I've been watching the conversation online about licensed infertility healthcare providers vs unlicensed (sometimes untrained) consultants. The ideas being expressed with passion bring me back to the good ol' days in two other realms I've haunted.
I am so old that I was a substance abuse counselor before there were licenses for such. Barely out of high school myself, I ran around trying to convince suburban parents that their middle schoolers were using drugs. Got a lot of laughs from the audience back then. Obviously this was pre-War on Drugs. Around the same time, rumblings were increasing that would lead to state licensing of chemical dependency counselors around the country. I could've 'grandmothered' in once the furor subsided and become a CADAC, but by then, I was done with cajoling parents and staring down wasted kids.
Years later, this time with Social Work license in hand, I was a case manager in another unploughed territory, serving HIV-positive women and children. For six years, I acted in roles a bit equivalent to what we're seeing more of now in the repro med arena -- I was a professional hand-holder.
My clients during those years were, like infertility patients, learning to live a new kind of life that required dependency on professionals to get through what had been thrown at them. Of course, in their cases, the choices they and their treatment teams were making could literally impact their survival. This was when HIV was still a vastly misunderstood entity, and most people died from it.
You would think that such a scenario might result in public uproar to pour every available resource into finding a way to stop the dying and the incredible poverty of existence that came before the sometimes merciful end. But that's water under a broken bridge now.
There were no experts yet back then - other than those whom the government-granted and granting agencies had deemed worthy of administering help, often for purely political reasons. It was quite true of both fields that much depended on who you knew and being in the right place at the right time.
In both situations, para-professional caregivers and volunteers led the charge for patient advocacy and rights. The few licensed pros (and they were far fewer than we have in repro med) often found themselves in positions of defense, rightly or wrongly.
The truth back then, as it is now, was just as Pam Madsen says: there's plenty to go around.
Middle-class 'burb parents in the late 70's scoffed -- literally laughed -- at the crazy idea that their "little" junior high kids would have the audacity to use drugs. Ten years later, those still with living children were struggling to make sense of their prior judgments.
In the late 80's and early 90's, a similar cohort of public believed that a deadly virus could be contained within invisible boundaries imagined to be between groups of people. How wild was it when, in 1992, a white middle-class woman named Mary Fisher revealed her HIV-positive status at the Republican National Convention?
Yes, these human conditions -- drug abuse and HIV -- might be in a different category from infertility in many ways. But my point is this: the numbers of people in need can leave an entire nation -- not just the individuals involved -- staggering under tremendous weight.
Let the first licensed professional who truly believes that he or she or they can manage the need alone, without many helpful hands, licensed or not, step forward.
The discussion, brought about by an attorney highlights some interesting points, but she has neglected to mention that while attorneys may attend courses and educational events, the majority of attorneys have not taken any courses in reproductive law, much less do they get a license in reproductive law from law school. And yet there are incredibly informed attorneys who manage to quite capably provide consumer education - without a "reproductive law" license.
That being said, perhaps the question could also be framed that attorneys who practice law and own their own surrogacy/egg donation firms may have their own "so-called independence" questioned. Perhaps the majority of educating ought to be done by trained professionals (who are certified or licensed as health educators) and who have no financial interest in their client's decision.
But that may not be cost-effective to those pointing fingers....
Posted by: Angie Best-Boss | October 28, 2008 at 12:20 PM