Moseley, Kathryn L.

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The Linacre QuarterlyVolume 52 | Number 1 Article 10February 1985Reproductive Technology and the ChildKathryn L. MoseleyFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationMoseley, Kathryn L. (1985) "Reproductive Technology and the Child," The Linacre Quarterly: Vol. 52 : No. 1 , Article 10.Available at: http://epublications.marquette.edu/lnq/vol52/iss1/10Philip C. Hill BUNDER, HARRELL & ROBERTSON 226 South Coll ege Square Bloomingt on , India na 47401 ATTORNEY FOR DR. JAMES LAUGHLIN , INTERESTED PARTY & WIT ' ESS BE IT FURTHER REMEMBER ED, t ha t on th e 1 4 th d:ly of April , 1 9 & The Court having taken this matte r under advise men t and being duly advi se• now makes the following findings: 1. Tha t Baby Doe is a fou r- day old chi ld wi th Down 's Syndrom e and a rther complicati on o f trac heoesophagea l fistul a, m eaning t h e esophagus is not P' perly connected to t he stomach. 2. That wi t hou t correcti ve surgery t he child will di e du e to its in a b ty to receive nour ishment . 3 . Tha t t his Court has p reviously determined tha t the parents have the ~ht to ch o ose a m edically recomme nde d course of treatme n t for their child at t h , t ime. 4 . Tha t two alterna t ive t rea t m ent plans ha ve been presented t o t h e 1 rents. The fi rst is correc t ive surger y at Riley Hospita l. The second would be to , ke no ac t ion knowing that th e child will di e as a result there of. 5. That this Court previousl y de termine d that these are m edicall y , ecom-m ended treatm ent modes and no evidence was presente d concerning thi s is·cue. 6. That t he parents, afte r cons ulta ti on with all physicians concern e d , cL ,se the second trea t m en t mod e of allowing the child to succumb. 7. That this d ec ision was made know ingly , voluntarily , and wi th t h e a dv ice of medical experts. 8. Tha t t he parents in accorda nce wi t h t he ir religious be lie fs have had t1 e child bapt ized and seen t hat it has rec e ived the last ri tes. 9 . That t he ch ild has, at the expense of th e parents, been pl ac e d in <J private room at t h e Bloomington Hospital under the supervision of private d u tv nurses hired by the parents where it is receiving no nourishment and und er d octors ' orders will rece ive pain medications if they appear necessary . 10. That this Court has previously conducted a hearing concerning t h is matter and entered a declaratory judgment, a copy of which is attached to this orde r. 11. That the Monroe County Child Protection T e am of the Monro e CountY Departmen t of Public Welfare , which was previously appointed Guardian a d Litem for the Baby Doe, conducted a hearing concerning this matte r and d ec ide d not to appeal this Court 's previous deci s ion . 12. That the State of Indiana has filed a Petition for Emergency De tention pursuant to I.C . 31-6-6-4 requesting that the Monroe County De par t ment of Publ ic Welfare take immediate custody of the Baby Doe and provide e mergencY treatment to said child . 13 . That in o rder for the Court to issue such an order it must be show n that the ch ild is a ch ild in need of services as defined in I. C . 31-6-4-3. 14. That aft e r considering the ev'idence the Court finds that the S tate has fa iled to show that this child's physical or m ental condition is seriousl y im pa ired or seriously e ndangered as a result of the inability , re fusal , or neglec t of his parents to supply the child with necessary food , and medical care. · WHEREFORE , the Court now DENIES the State 's Petition for Em ergencY Detention. 76 So ordere d this 14th day of April , 1982. C. Thomas Spencer, Judge Pro-Tempore. Linacre QuarterlY Reproductive Technology and the Child Kathryn L. Moseley, M.D. Kathryn L . Moseley graduated from Harvard University , cum laude, in June, 1974. She attended the Medical School of the University of Michigan at Ann Arbor and received her MD degree in May, 1978. Dr. Moseley's present position is assistant professor, p ediatrics/ adolescent medicine at St. Louis University School of Medicine. Her responsibilities include director of newborn services, St_ Joseph's Glennon Unit, and neonatal and general pediatric care at St. Joseph Health Center and Cardinal Glennon Children's Hospital. She is also a member of the faculty of the Center for Health Care Ethics, St. Louis International attention has recent ly been directed t o the in vitro fertilization (IVF) program in Melbourne, Australia. Two frozen embryos have been orphaned, their parents killed in a plane crash. Because this possibility was not foreseen, the ownership and disposi-tion of these embryos has been contested. The picture is complicated by the presence of a substantial inheritance and the fact that the embryos were · conceived with donor sperm . The "parents" were a middle-aged couple, who were unable to conceive a child together. After her daughter from a previous marriage was accidentally killed, the couple went to Australia for help in 1981. Three embryos were conceived in vitro, and one was implanted. The other two were frozen for later use. That pregnancy failed , and the couple elected to keep the embryos " on ice '~ awaiting a time when they would be emotion-ally ready to attempt another pregnancy. They died in Chile in 1983. 1 . Embryos conceived in .the lab are ready for implantation by the eight to sixteen cell stage of development. After incubation for 48 to 72 hours, they are transferred to the womb of the infertile woman. To increase the chances of the production of a healthy embryo, and a successful implantation, more than one ovum is usually removed at the time of laparoscopy. In the initial IVF attempts, all viable embryos were returned to the woman 's uterus. However, this creates the Possibility of multiple gestation.2. 3 Because of the risks of gen-eral anesthesia and laparoscopy involved -in removing ovum in succes-February, 1985 77 • • .. • ~ive in vitro attempts, freezing embryos began, in Australia, i ' ;ali-fornia, and elsewhere in the United States . When conception occurs in the usual manner, the newly crea t life imposes serious obligations and responsibilities upon the parent Fer-tilization is the beginning of the life of a new human being, gene ally distinct from either parent. When conception takes place in th ~ tb, a third party, the institution, also assumes a moral obligatic•· and responsibility for this new life, in the same way a hospital asst es a moral obligation and responsibility for the health and wel1-b( ;g of its patients. This responsibility to protect the new lives ha~ '>een overshadowed by a desire to provide a child for the infertile 1 uple irrespective of cost. The need of any human is to be cared for in an appropriate e; iron-ment and not to have life needlessly jeopardized. That t h very process of in vitro fertilization and reimplantation jeopardizes t l. lives of the newly conceived is obvious from the low success rate (le- t han 30% successful pregnancies) . 4 • 5 Whether this brief existence 1 r the majority of these new humans might be better than no existenc t •s not a resolvable issue. Having begun life under "hazardous environ • ental conditions," these lives are endangered further by freezing. Cor, mued survival is at the whim of either parents or institution. This re.cgates the human embryo to the status of property, another "tool" o~ medi-cal technology. While human ownership has been a part of the h story of the world, it is not something of which we who consider ot,rselves civilized, are proud. Some attempt to get · around the "property" question by making the distinction as to whether embryos are human persons . Only human persons, they would argue, possess rights. Non-persons are to be utilized in whatever manner best suits the needs of the persons. Non-persons impose no obligations other. than those which a human person is willing to bestow. s. 7 Taking this view, the Australian embryos could be nurtured by a surrogate mother, if (and o nly if) a woman (person) chose to do so to fulfill her own needs. If this was not possible, the embryos could either remain frozen indefinit ely or be destroyed, dependent solely on the desires and needs of the instit ution (or whoever becomes the legal "owners" of the embryos). N o woman is obligated to become a surrogate, so the lives of these embryos depend on finding a volunteer. In this case, the motives of any volun-teer would have to be suspect because of the inheritance problem. Even so, it is uncertain whether the embryos would survive the t haw-ing process because the technology used to freeze them was itself in its embryonic stages. The commission delegated to studying the disposi-tion of these emb~yos has recommended their thawing and destruc-tion. The freezing and storing of embryos must lead to the creat ion of an "embryo bank." This raises more serious questions. As the Austral-~ case demonstrates, the fate of embryos when the natural parents die or no longer want them is uncertain. In those instances in which ~l~~ing has occurred, it has riot been with the thought of any respon-~Ibiht~ or obligation to protect the life of the embryo. In a televised m~rvte~, a physician associated with the in vitro program at the Umvers1ty ?f Southern California stated that their policy requires the couple to s1gn a paper designating the disposition of the embryos not used. The ~ptions presented are donation to another couple, donation to_ the medical center for research, or destruction . s Having been con-ceiVed at the behest of parents with the help of the institution these new lives are totally at their disposal, treated as property to be dis-posed of, not as living human organisms. Refusal to Acknowledge Responsibility An essential problem with in vitro fertilization is a refusal to acknowledge responsibility to the newly conceived. By waving the banner of "delayed personhood," a more detached view of the un~orn, and consequently, the child itself is permitted. What this leads ~ ~ the concept of the child as an object, a possession of the parents vmg value only to the extent that he or she is wanted. Parents ar~ not encouraged to be content with any child; they must increasingly now be "built to specifications," e.g., free from diagnosable handi-~ps, of a specific sex, even fathered by a Nobel prize winner. A ewsweek cover story heralded the advent of "Superbaby " the :duct of ~ar~ful prenatal screening and selection, able to identify In Gogh pamtmgs and the parts of the brain before the age of two. 9 San Francisco. a woman, married or single, lesbian or heterosexual, ~~ for a fee, be artificially inseminated by the sperm of her choice, -.~ Vlng looked through a catalogue of donors where height weight .-uuc t · 1 . ' ' ~ 10? eve!, eye color, hau color, and occupation are listed.lO t This VIew of children being just one more status symbol in · the quest or se~f-fulfillment cannot help but have significant fallout. First and most Import tl ·t ill ff ' _ childr an Y' 1 w a ect the self-esteem and confidence of the se en who are born. The greatest gift anyone can give a child is a ... hnse of its own value and worth, not for what he or she is or even .. o they b t · · ' be-d . are, u simply that he or she is a special unique never-to-upbeat d · d ' 'd ' ' sto e m IV! ual. The message given by the creation and is t~~e 0~ multiple embryos, catalogues of sperm donors, and the like, ideal children are wanted because of the fulfillment of some parental doubt :t that t?e~ are intrinsically lovable and worthwhile. Self-"'"' 1 d questwnmg of parental love are basic to childhood and ~o escence H h · . dre d' · ow muc more mtense will these fears become as chil-less nt~over that unbor~ lives known to be physically or mentally if h perfect are termmated by their parents? How will a child feel e or she later becomes handicapped, knowing that his or her par-78 Linacre QuarterlY February, 1985 ----------------------Ia--------------------------79 .. . • I 0 I I I I ents, and society, in general, devalue the lives of handicapped fe' rses and newborns? How can we, as parents, teach our children respec for the worth of every human being regardless of handicap or intelle tual ability, when we would never permit a less-than-perfect child J be born in our own family? Medicine, too, has fallen into this trap. Foresaking its tradi anal role of protecting the sick, the helpless, and viewing the unborr ·hild as a patient at least equal in importance to the mother, w• have become dazzled by the brilliance of our successes. The " re ·arch imperative" has never seemed so strong as it has with repro (. .ctive technology. While there is great compassion and sympathy i f the plight of infertile couples, and an honest desire to help them t gin a much wanted family, there also seems to be a desire on the part ·f the physician to be a "co-creator" in this event, to the detriment . f the welfare of the newly-conceived. That this is the case, is eviden 2d by the marked lack of enthusiasm for the procedure of low tuba. ovum transfer (LTOT) in which an ovum is removed from the ova y and placed past the point of obstruction in the Fallopian tube. C lncep-tion is then achieved through normal intercourse or artificial in · •mina-tion. This poses no more risk to the child thus conceived ,han a normal conception. The success rate of LTOT is less than for ' vitro, ha,ving been less extensively researched, but one of the de vel ·. ers of L TOT feels that the two methods could be equal in achievin ~o, a suc-cessful pregnancy. However, few hospitals have chosen t o go this route. n . 12, 13 Psychological Dynamics Overlooked What also seems to be intentionally overlooked by the m edical com-munity is the psychological dynamics of couples who are involuntarily childless. While the research in this area is limited, anecdot al accounts abound of women seeking self-fulfillment through childbearing, to have someone to love, or to hold a failing marriage together . These are inappropriate motives for child-bearing under any circumstances, and in cases of medical intervention in the conception process (artificial insemination, in vitro fertilization, surrogate embryo t r ansfer), the physician has an obligation to' the soon-to-be created patient t o assure that the family situation is a healthy one. No one has a "right " to a child; no human being has a "right" to any other. That is slavery. Yet in the reports of the in vitro programs, there is no reference to anY investigation of the health of the marital situation, the coup le 's reaso~s for wanting a child, or their ability to care for any child. 1 4 . 1 5 · 16 It 15 well known that prospective adoptive parents undergo rigorous screend 1 in~ of their ~arit~, financial, and socio-ec~nomic sta~us by state .a~d pnvate agencies pnor to approval for adoption. Do children concetv · 80 Linacre QuarterlY via in vitro and other reproductive methods deserve any less considera-tion? Undoubtedly, it is more exciting to "create" children in the labora-tory, rather than staying on the sidelines and letting nature take all the credit. In the process, though, are we not somewhat tarnishing the . image of our profession? By becoming, in effect, vendors of new human life, we invite the salesman analogy: pushing our new human merchandise, always willing to give the customer what he or she wants, not needs, or what our "merchandise" deserves. What is being lost by the wayside is the traditional role of physician as counselor, healer, cognizant of patient needs and wants, but concerned for the health and well-being of all parties involved. Our country was founded on the assumption of the equality of all humans. The authors of the Constitution knew that all humans are valuable, that they are created equal, not are born equal or later become equal. They also stated that at the moment of creation, humans are endowed by the Creator with an inalienable right to life. These founding fathers realized that certain rights cannot be bestowed by others, but are innate and are bestowed by a higher power. We are ~t becoming an elitist, utilitarian society, where the person has no Intrinsic worth outside of the potential for material contribution to society. Physicians should resist that change vigorously. We know that human life is a continuum of development, each stage important in an~ of itself, as well as for what it contributes to the next stage. ~teria of "personhood," and classifying certain groups such as Infants, the unborn and the handicapped as "non-persons," either explicitly, or by our treatment of them, undermine the inherent worth of every one of us. · . Reproductive technology has great potential for good in helping Infertile couples begin a family . . But that good should not be achieved at the expense of devaluing its very goal - the child_ REFERENCES ; · St. Louis Post-Disp~tch, June 18, 1984. Pre· St~ptoe, P. C.; .Edwards, R. D. and Purdy, J. M., "Clinical Aspects of of t;;,ancle~ Established with Cleaving Embryos Grown in Vitro," British Journal 3 ste.tncsand Gynaecology, 8.7 (1980), pp. 757-768. Bei · ~lggers, J. D., "In Vitro Fertilization and Embryo Transfer in Human :gs,8.New England Journal of Medicine, 304 (1981 ), pp. 336-342. the ·P _1Iverman, A. V., "The Success Rate of in Vitro Fertilization : What Can (1982 a)ttent Expect?" American Journal of Obstetrics and Gynecology, 144 ' pp. 360-361. 5. B till PtfarshaJius o, ~- ; Buste~, J . E.; Freeman, J. A.; Gornbein, M.S.; Wheeler, N. and tility: WttJ. R., N~nsurg1cal Ovum Transfer as a Treatment for Intractable lnfer-Obate . at Effectiveness Can We Realistically Expect?" American Journal of tries and Gynecology, 149 (1984 ), pp. 371-37 5 . Febl'Uary, 1985 81 . . I 0 I I 

Reproductive Technology and the Child

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Reproductive Technology and the Child

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