Alabama Court Awards Fetus the Right to Sue

[oncemoreuntothejimbreech]

https://www.latimes.com/opinion/op-ed/la-oe-paulson-when-life-begins-20171026-story.html

Quote:Last week, the Department of Health and Human Services released a draft of its latest strategic plan, which will guide the agency from 2018 to 2022. Near the top of the document, the agency presents its mission statement: HHS activities “cover a wide spectrum of activities, serving and protecting Americans at every stage of life, beginning at conception” (the emphasis is mine).

This is a religious definition of life, not a scientific one. Health and Human Services is a government organization. Its actions should be evidence-based, not faith-based, and this decidedly unscientific language should be eliminated from its strategic plan.

As an infertility specialist, I witness human fertilization in the laboratory every day. The human egg is a single living cell and it becomes a one-cell embryo if it successfully combines with a live sperm. No new life is formed — the egg and the sperm were already alive — and fertilization is not instantaneous. Nearly 48 hours pass from the time sperm first bind to the outside of the zona pellucida, the human eggshell, until the first cell division of the fertilized egg. The two newly formed cells then have the potential to give rise to a human being, but only if they are appropriately nurtured so that they continue to divide and then successfully implant in the uterus.

As women age, the proportion of eggs with chromosomal abnormalities increases dramatically. If such eggs are fertilized, they implant rarely, or result in a miscarriage. In vitro fertilization has shown human reproduction to be a highly inefficient process. Even a chromosomally normal embryo will successfully implant and result in a live birth only about half the time. This is true whether fertilization takes place in the body or in the laboratory.

The multicellular pre-implantation embryo cannot be equated with a human being. It is a collection of stem cells, each of which has the capacity to grow into any part of the placenta, as well as fetal tissues and organs, but it is not itself a new human life. It is also potentially more than one individual, since identical twins are the result of a single implantation.

From a scientific perspective, life doesn’t begin at any one point, it is a continuum. For HHS to define it as beginning at conception is a transparent attempt to justify restrictions on certain contraceptives as well as abortion. It may also have an unintended consequence: the restriction of infertility treatments, especially in vitro fertilization.

Now nearly 40 years old, IVF has revolutionized infertility treatment. More than 7 million babies have been born worldwide as a direct result of this technology, though it fails as often as it succeeds. If a pre-implantation embryo were to be considered a human being, then its lack of implantation during IVF would logically have to be considered a human death. Fertility clinics would not be able to function if they could be accused of harming human life in the process of trying and failing to achieve a successful pregnancy.

A preimplantation embryo has the theoretical potential to become a human life, but it cannot be considered on the same moral plane as a human life. We should insist that the Department of Health and Human Services be driven by science and data, not faith-based belief. All those concerned with the unscientific nature of the current HHS strategic plan draft have until Oct. 27 to email their comments to HHSPLan@hhs.gov. We need to embrace the founders’ doctrine of separation of church and state, to keep faith and religion separate from the administration of our nation’s healthcare.

Dr. Richard Paulson is a professor of obstetrics and gynecology at USC, the director of the Keck School of Medicine’s infertility program, and the president of the American Society for Reproductive Medicine (ASRM.org). @DrRPaulson

https://www.statnews.com/2018/07/24/are-embryos-people-the-answer-will-determine-the-future-of-reproductive-medicine/

Quote:The announcement that Supreme Court Justice Anthony Kennedy will retire at the end of the month and President Trump’s nomination of Brett Kavanaugh to take his place has spurred concern over the future of women’s reproductive options. Not only is the legal status of abortion at stake, but the concept of embryos as “persons” could be decided by the next Supreme Court.

Despite the explosion of genetic technology that has revolutionized reproductive medicine over the past decade, I fear that an answer to the question of personhood based on faith rather than science could hinder our ability to improve the chance of having a healthy child.

Louise Brown, the first “test tube baby,” turns 40 this month. Since 1978, more than 8 million babies have been born using in vitro fertilization (IVF) and other assisted reproductive technologies. Couples who never would have conceived due to blocked Fallopian tubes or severely low sperm counts can now have children of their own.

Many of my patients have chosen to use preimplantation genetic testing to avoid severe, often life-threatening inherited conditions in their children. Some of these families have already suffered the loss of an affected child and want to avoid experiencing that heartbreaking situation again by selecting an embryo that does not carry a harmful genetic condition.

The process works like this: After in vitro fertilization, several embryos are grown in the laboratory for five to six days. A few cells are removed from each embryo for genetic analysis, after which the embryos are frozen. The DNA from each embryo is carefully assessed for a variety of genetic disorders. A single genetically normal embryo can then be thawed and returned to the prospective mother’s uterus.

This process is not for everyone as some women may not produce adequate numbers of eggs and embryos to select for an unaffected one; also, some do not have insurance coverage for IVF or cannot afford this costly procedure.

The goal of this process is to achieve a healthy child, which now occurs at a remarkably high rate. For specific genetic disorders, preimplantation genetic testing can reduce the odds of having a child with a lethal disorder from 25 to 50 percent to less than 1 percent.

Medicine’s ability to culture embryos and select healthy ones has improved dramatically in the last few years. A clinical trial that I led several years ago showed that transferring a single genetically tested normal embryo resulted in the same delivery rate as transferring multiple untested embryos. When genetic testing is performed, it is now standard of care to transfer just a single embryo at a time — gone are the days of risky triplet and high-order multiples after IVF. Actual babies, not embryos, are being spared from dying from the complications of genetic diseases and severe prematurity thanks to the increased use of single-embryo transfer afforded by preimplantation genetic testing.

During my training as an obstetrician/gynecologist specializing in reproductive endocrinology, I was incredibly optimistic about the future of this field. There was no doubt that we would continue to make IVF safer and more effective, helping more and more people have healthy children, one baby at a time. What could be more “pro” life than that?

But as I’ve watched what has played out in politics and society over the last few years, I’ve grown concerned about the future of reproductive medicine, and worry that doctors and prospective parents will no longer be able to improve this field and select healthy embryos.

Some disorders that individuals carry, like premutations in the long arm of the X chromosome that can cause fragile X mental retardation, do not always cause problems in their children. But the size of the premutation can increase with each ensuing generation, eventually leading to the full fragile X mutation. Children with fragile X can develop severe mental delays, autism, seizures, and other neuro-cognitive disabilities.

I used to counsel patients that by the time their (hopefully healthy) children were ready to have their own children (my patients’ grandchildren), our reproductive technologies would surely be even more precise and safer. Now I feel obliged to counsel them that there is a chance that these technologies won’t be permitted in the future if embryos are considered to be persons and that their children might not have the option to avoid passing down a severe disease trait. Should they do preimplantation genetic testing now to protect their future grandchildren, or risk a future in which their daughter may not be able to use such testing to have a healthy child?

The status of preimplantation testing of human embryos is a complex ethical and emotional issue. Some people believe that life begins at fertilization and, since every life has inherent value, we should not “play God” by choosing not to implant some embryos. Others recognize that embryos have the potential to create a child but require many more steps, and that most embryos are actually incapable of creating a baby.

I side with Dr. Richard Paulson, the former president of the American Society for Reproductive Medicine, who wrote that there is no scientific basis for the concept that life begins at fertilization. To paraphrase his argument, the egg cell and sperm cell are as alive before fertilization as the embryo that begins to form after it occurs. Melding egg and sperm does not create “new” life. I also believe that selecting a healthy embryo to place back in a woman’s uterus is preferable to possibly terminating an affected pregnancy or suffering the tragic loss of a child due to a lethal disease.

Eleven states have introduced “personhood” bills (none have passed) and more than a dozen court cases have been brought on this issue. The outcome of these cases could significantly limit the ability to practice reproductive medicine techniques such as IVF with preimplantation genetic testing.

If laws or the courts recognize embryos as people, that may restrict how many embryos may be created — if any — or women may be forced to use frozen embryos even after they have completed their desired family. The concept of preimplantation genetic testing itself may be challenged, as some embryos are discarded in the process.

Should my patients seize the opportunity now to avoid transmitting severe disease traits because their own children might not have this option? That and other reproductive issues are likely to be debated by future courts. My fervent hope is that they will be guided by science, not faith.

Eric J. Forman, M.D., is the medical and laboratory director at the Columbia University Fertility Center and assistant professor of obstetrics and gynecology at Columbia Irving University Medical Center.

https://www.fertstert.org/article/S0015-0282(17)30036-5/fulltext

Quote:We live in a time of unprecedented scientific progress. This is not a remarkable statement, as it could easily have been made anytime during the preceding millennia of cultural evolution. Information grows exponentially, and each era not only has access to more information than the preceding era, but also adds more new discoveries and data. Additionally, the present time has given us unprecedented access to information and rapid communication. Unfortunately, one unintended consequence of our near instantaneous communication is the rapid proliferation and dissemination of misinformation and outright disinformation. Indeed, topics such as false or “fake” news are a common topic of the news media.

Trying to decide whether information is accurate may be challenging. Those of us who live in the world of science and who use scientific journals to obtain information enjoy some protection from disinformation, which is afforded us by peer review and explicit scrutiny of the scientific data presented. Unfortunately, the subsequent dissemination of scientific studies by the lay media has no such protection. And thus, on an almost daily basis, we hear of results of “scientific studies” that seem hard to believe, which are then quickly contradicted by reports of other “scientific studies.” The consequence of such apparent scientific contradictions is that the lay listener develops skepticism about the scientific method, and concludes that science, like the news media, is not a reliable source of information. When we scientists do not speak up to correct the unscientific conclusions attributed to science, we are complicit in the spread of such disinformation, leading to the undermining of science credibility in general.

One observation that has been attributed to scientific consensus—one that is highly relevant to our field—is the concept that “human life begins at fertilization.” This statement is commonly offered by religious organizations and is often cited as the basis for so-called personhood amendments, but the assertion that it is scientifically sound is incorrect. And although it is often offered in the context of abortion, it has profound ramifications for the treatment of infertility, particularly for in vitro fertilization (IVF). We fertility doctors take extreme care to protect and nurture the preimplantation embryos in our incubators and cryotanks. We realize that in almost all cases these aggregates of cells represent the best chance for our infertile couples to realize their dream of building their families. However, handling an embryo with the potential to produce a pregnancy is not the same as handling a human life. If harm to a preimplantation embryo were to be considered the same as harm to a human being, then the demise of a preimplantation embryo—a not infrequent event in vivo, as well as in the IVF laboratory—might well be treated as a human death, perhaps with manslaughter charges brought against the embryologists.

What is scientifically incorrect about saying that human life begins at fertilization? First, it is a categorical designation in conflict with the scientific observation that life is a continuum. The egg cell is alive, and it has the potential to become a zygote (a single-celled embryo) if it is appropriately fertilized and activated by a live sperm. If fertilization is successful and the genetic complement of the sperm is added to that of the egg, the resulting zygote is also alive. The zygote has the same size as the egg; other than for its new genotype, the cell (comprising the cytoplasm and the rest) is nearly identical to the egg cell. From a biological perspective, no new life has been created.

Second, “human life” implies individuality, which is also not consistent with scientific observations. In the clinical practice of IVF, we often speak of preimplantation embryos as individual entities, with distinct qualities like a specific genotype (mosaicism notwithstanding), and morphologic and developmental characteristics. But at the same time we realize that each of the totipotent cells that comprise these embryos is, at least theoretically, capable of producing a complete new individual. Indeed, multiple individuals can arise from the implantation of a single embryo, as in the case of identical twins. Therefore, we know that the preimplantation embryo is not actually an individual. The preimplantation embryo is essentially an aggregate of stem cells, which has the potential to produce a pregnancy, including placental and fetal tissues, assuming that it successfully implants in a receptive endometrium. It is only after implantation that the early embryo can further differentiate into the organized cell groups that enable the developing conceptus to progress further in embryonic and eventually fetal development.

“Life begins at fertilization” may certainly be considered a religious concept; because religious ideas are based on faith, no further proof is necessary. It is pointless to use science as an argument against faith-based dictums. For example, it is also not in the realm of science to investigate the nature of life after death or the validity of holy books. The beginning of human life likewise occupies the legal realm, where line drawing can be essential to the application of civil and criminal law. But laws are created by legislators, not scientists. Many attempts already have been made to legally define life as beginning at fertilization. Although the impetus for this type of legislation is likely religious, a supporting argument is often made that this is a scientific fact as well, which is in contradiction to the arguments presented here.

In these interesting times of nearly instantaneous communication and unlimited information, scientific conclusions are easily drowned out by other opinions. It matters to our patients and to us how information about our field is presented in the lay media. We should not quietly ignore the multiple Web sites, lay publications, and other sources of information that claim there is scientific proof that life begins at fertilization. If we do not object, our silence will be interpreted as scientific validation of this wholly religious, entirely unscientific conclusion. We should not be complicit in the dissemination of this type of disinformation and, more specifically, we should not acquiesce to the claim that the concept of “life begins at fertilization” has a scientific basis.

Life begins at conception is a lie promoted by conservative Christians to promote their pro-life agenda.

What do you need for conception to occur? Two living gametes; one from the father and one from the mother.

What happens if one of the gametes isn't living?  Nothing.  What happens if both the gametes aren't living?  Nothing.

If you could take two gametes which aren't living and create a living zygote then you could rightly claim life begins at conception.  Life is inherited at conception, not created. Because life is a continuum like I have corrected you many, many times in the past.

Again, what is the difference between a living, single celled gamete and a living, single celled zygote except the ploidy?  Nothing.  They're both living cells with human DNA capable of developing into an individual, genetically distinct human given the right circumstances, but the gamete requires one additional step than the zygote.

Which means if Christians were really about protecting the sanctity of life they would also abolish all forms of contraception as well as abortion.  But, Christians aren't trying to outlaw contraception (yet). (Just deny insurance coverage to obtain contraception.)  Why?  Well, one, most don't understand biology (while lamenting our schools.) Two, Christians are cool with contraception because of the previous point, most don't understand biology.  So what if a gamete and a zygote are both a potential person? Due to their arbitrary line in human development it's okay for them to kill one of those two types of cells with a clean conscience while telling others what they can't do with their bodies based upon their religious beliefs, not biology.

So when you claim life begins at conception, you made it about religion.  Not biology.