Search

This article explores the impact of Dobbs on access to assisted reproductive technologies. Clinical aspects of IVF, including embryo discard and cryopreservation, preimplantation genetic testing, and selective reduction of multiple pregnancy are potentially jeopardized by a new legal landscape that protects embryos over the interest of infertility patients. [ABSTRACT FROM AUTHOR]

This article explores the impact of Dobbs on access to assisted reproductive technologies. Clinical aspects of IVF, including embryo discard and cryopreservation, preimplantation genetic testing, and selective reduction of multiple pregnancy are potentially jeopardized by a new legal landscape that protects embryos over the interest of infertility patients. [ABSTRACT FROM AUTHOR]

Advancing technologies in genetic testing of preimplantation embryos enable IVF patients to access detailed information about their future child's health status, facilitating and complicating their reproductive decision-making. Testing for embryonic genetic anomalies linked to future health has grown increasingly sophisticated. A patient's decision to seek transfer of a health-affected embryo may or may not be compatible with her physician's professional conscience, potentially resulting in a clash at the petri dish. This article sets out arguments in support of physician decisions to assist or decline to assist in the transfer of anomalous embryos upon patient request. Arguments in support of transfer include the preeminence of a patient's reproductive liberty, the value of equal protection as applied to pre- and post-implantation embryos, the allocation of dispositional authority over embryos, and the frailties of predicting a child's future health experience. Arguments that bolster a provider's decision to decline requests for transfer include the role of physician autonomy in the doctor-patient relationship, the theories of reproductive non-maleficence and procreative beneficence, and legitimate concerns over future legal liability. Regardless of a clinic's ultimate position, this article advocates that providers create or adopt detailed policies setting forth their preferences and practices regarding anomalous embryo transfer. [ABSTRACT FROM AUTHOR]

This Viewpoint discusses the potential ramifications for assisted reproductive technologies, such as in vitro fertilization, if the Supreme Court overturns Roe v Wade. [ABSTRACT FROM AUTHOR]

An introduction is presented which discusses articles within the issue on the themes of abortion, assisted reproductive technologies (ARTs) and stigma in the U.S.

Enactment of mandated pre-procedure disclosures in abortion and assisted reproductive technology (ART) services has swelled in recent years. Calls to equally regard these mandates as neutral tools in furtherance of patient protection fail to acknowledge key substantive and structural differences in these reproduction-affecting mandates. While ART mandates permit physicians to use their medical judgment to protect presumptively vulnerable egg donors and gestational carriers, abortion disclosures impart scientifically suspect messaging aimed at dissuading women from pursuing pregnancy termination. These and other distinctions counsel in favor of regarding and analyzing abortion and ART mandated disclosures as separate and distinguishable informed consent tools. [ABSTRACT FROM AUTHOR]

The article discusses conflicts and tensions between health care professionals, patients and their families in ethics consultations. Topics discussed include legal regime governing surrogate decision making as highly complex, pregnancy exclusions impacting health care providers in the exercise of their autonomy and professional judgment and ethicist providing guidance based on patient rights, principles and the family's narrative.

The article discusses the interconnections between assisted reproductive technologies and abortion and their relation to pregnancy as a distinct biological marker. A discussion of the medical and legal definitions of pregnancy, and of U.S. legislation which is concerned with women's reproductive health, abortion and reproductive technology, is presented. The history of and future of reproductive technology in the U.S. are examined.

The article presents edited remarks of the author that was delivered at a symposium on women's reproductive rights and the law presented by the Albany Law Journal of Science and Technology on October 11, 2012. He discussed several topics including reproductive technologies and bio-ethics, law and medicine, and human embryonic development under the Oklahoma Habitual Sterilization Act of the U.S. He also relates the decision of the U.S. Supreme Court in the case of Skinner v. Oklahoma.

This article addresses the of t-spoken urban myth that the field of assisted reproductive technologies (ART) is awholly unregulated medical subspecialty, leaving cowboy physicians to abuse vulnerable patients and disregard the well-being of ART-induced offspring. The birth of octoplets in January 2009 fueled this myth and launched a campaign to regulate the field by restricting the number of embtyos allowed for transfer in any single IVF cycle. This article critiques the merits of a federal law codifying embryo transfer limits in the provision of infertility care. Drafting a federal embryo transfer law is easy enough, but assuring enforcement by regulators and compliance by physicians and patients presents near insurmountable barriers. Even if such a law set out sensible clinical guidelines on the number of embtyos to transfer, validating that practitioners have complied with statutory standards may require invading patient privacy in a wholly distasteful manner. Moreover, data collected on the effectiveness of civil fines in the regulatory setting suggest rampant undercollection, casting doubt on fine-based penalty's capacity to deter banned conduct. Still other data suggests that criminal penalties fare no better, as both prosecutors and juries are reluctant to penalize a physician who, in good faith, responds to a patient's plea for help. Compliance with embryo transfer limits are in doubt not just because traditional penalty structures are ineffective, but because patients and physicians are incentivized by the high cost and low reimbursement rates for infertility care to prefer more embryos be transferred to maximize the chances for a live birth. When multiple births, particularly twins, is a preferred outcome based on financial constraints, looking to a stand-alone embryo transfer law to curb the high rate of multiples will have little effect. Instead, this article argues that now is the time to ease the financial burden by including infertility care in the package of essential health benefits being developed under the 2010 Patient Protection and Affordable Care Act. Matching the burden of embryo transfer limits with the benefit of coverage will have a real and lasting impact on the public health concerns that legitimately coalesce around multiple births. [ABSTRACT FROM AUTHOR]

This article explores the possibility that there is a parental duty to use preimplantation genetic diagnosis (PGD) for the medical benefit of future children. Using one genetic disorder as a paradigmatic example, we find that such a duty can be supported in some situations on both ethical and legal grounds. Our analysis shows that an ethical case in favor of this position can be made when potential parents are aware that a possible future child is at substantial risk of inheriting a serious genetic condition. We further argue that a legal case for a duty to use PGD for medical benefit can be made in situations in which potential parents have chosen to conceive through in vitro fertilization and know that any children conceived are at substantial risk of having a serious genetic condition. [ABSTRACT FROM PUBLISHER]

The article examines if prenatal diagnosis of cell-free fetal deoxyribonucleic acid (DNA) could lead to the genocide of affected fetuses. Topics include the termination of fetuses carrying a genetic anomaly, the availability of non-invasive prenatal genetic diagnosis (NIPD), and the pressure on women to test and/or selectively abort affected fetuses.

The article discusses the accessibility of assisted reproductive technology (ART) services in the U.S. The role of the state in interfering with the natural ability of a person to procreate is tackled. The barriers to ART access including cost, race and ethnicity, and marital status and sexual orientation of a patient are explained. It also tackles the potential harms associated with ART.

Highlights jurisprudence concerning a form of assisted reproductive technology which makes use of frozen embryo in the United States. Decision-making approach of the Massachusetts Supreme Judicial Court concerning a frozen embryo dispute; Enforceability of embryo disposition arrangements according to the New York Court of Appeals; Arguments for and against embryo disposition arrangements.

Describes an equality model concerning assisted reproductive technologies (ART) and the pregnancy process to protect reproductive liberties. Reproductive liberties within the context of ART; Creating equality in the disposition of frozen embryos; Presumed enforceability of preconception agreements; Notion of presumed validity of preconception agreements.

Discusses issues on disputes concerning frozen embryos. Information on assisted reproductive technologies; Use of the preference of the progenitors; Implementation of the equal protection clause in the Fourteenth Amendment to the U.S. Constitution.

Discusses the role of physician autonomy in the medical futility debate in the U.S. Status of physician autonomy; Rights of patients to select treatment options on the basis of their values; Institutional perspective on physician autonomy; Physician's right to decline to participate in a treatment plan he feels is medically or ethically inappropriate.

The article discusses the article "Assessing the Risk of Ovarian Hyperstimulation Syndrome in Egg Donation: Implications for Human Embryonic Stem Cell Research," by B. Ellison and J. Meliker. In the article the authors offer their opinions on Ellison's article, on the risks that are associated with oocyte donation and on compensating women who donate eggs for embryonic stem cell research.

The convergence of medical and social factors in the HIV-infected community has produced a growing interest in procreation with the aid of assisted reproductive technologies. Meeting the needs of fertile and infertile, concordant and discordant couples will require the establishment of multidisciplinary treatment centers and research programs to define and provide the safest and most effective therapy possible. [ABSTRACT FROM AUTHOR]

Comments on a study by Andrea Gurmankin which investigated the practice of informed consent in assisted reproductive technology medicine. Factor that complicated the role of informed consent in oocyte donation; How the physician must simultaneously maximize the opportunity for pregnancy; Details on the legislation drafted by lawmakers in California to address concerns on the vulnerability of egg donors.

Comments on a study by John A. Robertson on preconception gender selection (PGS) which was published in the December 2001 issue of `The American Journal of Bioethics.' Interests that may infringe upon PGS; How arguments for and against PGS are reminiscent of the initial and continuing controversy surrounding human cloning; Opportunities that PGS and cloning present for would-be parents.