Saturday, October 08, 2005

Fear and Loathing in Beverly Hills

Liza Mundy, a staff writer for the Washington Post, writes about America's obsession with infertility in a sharp and incisive critique of NBC's latest medical show -- a fertility clinic soap opera called "All Too Conceivable". Watching the show with a combination of what she describes as "revulsion and fascination", Mundy points out that in the United States, "we do not have much in the way of public discussions of reproductive technology, in part because we do not seriously regulate it." Which brings up a good question: in order to have serious public discussions, do we have regulate something? What do you think? Comments welcome...

1 comment:

Kevin T. Keith said...

I also found that article very off-putting. The writer clearly fears the "wide open" nature of fertility assistance. She does seem to assume regulation of the types of procedures allowed, and the conditions under which they will be performed, is necessary both to rein in the more startling procedures and provide an opportunity to create a public consensus about them.

For better and worse, in England and much of Europe there are laws and/or bureaucrats determining which procedures can be offered and to whom. The decisions that get handed down invariably lead to public disputes, which lead to ongoing, anguished attempts to hammer out a collective moral consensus. Here—where the U.S. Centers for Disease Control and Prevention does little more than track patient loads and outcome rates for clinics that choose to be monitored—moral "consensus" often means doctors sitting around a table, or e-mailing bioethicists, or deciding on their own. Rarely do these discussions bubble over into the public.

I'm not sure that her prescription is well-considered. Certainly the public discussions that have "bubbled over" in the US about reproductive freedom and assisted fertility have generated less consensus than a full-out political fight over who will control the decision-making. And I don't think, either, that there needs to be consensus on these issues, or that the procedures she mentions, which seem to be problematical only because they're unusual, need to be repressed.

The writer has an interesting point in the differences between East Coast and West Coast clinics in what they will allow or participate in (a "medical necessity" model in the former and a "consumer's choice" model in the latter). Her list of abuses, from this show or from real life, however, predictably enough just boil down to things that she personally doesn't feel comfortable with and therefore thinks should not be allowed.

To me that's not an argument for greater regulation - it's an argument for greater freedom.