State licensing boards must rein in free market fertility
Celebrity news website TMZ released this picture of a very pregnant Nadya Suleman, who gave birth to octuplets last month in California.
Last month, 33-year-old Nadya Suleman gave birth to octuplets in a California hospital. The eight babies — and their six older siblings, the oldest of whom is 7 — were the result of infertility treatments.
Ms. Suleman’s pregnancies raise troubling questions whose implications are at once both deeply personal and broadly societal.
Babies already have been conceived to donate bone marrow to a seriously ill sibling. Now, clinics are advertising their skills at sex selection, allowing prospective parents to choose a boy or a girl.
A Los Angeles clinic announces “the pending availability” of testing to achieve “a preselected choice of . . . eye color, hair color and complexion.”
Such practices raise profound questions as remarkable technological advances have, at times, leapt far beyond ethical guideposts.
In the case of the octuplets, Ms. Suleman has said that Dr. Michael M. Kamrava, a Beverly Hills, Calif., infertility specialist, implanted six embryos, two of which later split into twins.
Guidelines by the American Society of Reproductive Medicine say doctors should implant no more than two embryos in women under the age of 35.
Infertility medicine is a fiercely competitive business. Federal officials publish clinic success rates that many prospective parents use to shop for doctors.
Dr. Kamrava had a relatively low success rate. He achieved just five pregnancies from 61 procedures during 2006, the most recent year for which numbers are available. Only two resulted in births — one of them was a pair of twins born to Ms. Suleman before she got pregnant with the octuplets.
Dr. Michael Kamrava performs an ultrasound on Nadya Suleman in an image from a 2006 interview with KTLA TV.
The more embryos that are implanted, the greater the odds of success, which is good for business. But more embryos also increase the odds of multiple births, which put mother and babies at risk.
Pregnancies with three or more babies are much more likely to end prematurely. Premature babies are more likely to need expensive medical care.
Ms. Suleman, who is unemployed, apparently paid for her infertility treatments with money from disability payments. The treatments cost $12,000 or more.
The Kaiser Permanente hospital, where her octuplets were born, reportedly has billed MediCal, California’s Medicaid program, for the costs of their births.
One study found that fewer than 20 percent of infertility clinics perform psychological testing on prospective patients. Almost none make home visits, as an adoption agency would before placing a child. Ms. Suleman and her six children were living with her parents, who had filed for bankruptcy, before the octuplets were born.
Much as we love to hate them, insurance companies play an important role in health care. By spelling out what they cover and when, insurance companies encourage quality care and enforce ethical boundaries.
Hospitals probably would be happy to play a similar role, since that’s where risky multiple births take place.
But many fertility clinics aren’t associated with hospitals. And infertility treatment isn’t covered by insurance. The market, with a few broad federal or state guidelines, sets the rules.
Patients and doctors alike have been reluctant to change that, and with good reason. There’s something profoundly troubling about the idea of government deciding who should, or should not, become parents.
But there’s also something troubling about Ms. Suleman’s story. And about advertising that encourages parents to shop for a child’s “eye color, hair color and complexion” as if they were a buying a dress or a car.
If the market can’t regulate itself, someone else has to step in. That’s a role state medical licensing boards should fill. California authorities reportedly now are investigating Dr. Kamrava.
It won’t be an easy case, but it’s a crucially important one.
Doctors who put patients’ lives at risk by implanting too many embryos deserve censure — or more — just as much as those who endanger patients by incompetence or addiction. It’s
This only just adds to my positive view of this woman.
Only the Post-Dispatch could look at this situation and find yet another reason to “rein in the free market.” Of course, when you believe the free market is the root of all evil, that’s to be expected. And I guess employees of a corporation which the free market has so thoroughly drained of value could well be expected to have some animosity toward markets.
Frankly, while I find this whole situation a little frightening, if Suleman had the resources to pay for it all herself, it would be none of my business. But as Congress has said to banks who received bailouts, when the government pays the bills, the government calls the shots. We know the government is going to get stuck with the bill on these kids. We know she receives disability payments on several of the kids she already has. We know she receives food stamps. And we know that with 14 kids, she will be unable to work for years to come, and will receive a tremendous amount of government assistance.
I agree, there is “something profoundly troubling about the idea of government deciding who should, or should not, become parents.” But it is equally troubling when the government pays for a single, unemployed mother of six to have more children, and then supports her and the children after they are born.
I don’t think it is right that clinics allow people to choose the gender, and potentially other attributes of their child. But frankly, it is less offensive than encouraging a parent of a child with birth defects to obtain an abortion. I haven’t seen the Post editorial discouraging amniocentesis. In either case, medical technology is being used to allow parents to exercise preference as to what sort of child they have.
The Doctor that put 6 embryos into a woman with 6 kids already?? When he had to know her financial position. He should be given a choice. Lose your license to practice or be financially responsible for all 14 children. The Dr. is a criminal in this.
She will end up suing the doctor for allowing her to be irresponsible and raise the kids in the doctor’s big house and send them to school on his savings.
“We know the government is going to get stuck with the bill on these kids.”
-Nick Kasoff
Nick, I suspect you meant “taxpayers” rather than government. That is much of the problem with our “Great Society.” The parasites imagine they are receiving cash and services from “the government.” The few who would care never stop to think about the money coming from taxpayers. Meanwhile, folks who are often struggling to provide a better life and quality education for their own are penalized by tax policy for overtime, second jobs, or upward mobility. When you reward the parasite and punish the host the parasites will eventually destroy the host organism. That is us, fellow taxpayers!
I’m not sure what the uproar is about. These are just fourteen among millions of parasites produced since parenthood was relieved of financial obligation. Maybe Lyndon Johnson’s estate should support these fourteen kids. After all, he’s the one who devised the cottage industry of single women having children at taxpayer expense.
anyone find out if she got the 2 million for giving interviews? maybe she should repay bankrupt california for her procedure.
Not surprisingly, the Post-Dispatch has levied a frontal assault on a basic component of Liberty as contemplated in the 5th and 14th amendatory articles. It is not within the province of either State or Federal Power, and resulting authority, to regulate the parental rights of the People. Allowing State medical licensing boards the authority to prohibit particular infertility practices by doctors is equally repugnant - as applied - as direct proscriptions of infertility practices imposed upon individuals.
While I also find this woman’s actions to be selfish and irresponsible, it is not rightly our, or the governments’, concern. I can find no substantial state interest which would allow state action in the regulation of infertility procedures. The purpose of such procedures is to create life. It seems no other sector of our lives should garner more freedom from state oppression.
Further, these procedures are contemplated and effectuated in the private relationship between the patient and her doctor. If the patient grants informed consent to the procedures, there should be no intrusion upon the seclusion of that relationship. Clearly, if a treatment is performed negligently, recklessly, criminally, or otherwise unlawfully, an intrusion is warranted. But, wanting that, we are considering a Liberty precept afforded the highest guarantee against governmental interference (like the freedom of the press under our 1st amendment).
The protection of the Liberty at issue should dwarf the pittance of tax proceeds she used to secure her pregnancy. I presume the author of this opinion supports abortion rights. Doesn’t it seem antithetical to voice the foregoing concerns in regard to impregnation when those precise concerns are applicable to the discretionary cessation of pregnancy? It’s probably advisable to be consistent in principle.
In conclusion, that picture is super-duper gross.
DCL… I agree completely. The state should butt out. No food stamps, no welfare, no housing subsidy, no Medicaid, no Pell grants. Just butt out and let this woman and her doctors do their thing…..and pay for it.