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The Many Bumps on the Road to Babyville

Modern Technology and Lack of Regulation Have Combined to Create a U.S. Fertility Industry Rife With Moral Dilemmas

March 23, 1998|RICK WEISS | THE WASHINGTON POST

Miscarriages are always tragic, but some people couldn't help privately expressing relief when Tracy Veloff's pregnancy failed in December.

Veloff was a paid surrogate mother, and the fetus she was carrying had been made from the egg of a woman who had been dead for a year. It was the world's first case of posthumous maternity, a precedent many found troubling.

Lawyers were already haggling over who would be the child's parents. The biological mother, Julie Garber, was buried in December 1996 after freezing a few embryos produced from an anonymous sperm donor. Veloff had no intention of raising the child she was paid to carry.

Even Garber's parents, who had arranged the pregnancy, did not plan to raise the child themselves. They had inherited the embryos along with their daughter's furniture and other possessions, and, they said, it was their prerogative to grow them into grandchildren.

And, earlier this month, a state appeals court declared Santa Ana resident Luanne Buzzanca the legal mother of a 2-year-old girl who was conceived after Buzzanca and her then-husband, John, hired a surrogate to bear them a child using anonymous donations of egg and sperm.

The couple began divorce proceedings shortly before Jaycee Louise was born, and John Buzzanca petitioned the court to declare neither he nor his estranged wife was a legal parent, which would have left the girl parentless.

The Garber and Buzzanca cases are just two examples of an increasing number of ethical predicaments to emerge in recent years as a dizzying array of reproductive technologies has redefined the meaning of "parent" and "child" in ways wholly unfamiliar to American society and its legal system. Of the many areas of science that today are giving rise to bioethical quandaries, this one more than any other strikes at the heart of society's most cherished institution: the family.

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Today's ethical crisis in reproductive medicine is the product of converging social, economic and scientific factors. Many women in the work force have delayed childbearing to the point when technological intervention now offers their only hope of becoming biological mothers; a lack of financial support from the federal government has pushed the $2-billion-a-year fertility industry onto an aggressively entrepreneurial track; and recent advances in egg freezing, embryo manipulation and other techniques have shattered many of the biological barriers to parenthood.

The result of this convergence has been a large, uncontrolled experiment in novel methods of family-making. It has been, by some measures, a highly successful experiment--one that has brought the joys of parenthood to thousands who otherwise would have remained childless. In 1995 alone, 11,315 women gave birth to children conceived by some form of assisted reproductive technology, according to the American Society for Reproductive Medicine.

At the same time it has generated ethical, legal and social conundrums. New treatments are being rushed into use before they are fully proven to be safe or effective, potentially putting some women and children at heightened risk of physical and psychological harm. In some cases, women are not fully aware that they, their eggs or the resulting embryos are the subject of research, experts said.

As a result, a growing number of people are calling for new laws to regulate assisted reproductive medicine. The field today is largely free of federal or state oversight. In the continued absence of such regulation, critics say, more and more people--particularly children--could be harmed.

"This field is screaming for oversight, regulation and control," said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania. "If you are going to make babies in new and novel ways, you have to be sure it's in the interest of the baby."

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The ethical and legal confusion surrounding high-tech family building extends beyond the questions of embryo inheritance and parentage raised by the Garber and Buzzanca cases. Courts are also finding themselves embroiled in debates over fertility clinic record-keeping practices, which in some cases appear to have led to the loss of women's frozen embryos. And they are having to settle questions of who should bear responsibility when a woman's egg is inadvertently inseminated by diseased sperm.

In one far-reaching case, a Pennsylvania jury may soon decide the difficult question of whether fertility clinics are more than "baby marts" and have a responsibility to ensure that their clients are prepared for the challenges of child-rearing. The case came about after a 26-year-old bachelor paid a clinic $30,000 to have a child made for him, then killed the child within six weeks of bringing him home.

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