Scandal Is Symptom Of Deeper Problems

Ginger Canfield says she thinks Dr. Ricardo H. Asch “works for God.” Her reason is 7-year-old Tessamarie Canfield.

For 12 years, Ginger Canfield had tried to get pregnant. It was not until Asch, the director of the Center for Reproductive Health at the University of California at Irvine, transplanted a fertilized egg into one of her fallopian tubes that she finally had the daughter she so desperately wanted.

It is one thing for a patient to think a doctor is godlike. It is a very different matter for a doctor to act like a god. Asch is alleged to have done precisely that.

Records leaked to state and federal officials by courageous whistle-blowers reveal a scandal of staggering proportions at UC-Irvine. Asch apparently took eggs from one of his patients who, like Canfield, was trying to conceive, and he used them to create a baby for another. No one seems to have obtained the permission of the donor or the recipient. If that charge turns out to be true, it would represent the most serious betrayal of trust in the field of infertility treatment since the birth of the first “test tube” baby, Louise Brown in England in 1978.

Asch, one of the nation’s foremost fertility experts, resigned from UC-Irvine on May 19. He has denied knowingly violating the wishes of his patients, saying that, if any administrative mistakes were made at his clinic, the university must share the blame.

Making babies without consent is the most serious but not the only charge leveled against Asch’s program. The doctors at the clinic also are accused of conducting research without obtaining university approval and patient consent. Fiscal hanky-panky concerning overcharging for patient services and fertility drugs also is alleged.

The evolving scandal at the UC-Irvine infertility program is symptomatic of a much deeper problem that has haunted the field of assisted reproduction since its inception. While the goal of assisted reproduction is the worthy one of helping infertile people have babies, in many parts of the country the motives of those providing the services are something less than holy.

Infertility treatment is big business in the United States. Patients pay anywhere from $6,000 to $12,000 for a single attempt at in-vitro fertilization. Four, five or more attempts are not uncommon. Asch and his associates at UC Irvine reported earnings of $4.5 million during the last three years.

Fifteen years ago there were fewer than 30 institutions offering test-tube baby technology in the United States. Today there are more than 150. They operate with little oversight or control.

At too many clinics the only ethic that prevails is “caveat emptor” - “let the buyer beware.”

Can a 60-year-old woman use technology to try having a child? Should young women be paid to take fertility drugs so their eggs can be harvested for use by others? How many embryos should be used in each attempt to make a baby? What sort of psychological screening should prospective surrogate mothers receive? What impact does a test-tube birth have on a child’s self-esteem? Are there too many clinics that have not ever produced a single baby? Should the citizens of other nations be allowed to come here to find egg and sperm donors when the technologies do not exist at home or are scorned for religious or cultural reasons?

None of those questions is covered by law, policy or regulation. In the United States today there is more oversight of the breeding of purebred animals than there is the creation of human beings.

It would be wonderful if godlike beings provided infertility services to those who need them. The mess at UC-Irvine indicates that such is not the case. Government and the medical profession need to show less awe and more wariness of those involved.

MEMO: Art Caplan is director of the Center for Bioethics at the University of Pennsylvania.

The following fields overflowed: CREDIT = Art Caplan King Features Syndicate