Who Decides What Number of Children is 'Right'?

Abstract

I agree that eight is enough and am skeptical about assisting Nadya Suleman, who already has six children, to have more. Whose funds will finance fertility treatments for a single, unemployed mom, and provide the children‘s care? I am concerned about the ethics of the doctor who provided the reproductive care. But I have serious reservations about anyone imposing my views, or others, on the country as a whole.

I applaud Professors Cahn and Collins for asking the question ― Should we regulate? and for proposals distinguishing between the type to be federally regulated and personal decisions left to individuals. Although the distinction they draw is persuasive, it is unlikely to stick and address the ethical framework for reproductive technologies.

I do not reject government regulations, nor do I believe that the market will necessarily correct misguided decisions to implant six embryos in an unemployed thirty-two-year old. I question Cahn and Collins’ framework for determining when and what regulation is appropriate. I argue for a dynamic regulation, informed by evolutionary economics, that asks not just what kind of regulations are needed, but also how regulation will affect who becomes a patient, what doctors will provide the services, and where and when treatment will occur. This analysis is dynamic and evolutionary in that it anticipates how change in one arena, such as insurance coverage, might affect another area, such as the number of embryos to be implanted or the need to regulate fertility practices not yet of concern. I am more concerned about whether fertility clinics locate in Detroit or Windsor, whether the President or a governor appoints the regulators, and whether Ms. Suleman can afford in vitro fertilization at all than I am with having the government stop the next doctor willing to implant too many embryos.

Keywords: Fertility Treatment, In Vitro Fertilization, Reproductive Care, Federal Regulation, Government Regulation, Implant, Embryos, Public Policy

JEL Classification: J10, J11, J12, J13, J18, K10