Reply turned post, octuplet style, take three

On the slippery slope argument, I have written two replies. I wrote one on Shakesville:

As for the slippery slope argument, slippery slope is not a two word phrase that means analyzing any health decision = oh no, there goes reproductive rights. Much of this was done in the name of radical anti-choice positions, in which frozen embryos are precious snowflake babies, and selective reduction, regardless of the outrageous medical risk of a high order multiple pregnancy, is outright killing of babies and should not be done.

There is nothing wrong with asking for an acceptable ethical standard of care for women seeking IVF. In fact, outrageous cases like this and the unwanted quadruplets the same doctor transferred into another woman (without medical insurance to pay for her pregnancy) are much more likely to endanger women’s reproductive rights due to the huge, predictable (and yes, frequently out of control, hostile, sexist and classist) backlash than looking at these situations critically and making sure they do not happen.

There are multiple position statements on how many embryos to transfer that do not violate anyone’s reproductive rights. Medicine is not the same thing as ordering off of a menu. Health care practitioners should follow standard of care guidelines that protect their patients.

And, I wrote an earlier one on altdotlife:

I also wanted to answer the earlier post comparing controlling embryo transfer via IVF and requiring a patient to agree to selective reduction, to refusing to fill a prescription for birth control. I see many differences between these two examples. First of all, a licensed doctor wrote the prescription for the birth control. Birth control is standard medical care. 98% of women in the United States use birth control of some sort at some point in their lives. A pharmacist refusing to fill a birth control prescription is refusing to fill the prescription because it goes against his or her religious beliefs, not out of some concern for the health of the patient.

Now, if a doctor didn’t want to write a prescription for birth control for someone who has a history of deep vein thrombosis, (which can lead to pulmonary embollism or stroke and then death) then I would see it as being a similar situation to refusing to transfer six embryos. Health risk trumps reproductive rights. I would not write that prescription. I would offer her a copper IUD or some other non hormonal method.

If a doctor refuses to transfer six embryos or wants an agreement that HOMs will be reduced, we are talking about preventing or refusing a highly unusual situation outside of the standards of medical care. Many people have posted various links to position statements of medical organizations of fertility specialists about this topic. There is a difference between an intervention like this and standard medical care. No doctor should have to perform a procedure that he or she knows opens the patient and the future fetuses to extreme risk. One of the links from upstream has an infertility ethical specialist saying 50% of HOMs end in death or severe disability of the offspring. That is not acceptable risk, in my book. Birth control and abortion is remarkably safe in most situations, and is almost always safer than a full term pregnancy for most people.

Plus, do not forget, any doctor, resident, medical student, nurse, orderly, etc can easily refuse to participate in abortion services or refuse to prescribe birth control or perform sterilizations. Entire Catholic hospital systems do this, and it is even a struggle to get them to give emergency contraceptions to rape victims, even if they are the only place in town for a rape victim to be treated. It is not even questioned in the medical community (except for the EC for rape victims part. Some places states have passed legislation on this, thank goodness.)

A slippery slope is not a straight line. There is a lot of nuance here.


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2 responses to “Reply turned post, octuplet style, take three

  1. cileag

    Thanks so much for clarifying this! It drives me batty that people can’t see the difference between being outraged at the ethical implications of the situation, while ALSO being outraged at the hate mail etc that this family is receiving.

  2. Sarah

    I enjoyed your three posts on this topic. I had trouble clearly articulating my response to the “slippery slope” argument, and you’ve answered it very well.

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