May 2, 2007
Getting past the hype of promising treatments.
Slate magazine reviews two books that deal with some of the untold truths about fertility treatment. "The fertility industry has been far better at inventing awe-inspiring technology - and selling it to the public - than it has been at counseling patients about the risks of procedures and how these technologies will shape families, sometimes in ways they didn't anticipate." Patients, or consumers, are not told of the problems that may result from a multiple birth; they are not told about an increased likelihood of birth defects or cancer. They are unaware of the other unasked questions about the differences between babies born with the help of fertility treatments and those born without that help.
"In this commercial business, it's often left to families to figure out where and when to draw the line on treatments. That's particularly tough given how achingly desperate many patients are to have a baby." These families are easily manipulated by clinics with services to offer. "You don't notice your motivation distorting," writes Peggy Orenstein, "how conception rather than parenthood become the goal, how invested you become in its 'achievement.' "
Slate's Maggie Jones writes,
IVF cycles typically cost about $12,000, and only a handful of states mandate insurance coverage. So, when a doctor asks a patient, 10 minutes before the embryo transfer, whether she wants to implant two or three or four embryos - and she's recently taken out a second mortgage to fund her pregnancy attempts - it's pretty tempting to choose the greatest number of embryos.
Like many too many treatments on the frontier of medicine, bioethical and moral considerations often come only after the treatments have been tried. Those treatments, often hyped by supporters hoping to overcome moral objections, prove not to be as effective as promised or to have undesirable outcomes or side effects.
Of course, sometimes the actual effects of a treatment may only be known once thousands of people have tried it. And the frontier of medicine often produces wonderful treatments.
Unfortunately, when moral and ethical objections are raised debates often devolve into hyped promises by research proponents and hyped brave-new-world objections by those with ethical opposition. Ethical objections raised could be dealt with by thoughtful discussion and creative thinking (as some scientists are trying to do with stem-cell research by finding ways to study embryonic stem cells without destroying embryos). But some scientists and those with financial stakes in selling new treatments aren't interested in hearing moralistic objections.
Now that the fertility treatments covered in these books are so widely used, It's too bad that we're just now talking in dispassionate ways about them.