In his op-ed piece in the Philadelphia Inquirer, Art Caplan argues that the fertility doctors involved engaged in “grossly unethical” conduct by failing to set limits on who may take advantage of reproductive technology (article here (http://www NULL.philly NULL.com/inquirer/opinion/39190377 NULL.html)). The idea that patients are not entitled to whatever elective procedure they ask for and that doctors may ethically refrain from providing certain procedures based on their own perception of the potential risks involved is widely accepted and I have no disagreement with Prof. Caplan on this point. But, to claim that it is simply obvious that inserting 8 embryos puts the woman and her potential offspring at grave risk and should not be done is entirely unhelpful and unsatisfactory. There is a rather long list of elective procedures which doctors routinely perform – procedures which are not “medically necessary” in the strictest sense, procedures which subject the patient to unnecessary risk and procedures which at the same time are NOT considered to be unethical – or at least not obviously so. Among these: any type of fertility treatment, gender reassignment, any type of cosmetic procedure, gastric bypass surgery, vision correction procedures, etc. Shall we have the government weigh in on ALL such procedures in order to make sure that rogue doctors aren’t practicing unethically, or shall we keep such decisions between the doctor and the patient as has been our tradition? I believe the government does have a role to play in keeping us safe which is why I believe the limit of 3 embryos per in vitro cycle imposed by most European countries is not unreasonable. But we must tread with great caution when allowing the government to have a say in decisions once made exclusively by a patient in consultation with his or her doctor. Other medical procedures our government has legislated upon include female circumcision, electroconvulsive therapy (banned in Berkeley, CA) and, of course, abortion. We should be careful about adding in vitro fertilization to what should and must remain a very short list.
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