Public Health Law Map - Beta 5 - Medical and Public Health Law Site

women who for physical or psychological reasons should not carry a pregnancy. For
these woman, pregnancy becomes a threat to their own health and subjects the fetus
to great risk of permanent injury or death. Fertility technology itself becomes a risk
when it increases the probability of multiple births. Most fertility specialists are
conscientious in counseling their patients about the risks and limitations of fertility
treatment, but these physicians are reticent to deny a woman treatment if she is
willing to assume the risks of the treatment.
The legal problems arise because a woman does not have an unfettered right to waive
her injured baby’s cause of action against the physician. The informed consent to
fertility treatment must be complete and specific. Just reciting the risks is
insufficient. The consequences of risks such as multiple births must be described in
detail. Telling a woman that her baby may be premature does not give her the
necessary information that a frequent complication of severe prematurity is brain
damage. Although it may be improper to deny women the right to risk their lives and
the health of their potential offspring for the sake of becoming pregnant, they must
be told exactly what risks they are assuming.
a) Medical Fitness
The first question that should be asked is whether the woman is medically fit to
carry a pregnancy. There are many protective mechanisms within the body that
reduce fertility if the woman is in poor condition to conceive. Hormone therapies
can often overcome these protective mechanisms without correcting the underlying
problem and increasing the risk that there will be a poor outcome for mother or
baby. An obese woman who has ceased to ovulate may not want to hear that she
must lose weight to become pregnant. It is much easier to give her pills to stimulate
ovulation. This apparently simple solution can lead to respiratory compromise and
weeks of hospitalization for which the physician may be held liable. The physician
should exercise the same caution in recommending fertility treatment as any other
hazardous procedure.
Studies on the products of spontaneous abortions point to a higher than normal rate
of genetic problems. Given that the human body eliminates fetuses with genetic
diseases in many cases, women who have had several unsuccessful pregnancies
should be considered at risk for genetic disease. This is another situation in which
medical science can sometimes overcome natural protective mechanisms. The
couple who is disappointed at their lack of children may not realize that there could
be a genetic problem with the babies. They should have a careful evaluation to rule
out the presence of a genetic disease that might be complicating their efforts to
carry a fetus to term.
b) Psychiatric Problems
It is important to rule out infertility caused by compulsive behavior that undermines
a woman’s health. A woman who cannot conceive because she has an eating
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