2022- A year when law and public health got really tangled. We had the Supreme Court deal with abortion, gun control, and mandatory vaccination. Internationally, euthanasia laws burgeoned. Some states enacted laws to protect the rights of children born by fraudulent misuse of IVF, and courts addressed the question of proving causation in toxic tort cases.
Looking back over the year, several pieces especially resonated with me.
I have long been fascinated by the ability of science to assist women in reproduction. Our abilities at IVF are marvels, but at the same time, as with most technology, these techniques provide the opportunity for abuse and invoke confounding ethical issues. Attorneys and judges freely admit that the law has not kept up with our technological abilities and creates judicial and social problems.
For example: What are the rights of a child concerning learning the identity of the gamete “donor” involved in their creation? (Usually, some form of compensation is involved, so it is unduly charitable to use the term “donor.”) That problem bothered me enough to write several articles on the dangers and abuses of the new reproductive technology, which in the US is largely unregulated. In Fertility Fraud: A Fertility Industry Danger, I explore instances where doctors – without their patient’s consent- used their own sperm to inseminate wanna-be mothers. Learning a sperm donor’s identity- at least in the US- has been problematic; most sperm banks require confidentiality agreements. Some have threatened suits against women (and offspring) who try to locate their sperm donors. But here, technology comes to the rescue. New commercialized DNA identification techniques and support groups such as those hosted on Facebook- have enabled half-siblings to connect with each other and identify their dads, which in some cases, turns out to be these errant doctors.
Other IVF problems have resulted when the wrong sperm is sent to the wrong mother, or the wrong embryo is implanted in the wrong woman. Legal remedies are few – leading me to write Buyer Beware: IVF Damages And The Value Of Life, along with a piece about hope for new legal remedies: The Death Of Wrongful Life.
Here’s another issue: Will new advances in genetic sequencing create a Gattaca world where genetic determinism rules? How accurate are pre-implantation genetic tests -- and should we even be using them in baby-making selection? These issues lead me to write The Curse of Knowledge And Whole Genome Sequencing.
Just as legal and bioethical issues appear with scientific advances at the beginning of life, they reappear at life’s end. The expanding use of euthanasia or medically assistance in dying (MAID) around the world led to my writing Euthanasia Run Amok (Aka Population Culling). Canadians are especially passionate about broadening this “right.” Here are some updates. According to the Dying With Dignity Canada organization,
“One of the most frustrating comments … is that medical assistance in dying (MAID) should only be for aging seniors or those with a terminal illness. It’s infuriating because it’s not true.”
Even providing MAID for aging seniors (especially without a terminal illness) boggles the mind. Yet, the move is on to expand the option to those with the early stages of a devastating illness or those whose chronic conditions limit the quality of life – at least according to outside arbiters. In 2021, Canada, which allows direct euthanasia or MAID (physician-assisted suicide) for non-terminal illnesses, hosted 10,000 people who ended their lives voluntarily. A further extension allowing such practices for mental health conditions will take effect this coming March.
Those seeking MAID in jurisdictions not providing it must travel to locations that do, for example, Switzerland. This costs money, a feature that rankles some who claim that current euthanasia practices favor the rich and argue that the “right to die” shouldn’t depend on income.
“MAID expansion is a poor alternative to increased funding for social housing and mobility assistance. [People with disabilities] don’t actually want to die, they want to live. But they want to live a life on par with other people, which is entirely possible with proper support.” Krista Carr, VP Inclusion Canada.
Sadly, the proponents of broadening the right to die don’t see the abuses this option can foster. Instead of providing better quality of life options, the legislation optimizes the escape of death for those whose lives are intolerable, not due to illness, but due to inadequate social planning, lack of resources, and unavailability of assistance. In one case I wrote about last year, facing another year of COVID lockdowns and the intolerable social isolation that came with it, an elderly, non-terminal Canadian nursing home resident chose to end her life voluntarily
Expansion of euthanasia and MAID laws provides a facile “out’ for failing to fund options that would make life more tolerable for the depressed, the aged, the disabled, and those in chronic pain who are not in danger of imminent death. The knee-jerk response to pariah-tizing the elderly, fostering a disposable-elderly mentality, and blaming them for society's deficiencies, is another subject I wrote about.
On a happier note, progress and public health leadership is possible. We just need to look to the past. Examples such as Dr. Frances Kelsey, who prevented the epidemic of thalidomide-related phocomelia (birth-related anomalies), and Dr. C. Everett Koop, who stood fast to championing science in forming policy, even when it went against his personal convictions such as supporting abortion choices, and bucking the government when it came to educating about AIDs, are lessons to us all. Sometimes a look to the past inspires the future.
A Happy, Healthy, and Scientifically Accurate New Year to All.