BLOODLINES . Making Precedent . Can you judge a good parent?

Your final case arguments: Read on and rule again

You firmly believe that a person's decisions about such intimate matters as selecting a mate and building a family are private, well within what most people think of as reproductive rights. Indeed there is a body of law that supports the idea that reproductive decision making is a constitutional right with which the government cannot interfere.

In addition, the technologies you offer—from artificial insemination to gamete (egg and sperm) donation and surrogacy—make it possible to separate biology from kinship, sometimes in dramatic and surprising ways. And at least in your state, such technologies are both legal and largely unregulated.

Furthermore, you agree with court decisions in your state that say the intentions of the parties in making a baby override biology when it comes to the question of who is a parent. After all, without the efforts of the intended parents, there would be no child.

Still, unusual requests from patients, like the ones you heard today, persuade you that certain family structures are more problematic, especially for a child, and that technology is creating reproductive options that make you uncomfortable.

If you support a fundamental right to reproduce and agree that the intentions of people trying to make a baby should carry weight, it would be hard to turn down any of the patients you have seen today. What, then, should be the logical (or ethical or legal) limit to their reproductive choices, if any? Should we have the right to clone ourselves?


Yes		No

	Yes, and I changed my mind		No, and I changed my mind
	Yes, and I did not change my mind		No, and I did not change my mind


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Context

U.S. courts have held that married couples have a constitutionally protected right to reproduce (though in some instances, restrictions on age, marital status and mental competence may apply). In addition, courts recognize an individual's right not to reproduce.

Cases

A series of U.S. Supreme Court rulings establish a person's federal constitutional right of privacy and reproductive choice. This right was most recently affirmed in Planned Parenthood v. Casey (1992), where the Supreme Court "recognized protection accorded to liberty relating to intimate relationships, the family, and decisions about whether to bear and beget a child."

The right not to reproduce is clearly recognized in the U.S. Supreme Court decisions protecting the right to abort a pregnancy (Roe v. Wade, 1973) and the right to use contraception to avoid pregnancy (Griswold v. Connecticut, 1965). In addition, the Court has shown its broad support for a fundamental right of married people to reproduce without interference by the government (Skinner v. Oklahoma, 1942).

1942: In Skinner v. Oklahoma the U.S. Supreme Court rules that a 1935 law allowing the forced sterilization of certain kinds of criminals is unconstitutional.

1965: In Griswold v. Connecticut the U.S. Supreme Court rules that married couples have the right to privacy, including the right to use contraception to avoid pregnancy.

1972: In Einstadt v. Baird the U.S. Supreme Court rules that a Massachusetts law allowing the sale or distribution of contraceptives to married persons only is unconstitutional. The court finds that the right to privacy established in Griswold v. Connecticut extends to all individuals and thus protects the right of unmarried people to obtain contraceptives.

1973: In Roe v. Wade the U.S. Supreme Court determines that the unborn are not persons, and therefore do not come under protection of the 14th Amendment, and that abortion is a protected reproductive (privacy) right.

1992: In Planned Parenthood v. Casey the U.S. Supreme Court votes to uphold Roe, but it also imposes notification and consent requirements as a prerequisite for obtaining an abortion.

Look Deeper

In late 2002, a poll of the members of the American Society for Reproductive Medicine (ASRM) found mixed feelings about the use of cloning to make babies, even though the society officially supports a temporary ban on human cloning. The group's ethics committee head, John Robertson, has long made the argument that reproductive cloning is consistent with the range of reproductive rights guaranteed by the U.S. Supreme Court, and that limited cloning should be considered if the technology can be proven safe.





	"It's a giant social experiment."

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	It is now possible to create a child with three genetic "parents," that is, a child with genetic material from three people. The technique is called cytoplasmic transfer, where cytoplasm from a donor egg is injected into an infertile woman's egg. This procedure is performed when the cytoplasm in a (usually older) woman's egg is considered unable to support a pregnancy and this woman would like to have a genetic connection to a child. Because cytoplasm has mitochondrial DNA, the resulting embryo has been shown to carry genetic material (DNA) from the sperm and from both women, the egg donor and the infertile woman. The first child conceived through this procedure was conceived at Saint Barnabas Medical Center in New Jersey in 1997. Many ethicists and other commentators were appalled, calling it the first inroad into germ-line genetic manipulation (manipulation that affects future generations.) The FDA has since claimed jurisdiction over the procedure, calling it a kind of gene manipulation.


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