When Nadya Suleman, dubbed “Octomom” by the media, gave birth to eight babies in January, she not only made medical news, she shone a light on America’s fertility clinics, renewing a debate already swirling around the ethics of assisted reproductive technology.
Suleman has another six children also conceived through in-vitro fertilization. Unemployed, she lives with her mother and 14 children in a three-bedroom house in California which is scheduled to be sold at auction this month because of mortgage default. Her father has returned to Iraq to work as a driver in order to support his daughter and her brood.
“Something has gone terribly wrong when a 33-year old single woman – who has no home of her own, no job, and a mother who worries her daughter is ‘obsessed’ with having children – winds up with 14 of them,” says Arthur Caplan, Director of the Center for Bioethics at the University of Pennsylvania.
Caplan notes that there are no known cases of octuplets in which all escaped severe disabilities, a concern that raises ethical issues, including “the hijacking of health care dollars.” Dr. Caplan estimates the cost of neonatal care for the eight babies probably exceeded $1 million; he also notes that millions more in medical costs will be needed as the children grow.
The physician who treated Suleman, Dr. Michael Kamrava, is now under scrutiny by the California Medical Board. In addition to several malpractice suits against him, Kamrava is criticized for implanting large numbers of embryos instead of the two recommended by the American Society for Reproductive Medicine. Critics charge that he does multiple implantations in order to keep up his success rate. (Despite multiple implants, Dr. Kamrava’s success rate is actually low.) In February, Kamrava was removed from the American Fertility Association’s Physician Network pending the outcome of the Medical Board’s findings.
Dr. Kamrava’s practice is among those now advertising the “coming” availability of embryo screening for “gender, eye color, hair color and complexion.” Known as PGD or “pre-implantation genetic diagnosis,” it is already being used for sex selection.
“Assisted reproduction in America has been a Wild West for too long,” says Marcy Darnovsky, Executive Director of the Center for Genetics and Society (CGS). “Responsible oversight of extreme reproductive technologies such as embryo selection based on skin color is long overdue.” According to Darnovsky, “the U.S. is notorious for its inadequate regulation and oversight of assisted reproduction, which has become a $3 billion business in this country alone. A large majority of industrialized countries, including Canada, the UK, most of Europe, Japan, Israel, china and Australia, prohibits non-medical sex selection.”
The Center for Genetics and Society points out that “women’s well-being must be a central concern” in human biotechnology and underscores that “reproductive rights must be firmly protected.” It also sounds further alarms: While assisted reproductive technologies have helped many people become parents, the technologies are costly and invasive, and success rates remain low. Long term risks to women and children have yet to be well studied. Treating infertility is now a highly competitive business and is “notoriously” under-regulated.