Final Report (all chapters)

countries have imposed strict limits on the number of embryos that can legally be transferred. In
this case at least, an inflexible rule that protect the health of ART children would seem preferable
to a flexible approach that preserves professional autonomy and furthers the prospective parents’
interests.
Opinion
Date of Publication
Fertility treatment when the prognosis is very poor or futile 2004
Child-rearing ability and the provision of fertility services 2004
Informing offspring of their conception by gamete donation 2004
Family members as gamete donors and surrogates 2003 (reviewed 2004)
Donating spare embryos for embryonic stem-cell research 2002 (reviewed 2004)
Table 3: Ethical opinions recently published by ASRM/SART. 49
A crucial limitation of the ASRM system of self-regulation is the absence of any formal
system of monitoring and compliance assurance. The ASRM does not monitor adherence to its
recommendations, nor has it ever considered doing so. In this regard, ASRM is not unique. Most
self-regulatory systems do not have formal mechanisms of oversight. There are two reasons for
professional groups’ reluctance to adopt systems of compliance assurance. In the United States,
trade and professional groups are very concerned that by taking enforcement action, they might
violate anti-trust legislation. Judicial decisions in this area indicate that the reluctance to interfere
with private business practices is indeed justified. 50 The second reason for this reluctance is
organizational. Since the membership to a trade or professional group is usually voluntary, these
groups have virtually no authority to ensure compliance with their guidelines; a member can
easily avoid private regulatory strictures by leaving the association.
American College of Obstetricians and Gynecologists. Just like the ASRM, ACOG – the
largest gynecology and obstetrics professional association in the United States – has issued
several ethical opinions on questions ranging from surrogacy to embryo research. 51 And just like
the ASRM ethical guidelines, ACOG opinions are meant to inform, not to constrain medical
practice. Accordingly, ACOG does not monitor compliance assurance nor has it ever considered
sanctioning violations, except for highly visible cases where inaction could seriously undermine
the association’s credibility.
49
50
51
and Three-Embryo Transfers in IVF," in Triplet Pregnancies and Their Consequences, ed. Keith Louis G. and
Blickstein Isaac (London: Parthenon Publishing Group, 2002).
See Appendix F for a complete list of published ethical recommendations and links to the full-text articles.
Jack R. Bierig, "Whatever Happened to Professional Self-Regulation?," American Bar Association Journal 69
(1983); Gerla, "Federal Antitrust Law and Trade and Professional Association Standards and Certification.";
Robert Heidt, "Industry Self-Regulation and the Useless Concept of 'Group Boycott'," Vanderbilt Law Review
39, no. 6 (1986); Thomas A. Hemphill, "Self-Regulation Industry Behavior: Antitrust Limitations and Trade
Association Codes of Conduct," Journal of Business Ethics 11 (1992); Murray S. Monroe, "Trade and
Professional Associations: An Overview of Horizontal Restraints," University of Dayton Law Review 9, no. 3
(1984).
See http://www.acog.org/from%5Fhome/publications/ethics/.
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