Medical Ethics

The Beverly Hills doctor whose fertility treatment led to the birth of Nadya Suleman's octuplets -- and her six previous children -- has one of the worst success rates of any fertility clinic in the country, according to federal records reviewed by The Times. In fact, Suleman's children represent a sizable portion of the pregnancy rate at his clinic over the last several years -- and taxpayers are already footing part of the bill.

Even as the birth of octuplets at Kaiser Permanente Bellflower Medical Center drew attention and applause from around the country, questions arose Tuesday about whether the mother's doctors did enough to prevent such a risky pregnancy. The chances that the eight babies born Monday were conceived naturally are infinitesimal, infertility specialists and doctors in maternal-fetal medicine say.

When the identity of Nadya Suleman's fertility doctor was made public this week, the Internet lit up with angry commentary. Many called for Dr. Michael Kamrava to be stripped of his medical license -- or worse -- for providing the fertility treatments that led to Suleman's 14 children, including last month's octuplets. Rosalind Saxton had a different reaction.

A few months after Dr. Michael Kamrava helped Nadya Suleman become pregnant with octuplets, he transferred at least seven embryos to another patient. She was in her late 40s and wanted just one baby. Now she's five months pregnant with quadruplets and hospitalized at Los Angeles County-USC Medical Center, according to several sources familiar with the situation. The new case could add to concerns about Kamrava's practice and about whether the fertility industry needs more regulation.

An influential U.S. senator sent a series of letters Friday seeking additional details about four liver transplants at UCLA Medical Center involving patients who were suspected members or associates of Japanese organized crime groups. "While surgeons do not seek to pass moral judgment on the patients they treat, Americans hope at the very least that foreign criminal figures wait in line along with the rest of us," Sen. Charles E.

For physicians of a certain age, the weekly teaching session known as grand rounds is a ritual steeped in formality and tradition. Presided over by the profession's graybeards, grand rounds are attended with white coats on and clinical details in hand. Here, young physicians learn to accept their elders' old-school admonishments with reverence and humility. Grand rounds on the Internet, however, is another thing altogether.

Six years of frustration and heartbreak. That's how Gina Rathan recalls her attempts to become pregnant. Finally, she and her husband, Cheddi, conceived a daughter, now 3, through in vitro fertilization. About a year later, she became pregnant with a second child, naturally. Their family was complete. Then, a year ago, the Fountain Valley couple received a bill reminding them that their infertility journey wasn't quite over.

Dr. Jay Katz, a psychoanalyst and Yale Law School professor whose analysis of the conflicting interests and motivations of doctors and patients made him a leading authority on medical ethics, died of heart failure Monday in New Haven, Conn. He was 86. Katz was best known for his 1984 book "The Silent World of Doctor and Patient," which examined the complex factors that shape the physician-patient relationship and hinder the medical decision-making process. "This was his most significant work. .

Patients of a West Hollywood dermatologist became unwitting guinea pigs for an experimental drug when the doctor began secretly injecting them with an unapproved substitute for Botox, federal authorities allege. Dr. David Cary Hansen was indicted Wednesday by a federal grand jury in Los Angeles in connection with an alleged scheme to treat patients with an experimental form of the popular wrinkle reducer that was labeled "Not for Human Use."

This is about Ashley's dignity. Everybody examining her case seems to agree at least about that. Ashley is a 9-year-old girl who has static encephalopathy, a severe brain impairment. She cannot walk or talk. She cannot keep her head up, roll over or sit up by herself. She is fed with a tube. Her parents call her "Pillow Angel" because she stays right where they place her, usually on a pillow.