We are allowing politics to undermine serious thinking about serious matters. The recent Alabama Supreme Court decision on In Vitro Fertilization (IVF) put a spotlight on this truth.
The noise and political hype in the immediate aftermath of the decision make it a safe bet that most people don’t know the facts about what occurred. Three couples underwent IVF in an Alabama clinic and all gave birth to healthy babies. A routine part of this process is freezing additional fertilized eggs to enable couples to return for another baby at a later date and bypass the parts of the treatment that require hormones and surgery. The embryos of these three couples were removed from the freezer, and unintentionally dropped and destroyed. The couples sued under the Wrongful Death of a Minor Act. The suit was dismissed by the lower court, which said embryos in vitro are not people or children. 8 of the 9 members of the Supreme Court disagreed. They said the Wrongful Death of a Minor Act applies “to all unborn children without limitation and that includes unborn children who are not located in utero at the time they are killed”. The Court also said this is a matter for the Legislature, not the Court. Both Republican-controlled Houses of the Alabama Legislature acted immediately, and almost unanimously, to make it clear IVF clinics are not subject to the Wrongful Death of a Minor Act, something most of us did not hear because it does not fit the political narrative being pushed. Some Alabama IVF Clinics paused their services until the legal ramifications could be understood because unintentional destruction of a fertilized egg can occur during the IVF process.
The political rhetoric and sensational media coverage drowned out serious discussion about the Alabama case. The immediate focus was how to use this decision to revitalize the issue of abortion, which liberals fear is fading in importance to other concerns in the November election.
My experience with bioethics is both personal and professional. Thirty years ago, a member of my family was conceived and born through IVF. She was a desperately wanted child and is a much-loved gift. Undoubtedly, the destruction of unused fertilized eggs was part of the process.
In the early 1980’s, while a Clinical Nurse Specialist in Critical Care at St. Luke’s Hospital in Milwaukee, I was appointed along with a physician and administrator to research and propose one of the first Bioethics Committees in the country. Today these are the norm in healthcare. They were born out of the realization that we face many dilemmas in the course of caring for patients and what we can do and what we should do may differ. This committee served as a very helpful educator and advisor to patients, families, and care teams as they wrestled with difficult decisions.
While Vice President for Patient Care and Chief Nursing Officer at St. Mary’s Hospital in Madison I routinely attended the interdisciplinary Ethics Rounds that were regularly conducted by clinicians. They presented their most difficult cases; all points of view were welcome; and their sole objective was to capitalize on everyone’s best thinking to give their best to those they served. They wanted to learn. It was so inspiring and reassuring to me to work with people who were humbled by their responsibilities and driven by their integrity in search of the right answers.
The growth of bioethics in healthcare resulted from the recognition we need to think seriously about the (often unintended or unexpected) consequences created by rapid advances in science and technology. Clarity requires serious thought. Here is another example. Abortion of a developing fetus is legal, with varying limitations, in most states. It is a decision made by the pregnant woman. At the same time, the “Unborn Victim of Violence Act of 2004”, a federal statute, says a fetus or embryo in utero is a legal victim. The law defines “child in utero” as a member of the human species at any stage of development who is carried in the womb. 38 states also recognize the fetus or “unborn child” as a victim of homicide. These laws explicitly exempt abortion.
We seem to be saying if a fetus, wanted by its mother, is killed by some “other,” the killer can be prosecuted for murder. If the mother chooses to kill the fetus, it is not murder. Therefore, whether the mother wants, or does not want, the fetus she is carrying determines whether that fetus is a person. Or, conversely, the fetus is always a person, but only the mother has the right to kill her child before it is born. Which is true?
It is not my intent to take a position on any specific ethical dilemma. Rather, I am sounding the alarm that when we don’t think honestly and deeply about things that matter, we bury the truth, which is fundamental to a righteous society. We have many challenges beyond biomedical ethics. Artificial Intelligence, looming on the horizon, is one more example with implications we cannot begin to imagine. When we seriously confront complex issues, ethics, science, and the law intersect, and sometimes collide. We would be wise to keep these things in mind:
- Reasonable people can disagree.
- The ramifications of our pursuits merit serious thought.
- What we can do and what we should do may differ.
We are living in a world where jockeying for political advantage often supersedes any other consideration, regardless of the implications for the American people. Those who scream the loudest are often the shallowest thinkers. We must apply our intellect and what we know about right and wrong to the issues we encounter, no matter how uncomfortable it makes us. Politicians, who are most concerned with power and control, much prefer that we act on emotion. Critical thinkers in search of the truth are not easily led.
