We talked about this awhile ago, but I thought this article brought up some interesting issues that never came up in class, namely the insurance aspect of the case. Medical insurance covers IVF, so people like the Octomom have the opportunity to have children; however, those without insurance must pay out of pocket, which can run in the tens of thousands of dollars. With the right to give birth being a negative right, how can doctors and insurance companies limit a woman's ability? Why is the right to have children only a wealthy right? Should abuses, like the octomom, constitute grounds for unethical behavior by both the mother and the doctor? What can be done to stop such abuses, and allow for more equitable justice of the right to give birth?
(Submitted by Jane Tingley)
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There are many ethical issues in the Octomom case. First off, although insurance does cover some fertility treatment, such as IVF, the Nadya Suleman paid out of pocket for the IVF treatment that resulted in the octuplets. Additionally, she was on welfare, so it is questionable as to how this occurred. Although it is unfair that wealthy people may be better able to afford IVF treatment, the right to reproduce is a negative right, meaning that it is not the government, or insurance companies duty to interfere with this right. In the same sense, no one has a duty to provide fertility treatment for people who have difficulties conceiving. In the case of Nadya Suleman, she should not have been able to transfer six embryos, primarily because it was unlawful. Furthermore, the fact that she was on welfare means that it will be extremely difficult for her to adequately support her fourteen children, and b) taxpayers in California will end up paying for her decision to implant all six of the embryos. Although it is not an obligation to provide fertility services, we do provide them. In some ways, since they are provided, the government does have an obligation to limit and regulate them, in order to ensure that the services that they are providing are producing the greatest outcome for everyone involved and affected. This would mean the fetuses, the mother, the children, and the taxpayers of California.
ReplyDeleteIn the octomom case, it is important to remember the duty of a parent to provide adequate and quality care to her children. We have a right to reproduce, but that does not give a mother the right to have IVF for eight children at once. First, it is not safe. A human female body is not made to hold and birth eight children at one time, whether the mother is young or not. Having eight children at one time increases likelihood of complications in the pregnancy, chances of having children with disabilities, and prematurity, which in itself can cause problems. In this case, the mother, Nadya Suleman, states that although it is an unlikely outcome, the children are alive and fully functioning. However, this leads to the next problem, quality of life for her children. Suleman is a single mom with no job, and she already had, as far as I know, six children. After the birth of her octuplets she has 14 children, with no job or partner to help her to support them. Hypothetically speaking, there is a chance all 14 of them will develop normally, in a stimulating environment, and become normal adults. However the likely outcome to this situation is the opposite. The mother will not be able to give each of them the attention and developmental stimulation that they require, and many of them will grow up feeling left out, which can foster some disorders. Also, growing up in a low income environment with minimal parental attention is known to increase likelihood of deviant behaviors in children, therefore it may be ethical to put regulations on IVF from a utilitarian perspective as well for the safety of the mother and children. In this situation, it is likely that the children will grow up with a poor quality of life and thus partake in deviant behaviors, which will not be beneficial for the society, in fact it will be the opposite.
ReplyDeleteI agree that having children is a negative right that should not be restricted, however this must be maintained at a realistic level. There must be restriction on how many children one can have at once, and also if a parent is incapable of supporting/providing optimal care for a their children they should not be allowed to have IVF. There can be no control over natural pregnancy of course, however unregulated IVF is unethical if it causes unethical treatment of children/low quality of life.
I agree with Meredith in that since fertility services are available to the public (regardless of how the services are being paid for) there is a governmental obligation to provide some limitations for them. What happened with Nadya Suleman is an example of this: why was a woman on welfare, clearly unable to provide for herself and the (6?) children she already had, permitted to undergo this IVF treatment, with the knowledge that she would likely have a set of multiples? I'm not saying that it's ethical to limit the number of children an individual has, but as far as IVF is concerned I think there should be some sort of screening process to determine the quality of life the potential children will have if conceived, similar to the screening process families who want to adopt children have to undergo. A family friend recently adopted a baby from Guatemala, and it took over a year for the paperwork to be complete. She needed to have many letters of recommendation and was interviewed countless times, and her finances were thoroughly examined by the agency. I am not as familiar with the process for IFV and how one qualifies to undergo the procedure, but if "Octomom" was able to become implanted with 8+ embryos while on welfare, the screening methods must not be as rigorous as they are for adoption. There definitely needs to be some regulation of the system.
ReplyDeleteAlthough having children is a negative right, the rights of the children, now that they are born, have to be considered. The children do not only include the octuplets Suleman conceived with her most recent implantation of 6 embryos through IVF, but also her other children. In the above article it says that the children have many risks including "... pulmonary problems, eye problems, cerebral palsy. All these are issues associated with prematurity." In addition, the other children Suleman has are going to suffer because of Suleman's inability to provide for them. Suleman was already using government benefits before the birth of her octuplets, now she has a larger burden and has to provide for more children.
ReplyDeleteUtilitarianism states that we should provide the greatest good to the greatest number of people. It seems as if many people are being harmed in the process of Suleman's choices. All of her children are being harmed financially and potentially medically. In addition, since Suleman cannot afford to provide for her family, the taxpayers will be forced to pay more to cover the cost of her family. In this way, they are also harmed. Suleman's choices were definitely not ethically appropriate.
Because a woman has the negative right to bear children, denying means to that right would be unjust if the woman posses the means to provide for that child. If a woman cannot be denied the right to bear a child than it is only justifiable that, considering she has the means to undergo IVF, she not be denied the right to use it. However, the rights of the potential child being born need to be accounted for as well. If the child is not going to be raised in an environment suitable for living, then that child's autonomy needs to be respected in the sense of what kind of environment would be appropriate for the child to have to live in. The parent also has a duty to provide for the potential child that would be born of IVF and their means of doing so need to be accounted for as well. This is where the government should have the responsibility (sense they allow IVF to be a means of having a child) to step in and determine if going through IVF should even be an option for the interested person/family.
ReplyDeleteSome have said that it is the responsibility of the government to regulate access to IVF, and that this responsibility is prevent situations where the mother/parents have no ability to support the children after birth; however, this raises the question of whether it is ethical for the government to decide this for individuals based solely on their inability (for whatever reason) to conceive. This seems to be unjust in terms of limiting equal access to the ability to exercise one's right to reproduce. Afterall, many people have children that they are unable to support, but they do so natuarlly and therefore this is never subject to examination.
ReplyDeleteIn my opinion, although the situation is unfortunate and creates a burden on society, to allow the interference with an individual's autonomy in such a way as to prevent them from reproducing is ethically unsound and may well prove a slippery slope in determining where the line should be drawn on the decisions a person is allowed to make.
As Meredith said, because procreation is a negative right, doctors and the government cannot interfere with your decision to have children or not have children. However, when nature impedes on that right, and you cannot have children naturally, it is also not the doctor's or the government's duty to assist you in trying to conceive children unnaturally. Therefore, doctors do not have to go to heroic measure (ie: implanting 8 embryos) to help a woman conceive. Furthermore, the implantation of multiple embryos (any number over 2) puts both babies and mothers more at risk for complications. Any embryo implanted after two increases risk at an unnecessary rate, and therefore the doctor is violating his/her oath to do no harm. While the patient's autonomy is at stake for choosing how many embryos should be implanted, in this case, the doctors oat of nonmaleficience and beneficience towards both mother and potential child trump. The doctor is not "limiting" the woman's ability in this way because the woman had no natural abiltiy in the first place.
ReplyDeleteIn regards to insurance, it is within reason that insurance pays for IVF, but it is not unethical if some insurance carriers do not cover IVF, because it is not medicine's duty to help or hinder a person's reproductive right. The women who do have insurance that cover IVF should see it as a privilege, and not a right. Therefore, it is ethical then that women who do not have insurance cannot pay for IVF, because once again, IVF is a privilege, and not a moral right.
-Kathryn Roberts
To give birth is a women’s fundamental right. However, when having children is a detriment to society and a burden on the children’s quality of life is when society should consider suspending a women’s right to give birth. Doctor’s and insurance companies can suspend a women’s ability to have birth in multiple ways. The USA could implement a law stating that a family can only have so many children. This will control the number of children a person is allotted per family and be an equal opportunity to every family. Therefore whether rich or poor all is equal in family opportunities. Another option is to tax families for every child they have therefore guaranteeing that the family or individual is able to take care of their child. People who are unable to afford a child would have to give the baby up and the taxes already paid would go towards taking care of that child. The right to have children is a wealthy right because most insurance companies do not cover abortion. The problem with this is that if you get pregnant you have to have a child. When you are wealthy you can afford to have children, you can give them a good quality of life. Wealthy individuals tend to afford better insurance and therefore if facing infertility they have the option to have a surrogate or undergo infertility treatment, therefore allotting them to have children. Abuses such as the Octomom are not unethical when pertaining to the moms abuses. She wanted to have another child and with expenses the doctor made a questionable decision by putting six embryos in, not the woman. The women, however, should not undergo treatment unless sure that they can take care of and afford the children. The doctor should be the one held responsible. If the women could only afford to have one child the she should only be able to receive 3 embryos. Because the rate of failures is so high, three embryos should be conducive to limiting the amount of children. A lot of individuals feel nothing should be done because giving birth is a fundamental right and the United States is all about freedom and rights to all. However if the government imposed a tax on children instead of tax breaks then more people would be less likely to have a child. Another option is to require the mother/family to pay for birth. Any hospital visits and so on would not be covered by insurance. Baby food and formula could be more expensive to guarantee that individuals could afford a child. However, nothing should be done to stop a women from having a child. The only steps ethically reasonable would be to take the child from a mother who cannot afford to have a kid and put them in foster care. Thus, allowing the child a right to life.
ReplyDelete-KEENAN
It was noted above that while Suleman paid out of pocket for her IFV treatment that resulted in her octuplets, she was on welfare at the time. This makes me question how one could afford such an expensive procedure when she already had six children at home. While it is her right to have children, is it the tax payers duty to help pay for them? While I do not believe that Suleman, for example, should just be able to keep having as many children as she wants while she cannot afford to do so, trying to regulate who can have children and how many is a slippery slope, and is a violation one's procreative liberty. A person has the right to choose to reproduce or to choose not to reproduce, both of which cannot be taken away. Government regulation of who can reproduce and how many children they can have is not the best way to go because it opens up a wide variety of populations to questions whether they should be allowed to conceive a child or have more than a certain number. Should past drug users really be allowed to have children? What about people who have genetic disorders? While I believe that it is ethically not right to have 14 children when you cannot support them, I do not think that government regulation is a better option. In terms of IVF, the regulation should be in the hands of the doctor. In the Suleman case, it is unclear as to why the doctor implanted so many fertilized eggs at once. While it is common practice to implant more 2-3 because it not likely that more than 1, if at all, will grow into a fetus, the implantation of 8 embryos is unethical. By practicing medicine the way he did, the doctor is in violation of his duty to do no harm.
ReplyDeleteTorri
Infertility is an issue that should be focused on. If we claim that the right to reproduce is a negative right, and therefore shouldn't be taken away, then how can you justify claiming that the octomom was unethical for having so many children? We can use another well known family to justify our case. Currently, there is a family doing a reality tv show about their family. They have 18 children. The ocoto mom has 14, 6 previous children and the octuplets. This family has more children than the octomom but they are not recieving the same critcism the octomom is recieveing. Why? Because they did not, as far as I know, ever utilize IVF in order to have so many children. How can we claim that it isn't ok for octo-mom to have so mnay children, but for another family to have more children?
ReplyDeleteHowever, it is important to recognize that having multiples is extremely expensive on the health care system. Multiples are more at risk for low-birth rate and all the problem associated with low birth rate babies and pre-mature babies. For the sake of the unborn children, I suppose you have to weigh their rights to a healthy life, with the rights of the mother to have multiples? With IVF, this isn't a natural process but one that could be controlled and regulated to prevent such high risk circumstances as having eight children at once. However, for IVF to be better regulated, there must be carefully thoughght out regulations put into place, that do not violate the right of a women to procreate and the right to her autonomy in decided how many children she wants to have. It is indeed, a slippery slope.
-A.Rabens
The case of the octomom is a highly specific and anomalous situation that requires careful consideration of both the law and ethics. Nadya Suleman explicitly when against the law when she implanted 6 embryos during her IVF treatment which was paid for with by Welfare money. This seems like an ethical violation for Welfare to give her the money to do this when many women who cannot have children and aren't on Welfare or insurance have to play for this service and usually can't afford it. Because the octomom abused the services of Welfare when she implanted more than the legal amount of embryos, this is a clear violation of the principle of justice. Because Welfare money comes from taxpayers, all of the eight children that Suleman had will be supported on that money that taxpayers had to give to a woman who broke the law. It is not ethical for people to have to compensate for the illegal abuse of IVF treatments that Suleman committed. Usually this would not be an issue for other women who have children while on Welfare, it is the abuse of the treatment that throws the balance of justice off and forces other people to have to overcompensate for another person's wrongdoings. Even though having children is a negative right, the case of the octomom should make people examine more closely what constitutes an exception to this rule. More and more exceptions will likely come up as more types of reproductive technology is invented. This exception is that other people were harmed (both the taxpayers and the other women that can't afford IVF.)
ReplyDeleteIsabel Shanahan
I believe that it is right for insurance companies to limit a woman's ability to reproduce. Exactly as hinted at in the prompt, reproducing without heeding the consequential restrictions that will be imposed upon your offspring is, simply put, being absoultely irresponsible. From a purely economical perspective, the outcome of having a ridiculous amount of children is either one where each child does not get the sufficicent attention and care that he or she needs, or one where only a select number of her offspring gets any attention and care at all while the others suffer from negligence; one's attention can only be split a certain number of ways at once, afterall.
ReplyDelete