their health behaviors and their health outcomes.
Summer Johnson McGee, PhD
November Issue of AJOB is Now Available Online!
This month's issue of The American Journal of Bioethics is now available online. Research ethics is featured prominently in this issue with Rosamond Rhodes et al arguing for a new category of research risk and an article about the recruitment of research participants.
In addition, John Lantos and William Meadow discuss the ethics of the "slow code." Hence the picture of a snail on our November cover!
Also, this month all of this content is FREE from our publisher. So visit the Table of Contents today!
To read more about these topics, visit us at bioethics.net.
Summer Johnson McGee, PhD
In Memoriam: Bioethics Pioneer, Erich Loewy, Dies at 83
A bioethics pioneer within his institution, the country and worldwide, Dr. Erich Loewy changed bioethics in innumerable ways. HIs emphasis on justice in healthcare was evident in his national and international work on the role of the physician in health and health care, rationing and more. His service to the bioethics community was extensive--as a leader in SSHV, on numerous editorial boards, and serving as an editor of Theoretical Medicine.
Loewy's life has been described as nothing short of "remarkable." He certainly had a remarkable impact on our field. He will be missed.
To read more about Dr. Loewy, click here.
Summer Johnson McGee, PhD
