How to Make a Family: The Blog

Where I Imply That You May Not Have a "Right to Life" (or anything else, for that matter)

Oh, boy. Another time and post where I set about putting myself out there and quite possibly inserting my foot into my mouth. But at least I'm clear on the risks. 

Let's start here: I think harming other lifeforms is not The Thing To Do. 

And here's another facet of that whole What Do I Believe About Life gem: I think telling someone else what to do with their life is not The Thing To Do.

And how about this addendum: I believe that reasonable, flexible boundaries are a prerequisite for peace.

You can argue against and around all of the above. But I bet nobody would argue against this one: I think every human wants to feel peace.

What does any of that have to do with the infertility industry? This: In our silly national debates over health care, the apparition of rights -- right to access health care, right to insurance coverage specifics, and accordingly, the right to life -- is wafting through it all like the ever-present, silent mist that nourishes a life-filled rain forest (on a good day).

With any luck, we will all get very wet from the debate process. But who's listening?

Three pieces today -- and just three, but there are more; have been and will be -- that conjured up this morning's philosophical nature in me:

My morning ramble's starting point: The video that's making the community's rounds, Is Infertility Treatment a Right or Privilege? 

[insert Big Sigh] How unfortunate that this is a Fox-produced video. I extricated myself from the Hell of TV Watching years ago, so on the occasional glance I take to spy on What Others Are Viewing, I have to remind myself that I wasn't around for the slow, hair-growth-like transformation that TV Watchers underwent in their tolerance levels. After I shake off the unnerving feeling that I'm being yelled at by talking heads, I do my best to watch this drivel with a little bit of calm objectivity. The only good I see coming from such "debates" (how special that the "journalist" is a new RESOLVE Board member! did I hear that right?) is that maybe -- just. maybe. -- thoughts about the bigger picture will be conjured up in a wider swath of minds.

Then, in a media format a little more palatable to my out-of-sync brain, a piece by Liz Zemba on the Pittsburgh Tribune-Review's site, Debate swirls around overseas surrogacy 

It's a good introduction to what Arthur Caplan calls "a weird version of medical tourism." Weird, indeed. Another term you might use is "nauseating." 

My eyebrows first furrowed in paragraph one, where the couple who's started a surrogacy service gave up on adoption "after 22 years of marriage" -- where's the 'why'? On their business website, that's where. The Hui-Wee's cratered under the adoption option because of "too much red tape, too expensive, or too much competition." Their surrogacy journey wasn't a piece of cake, either, but at least they got a baby out of the deal.

On The Telegraph, a review by Jim Endersby of the book "Unnatural: The Heretical Idea of Making People" by Philip Ball

I've always enjoyed using phrases like "making people" (usually "making babies" when I can get away with it) because it brings down to a fine-point all the more euphemistic terms, many of which I generate right here at my laptop, in the field of reproductive medicine. 

Endersby's review is the first I've heard of "Unnatural", and it's a positive one. He does finish his coverage by stating plainly, "I found myself persuaded by Ball’s ethical and practical arguments, yet unconvinced that the benefits of making artificial people are sufficient to justify the costs."

Instead of meander on and on about what I think or how I think the dots are connected up there, I'll just rest my fingertips and let the silence do the talking.

 

Finally. Can We Get Real About Old School Medicine?

I woke up this morning listening to NPR's Chana Joffe-Walt and David Kestenbaum explore the question "Are Doctors More Like Moms or Mechanics?"

Yes, I thought, finally. A really accessible description of this very non-traditional market -- health care -- that is "full of peculiarities" and that our very lives depend upon. (By the way, if you check out the link, be sure to "Listen to the story" from the page -- it's more entertaining and informative than the dry read sample on the webpage.)

As usual, I then checked a few blogs... lo and behold, Pamela Madsen is raising a ruckus (again), but this time instead of whistling a solo off in the distance (as she's been known to do), Pam's tune (Speaking Out in The Field Of Reproductive Medicine: It takes Courage) chimes in harmonically with what National Public Radio was just emitting.

The Internet has given us all the ability to know more about wellness, illness, and health care than any other information purveyor. Sure, it's also meant a lot of dangerous and ill-fated self-diagnosis scenarios, but for someone who was mucking around with sick people long before the Web was more than a Department of Defense contract, the difference in overall understanding is phenomenally clear. Heck, if the Internet had been around earlier, my grandmother might have known more about that boil she had me peering at on her leg... But seriously, we don't yet know the full impact on our society of the data proliferation and dissemination that has been enabled by the Web, though you can be sure those databases are in progress.

Now that our brains are filled to the brim with "how-to's" and "quick tips" and "faq's" on how these vessels we call "bodies" work, some subtler dynamics become more clear to us. Messages that have been (like Pam's) dismissed as personalized grumbling, even by over-educated academics and professionals from within the bowels of the health care beast, are being heard by more than just the crazy old ladies down the street.

The old hippie saying about paranoia and whether you really should be or not comes to mind. That's not to say that the best path right now is to harden into a complete "us versus them" attitude. After all, even the creepiest doctors were loved by their mothers once.

Okay, all snarky back-sliding aside, I've long ranted that consumers are the ones who let this quagmire happen. We wanted to believe in fairy tales, where the knight (doctor) in shining armor (medical school training) swoops by on that fiery steed (health care delivery system) and scoops us up with that comforting and strong arm (medical practice) and delivers us safely back to wholeness.

Sometimes I like to be dragged kicking and screaming away from my escapist fantasies.

Rather than wagging harsh fingers in our own faces at our naivete, let's pat our own little heads with compassion as we enter the brave new world of, finally, truly understanding that doctors are people, the institutions that envelop them are thus changeable even if faulty, and there's really nothing wrong with a round or two of 'Kumbaya' now and then. Finally.

Fear Not, Infertile & Uncovered: Julie (Among Others) to the Rescue

Our community's very own Juggernaut of Persuasion has written a sweet note to "Dear Composite Member of Congress Totally Not Based on Anyone in Particular" -- just a little forewarning that she'll be visiting DC with others during RESOLVE's Advocacy Day on June 25.

I'm going to gush about Julie for just a minute. This woman's been around forever and, like she says in the post, she's 'got hers' -- in the way of some rip-roaring kids. Still, Julie not only stays out there thumping the ground for fertile justice, she does it with some of the best humor ever, hands down. In fact, she calls (in her own beautifully self-deprecating way) for others who are done and through with the whole Om'ing to Ovulation thing to pick up the bat for those who are still plugging away. These particular pieces of proposed legislation affect adoption tax credits and infertility insurance coverage.

Join in with Julie and the other 'Been There Done That Now We're Sticking Up For Others'...

Gettin Gay n' Giggly With The Guys n' Girls

You've got to hand it to Corey Whelan: her distinct voice comes through in the AFA blog.

But you know how it can be with some voices, and sometimes it's hard to even know why certain words and tones tickle the hair on your forearms and make you remember the first time you tried brussel sprouts.

I think I've narrowed it down in this case, though…

So, yes, someone directed me to Corey's latest blog, titled "Happy Pride!", in a mildly inflammatory way: "She said 'gay is the new black' - seriously!"

Now, while Corey may be a "Middle Aged Straight Woman" (at least her boss wanted to buy her a shirt to wear to BrooklynPride pronouncing thus), I might be described as a "40-Something Crooked Woman" -- but I also like to add other descriptors when the time is right. In this case, when I headed to the AFA blog to survey the damage I tried to be a "40-Something Crooked Woman Who Makes Regular Albeit Feeble Attempts at Buddhist Practice" in order to be centered in my assessment, incendiary set-up notwithstanding.

I tried, I really did.

I'll give her this: she did NOT choose to title her blogpost 'Gay is the New Black', as she writes was her first plan.

As I slip-slide into "Who Am I Kidding I'm Really Just A Grumpy McGrumpy (thanks Jason) Rattled & Jaded Mama Who Went There & Did That a Few Times Long Ago" mode, my try at Being Reasonable While Reading Corey was thwarted by the little words that kept leaping off of the page and into my face.

Words like:

'I've never seen so many cute dogs'

'gawd, so many of them were very young!'

'we fell in love with Anthony and Ricky, what a handsome couple'

'I've never seen so many colors worn at once, so amazingly well.'

And admittedly, I bristled a bit upon reading her final admonition that "We have a lot of work to do to make sure... that people know and understand what they can do so that they make the right choices early on, and protect themselves and their futures." Now this hackle-raise is very likely MY bad -- stemming as it does from my "Repressed But Ever-Present Anyway Vigilance Toward Finger-Pointing at the Gay Community In Reaction to HIV's Prevalence" persona (isn't it amazing how 'protect themselves' can be heard as code for 'and stop infecting Us' with just the right amount of historical neurosis?) -- because I'm sure Corey really is referring, rather, to fertility preservation methods like cryopreservation of eggs and embryos.

But see, that's how that works. My history quickly yet grossly informs my perception. Try as I might.

With that Reminder to Self, I am able to nod benignly in Corey's direction this time, recognizing that not all Middle Aged Straight Women have spent enough time among people unlike themselves to be quite over the initial "aren't they cute?" phase.

In time, and maybe it won’t be too much longer, we’ll have a whole generation that was raised from the start living amid people who are “different” in all sorts of ways. We’ll finally have a huge percentage of people who see that there really are more similarities among us, and we’re each adorable in our unique way. We will stop getting giggly at ourselves because “We” are among “Them” and enjoying it (what a surprise!)

And now I realize that, at least for the moment, I am really only “Nearly-50 Crooked Woman Whose Least Favorite Practice Is Right Speech But Who Understands That In This Hyper-drive World Attention Is Attention”…

I should instead be inviting -- encouraging -- all the Middle Age Straight Women (and Men) to visit any of their local Pride activities this month. It’s only a matter of time before I break into “Kumbaya”  here at my kitchen table.

Colorado Voters Reject Amendment

FOR IMMEDIATE RELEASE                                                                 
November 4, 2008                                                                                  

CONTACT: Melissa Fowler
202.667.5881 ext 217
after hours/cell: 202.595.4395
mfowler@prochoice.org
www.prochoice.org <http://www.prochoice.org>

Colorado Voters Reject Amendment Defining a Fertilized Egg as a Person

Washington, DC-Today, Colorado voters rejected Amendment 48, which would have redefined "person" in the state constitution and granted constitutional rights from the moment of conception.

"This amendment was nothing more than an attempt to outlaw all abortions in Colorado," said Vicki Saporta, National Abortion Federation (NAF) President and CEO.

The so-called "Definition of Person" Amendment would have eliminated a woman's right to make private health care decisions. In addition to outlawing abortion, the amendment was so far-reaching that it could have banned commonly used birth control methods like the pill, IUDs, and emergency contraception. Women suffering from illnesses such as cancer could have even been refused life-saving medical treatment because of the risks it might pose to a fertilized egg.

Leading lawyers, doctors, and even Colorado Governor Bill Ritter (R) opposed this amendment. The Executive Board of the Colorado Gynecological-Obstetrical Society voted unanimously to oppose this ballot initiative citing that the "moment of fertilization is not a medical definition of pregnancy and as such represents inappropriate intrusion into the practice of medicine." 

"Amendment 48 was another attempt by abortion opponents to substitute political ideology for scientific evidence and the citizens of Colorado did not let them succeed," said Saporta.


###

The National Abortion Federation (NAF) is the professional association of abortion providers in the United States and Canada. Our mission is to ensure safe, legal, and accessible abortion care to promote health and justice for women. Our members include health care professionals at clinics, doctors' offices, and hospitals, who together care for more than half the women in both countries who choose abortion each year. For more information, visit our website at www.prochoice.org.

Let's Watch Georgia, But Divert Your Eyes From the Sidebars

A senate committee in the state of Georgia is considering legislation that will try to nail down embryo ownership issues. This article in the Atlanta Journal-Constitution says there's additional talk about "limiting the number of eggs a couple can fertilize at a time."

I don't see such topics being given more than a glancing write-up, but look at the ruckus started by the article, in the readers' comments at article bottom. There's scarcely a thing so filled with unbridled emotion as infertility discussions.

Just makes me wonder who needs attention at this time of this particular year in Georgia.

Link: Questions arise about procedure's surplus embryos | ajc.com.

Speaking of... Voice of patients

Over at Revolution Health, Tara Cousineau, PhD, has commented on recent reports about an upcoming article in Science. The article will give more voice to fertility patients regarding the question of what to do about the embies...

Link: Embryo donation: Voice of patients - Blogs - Revolution Health.

... and stem cells' creators??

I admire Nature, the work they do, service they perform. But, well, maybe I'm just a tad sensitive of late -- please don't ask the people who know me best, they'll only nod their heads and walk away muttering -- or perhaps I should just put that partition up again, the opaque one that I built in 2001 when it became clear to me that my audience really gives fewer than two whits about stem cell news... At any rate, here I go again, feeling left out on behalf of the creators of stem cells.

So, I hear about a new site by Nature, tightly focused on all-things-stem-cells. Some of you know me well enough to recall my stance that the first area of a site worth visiting is the About Us page. The new site, called Nature Reports Stem Cells, includes some heavy hitting commentary and reporting on the related science, research, politics, and society ramifications. It's packaged neatly, too, warmer than a deep science site usually appears. Pretty, even.

But here's the rub -- for me. Could be only me. I get that. But here it is, from their About page... "Our goal is [to] enlighten and promote communication in stem cell research by providing content as diverse as the stakeholders in this field—all the scientists, policy makers, ethicists, clinicians, and patients who are driving stem cell research forward."

So, just to clarify -- are the people who are making the hundreds of thousands of embryos that could be culled for use by this science being lumped into the stakeholder category of "patients"?

True, the broad topic of "stem cell" isn't only about those derived from the embryos about which I'm concerned. But really... a lot (most?) of the politics of this science is indeed derived from the heated debates related to life, when it begins, and within which frame we should view these embryos lying frozen in cryo facilities around the U.S.

When I read the mission sentence above from Nature Reports, I hear "patients" to mean the people who will likely wind up benefiting the most from stem cell research -- individuals and groups with certain conditions that can possibly be rectified with treatments and cures from stem cell research and development. I don't hear "infertility patients" within that text.

Maybe I'll find what I'm looking for once I take a deeper gander at the site. I'm hoping to find some real addressing of the issues as they relate to the people who are, at this moment, creating tens of thousands more embryos that will be added to the stockpile.

At this point, a solid seven years after I first wrote about connecting the baby-making-cum-stem-cell-creators with the decision makers and hearing the font fall with a silent thud on the cyber copyroom floor, I'd be appeased by even just a mention of this group's existence.

But again, maybe it's just me.

Link: about the site : Nature Reports Stem Cells.

Optimist's Prediction on Embryonic Stem Cells

On Edge, several great brains were asked to give the rest of us an optimistic viewpoint on myriad scientific topics. Oxford professor, Chief of the UK's Medical Research Council, and author of The Mind's Brain, Colin Blakemore said that the hooplah surrounding embryonic stem cell research will die a natural death.

Referring to morality as "a matter of utilitarian dialectic", Blakemore says that as a mathematical "ratio of perceived benefit to theoretical cost" shifts, attitudes toward using embryos to create miraculous cures and fixes to human conditions will move from moral outrage to tolerance of necessary evils and, finally, acceptance for the common good.

He disclaims his own prediction by calling himself a natural optimist.

Stem-Cell Funding Tug o'War

Funding for stem cell research has been turned into a love-hate scenario for voters. As is often the case, the answer probably lies in the middle. Recent elections point to a public that likes the idea of government getting into the game, in spite of what Bush said in 2001.

However, Sigrid Fry-Revere, director of bioethics studies at the Cato Institute, says that government-funded research is proving to be "bureaucratic, expensive, wasteful, fickle and divisive." She says that among the recent related elections, only Missouri got it right. Using the story of how IVF developed into the giant industry it is now even after government refused to get on board the research train, Fry-Revere illustrates her point that private money is the way to go and broad legalization of stem cell research is the real issue.

Source: No Tax Money for Stem Cells, by Sigrid Fry-Revere