Assisted reproductive technology studied by New York task force.

A New York panel of doctors, lawyers, and ethicists has issued recommendations designed to make new ways of baby-making easier on those involved in this increasingly high-tech process.

The primary aim of the State Task Force on Life and the Law was to improve legal and professional oversight of assisted reproductive technology (ART) practices. Some of the group's recommendations may be proposed as legislation in New York and could act as model legislation for other states, panel members said.

The task force looked into nearly every aspect of ART--from parental rights and abortion to infertility clinic regulation and sperm harvesting--and came up with answers to some of the more perplexing questions found in modern-day life.

The task force recommended that

* the birth mother be considered a child's legal mother, even if the child was not conceived with the birth mother's eggs;

* state licensing or certification of embryo laboratories be required;

* regulations be set for the use of frozen embryos;

* the retrieval of sperm from dead or comatose men be banned except when advance consent or a court order has been given;

* ART practitioners have a professional obligation to minimize multiple births (such as quadruplets and quintuplets);

* ART practitioners have wide latitude to decide who they treat but should not discriminate against unmarried couples, including lesbians; and

* New York should enact laws to make sure patients are told all the facts concerning ART, including the low chance for success and whether the chosen technology is experimental.

The task force specifically rejected a requirement for mandated health insurance coverage of ART in New York, noting "no persuasive reason for giving assisted reproduction special priority" over other health care needs, especially in the absence of universal coverage.

The panel also rejected calls for legislation that would limit the number of embryos transferred to a woman's womb--an issue directly related to "fetal reduction," the intentional abortion of embryos undertaken to limit the incidence of multiple gestations.

The task force instead recommended that professional organizations, such as the American Society for Reproductive Medicine in Birmingham, Alabama, provide embryo transfer guidelines that practitioners can discuss with patients.

Task force members--who come from the fields of medicine, law, religion, bioethics, and public policy administration --consulted with colleagues, ART practitioners in New York, and individuals and couples who have used or hope to use assisted reproduction.

The report, Assisted Reproductive Technologies: Analysis and Recommendations for Public Policy, noted that in 1995 about 7 percent of married couples with wives of childbearing age were infertile. Nearly 13 percent reported problems conceiving or carrying a child to term.

The report also said that one in three ART births results in multiple gestations, which can pose serious medical risks to the newborns.

While many of the issues addressed by the task force pose complex ethical dilemmas for practitioners and patients alike, the panelists appeared to come to a general consensus on most of the hot-button issues. Still, the main report, which is 474 pages long, was accompanied by two minority reports.

Four of the 24 task force members expressed concerns for potential ART abuses by a "large and growing... industry" that serves a "vulnerable population yearning for children."

They also wrote of their concern for increased congenital abnormalities resulting from assisted reproduction; the treatment of human embryos as "merely property"; and fetal reduction procedures, which they view as "wrong, unjustified, and bad public policy."

A second minority report called for a state law limiting the number of embryos that can be transferred to a woman's womb to two, thus eliminating the need for fetal reduction.

The task force's recommendations do not carry the weight of law, but the ART report was referenced in a recent frozen embryo custody dispute by the New York Court of Appeals. (Kass v. Kass, No. 53, 1998 WL 225157 (N.Y. May 7, 1998).) A previous report by the Task Force on Life and the Law relating to physician-assisted suicide was cited by the U.S. Supreme Court when it decided Washington v. Glucksberg and Vacco v. Quill. (117 S. Ct. 2258, 2293 (1997).)

For a copy of the report, write to Health Education Services, P.O. Box 7126, Albany, NY 12224, or call [phone].