REPRODUCTIVE TECHNOLOGIES
AND THE LAW
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
LexisNexis Law School PublishingAdvisory Board
Paul Caron
Charles Hartsock Professor of Law
University of Cincinnati College of Law
Olympia Duhart
Professor of Law and Director of Lawyering Skills & Values Program
Nova Southeastern University Shepard Broad Law School
Samuel Estreicher
Dwight D. Opperman Professor of Law
Director, Center for Labor and Employment Law
NYU School of Law
Steve Friedland
Professor of Law
Elon University School of Law
Joan Heminway
College of Law Distinguished Professor of Law
University of Tennessee College of Law
Edward Imwinkelried
Edward L. Barrett, Jr. Professor of Law
UC Davis School of Law
Paul Marcus
Haynes Professor of Law
William and Mary Law School
John Sprankling
Distinguished Professor of Law
McGeorge School of Law
Melissa Weresh
Director of Legal Writing and Professor of Law
Drake University Law School
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
REPRODUCTIVE
TECHNOLOGIES AND THE
LAW
Second Edition
Judith DaarAssociate Dean for Academic Affairs and Professor of Law
Whittier Law School
Clinical Professor of Medicine
University of California Irvine School of Medicine
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
ISBN: 978-0-7698-4603-3
Looseleaf ISBN: 978-0-7698-4604-0
E-Book ISBN: 978–0–3271–7935–1
Library of Congress Cataloging-in-Publication Data
Daar, Judith.
Reproductive technologies and the law / Judith Daar. -- 2nd ed.
p. cm.
Includes index.
ISBN: 978-0-7698-4603-3
1. Human reproductive technology--Law and legislation--United States. 2. Human reproductive technology--
Law and legislation. I. Title.
KF3830.D33 2012
346.7301’7--dc23
2012035848
This publication is designed to provide authoritative information in regard to the subject matter covered. It is soldwith the understanding that the publisher is not engaged in rendering legal, accounting, or other professionalservices. If legal advice or other expert assistance is required, the services of a competent professional shouldbe sought.
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(2012–Pub.3197)
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Dedication
For Eric and our beloved sons,
Evan, Jared, Adam and Ryan
iii
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
Preface to the Second Edition
Tracking a field that is in constant motion poses unique challenges and opportunities.
In the six years since the first edition of this book appeared, the field of assisted
reproductive technologies (ART) has, at the same time, advanced, matured, stabilized and
stalled. Each of these trajectories is explored alongside the particular area to which they
attach. This new edition invites readers to plumb the origins of the world of assisted
conception and then trace its development to the present day. Now that the world has
welcomed more than 5 million children born via ART, and nearly 3 out of every 100
babies born in the United States are the product of assisted conception, the impact and
import of the field cannot be overstated.
While the book contains an array of new cases, statutes, policies and commentaries, the
fundamentals remain largely unchanged. ART continues to develop as an
interdisciplinary field in which physicians and scientists work to create and improve
techniques for family formation, and more recently medical therapy, while lawyers and
lawmakers strive to understand and organize society’s response to each new
development. As more ART laws pepper the legal landscape, and demand for the
technologies grow, so too will the need for informed practitioners who can represent the
interests and needs of each stakeholder in the complicated equation. This book is
designed to pique interest in ART as an academic discipline, as well as a robust and
satisfying practice option.
This new edition is the work product of many generous students, colleagues, assistants
and readers who have contributed their insights and efforts to help produce a book that is
worthy of today’s ART enthusiast. First, I want to thank the countless students who have
pondered the book’s material and reached out to share their thoughts and comments,
many of which are incorporated throughout the pages that follow. Next, enormous credit
and gratitude go to my tireless research assistants who have exhibited nothing but good
cheer is responding to myriad requests over several years. My sincere thanks to Gerrick
Warrington, Megan Emmer, Michael Ruttle and Nelly Ispiryan, all RAs extraordinaire.
Finally, our institution is enormously benefitted by the services of an outstanding staff,
including two members who worked with me throughout the writing process. Special
thanks to Jennifer Maniscalco for her consistently superb administrative assistance and
Rosalie Robles for her keen editing eye. Above all, any modicum of success this book or
its author enjoys is made possible by the loving support of my husband Eric and our four
sons. You are the light in my life.
Judith Daar
May 2012
v
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
Preface
The world of assisted reproductive technologies is a relative newcomer to the law
school curriculum, making its perceptible entrance only within the past two decades or
so. Yet the discipline mixing law and assisted conception seems to have established firm
roots, sustained by a nearly daily dose of activity somewhere around the globe. The study
of reproductive technologies has branched out from its founding in the late 1970s with
the introduction of in vitro fertilization, to a field that includes such emerging topics as
posthumous reproduction, embryonic stem cell research and human cloning. These topics
often take center stage in our political and social world, making them ideal for dissection
in the law school classroom.
This casebook is designed to introduce our students to the essentials in science,
medicine, law and ethics that underpin and shape each of the topics that combine to form
the law of reproductive technologies. As each new technology is introduced, an effort is
made to fully inform the reader about the clinical application of the technique — that is,
how the procedure is used to treat patients facing infertility or produce advances in
medical research. Once comfortable with the science, students can then contemplate the
legal parameters that do or should accompany the technology. Since so much of the law
in this area is either nascent or wholly unformed, students are free, and indeed
encouraged, to design legal systems that meet the needs of patients, parents, children and
society at large — participants all in the world of assisted reproduction.
A cautionary note about the intensity of feelings that often attaches to discussions
about the essential core of this book. At the heart of reproductive technologies beats the
debate over the moral status of the early human embryo, and no book could do justice to
the topic without fully exposing the depth and complexity of that debate. Early on, and
continuing throughout the book, students are asked to contemplate, and even reveal, their
views on the status of early human life so as to shape the various lenses through which
the class will see the panoply of issues that implicate embryonic development. In my
experience, this classroom discussion has been among the richest, often displaying a wide
range of views yet always breeding respect for difference and the rights of expression that
follow.
Writing this book has been nothing short of glorious. The mysterious world of a law
professor is filled with many joys, from watching students blossom in the classroom to
advancing one’s own fund of knowledge through dialogue with gifted colleagues. For my
already ideal academic world, the experience of preparing this casebook added an
exquisite dimension that served to buoy my enthusiasm for this subject and for the art of
writing in general. Though writing is a solitary sport, its very existence rests in the good
graces of the many who patiently support the writer in her pursuit of the perfect turn of
phrase. For me, those supporters were many and my gratitude is deep.
I want to first thank my dear friend Stacy Herman who assured me that she did indeed
want to read the entire manuscript as each page slowly emerged from the printer. In her
precious spare time, she diligently read every word, editing and making suggestions that
undoubtedly added to the overall quality of the work. In life, such friends are rare and to
be zealously cherished. Equal thanks are due Rosalie Robles, my law school assistant,
who aided throughout the writing process, showing particular strength in helping secure
vii
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permission to include works from the many folks whose writing I have relied upon to
present a comprehensive view of the field.
Finally, and most importantly, I am profoundly grateful to my husband Eric, whose
unconditional love and abiding support has been the pillar of my existence for nearly a
quarter century. Together we have been blessed with the privilege of reproduction four
times over, and with the birth of each son I gained a further appreciation for the quest of
parenthood that, when elusive, can shake one to the core. I hope this book helps and
inspires our students to probe deeply into that quest, whether for academic or personal
satisfaction.
Judith Daar
May 2005
Preface
viii
Copyright © 2013 Carolina Academic Press, LLC. All rights reserved.
Table of Contents
Preface
Acknowledgments
Chapter 1 HUMAN REPRODUCTION: NATURAL AND ASSISTED
METHODS OF CONCEPTION . . . . . . . . . . . . . . . . . . . . . 1
SECTION I: THE WONDERS OF HUMAN REPRODUCTION . . . . . . . . . . . . . . 1
A. Natural Conception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Lawrence J. Kaplan & Carolyn M. Kaplan, Natural Reproduction and
Reproduction-Aiding Technologies . . . . . . . . . . . . . . . . . . . . . . . . . 2
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
B. Infertility: When Natural Conception Does Not Occur . . . . . . . . . . . . . . 9
1. Defining the Causes of Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . 11
The New York State Task Force on Life and the Law, Assisted
Reproductive Technologies: Analysis and Recommendations for Public
Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2. Defining the Incidence of Infertility . . . . . . . . . . . . . . . . . . . . . . . . . 12
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
SECTION II: JUDICIAL PERSPECTIVES ON THE MODERN ROLE OF
REPRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
A. An Introductory Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Bragdon v. Abbott . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
SECTION III: ASSISTED CONCEPTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
A. A Brief History of ART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
1. The Earliest Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
2. Human Artificial Insemination . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Gursky v. Gursky . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
B. Conception in the Laboratory — In Vitro Fertilization . . . . . . . . . . . . . 35
1. Investigating the Possibility of Conception Outside the Body . . . . . . . 35
2. Advances in IVF and the Future of ART . . . . . . . . . . . . . . . . . . . . . 36
3. A Glossary of ART Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
C. Successes and Failures in ART Medicine . . . . . . . . . . . . . . . . . . . . . . 40
1. Is ART Effective? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
2. Is ART Safe for Children and Adults? . . . . . . . . . . . . . . . . . . . . . . . 45
a. Safety to Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
ix
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Manon Ceelen, Mirjam M. Van Weissenbruch, Jan P.W. Vermeiden,
Flora E. Van Leeuwen, and Henriette A.
Delemarre-van de Wall, Growth and Development of Children Born
After In Vitro Fertilization . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
George Kovalevsky, Paolo Rinaudo, and Christos Coutifaris, Do
Assisted Reproductive Technologies Cause Adverse Fetal Outcomes?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
b. Safety to Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Edward G. Hughes and Mita Giacomini, Funding In Vitro
Fertilization Treatment for Persistent Subfertility: The Pain and the
Politics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
SECTION IV: WHAT IS THE NATURE AND STATUS OF THE HUMAN
EMBRYO? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
A. The Biological Status of the Human Embryo . . . . . . . . . . . . . . . . . . . . 56
Howard W. Jones, Jr. and Lucinda Veeck, What Is An Embryo? . . . . 56
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
B. The Legal Status of the Human Embryo . . . . . . . . . . . . . . . . . . . . . . . 60
1. An Introductory Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Davis v. Davis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
2. Legal Responses to the Status of the Human Embryo . . . . . . . . . . . . 70
Timothy Stoltzfus Jost, Rights of Embryo and Foetus in Private Law
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
C. The Moral Status of the Human Embryo . . . . . . . . . . . . . . . . . . . . . . . 74
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Chapter 2 PROCREATIONAL LIBERTY: CONSTITUTIONAL
JURISPRUDENCE AND THE RIGHT TO
REPRODUCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
SECTION I: TRADITIONAL REPRODUCTION AND THE CONSTITUTION . . 81
A. Establishing Reproduction as a Fundamental Right . . . . . . . . . . . . . . . 81
1. The Early Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Meyer v. Nebraska . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Skinner v. Oklahoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
2. State Support for Mandatory Sterilization . . . . . . . . . . . . . . . . . . . . 92
Buck v. Bell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
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Paul A. Lombardo, Facing Carrie Buck . . . . . . . . . . . . . . . . . . . 95
B. The Right to Avoid Procreation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
1. Emerging Advances in Human Contraception . . . . . . . . . . . . . . . . . 100
Griswold v. Connecticut . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Eisenstadt v. Baird . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
2. Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
a. The Seminal Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Roe v. Wade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
b. The Roe Progeny . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Webster v. Reproductive Health Services . . . . . . . . . . . . . . . . 120
Planned Parenthood of Southeastern Pennsylvania v. Casey . . 123
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
c. The Latest Word on Abortion, For Now . . . . . . . . . . . . . . . . . . . 130
SECTION II: ASSISTED REPRODUCTION AS A FUNDAMENTAL RIGHT . . 130
A. Arguments for Recognizing ART as a Fundamental Right . . . . . . . . . 130
John A. Robertson, Children of Choice: Freedom and the New
Reproductive Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
B. Arguments Against Recognizing ART as a Fundamental Right . . . . . . 138
Radhika Rao, Constitutional Misconceptions . . . . . . . . . . . . . . . . 138
Ann MacLean Massie, Regulating Choice: A Constitutional Law
Response to Professor John A. Robertson’s Children of Choice . . . 143
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
C. Judicial Perspectives on ART as a Fundamental Right . . . . . . . . . . . . 150
1. Equating ART and Natural Conception . . . . . . . . . . . . . . . . . . . . . 151
Lifchez v. Hartigan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Kass v. Kass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
2. Distinguishing ART from Natural Conception . . . . . . . . . . . . . . . . 158
Davis v. Davis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Gerber v. Hickman . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Chapter 3 THE BUSINESS OF ART: SELLING, DONATING AND
INSURING ASSISTED REPRODUCTION . . . . . . . . . . . 173
SECTION I: UNDERSTANDING THE MARKET FOR REPRODUCTIVE
TECHNOLOGIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
A. Fertility Clinics as Providers of ART Services . . . . . . . . . . . . . . . . . . 173
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1. A Patient’s Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
2. The Physician’s Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Ethics Committee of the American Society for Reproductive Medicine,
Shared-Risk or Refund Programs in Assisted Reproduction . . . . 179
B. Profiles of ART Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Dorothy E. Roberts, Race and the New Reproduction . . . . . . . . . . . 182
SECTION II: SPERM AND EGG “DONORS” . . . . . . . . . . . . . . . . . . . . . . . . . 188
A. Sperm Donations: Assessing Risks and Benefits . . . . . . . . . . . . . . . . . 188
1. Donor Disclosure: A Child’s Perspective . . . . . . . . . . . . . . . . . . . . 191
Notes and Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194
2. The Pitfalls of Sperm Donation . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
Johnson v. Superior Court . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
B. Egg Donations: Assessing Risks and Benefits . . . . . . . . . . . . . . . . . . 205
1. The Business of Egg Donation . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Martha Frase-Blunt, Ova-Compensating?; Women Who Donate Eggs
To Infertile Couples Earn a Reward — But Pay a Price . . . . . . . 207
Judith Daar, Physical Beauty Is Only Egg Deep . . . . . . . . . . . . . 211
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
2. The Ethics of Egg Donation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Ethics Committee of the American Society for Reproductive Medicine,
Financial Compensation of Oocyte Donors . . . . . . . . . . . . . . . . 215
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
3. Informed Consent and Egg Donation . . . . . . . . . . . . . . . . . . . . . . . 223
a. Informing Egg Donors of Risks and Benefits . . . . . . . . . . . . . . . . 223
Gregory Stock, Eggs for Sale: How Much Is Too Much? . . . . . 223
Judith Daar, Regulating the Fiction of Informed Consent in ART
Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
b. Informing Donors About Gamete Placement . . . . . . . . . . . . . . . . 228
Litowitz v. Litowitz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
SECTION III: THE BENEFITS AND BURDENS OF AN ART MARKET . . . . . . 233
A. Should We Ban a Market for the Sale of Gametes? . . . . . . . . . . . . . . . 233
1. Arguments for Market Inalienability . . . . . . . . . . . . . . . . . . . . . . . 233
Mary Lyndon Shanley, Collaboration and Commodification in Assisted
Procreation: Reflections on an Open Market and Anonymous Donation
in Human Sperm and Eggs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
2. Arguments In Support of a Gamete Market . . . . . . . . . . . . . . . . . . 239
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Richard A. Posner, The Ethics and Economics of Enforcing Contracts
of Surrogate Motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
B. Should the ART Market Be Open to All Willing Buyers and Sellers? . . 243
1. Exclusions Based On Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Judith Daar, Death of Aging Mother Raises More Questions About IVF
Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Ethics Committee of the American Society for Reproductive Medicine,
Oocyte Donation to Postmenopausal Women . . . . . . . . . . . . . . 245
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
2. Exclusions Based on Health Status . . . . . . . . . . . . . . . . . . . . . . . . 247
Ethics Committee of the American Society for
Reproductive Medicine, Human Immunodeficiency Virus and Infertility
Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Notes and Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
3. Exclusions Based on Marital Status and Sexual Orientation . . . . . . . 256
North Coast Women’s Care Medical Group, Inc. v. San Diego County
Superior Court . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
SECTION IV: INSURING ART SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
A. The Market Landscape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
1. The Status of Infertility Insurance Coverage . . . . . . . . . . . . . . . . . . 262
a. Statutory Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
b. Case Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266
Lisa M. Kerr, Can Money Buy Happiness? An Examination of the
Coverage of Infertility Services Under HMO Contracts . . . . . . 267
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Saks v. Franklin Covey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
2. The Politics of ART Insurance Coverage . . . . . . . . . . . . . . . . . . . . 280
Edward G. Hughes & Mita Giacomini, Funding In Vitro Fertilization
Treatment for Persistent Subfertility: The Pain and the Politics . . 280
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
B. ART Insurance Coverage and the Effect on Clinical Outcomes . . . . . . 282
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Chapter 4 CHOOSING OUR CHILDREN’S TRAITS: GENDER AND
GENETIC SELECTION IN ART . . . . . . . . . . . . . . . . . . 285
SECTION I: THE CURRENT STATE OF TECHNOLOGY . . . . . . . . . . . . . . . 288
A. Choosing a Child’s Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
1. Preconception Gender Selection . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Ethics Committee of the American Society for Reproductive Medicine,
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Preconception Gender Selection for Nonmedical Reasons . . . . . 292
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296
2. Postconception Gender Selection . . . . . . . . . . . . . . . . . . . . . . . . . 299
The Ethics Committee of the American Society for Reproductive
Medicine, Sex Selection and Preimplantation Genetic Diagnosis . 299
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
John A. Robertson, Extending Preimplantation Genetic Diagnosis:
Medical and Non-medical Uses . . . . . . . . . . . . . . . . . . . . . . . . 308
The President’s Council on Bioethics, Beyond Therapy: Biotechnology
and the Pursuit of Happiness . . . . . . . . . . . . . . . . . . . . . . . . . . 310
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
B. Choosing a Child’s Genetic Make-Up . . . . . . . . . . . . . . . . . . . . . . . . 313
1. Using Preimplantation Genetic Diagnosis to Cure Illness . . . . . . . . . 314
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Susan M. Wolf, Jeffrey P. Kahn, John E. Wagner, Using
Preimplantation Genetic Diagnosis to Create a Stem Cell Donor:
Issues, Guidelines & Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . 316
R (on The Application of Quintavalle) v. Human Fertilisation and
Embryology Authority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
2. Using Preimplantation Genetic Diagnosis to Avoid Illness . . . . . . . . 334
a. PGD and the Meaning of Disability . . . . . . . . . . . . . . . . . . . . . . 334
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336
b. PGD and Adult-Onset Diseases . . . . . . . . . . . . . . . . . . . . . . . . . 339
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
3. Using Preimplantation Genetic Diagnosis to Achieve Pregnancy . . . 341
SECTION II: THE CURRENT STATE OF THE LAW . . . . . . . . . . . . . . . . . . . 343
Genetics & Public Policy Center, Preimplantation Genetic Diagnosis: A
Discussion of Challenges, Concerns, and Preliminary Options Related to
the Genetic Testing of Human Embryos . . . . . . . . . . . . . . . . . . . . . . 343
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
SECTION III: ETHICAL AND LEGAL DEBATE SURROUNDING GENDER
SELECTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 352
A. Constitutional Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
Carl H. Coleman, Is There a Constitutional Right to Preconception Sex
Selection? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
B. Ethical Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 356
Rebecca Dresser, Cosmetic Reproductive Services and Professional
Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 356
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
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SECTION IV: ETHICAL AND LEGAL DEBATE SURROUNDING GENETIC
SELECTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358
A. Ethical Dilemmas Surrounding Genetic Selection . . . . . . . . . . . . . . . 358
Maxwell J. Mehlman, The Law of Above Averages: Leveling the New
Genetic Enhancement Playing Field . . . . . . . . . . . . . . . . . . . . . . 359
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362
B. Legal Dilemmas Surrounding Genetic Selection . . . . . . . . . . . . . . . . 366
Paretta v. Medical Offıces for Human Reproduction . . . . . . . . . . . 366
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 370
Chapter 5 FAMILY LAW ISSUES IN ART: QUESTIONS OF
PARENTAGE AND PARENTAL RIGHTS . . . . . . . . . . . 371
SECTION I: EARLY DILEMMAS IN FAMILY LAW . . . . . . . . . . . . . . . . . . . 371
A. Determining Paternity in AID Families . . . . . . . . . . . . . . . . . . . . . . . 371
Strnad v. Strnad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372
People v. Sorensen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 376
B. Early Changes in the Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Jhordan C. v. Mary K. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383
C. The Problem of Known Donors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384
Ferguson v. McKiernan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392
SECTION II: BUILDING FAMILIES THROUGH SURROGATE PARENTING
AGREEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
A. An Introductory Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
In the Matter of Baby M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404
B. Distinguishing “Traditional” and “Gestational” Surrogacy . . . . . . . . . 408
1. Traditional Surrogacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
R.R. v. M.H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413
2. Gestational Surrogacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415
Johnson v. Calvert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422
A.H.W. v. G.H.B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
3. Profiles in Surrogate Parenting Arrangements . . . . . . . . . . . . . . . . . 431
a. Profile of a Traditional Surrogate Mother . . . . . . . . . . . . . . . . . . 432
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b. Profile of a Gestational Surrogate Mother . . . . . . . . . . . . . . . . . . 433
c. Profile of an Intended Mother . . . . . . . . . . . . . . . . . . . . . . . . . . 435
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
C. Statutory Responses to Surrogate Parenting Arrangements . . . . . . . . . 439
1. Laws Regulating Surrogacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
a. Individual State Laws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 446
b. Uniform Laws on Surrogacy . . . . . . . . . . . . . . . . . . . . . . . . . . . 447
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451
2. Constitutionality of Surrogacy Laws . . . . . . . . . . . . . . . . . . . . . . . 453
J.R., M.R. and W.K.J. v. Utah . . . . . . . . . . . . . . . . . . . . . . . . . . 453
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
SECTION III: BUILDING FAMILIES THROUGH THE USE OF DONOR
GAMETES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 462
A. The State of the Art in Donor Gametes . . . . . . . . . . . . . . . . . . . . . . . 462
B. The State of the Law in Donor Gametes . . . . . . . . . . . . . . . . . . . . . . 464
1. Judicial Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464
In re Marriage of Buzzanca . . . . . . . . . . . . . . . . . . . . . . . . . . . 464
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 470
2. Statutory Perspectives on Donor Gametes . . . . . . . . . . . . . . . . . . . 472
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474
SECTION IV: BUILDING FAMILIES IN SAME-SEX RELATIONSHIPS . . . . . . 474
A. The Prevalence of Same-Sex Parents . . . . . . . . . . . . . . . . . . . . . . . . 474
B. Family Law Dilemmas For Same-Sex Parents . . . . . . . . . . . . . . . . . . 478
1. Determining Paternity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478
C.O. v. W.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478
Lamaritata v. Lucas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Adoption of Tammy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 483
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 487
K.M. v. E.G. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 496
SECTION V: MISHAPS IN THE LABORATORY: THE CHILDREN OF ART
GAMETE MIX-UPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 498
A. Defining the Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 498
B. Judicial Perspectives on Gamete Mix-Ups . . . . . . . . . . . . . . . . . . . . . 500
1. The Case of Physician Malfeasance . . . . . . . . . . . . . . . . . . . . . . . . 500
Prato-Morrison v. Doe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 500
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 504
2. Cases of Physician Negligence . . . . . . . . . . . . . . . . . . . . . . . . . . . 506
Robert B. v. Susan B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 506
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509
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Perry-Rogers v. Fasano . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 510
Leslie Bender, Genes, Parents, and Assisted Reproductive
Technologies: ARTs, Mistakes, Sex, Race, & Law . . . . . . . . . . . . 514
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515
C. Legislative Perspectives on Gamete Mix-Ups . . . . . . . . . . . . . . . . . . 517
Chapter 6 LIFE AFTER DEATH: POSTMORTEM
REPRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521
SECTION I: THE POSSIBILITIES FOR POSTMORTEM REPRODUCTION . . 522
A. Freezing Sperm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 522
1. Sperm Retrieval During Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 522
a. Sperm Freezing — Past and Present . . . . . . . . . . . . . . . . . . . . . . 522
b. Emerging Legal Disputes Over Frozen Sperm . . . . . . . . . . . . . . . 524
Hall v. Fertility Institute of New Orleans . . . . . . . . . . . . . . . . 525
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528
Michael H. Shapiro, Illicit Reasons and Means for Reproduction: On
Excessive Choice and Categorical and Technological Imperatives
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 530
2. Sperm Retrieval After Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
Carson Strong, Ethical and Legal Aspects of Sperm Retrieval After
Death or Persistent Vegetative State . . . . . . . . . . . . . . . . . . . . . 535
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 538
B. Freezing Eggs: Retrieval During Life and After Death . . . . . . . . . . . . 540
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 542
C. Freezing Embryos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 542
SECTION II: LEGAL DILEMMAS IN POSTMORTEM REPRODUCTION . . . . 545
A. Family Law Questions: Who Is A Parent? . . . . . . . . . . . . . . . . . . . . . 545
In re Estate of Kolacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 546
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549
B. Probate Law: Awarding Inheritance Rights and Death Benefits . . . . . . 551
Woodward v. Commissioner of Social Security . . . . . . . . . . . . . . . 551
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 556
SECTION III: STATUTORY FRAMEWORKS FOR EVALUATING THE RIGHTS OF
POSTMORTEM CONCEPTION CHILDREN . . . . . . . . . . . . . . . . . . . 560
A. Uniform Laws Governing Postmortem Reproduction . . . . . . . . . . . . . 561
1. The Uniform Parentage Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 561
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 562
2. The Uniform Probate Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 564
B. Emerging Laws Governing the Rights of Posthumous Children . . . . . . 566
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567
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C. Model Laws and Task Force Reports . . . . . . . . . . . . . . . . . . . . . . . . 569
1. The ABA Model Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 570
2. The New York State Task Force on Life and the Law . . . . . . . . . . . 570
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 571
Chapter 7 ART AND DIVORCE: DISPUTES OVER FROZEN
EMBRYOS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
SECTION I: THE POPULARITY AND FRAILTY OF EMBRYO
CRYOPRESERVATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574
Frisina v. Woman and Infant Hospital of Rhode Island . . . . . . . . . . . 575
Miller v. American Infertility Group of Illinois, S.C. . . . . . . . . . . . . . 580
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 583
SECTION II: THE LEGAL LANDSCAPE SURROUNDING FROZEN EMBRYO
DISPUTES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 585
A. An Introductory Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 585
Davis v. Davis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 585
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 589
B. The Contract Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591
Kass v. Kass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 597
Litowitz v. Litowitz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 604
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611
C. The Public Policy Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612
A.Z. v. B.Z. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612
Judith F. Daar, Frozen Embryo Disputes Revisited: A Trilogy of
Procreation-Avoidance Approaches . . . . . . . . . . . . . . . . . . . . . . . 618
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 621
J.B. v. M.B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 625
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 632
D. The Question of Parental Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . 634
In re O.G.M. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 634
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 637
SECTION III: THE PROBLEM OF EXCESS AND ABANDONED EMBRYOS . 638
A. Excess Embryos and Patient Choice . . . . . . . . . . . . . . . . . . . . . . . . . 639
1. Donate the Embryos for Research . . . . . . . . . . . . . . . . . . . . . . . . . 639
a. Type of Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639
b. State Law Prohibitions on Embryo Research . . . . . . . . . . . . . . . . 640
2. Discard the Embryos After a Designated Time Frame . . . . . . . . . . . 641
3. Maintain the Embryos in Frozen Storage . . . . . . . . . . . . . . . . . . . . 642
4. Donate the Embryos to Another Couple . . . . . . . . . . . . . . . . . . . . . 642
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B. Excess Embryos and Lack of Patient Choice: The Problem of
Abandonment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 645
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 647
York v. Jones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 648
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 652
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 652
Chapter 8 REGULATING REPRODUCTIVE TECHNOLOGIES . . 655
SECTION I: THE LEGAL LANDSCAPE FOR ART: AN INTRODUCTION . . . 656
A. The Goals of Regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 656
Judith F. Daar, Regulating Reproductive Technologies: Panacea or Paper
Tiger? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 656
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 657
B. The Current State of Regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 659
1. Direct Regulation by the Federal Government . . . . . . . . . . . . . . . . 659
2. Indirect Regulation by the Federal Government . . . . . . . . . . . . . . . 661
3. Direct Regulation by State Governments . . . . . . . . . . . . . . . . . . . . 662
4. Indirect Regulation by State Governments . . . . . . . . . . . . . . . . . . . 663
5. Self-Regulation by the Fertility Industry . . . . . . . . . . . . . . . . . . . . 665
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 666
SECTION II: IS (INCREASED) ART REGULATION NECESSARY? . . . . . . . . 668
A. Protecting ART Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669
1. Luring Patients: False Advertising and Deceptive Statements . . . . . . 669
Karlin v. IVF America, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . 669
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 672
2. Lack of Informed Consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 673
Elements to Be Considered in Obtaining Informed Consent for
ART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 673
3. Treatment Errors: Negligence, Theft, and Fraud . . . . . . . . . . . . . . . 675
4. Protecting Patient Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 677
B. Protecting ART Offspring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 680
Doolan v. IVF America (MA), Inc. . . . . . . . . . . . . . . . . . . . . . . . . 680
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 683
C. Protecting ART Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686
1. Enhancing Public Confidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686
2. Authorizing Treatment Denials . . . . . . . . . . . . . . . . . . . . . . . . . . . 687
The Ethics Committee of the American Society for Reproductive
Medicine, Child-Rearing Ability and the Provision of Fertility Services
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 687
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 690
SECTION III: PROPOSED REGULATORY SCHEMES . . . . . . . . . . . . . . . . . . 691
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President’s Council on Bioethics, Reproduction & Responsibility: The
Regulation of New Biotechnologies . . . . . . . . . . . . . . . . . . . . . . . . . 693
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 698
Chapter 9 HUMAN EMBRYONIC STEM CELL RESEARCH . . . . 703
SECTION I: THE SCIENCE OF EMBRYONIC STEM CELL RESEARCH . . . . 704
A. Introduction to the Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 704
Jennifer L. Enmon, Stem Cell Research: Is the Law Preventing Progress?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 704
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 706
B. Human and Animal Stem Cell Studies . . . . . . . . . . . . . . . . . . . . . . . 712
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 716
C. Framing the Debate Over Stem Cell Research . . . . . . . . . . . . . . . . . . 717
The President’s Council on Bioethics, Monitoring Stem Cell Research
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 717
SECTION II: THE LEGAL FRAMEWORK SURROUNDING STEM CELL
RESEARCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 718
A. Laws Relating to Aborted Fetuses as Sources of Stem Cells . . . . . . . . 719
1. Federal Law Relating to Aborted Fetuses as Sources of Stem Cells . . 719
National Bioethics Advisory Commission, Ethical Issues in Human
Stem Cell Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 719
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 722
2. State Laws Relating to Aborted Fetuses as Sources of Stem Cells . . . 724
National Bioethics Advisory Commission, Ethical Issues in Human
Stem Cell Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 724
Margaret S. v. Edwards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 726
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 729
B. Laws Relating to Embryos as Sources of Stem Cells . . . . . . . . . . . . . 731
1. Federal Law Relating to Embryos as Sources of Stem Cells . . . . . . . 731
Kara L. Belew, Stem Cell Division: Abortion Law and Its Influence on
the Adoption of Radically Different Embryonic Stem Cell Legislation in
the United States, the United Kingdom, and Germany . . . . . . . . 731
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 734
Doe v. Shalala . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 735
Question . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 741
2. State Laws Relating to Embryos as Sources of Stem Cells . . . . . . . . 741
National Bioethics Advisory Commission, Ethical Issues in Human
Stem Cell Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 741
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 743
SECTION III: GOVERNMENT FUNDING OF STEM CELL RESEARCH . . . . . 745
A. Federal Funding of Stem Cell Research . . . . . . . . . . . . . . . . . . . . . . . 746
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1. The First Presidential Proclamation: August 9, 2001 . . . . . . . . . . . . 746
Remarks by the President on Stem Cell Research . . . . . . . . . . . . 746
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 749
2. Defending and Questioning the Bush Administration Policy . . . . . . 751
O. Carter Snead, The Pedagogical Significance of the Bush Stem Cell
Policy: A Window into Bioethical Regulation in the United States
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 751
James F. Childress, An Ethical Defense of Federal Funding for Human
Embryonic Stem Cell Research . . . . . . . . . . . . . . . . . . . . . . . . 756
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 758
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 759
3. President Obama and a New Era of Stem Cell Research Policy . . . . 760
The White House, Removing Barriers to Responsible Scientific
Research Involving Human Stem Cells . . . . . . . . . . . . . . . . . . . 760
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 761
Sherley v. Sebelius . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 764
B. State Funding of Stem Cell Research . . . . . . . . . . . . . . . . . . . . . . . . 768
1. California . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 768
2. New Jersey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 770
3. Other State Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 772
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 773
SECTION IV: INTERNATIONAL AND CROSS-CULTURAL PERSPECTIVES ON
STEM CELL RESEARCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 774
A. International Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 774
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785
B. Religious Perspectives on Embryonic Stem Cell Research . . . . . . . . . 786
National Bioethics Advisory Commission Summary of Presentations on
Religious Perspectives Relating to Research Involving Human Stem
Cells, May 7, 1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 787
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 794
Chapter 10 HUMAN REPRODUCTIVE CLONING . . . . . . . . . . . . . 797
SECTION I: THE SCIENCE OF HUMAN REPRODUCTIVE CLONING . . . . . 797
A. Three Types of Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 798
1. Reproductive Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 798
2. Therapeutic Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 799
3. Embryo Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 800
B. Advances in Animal Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801
1. Safety and Efficacy Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . 802
2. Purposes of Animal Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 804
C. Inroads Into Human Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 805
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Judith F. Daar, The Prospect of Human Cloning: Improving Nature or
Dooming the Species? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 807
Lori B. Andrews, Is There a Right to Clone? Constitutional Challenges to
Bans on Human Cloning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 811
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 814
Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 815
SECTION II: THE POLITICS OF HUMAN CLONING . . . . . . . . . . . . . . . . . . . 816
A. Initial Reaction from the Federal Government . . . . . . . . . . . . . . . . . . 816
National Bioethics Advisory Commission, Cloning Human Beings . 816
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 819
B. Later Reactions from the Federal Government . . . . . . . . . . . . . . . . . . 822
The President’s Council on Bioethics, Human Cloning and Human
Dignity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 823
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 825
C. Reactions from the States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 826
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 829
SECTION III: CONSTITUTIONAL ASPECTS OF HUMAN CLONING . . . . . . . 831
A. Cloning and Procreational Autonomy . . . . . . . . . . . . . . . . . . . . . . . . 831
Elizabeth Price Foley, Human Cloning and the Right to Reproduce
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 833
George J. Annas, Lori B. Andrews and Rosario M. Isasi, Protecting the
Endangered Human: Toward an International Treaty Prohibiting
Cloning and Inheritable Alterations . . . . . . . . . . . . . . . . . . . . . . . 838
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 841
B. Cloning and the Right to Scientific Inquiry . . . . . . . . . . . . . . . . . . . . 842
John Charles Kunich, The Naked Clone . . . . . . . . . . . . . . . . . . . . 842
Notes and Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 846
GLOSSARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 849
TABLE OF CASES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TC-1
INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-1
TABLE OF CONTENTS
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ACKNOWLEDGMENTS
The author acknowledges the permissions kindly granted to reproduce excerpts from, or
illustrations of, the materials indicated below.
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