artificial insemination, in vitro fertilization, embryo

Download Artificial Insemination, In Vitro Fertilization, Embryo

Post on 10-Feb-2017

215 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

chapter 13

Legal Considerations:Artificial Insemination, In Vitro

Fertilization, Embryo Transfer, andGamete Intrafallopian Transfer

CONTENTS

PageStructure of Applicable Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ..240Artificial Insemination by Husband . . . . . . . . . . . . . . . . . . . . . . ................241

Improper Handling of Sperm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .241Disposal of Sperm After Husbands Death . . . . . . . . . . . . . . . . . . . . . ..........242

Artificial Insemination by Donor . . . . . . . . . . . . . . . . . . . . . ...................242Physician Requirement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., .. ...244Marital Status of the Recipient . . . . . . . . . . . . . . . . . . . . . ...................246Requirements for Consent of Recipients Husband . . . . . . . . . . . . . . . . . . . . ....246Husbands Rights and Duties to the Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,246Legal Status of Resulting Children . . . . . . . . . . . . . . . . . . . . . ................246Requirements for Consent of Donors Wife. . . . . . . . . . . . . . . . . . . . . . . . . . ....246S p e r m D o n o r s R i g h t s a n d D u t i e s t o t h e C h i l d . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 4 6Professional Responsibility for Screening Sperm. . . . . . . . . . . . . . . . . . . . . .. ...248Recordkeeping and Confidentiality . . . . . . . . . . . . . . . . . . . . . . ...............249

In Vitro Fertilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , ., . ............250Control Over Disposition of Embryos. . . . . . . . . . . . . . . . . . . . . . .............250Juridical Status of the Extracorporeal Embryo . . . . . . . . . . . . . . . . . . . . . . ....253Later Implantation for Same Couple . . . . . . . . . . . . . . . . . . . . . . . . . . . ........253Trusts and Estates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .........254

Gamete Intrafallopian Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .255Embryo Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ..,255

Existing Legislative Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..256Professional Responsibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....257E m b r y o D o n o r s R i g h t s a n d D u t i e s t o C h i l d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 5 7R e q u i r e m e n t s f o r C o n s e n t o f O v u m D o n o r s H u s b a n d . . . . . . . . . . . . . . , . . . . . . 2 5 8E m b r y o R e c i p i e n t s R i g h t s a n d D u t i e s t o C h i l d . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 5 8

Res t r i c t ing or Regula t ing the Sa le o f Gametes or Embryos , . , . . . . . . . . . . . . . . . . 259Models of State Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..................261Summary and Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ...262Chapter 13 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......262

BoxBox NO. Page13-A. Summary of State Laws That Specifically Address In Vitro Fertilization. ..252

TablesTable No. Page13-1. State StatutesArtificial Insemination. . . . . . . . . . . . . . . . . . . . . . ..........24313-2. State StatutesFetal Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....251

Chapter 13

Legal Considerations:Artificial Insemination, In Vitro Fertilization,

Embryo Transfer, and Gamete Intrafallopian Transfer

This chapter reviews the legal rights and dutiesrelated to a variety of the infertility treatment andcircumvention techniques discussed in this assess-ment. In many cases, the techniques are so newthat little or no guidance is available on how thelaw will be applied. There is, however, a greatdeal of speculation in the legal literature, alongwith a wealth of inadvertently and peripherallyrelated legislation and case law based on princi-ples that may have some application in the areaof new noncoital reproductive techniques.

The established medical and surgical techniquesfor treating infertility do not raise unusual legalproblems. They fall squarely within the largerarea of medical and public health laws, whichencompass questions of informed consent andprofessional standards of practice. Noncoital re-productive technologies, however, challenge tra-ditional legal thinking by introducing two novelfactors into human reproduction: the extracor-poreal embryo and the child of up to five parents:genetic mother, gestational mother, rearingmother, genetic father, and rearing father.

The conflicting interests of the many parties innoncoital reproductive technologies are difficultto adjudicate. First, some techniques separate theconcept of (biological mother, traditionally a uni-tary term, into two component parts: the genet-ic mother and the gestational mother. Existing le-gal models of the role of the purely geneticconnection between parent and child have beenworked out in the context of fathers, not mothers.For example, a genetic connection between a manand a child will render him legally and financiallyresponsible for the child, absent a formal legalintervention such as adoption (17,38). The inten-tions of the man to produce offspring or not areirrelevant.

This legal outcome protects the interests of thechild, and explains the one general exception to

this rule, i.e., that a child born to a marriedwoman is presumed to be the child of thewomans husband, regardless of the genetic real-ities of the situation. This presumption of pater-nity is common in State legislative codes (9,45).Provided that the child has two parents, the lawwill then consider other interests, such as sanc-tity of marriage, when adult responsibilities forchild care are allocated. Note that the emphasison genetic relationships with men is based on theself-evident fact that men are incapable of anyother sort of biological relationship.

Similarly, a fairly coherent body of law outlinesthe rights of biological versus rearing mothersin the context of adoption (17). Never before, how-ever, have the component rights and responsibil-ities associated with gestational versus geneticrelationships been delineated, let alone balancedagainst those of social mothers and fathers.Models of responsibility based on male biologi-cal linkages may well be inadequate to cover thecomplexities of female biological linkages, whichcan entail a gestational relationship as well as onebased on genetics.

A second problem is that many of these tech-niques involve extracorporeal gametes or em-bryos. The still imperfect national consensus onthe status of unborn children affects reproduc-tive technologies, as questions arise concerningthe management of unimplanted embryos. Where-as the abortion issue is complicated by the rightof an adult woman to control the physical stateof her body, the extracorporeal fertilized eggraises the narrower issue of embryo rights. Ifsuch rights are found to exist by virtue of the U.S.Constitution or are created by legislative action,then the course of reproductive biology researchand treatment will be profoundly affected by limi-tations on actions that might harm an embryo.

239

240 Infertility: Medical and Social Choices

Finally, new reproductive technologies raise ahost of issues that are familiar to the law, but thatrarely have been seen in such a tangled combina-tion. These include equal access to reproductiveservices by the poor, the unmarried, and thehomosexual; the rights of children with respectto their biological and social parents; the use ofcontractual arrangements to govern parental rela-tionships; and the role of governmental and com-mercial interests in areas typically viewed as pri-vate. The arrangements facilitated by noncoitalreproductive techniques invite a fresh consider-ation of the legal significance of genetic and so-cial connections between parent and child, andalso invite a review of the legal obstacles to theformation of nontraditional family groupings.

STRUCTURE OF

Both Federal and State law will affect the sta-tus of noncoital reproductive technologies. TheFederal Government has limited powers, i.e., onlythose powers granted by the U.S. Constitution,with all residual powers falling to the States orthe people (Ioth Amendment), As a result, Statesgenerally have the authority by judge-made law(also known as common law) or by State legisla-tion to protect the public health, safety, andmorals. It is on this basis that States have the au-thority to regulate familial relations, includingmarriage, divorce, adoption, inheritance, andparental duties.

In addition, contracts are generally regulatedby State statute. Thus, contracts to arrange fora surrogate mother would be subject to State lawrules governing interpretation or enforceabilityof the agreement. As each State is free to writeits own laws, a contract may have differing de-grees of enforceability from State to State (32).Some States may consider certain contractual ar-rangements as entirely void because they are con-trary to public policy, such as, for example, a con-tract of marriage between an adult and a minor.Another State might consider the contract void-able, i.e., the contract may be voided upon requestof one of the parties. In many cases, the requestto void a contract may come only from th

Recommended

View more >