Reaction to Karen’s post

I read Karen’s post this morning and started typing a comment which turned into a (bad) college essay. So, instead of using up her space, I’m posting it here..

I have mixed emotions after reading the two review articles on Debora L. Spar’s book The Baby Business. The tone of both reviews sounds like it was written by someone who read the book, but clearly never had to deal with IF. The business week article, in particular, was highly judgemental about IF treatment and adoption. It seemed like it was written by a person who was more interested in perpetuating his/her disdain of IVF (which seemed to be based on either an ignorance of technology or an over-simplified understanding of it) rather than a review of what was actually written in the book.

I was especially irked by two things written in the business week article:

“…in the emotional world of infertility, couples often keep paying until they run out of money; very few run out of will. Those who do give up can turn to adoption along with about 120,000 other U.S. families each year, shelling out up to $35,000 per child.”

“The most disquieting parts of the book are those chapters that detail some very advanced reproductive technologies. Doctors can now remove one or two cells from a two-day-old embryo in a test tube, tell the parents its gender, and test for certain genetic defects. The parents then choose which embryos they want implanted. Scientists are also only steps away from cloning a human.”

The first because it feeds the desperation concept (us infertiles will throw all our money at IVF treatments, then throw another 35k we don’t have to adopt—plus, it implies the 35k is all going to one source to “buy” a child) and the second because it equates IVF with eugenics and human cloning. We are not “steps” away from cloning a human. That is a misconception perpetuated by the media and by a general public fear of cloning.

I thought the Plotz review was slightly less judgemental and at least it seemed to deal more with the content of the book. I do agree with the fact that one aspect of IVF clinics is that it is a business. (I also think that medicine is a business, but calling something a business doesn’t mean that it is bad. I think businesses can do good things, including helping people.) And that some IVF clinics maybe many (but not all) are ran more like businesses than medical treatment facilities (for example, those that exclude women from treatment because they deem them as having a low chance of success, in an effort to maintain high stats for CDC). But, I think the business aspect of medicine is inherent in all medical care in the US. I also agree with the assessment that some RE’s don’t wish to deal with or want to recognize (publicly) the business part of their practice, that they like the perception that all medical professionals do their job solely because they want to help people. And that this leads to a

“…pretense of noncommercial activity makes infertility opaque for customers: They don't know whether they ought to be paying what they are paying, or if they are getting a good service, because the usual market checks — information, competition, transparency — are absent.”

I think that most of the time, medicine lies somewhere in between being a business and being altruistic care of people’s medical needs and it would be nice if more people, especially doctors, acknowledged that.

As for Spar’s point about a need for more regulation of IVF like what is seen overseas (number of eggs retrieved, number transferred, etc.), I have problems with that. Each person is different with a different set of circumstances. Medical choices, it seems to me, should be made, assessed and presented by medical experts and chosen by the patient, not by any branch of government.

From the reviews of the book (which I haven’t read yet), it seems like Spar presents a very academic, economic and cold assessment of reproductive technology and forgets (or more likely never considered) the emotional, human aspects. From the salon interview she gave, I don’t think it was ever her point to consider any emotional aspects of IVF because that was not what she was interested in. She is interested in assessing the business aspects of IVF, not making judgements on the people undergoing IVF. It’s the reviewers of the book who are making judgements about infertiles. I think that is where the damage lies. That people will only read the reviews and the reviewers' biases and misconceptions about IVF and adoption and believe infertiles are all desperate people willing to do everything and anything to “buy” a baby.