Returning to the question of regulation on IVF clinicians, it seems to me that it would be too difficult to regulate who can can’t can’t have what type of IVF procedure in a fair way. A rule limiting the number of embryos that can be implanted to, say, 3 or 4, might actually infringe on the reasonable liberties of a woman who was young and healthy who had previous trouble getting embryos to take. And simply setting age brackets wouldn’t work, because age is only one of the factors determining a mother’s fitness and the safety of the procedure — in the end, it really needs to be an individual medical decision, and only doctors who know the patients involved can really decide what is and isn’t safe and appropriate in any given case. A doctor who performs a procedure acknowledged to be unsafe can be disciplined by existing systems, as is happening now.

It’s hard to know exactly where things went wrong for Ms. Suleman — perhaps in many places along the way — but I wonder if one possible step might be to require more, or even more specific, information to be given to prospective patients, much in the way that women seeking abortion are required to be counseled about the procedure in many states. Don’t some states even dictate the content of the materials that must be either given or made available to women undergoing that procedure? Perhaps a similar rule for IVF would prevent women from becoming pregnant with “extreme multiples” without having previously been aware (as Ms. Suleman claims she was not) of the likelihood of that outcome and the health consequences for herself and her babies. Perhaps including something about the cost could address the very edge of the economic concern.

Do you think we need tighter legal regulations on IVF clinicians? Or are you satisfied with the professional sanctions that the IVF clinician is receiving (he’s being investigated by the relevant medical board)? Is that enough to deter future negligent conduct? Please give us your thoughts!

Thanks for your post.

One area you brought up where there is a legal issue to discuss caught my eye: It is my understanding that there are guidelines, but no regulation, surrounding how many embryos can be implanted. The doctor who did the implantation is under a lot of scrutiny right now for what seems like a disregard of guidelines. Regulating a medical procedure like embryo implantation doesn’t seem to have quite the challenges (constitutional and otherwise) of regulating number of children a woman is allowed to have — might there be some benefit to such rules? It seems to me likely to protect women’s health, potential infants’ health, and the resources of our already suffering healthcare and educational systems if we tried to curb not number of children allowed, but number allowed at one time through artificial, controllable means.

In the mean time, I hope all involved can be as healthy as possible. I also add my wish that Ms. Suleman will find a way to pay for all of her family’s needs without allowing the media to exploit her and especially her children. Yet another area where so many behave irresponsibly, without the prospect of legal repercussions… a can of worms for another day.