More reactions to the octuplets

Fertility doctors don't say no - nor should they - to single or gay patients or those who already have children.... But shouldn't there be limits?...

And - here we get to the heart of this case - it turns out there are no laws in this country limiting the number of embryos that can be implanted in one womb....

Meanwhile, a reproductive business that generates so much controversy has produced a remarkable consensus. Infertility treatment for an unemployed, single mother of six? Eight embryos in one womb? There must be a proper word in the medical literature to describe this achievement. I think the word is "nuts."

Society must guard against judging who is allowed to have children. A doctor cannot refuse to provide fertility treatment to a lesbian, as the state Supreme Court rightly ruled, because of his own moral objections. Nor is marital status or wealth a fair criterion for calculating someone's fitness to be a parent; nor, for that matter, how many children they want to have, as long as they can provide the necessary care. The rearing of children is a personal decision, unless there is mistreatment.

That's different from the medical considerations that should have played a part in the octuplets case. Doctors have an obligation to weigh the health risks to both mother and child -- and those are considerable with so-called high-multiple births. The guidelines set down by medical organizations affect whether insurance will cover a procedure, but carry little force otherwise. Clearly, the field of fertility treatment needs more than guidelines.

We urgently need a public dialogue - involving physicians, theologians, ethicists, clergy, health advocates and the scientific community - that responds to the social, religious and medical issues raised by the use of ARTs.  We need to assess individual choice within a larger social context, so that we do not divorce moral choices from moral responsibilities to one's self, family or the larger community.   In other words, the moral questions not only involve the individual -- health risk to self and potential child(ren), ability to care for child(ren), religious belief/teaching, partner's desires, and personal motive.  But there are social justice issues we as a community must weigh -- medical effectiveness, cost, and equal access.  We also must consider how ARTs reinforce biological children as superior and women as valued only for childbearing.  

If the medical profession is unwilling or unable to police its own, then government needs to get involved. We already have rules governing who can get involved with adoption and foster care. Shouldn't these minimal requirements be extended to fertility treatment? And shouldn't some limit be set on how many embryos can be implanted at one time, along with some rules about what to do with embryos that no one wants to use?

Other nations, such as Britain, keep a regulatory eye on reproductive technologies and those who wish to use them, knowing their use can put kids at risk in ways that nature never envisioned. We owe the same to children born here. 

Pamela Madsen, executive director of the American Fertility Association:

Would the choices that this woman made be my choice on how to live? No. Do I support her right to have the family that she wants to have? Yes, I do.”

James Grifo,past president of the Society for Assisted Reproductive Technologies:

Legislation about how to practice medicine threatens doctor-patient relations and has unintended consequences that may be worse than the actual problem. We live in a country that doesn’t regulate family size. If we were to decree a proper number, who would decide?