Topic Writing Assignment #1

Rebecca Cupp

Dr. Fantz

Biotechnology

September 19, 2013

Medical professionals are always subject to mistakes: prescribing inappropriate medications, reporting inaccurate test results, even forgetting medical sponges within patients after invasive surgery. It’s no surprise that as of 2003, the Congressional Budget Office (CBO) reported that 181,000 severe injuries could be connected to medical negligence (“Preventable Medical Errors”). But what about a mistaken birth? When Arceli Keh, 60 and childless, was accepted into an In-Vitro Fertilization (IVF) clinic for women 55 and under, receiving treatment and eventually a healthy baby, who would be at fault?

 Not the government. As of 2013, there are no regulatory agencies overseeing all patient criteria, instead, patients, in conjunction with the clinic, create an individualized Assisted Reproductive Technology (ART) plan (“Selecting Your Assisted Reproduction Technology”). Within the United Kingdom, the National Health Service (NHS), a free, public healthcare system provided by the government through taxes, decides which patients can receive IVF through a Clinical Commission Group (CCG), who ultimately decides whether to fund IVF treatment based upon the patient’s ability to meet the guidelines of the National Institute for Health and Clinical Excellence (NICE). Criteria from NICE includes the female’s age to be between 23 and 39, that one member of the couple has been formally diagnosed with a fertility problem, and one member must have been infertile for at least two years. NICE provides additional criteria for women 40-42, including no previous IVF treatment, no evidence of fertility problem due to low egg count, and an additional discussion on the implications of a late pregnancy. Finally, the individual CCG will consider their own additional criteria, typically related to living children from previous relationships, children living in the same house, whether the mother smokes,  and whether the potential mother’s and father’s ages are appropriate. The CCG can decide to allow a couple to receive IVF whose ages are different from the recommended age range provided by NICE. Patients denied by the CCG, and therefore the NHS, still may still apply for treatment in private fertility clinics, much like the U.S (“Can I get IVF treatment on the NHS?”).

            Similar to the NICE, the U.S. has a strong non-profit organization that is the central voice of reproductive health in Congress, the American Society for Reproductive Medicine (ASRM). American patients primarily use private clinics, whose criteria are based on individual discretion and a physician’s guidelines. This system, unlike the NHS, is more efficient and more profitable. American patients, such as Arceli Keh, who became the oldest woman who carried a baby to term with the help of egg donation in 1996, passed all the medical tests required for in-vitro fertilization, and gave birth to healthy child (“Arceli Keh”). Instead of being limited by the judgment of your peers, as seen in CCG, or a standardized set of criteria, such as NICE; the decision to have a child with the aid of reproductive technologies should be just as private as the decision to have a child naturally. Mothers should not be assessed by age alone; in fact, medical tests such as the treadmill test would have more to do with the physical ability to raise a child. NICE did not allow woman that produced low egg counts to qualify for IVF, perhaps to save money from egg donors, however, with the power of egg donation, the mother’s age would become irrelevant, she could simply have a young, healthy donor egg and the nucleus of one of her or her partner’s adult stem cells. Physical and mental wellbeing criteria should be standard in any public or private treatment. If a public health-care system is footing the bill, essentially, if everyone’s tax dollars will pay for a baby, then a jury of peers (CCG), and a regulating  non-profit agency (NICE or ASRM) should apply regulations set by federal government. This would allow a centralized health-care system to emerge as a public, affordable option for treatment, while monitoring private clinics.

Although Arceli lied to have a child, she did pass all her medical tests, and is still, at 78 years old, a good mother, taking interest in her daughters activities by going to the mall and listening to music together (Watson 1). The fact that she brought a donor egg to term brings a whole new realm of reproduction methods to light: could mothers still have a child, even in menopause, by having an egg donor?  Although what she did was illegal, it is also very illegal to leave sponges in a patient’s abdominal cavity after surgery. What Arceli did was wrong, but more importantly, may redefine what reproductive scientists think is right. Menopausal women should have the right to a child, to all reproductive techniques, and if needed, an egg donor. All women should be able to prove their physical and emotional abilities through medical exams, and be given guidance throughout the process, but all other criteria, including marital status, race, monetary worth, age, will not correlate with how much they love their child.

Menopausal woman that did not get the chance to become mothers should not be reduced to sneaking into reproductive care facilities just to have a child. They should be given options, just like anyone else. The social and ethical stigmas of lying to have to a child will never be repeated if regulatory laws are inspired by non-profits, passed by congress, and enacted by regulatory agencies.

Works Cited

"Arceli Keh." Medical Dictionary. N.p., n.d. Web. 19 Sept. 2013. <http://medical-dictionary.thefreedictionary.com/Arceli+Keh>.

"Can I get IVF treatment on the NHS?." NHS Choices - Your health, your choices. N.p., n.d. Web. 19 Sept. 2013. <http://www.nhs.uk/chq/Pages/889.aspx?CategoryID=54>.

"Preventable Medical Errors: the sixth biggest killer in america ." The American Association for Justice. N.p., n.d. Web. 19 Sept. 2013. <http://www.justice.org/cps/rde/justice/hs.xsl/8677.htm>.

"Selecting Your Assisted Reproductive Technology Program." American Pregnancy Association. N.p., n.d. Web. 19 Sept. 2013. <http://americanpregnancy.org/infertility/selectingartprogram.html>.

"The American Society for Reproductive Medicine (ASRM)." ASRM: Infertility, Reproduction, Menopause, Andrology, Endometriosis, Diagnosis and Treatment. N.p., n.d. Web. 19 Sept. 2013. <http://www.asrm.org/default.aspx?id=93>.

Watson, Leon. "America's oldest mother, Arceli Keh, 78, Reveals How Every Day is a Blessing." The Daily Mail. N.p., n.d. Web. 19 Sept. 2013. <http://www.dailymail.co.uk/news/article-2030350/Americas-oldest-mother-Arceli-Keh-78-reveals-day-blessing.html>.