One of the most fundamental principles of reproductive justice, as it has been communicated to me, is that every woman has a fundamental right to bear as many children as she wishes to have. Article 16 of the Proclamation of Teheran, a foundational document in international human rights, states quite clearly:
There are also health considerations to bear in mind. Guidelines issued by the American Society for Reproductive Medicine (ASRM) strongly discourage the implantation of more than two concurrent embryos in a 33-year-old woman due to the risk posed to both the woman and the eventual fetuses, ranging from birth defects to premature birth.
But Suleman wanted to implant the embryos, and it's difficult to reconcile a broad understanding of reproductive rights with the idea that she should have been prohibited, by the government and implicitly by force, from implanting embryos she had fertilized herself into her own body.
Most Supreme Court decisions affecting reproductive rights have to do with attempts to end or prevent pregnancy, such as birth control or abortion, rather than attempts to follow them through. But if we follow the logic of Roe v. Wade (1973), there is a clear loophole that would allow for government regulation preventing the intentional implantation high numbers of embryos:
Another strong argument can be made in favor of regulating high-order births based on the established argument that the government has a "compelling interest"--i.e., an interest more fundamental than protecting the zone of privacy--in protecting prenatal life after the point of viability, currently assessed at 22 weeks under the Casey v. Planned Parenthood (1993) standard. High-order births (with four or more infants) are almost ubiquitously premature--the Suleman octuplets, for example, were born at 27 weeks. It's also worth noting that, as far as we know, there have never been nonuplets--no woman in recorded history has ever successfully given birth to more than eight infants who survived.
But there are some problems with these arguments. The first is, again, paternalistic; it places the government in a position of determining what is in the best interests of a woman's long-term health, instead of leaving the decision to her or her doctor. And limiting a woman's reproductive options on the basis that implanted embryos could become viable and could suffer later seems like a risky precedent to set, particularly given some of the harsh regulations already documented by organizations such as National Advocates for Pregnant Women.
As things stand now, I can't comfortably say what the proper role of the government should be in regulating high-order embryo implantation. What are your thoughts, readers? Share them in the "Comments" field below.
Parents have a basic human right to determine freely and responsibly the number and the spacing of their children ...The Nadya Suleman case, which has been covered extensively by others on the About.com community, is a troubling one for civil libertarians. It's clear that Suleman does not have the financial means to take care of 14 children, and it's difficult for any parent to understand why a woman who already has six young children would feel prepared to take on eight more.
There are also health considerations to bear in mind. Guidelines issued by the American Society for Reproductive Medicine (ASRM) strongly discourage the implantation of more than two concurrent embryos in a 33-year-old woman due to the risk posed to both the woman and the eventual fetuses, ranging from birth defects to premature birth.
But Suleman wanted to implant the embryos, and it's difficult to reconcile a broad understanding of reproductive rights with the idea that she should have been prohibited, by the government and implicitly by force, from implanting embryos she had fertilized herself into her own body.
Most Supreme Court decisions affecting reproductive rights have to do with attempts to end or prevent pregnancy, such as birth control or abortion, rather than attempts to follow them through. But if we follow the logic of Roe v. Wade (1973), there is a clear loophole that would allow for government regulation preventing the intentional implantation high numbers of embryos:
Of course, important state interests in the areas of health and medical standards do remain. The State has a legitimate interest in seeing to it that abortion, like any other medical procedure, is performed under circumstances that insure maximum safety for the patient. This interest obviously extends at least to the performing physician and his staff, to the facilities involved, to the availability of after-care, and to adequate provision for any complication or emergency that might arise. The prevalence of high mortality rates at illegal "abortion mills" strengthens, rather than weakens, the State's interest in regulating the conditions under which abortions are performed. Moreover, the risk to the woman increases as her pregnancy continues. Thus, the State retains a definite interest in protecting the woman's own health and safety when an abortion is proposed at a late stage of pregnancy ...Since high-order births can be hazardous to pregnant women, the State could assume a paternalistic argument in favor of preventing doctors from implanting more than two or three embryos at the same time, based on the health of the pregnant woman.
Another strong argument can be made in favor of regulating high-order births based on the established argument that the government has a "compelling interest"--i.e., an interest more fundamental than protecting the zone of privacy--in protecting prenatal life after the point of viability, currently assessed at 22 weeks under the Casey v. Planned Parenthood (1993) standard. High-order births (with four or more infants) are almost ubiquitously premature--the Suleman octuplets, for example, were born at 27 weeks. It's also worth noting that, as far as we know, there have never been nonuplets--no woman in recorded history has ever successfully given birth to more than eight infants who survived.
But there are some problems with these arguments. The first is, again, paternalistic; it places the government in a position of determining what is in the best interests of a woman's long-term health, instead of leaving the decision to her or her doctor. And limiting a woman's reproductive options on the basis that implanted embryos could become viable and could suffer later seems like a risky precedent to set, particularly given some of the harsh regulations already documented by organizations such as National Advocates for Pregnant Women.
As things stand now, I can't comfortably say what the proper role of the government should be in regulating high-order embryo implantation. What are your thoughts, readers? Share them in the "Comments" field below.
Comments
I find it interesting how many people have made this a “rights” issue to justify the mothers actions, instead of looking out for the rights of the kids that she brought into this world. (Or I should say, how intimidated people are by the idea of the government infringing on these “rights” when we all know how blatently wrong Ms. Suleman was in choosing to do this).
It seems to always come down to two fundamental questions: What role SHOULD the government play and Where’s the line drawn between regulating common sense and violating rights?
I think that line is drawn when people express their greed and selfishness to a degree when it not only infringes on common sense, But OTHER peoples rights. (i’m not even referring to the taxpayers of CA, but the kids).
People will scorn me for saying this, But i’ve got NO PROBLEM with legislative steps being taken to prevent the actions of people such as Ms Suleman. This attitude of “I can, because it’s my right to”, is grotesque to say the least, and there SHOULD be regulations. On that note…. I often times feel that as a nation, we have TOO many rights. (The number of attorneys listed in your local phone book should be enough proof, but if it isn’t… keep reading)
This story reminds me of a gentleman that I read about while Living in San Fransisco. He was a white man who walked into Valencia Gardens (A set of projects) down in the Mission district while drunk one evening. He apparently began ranting about (and I quote) “n____rs on welfare” and naturally… got stabbed as well as had the shit kicked out of him. He’s lucky he wasn’t killed.
HIS line of thinking was that he was “excersizing free speech”. Because his words weren’t directly pointed at a specific individual, Legally…. He WAS excersizing his rights, and did have the right to say so. So what’s the moral of the story?? Even though he had the RIGHT to do something, he got what he deserved. (Which was the shit kicked out of him).
As for Ms. Suleman… she should get what she deserves. Her kids taken away.
We are spoiled rotten as a nation. This is proven by a NUMBER of facts. (i.e. Largest health epedimic for our children is obesiety)When the citizens in this country excersize our rights TO A FAULT (such as Ms. Suleman), then yes…. I think the government SHOULD step in. The fact is, the people DO GOVERN our laws in the long run, and with the level of scorn that the public has shown Ms. Suleman, why shouldn’t the laws govern this?? All it would do is save a step.
Then again, “Womens Rights” activits would surely step in, and focus on this “violation of womens rights” completely disregarding what’s in the best interest for the children. After all…. They have that right.
The entire situation angers and sickens me! Ms. Suleman, who has no means of support, well of course other than the public money she will be sucking in for the next 18 or so years, should have never been allowed to have the in-vitro procedure. The physicians who performed this procedure should be held accountable for the immense cost that the general public will now be burdened with. And Chris Myers feeble attempts at justifying the spending habits of Suleman are disgusting! Saying that her trips to the nail salon, the hair salon and stores were normal and that already having six children she can’t keep them cooped up! Wow, this is why people like Suleman will be a leach on this society for a long time! Guess what? I had four children and I did not have the funds to get my nails done, or get my hair done or to take them shopping. That is NOT what every “Mom” does. What we do is go to the park, go to the library for story time and a host of other NO COST activities. When you depend on public money to fund your ridiculous lifestyle people do have the right to question, comment and condemn any action they do not agree with. I’ve raised my four children and the reason I didn’t have any more is because I could not afford them. If you can’t afford children, which Ms. Suleman obviously can’t you should not be giving birth to a brood. And the fact that T.V. cameras will continue to follow her around helping to raise funds to give her the lifestyle she is after is criminal. The cycle on our television these days is the ‘reality’ show, which has no basis in reality or sanity actually. But it is what sells for the stations and the advertisers, for the moment, until the public tires of this form of entertainment and moves on to the next “big” thing on the tube. Being bombarded daily with these shows that make millions for the super-sized family, propelling them into a semi super-star status, why wouldn’t a leach like Suleman want to jump on that band wagon? Oh yes, I hear you all screaming…they are her embryos…her children and she has a right to have them! Well then she should have the responsibility to take care of them! And that means she should be able to put a roof over their head, food in their stomach and clothing on their backs! Not depend on me to do it for her!
Personally I don’t care how many children this horrible selfish woman wants to have. Let her have 36 for all I care. But DO NOT ask me, as a taxpayer in California, to contribute one solitary penny to her and her spawns’ upkeep. Let her pay for them HERSELF. I’m disgusted by her entitled attitude. If she can’t feed her children then they should be taken away from her and given to families that CAN properly care for them. And she can live on the street and starve as far as I am concerned.
Don’t justify this selfish pig’s existence. She needs to be made to pay for what she has done.
For me, much of being pro-choice is predicated on a sort of “lesser of two evils” principle. Given a choice between early termination of an unwanted pregnancy, with a mother who is ill-equipped to care for a child, and having that child born into a statistical nightmare of poverty, lack of education, malnutrition, neglect, and possibly abuse–only to likely perpetuate the cycle–I would opt for termination as the most humane choice, every time. And while some ill-prepared mothers do end up getting an education, raising their child in a stable home, and ending the cycle of generational poverty, statistically, that’s not the norm. (And for all the cries of, “Give the baby up for adoption!” there’s a lot of social pressure and expectation that a “normal woman” will want to keep her baby after 9 months of pregnancy. And let’s face it–unless you’re a pretty white teenager from an upper middle class family, people are not going to be lining up to adopt your baby.)
Limiting the use of reproductive technology seems to me along the same lines: ultimately, not condeming children to a lifetime of preemie-caused medical problems, almost certain learning disabilities, and certain poverty because of being born to an ill-prepared mother.
One of the main reasons to ensure that the government does not intervene in women’s reproductive choices is to keep women safe from “back alley” abortionists; I think an analagous argument can be made for unscrupulous fertility specialists. Also, a primary concern of pro-choice activists is to avoid any other woman being forced into a situation a la Angela Carder, or Carrie Bell. However, the former case involved a life-threatening pregnancy already in progress; the latter involved forced sterilization. Neither scenario would be caused by regulating the number of embryos transferred, so the government would not be enforcing anything harsher than nature/biology was already dealing out.
As for the paternalistic argument: governments not only look out for individual right, they must also balance that with the interests of greater social good. Governments “protect” people from their own possible bad judgment all the time: helmet and seatbelt laws, for example. And those laws exist not only to look out for people too ignorant/stubborn/deluded/whatever to make wise decisions, but also to lessen the chance that the public will end up footing the bill for a catastrophic injury that quickly runs past any personal insurance cap. Those same principles of protecting both the unwise individual and the greater social good would both apply here, I think.
Nice that someone is taking this discussion upmarket by attempting to intelligently & informatively discuss emotive matters.
It’s funny how people can be outrageously mad at the public money spent on Nadya’s babies. I wish that caring for babies and children was all that public funds were spent on. No body’s in an uproar when its spent on much worse things (bomb and weapons creation).
But the reality is that for all that it will cost the state to help raise her kids, its nothing compared to what it will cost the state not to financially help to raise them.
People need to get off their soapbox. Taking care of 14 kids is no free ride, no matter how much money she gets. Money only helps to pay for things; the day to day of child rearing is priceless. And I’m not mad at her for going to get her hair or nails done. If that calms her nerves just a bit so that she can emotionally be there for those kids then so be it.
The public sucks.
The state should NOT take her kids away. That would be devastating.
Very coherent and intelligent arguments. A pity that most readers/commentators except Lee have not responded to the arguments made.
This woman is a fripping complete wacko. You people trying to intellectually discuss her situation as though she is sane are dreaming almost as badly as she is. Some entity, I assume the state, should take away all 14 of them and forbid her from cranking out some more. Were it not for her Mother and the safety net which she is abusing, the children she already has would be starving. It is unconscionable to condone her behavior!
[personal attacks deleted. -- TH]
@Lee
Very nicely put. While I do not agree with everything you wrote, it was put in a intelligent manner. My thoughts are that the government NEEDS to step in and start telling people whether they can or cannot have kids. Why should my tax dollars be spent paying a woman to have children when she cannot take care of them. Unlike the moronic comments ‘Me’ made, love IS NOT going to pay the bills. Believe me, I wish it would but in the real world, it doesn’t. Also, why should a woman who is not in a ‘proper place’ in life to have children be allowed to? “Let’s see…I live with my family, I don’t have a job. I don’t have money. I am a single woman…YUP, now is the time to have a kid!”
Check out the Times UK article February 14, Obama Warned Over Welfare Spendathon
http://www.timesonline.co.uk/tol/news/world/article5733499.ece
Perhaps Suleman can cash in like the four sisters with 17 children in Wisconsin!
“In Wisconsin, the state that forged a pioneering path in welfare reforms in the 1990s, residents were astonished by a newspaper investigation that disclosed that a $340m (£236m) programme offering taxpayer-financed child care to low-income working parents was riddled with fraud and expensive loopholes.
In one case, a family of four sisters who had 17 children between them put all of them together, took it in turns to babysit them and over the past three years claimed $540,000 (£374,000) in perfectly legal state childcare subsidies.”
“Perfectly legal” for taxpayer funds to pay low-income women to stay at home with their own children. How many mothers in two-parent households would love to stay at home with their own children but must actually work outside the home to help provide for their families?
All the more reason to pay, and get paid, in cash!
Rather than look at Nadya Suleman’s case as a “reproductive rights” question, I think we also need to consider the best interests of the children, in terms of already-established care standards, on a case-by-case basis. The size of a family alone does not necessarily determine quality of care. In the past generation, larger families were more common. Older siblings, in effect, helped raise the younger ones, and most did this without reliance on public welfare systems. In today’s economy, that has changed, and very large families are more of an exception than a rule. However, it’s not totally impossible to have a large family that is functional and self-sufficient. Some large families that have received public attention in recent times are the “TV families,” the Duggars and Jon and Kate Plus 8. In these two-parent families, the needs of the children are met. Celebrities noted for large families include Angelina Jolie and Brad Pitt (with 3 adopted and 3 biological children) and Mia Farrow, who has adopted and raised 15 children throughout her adult life. Clearly, these individuals have the economic resources and parenting commitment to be successful without depending on the support of public resources.
There are several important differences in Nadya Suleman’s case. Most obviously, she does not have either the parenting support or financial and logistical resources to adequately care for 14 children. She has survived until the present by depending on the support of her elderly parents to physically and financially take care of the children, and raised the funds necessary for her in-vitro procedures from a variety of taxpayer-supported programs (fraudulent worker’s compensation claim, misuse of student loan money, and social security disability payments for three of her children). Her first six children are currently living in overcrowded substandard conditions, and her elderly parents have been personally and financially exploited. There have also been valid questions raised about Ms. Suleman’s mental health, and her ability to truly understand and fulfill the actual responsibilities of parenthood. Because of these factors, staff of the hospital where the babies were delivered, and the California Department of Child Protective Services, are currently assessing this situation to determine whether or not the octuplets can safely be released to their mother’s care when they are well enough to leave the hospital.
Rather than try to determine the “correct” number of children a family or individual can have, we may want to consider programmatic regulations that would help manage such cases. Limiting the number of children in a family that would be eligible for public support would be one example. This would reduce the number of “repeat offenders” who consciously choose to make their living off the welfare system. Another might be the establishment of criteria for medically-assisted pregnancies that are similar to those used by most reputable adoption agencies. It is tragic that we live in a country where animal welfare agencies and shelters have reasonable criteria to assure that a cat or dog is taken into a decent home, but a fertility specialist can implant eight embryos into a mentally-challenged single parent who has already had five previous procedures and still not established a responsible pattern of caring for the children.
And… thank you for providing a forum for a reasonable discussion of this important issue!
I’d like to see an examination of the laws regarding fertility doctors and their financial responsibility for bringing all these babies into the world.
I can tell you that if I were to get eight women pregnant, the state would come after me to pay for it. My guess is that the medical lobby made sure that there is no way possible to hold the doctor responsible for his actions.
re Tanya: Very coherent and intelligent arguments. A pity that most readers/commentators except Lee have not responded to the arguments made.
Tanya – YOU have not responded to the arguments made!
Having the government regulate the number of babies a woman may choose to have is a slippery slope. Women are entitled to make this choice for themselves, both in terms of limiting family size through birth control or abortion, and in allowing family size to grow. Allowing the government to limit family size could easily lead to forced abortions. It makes no sense to say a woman is incapable of caring for 8 babies born on the same day, but not for 8 babies born over 8 years. Furthermore, a limiting on the number of embryos that could be implanted for a given pregnancy would not address the issue of women who use fertility drugs and ends up with multiple fetuses – controlling that situation means, again, the possibility of forced abortion.
I don’t see that either of Tom’s arguments for government intervention holds water. The first is based on text from Roe v. Wade that is clearly in the context of an abortion procedure. The second is based on the assumption that an embryo will survive to 22 weeks, which is by no means a certainty in any pregnancy, even in the 21st century.
The biggest problem is a medical one: What is the proper balance between the number of fetuses and the chances for healthy births? I would like to see the medical community come up with some guidelines, perhaps under the leadership of the Surgeon General. Any IVF doctor is morally obligated to discuss with his patients, before the procedure, not only the issue of how many embryos to implant, but also the health risks to the babies for a pregnancy with more than two fetuses. The practitioner should explain to the mother what the options are if all implanted embryos survive – that is, about selective abortion. The woman will need to decide not only whether she will abort one or more fetuses, but also which ones to keep and which to abort. A woman undergoing IVF (and using fertility drugs, for that matter) needs to make the decision beforehand how she will proceed and to what extent she is willing to risk the health of her unborn babies. If we make the fertility practitioner’s moral obligation a legal one, it would become an “informed consent” issue.
To those of you who are concerned about the cost to the taxpayer of supporting children in low income families: Welfare is not a fun lifestyle. No one chooses to live on welfare, when there is a better alternative. The solution is to make better alternatives available.
If you are truly concerned about your tax dollars (and not simply mean-spirited), you should complain about the cost of going to war, which requires many more of my tax dollars than paying for child care for a working mother, or health-care for her babies. Furthermore, child care and health care costs promote life, whereas war destroys life. What do we value more, life? or death?
In an overpopulated increasingly polluted world, I personally question whether more people are needed. Assuming it is a “right” to reproduce, I think there is also the *responsibility* to provide for those children.
Ms. Suleman has been unemployed for nine years, three of her six older children are receiving state disability money, as she is. That’s already a large family, and it is the public who is supporting them.
Just because somebody *wants* to have children does not mean help them to have a litter.
The worst part to me is that those poor octuplets were doomed to medical complications. Seven are Extremely Low Birth Weight babies. It is known that the majority of such babie will have IQ’s of 85 or less, lifetime learning disabilities, a fifth will have cerebral palsy, and numerous other problems because they were so immature. While female babies in this category have higher survival rates and lower chance of “profound disability”, six of these octuplets are male.
It is a strange kind of love to deliberately bring children into the world in such a way as to almost guarantee that they will never have a normal life.
I think the fertility doctor was remiss in not doing some screening first. And implanting *six* embryos in a woman who’d already succeeded six times with in vitro fertilization was practically criminal. There’s a really easy way to tell how many babies a mammal can optimally birth at once: just count the nipples! That is so low tech and apparently has been forgotten.
It is sad that they may have to legislate now due to some demented woman’s foolish, selfish decision to bring more kids into the world when she could not afford to care for the six she already had. Some doctor was stupid enough to assist in this scheme and must be held accountable. As long as the system rewards people for doing stupid things, this is going to happen. I am positive Nadya is counting on being handed a huge new house, a staff, and all the material goods her manicured, plastic-surgeried little brain could dream of. She’d be rich and famous! Who are the role models? Celebrities that breed or collect and show off babies like fashion accessories? “Reality” show families with 18 kids and counting? Science has made it possible for countless embryos to be conceived in petri dishes, frozen and implanted at the whim of any demented nutcase for whatever deluded and self-serving purpose there is. Sadly, this is the world we live in. Common sense is no longer common. As long as stupidity is rewarded the rest of us are going to have to pay. Sadly, this kind of legislation is going to be necessary. Who is going to pick up the tab for this enormous hospital bill for Nadya’s months of care prior to the birth + care of 8 premies? Even if there is a law, what will stop some nutcase moron from going outside the US, having 50 embryos implanted and showing up at a hospital demanding care? The healthcare system is already stretched to the max. Somewhere a line has to be drawn to protect taxpayers because this thing can just get bigger and bigger, bankrupting us all. There also has to be some kind of protection for all the children who are the result of such recklessness and selfish decision making.
Simple cure: Where apathy left off, common sense begins; where commom sense is lacking, law fills in. Simple ill: Law failed to catch up with Technology!!
Tom,
You quote part of Article 16 of the Proclamation of Teheran as “Parents have a basic human right to determine freely and responsibly the number and the spacing of their children …” and I agree with that. However, the key issue with this particular parent is “responsibly”. This woman’s actions are totally irresposible to herself, society as a whole, and certainly to her children.
She certainly isn’t due whatever protection the Proclamation of Teheran offers since she clearly violates its tennets.
Most of us plan our children based on what we can afford rather than “how much can I get the tax payer to pay for”. How ignorant can someone be? And she doesn’t even see it as welfare? I am repulsed by her lack of responsiblity towards those babies. I don’t mind it when my taxes go to someone that is neither physically or mentally able to care for themselves,it should not cover stupidity! STOP USING OUR HARD EARNED TAX DOLLARS. GET A JOB and provide for your own children as the rest of us have.