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The Connection Between Euthanasia & In Vitro Fertilization: A Moral Analysis

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Bioethics in Law & Culture                                                                                                                            Summer  2021       vol. 4  issue  3

Katie Breckenridge, M.S.

Operations Manager, Them Before Us

Abstract

Euthanasia and IVF concern both the creating and taking of human life. On first examination, the similarities between these two acts may be overlooked, as euthanasia and assisted suicide are about ending one’s life, while IVF is about creating life. However, on further exploration, these two issues are an immense affront to both the sanctity of human life and human dignity.

Introduction

Supporters of Euthanasia argue that the terminally ill should have the right to end their lives with “dignity” by getting to determine how and when they will die. They argue that no one else should be allowed to deny the terminally ill the “right” to end their lives, and that voluntary euthanasia is acceptable if all persons involved agree that euthanasia is in everyone’s best interests and does not violate any human rights.[i]

 

Is there really a “right” to determine how and when you will die? When someone who is not terminally ill speaks of ending his or her life, do we encourage that person to do so because he or she possesses some “right” to make that choice, or do we try to discourage that choice because we know they are valuable human beings? A terminally ill person does not suddenly become invaluable and unworthy of life because their time is most certainly shortened. Euthanasia violates human rights in that it devalues and dehumanizes every infirm human being.

 

Does Euthanasia truly ever consider the best interests of all parties involved? Often, those seeking to end their lives do so because they feel they are burdens on their caregivers, or because they have fallen into depression due to their physical states. In these cases, allowing someone to die most certainly benefits one party more than another, as a burden is lifted from those responsible for putting forth the needed care to nurture the infirm patient’s physical and/or mental state. The insurance industry also benefits from euthanasia, as it is inarguably less costly in the long run for insurers to provide payments for life-ending medications (if we can even call such drugs medications) than it is for them to continue paying for life-sustaining treatments. 

 

Similarly, the process of In Vitro Fertilization devalues human life, commodifies human beings, and often benefits the adults much more than it benefits the children created through the process. Many view IVF as a fantastic endeavor allowing infertile/single/or same-sex couples to create new life, and what could possibly be wrong with creating the gift of new life? First, as with euthanasia, life is not ours to give or take, as God is the ultimate giver of life. As stated in John 10:10, “The thief does not come except to steal, and to kill, and to destroy. I have come that they may have life, and that they may have it more abundantly.”[ii]

 

IVF treats human beings as commodities which one has the right to manufacture at the expense of the created persons. These persons' lives are experimented on, they are made-to-order, and their basic human rights and foundational human needs are often ignored. Contrary to the beliefs of many, IVF is not simply about “creating new life,” but is also about sacrificing millions of children to their deaths in the belief that adults have a “right” to children.

 

Argument/Critique

Different types of euthanasia

Before delving into the similarities between euthanasia and IVF, it is imperative to define the different types of euthanasia.

 

There are six types of euthanasia: active voluntary, passive voluntary, active non-voluntary, passive non-voluntary, active involuntary, and passive involuntary. There is also physician-assisted suicide, or what is sometimes referred to as “physician aid-in-dying.”

 

Active voluntary occurs when a patient willingly makes the decision to end his or her own life, and a physician or other person either administers a lethal injection, or administers a lethal amount of a drug to kill the patient.

 

Passive voluntary occurs when a patient willingly allows for the use of non-heroic measures to be withdrawn, such as the halting of providing food, water, or oxygen machines in order to end the life of the patient.

 

Active non-voluntary occurs when the patient is unconscious or is unable to give consent, and a lethal injection or drug is given to kill the patient.

 

Passive non-voluntary occurs when non-heroic measures are withdrawn from a patient when he or she is unable to give consent. For example, if a baby survives an abortion and is left to die without treatment when he or she would have otherwise survived, this would be passive non-voluntary euthanasia. Also, when a person may or may not survive a coma and food and water are withheld from them because their health condition is not improving rapidly enough, this is passive non-voluntary euthanasia.

 

Active involuntary occurs when a patient is administered a lethal injection or lethal dosage of a drug despite his or her wishes to the contrary.

 

Passive involuntary occurs when a patient is withheld non-heroic measures despite his or her wishes to the contrary.

 

Physician-assisted suicide is the act of a physician’s providing patients with the means to kill themselves. The difference between physician-assisted suicide and active voluntary euthanasia is that the patient will inject or ingest the lethal dose themselves instead of the lethal drugs being administered by the physician.[iii]

 

The IVF process can be compared to active non-voluntary, active involuntary, passive non-voluntary, and passive involuntary euthanasia, as these human beings are unable to give consent regarding whether they are allowed to continue living. Of course, as all human embryos are unconscious and unable to give consent, they are always under the influence of active non-voluntary euthanasia when fertility specialists create and transfer embryos knowing that they will not all survive. This creation and roll of the dice is nothing more than the intentional killing of human beings, and these human beings surely would not consent to dying if they were conscious, hence, active involuntary euthanasia is also being applied. The two active forms of euthanasia also apply to the outright disposal of “extra” unwanted embryonic lives.

 

Much like the overlap between the previous two active forms of euthanasia, passive non-voluntary and passive involuntary are also similar. Passive non-voluntary and passive involuntary euthanasia are similar to donating embryos to scientific research, and the opting for selective reduction of fetuses when too many embryos have implanted. In order for “extra” embryos to have a chance at survival, they must be frozen or transferred right away. When the options that are required for this minimal chance of survival are intentionally withheld from them for the purpose of destruction through scientific research, they surely are being withheld non-heroic measures despite their wishes to the contrary. An example of selective reduction after IVF occurred when two adopted embryos (meaning, embryos who were not the biological children of the carrier) were successfully implanted into an infertile woman. This woman ended up becoming pregnant with three children and later decided to kill two of them because of the risks involved in carrying triplets, and the risk that these commissioned children may be born with less than perfect health. She stated that she couldn’t risk the lives of all of these children when she knew one of them could thrive and went on to state, “...As a mother, it was the only choice I had. It was a sacrifice beyond what I thought I was capable of making, but, as parents know, that's part of being a parent...Maybe the most important part.”[iv]

 

First, she is sacrificing someone else’s children, as they are not her genetic children. Second, this act does not show self-sacrificial love for these children. This act does not show that this woman had the best interests of these children in mind, as two of them are now dead and the surviving child has to live with the fact that two of his siblings were intentionally killed by his adoptive mother, leaving him with a life-long separation from them. Part of being a parent does not involve killing two children for one of them to survive. Non-heroic measures are being withheld from these fetuses during selective reduction, as the womb is what is needed to keep these fetuses alive. When their only life source is intentionally taken from them, then they are being passively euthanized, as they would continue growing and surviving otherwise.

This shows nothing more than an action, much like euthanasia, which benefits one party more than the other, and it most certainly is not the “only choice” possible for anyone in either of these situations.

Devaluing of life

Both IVF and Euthanasia have within them an inherent disregard for the sanctity of life, and a callous view of the dignity and worth of every human being. If we can unnaturally make life, then why can’t we take it unnaturally? What is the value of a human life anymore?

 

In IVF, children are deliberately created with the full knowledge that not all of them, if any, will make it, and this process tells the world that the lives of these human beings are our property to do what we wish with them in order to achieve our desires. Those employed by the fertility industry, in their efforts to help others achieve their desires, are complicit in the deaths of millions of human beings.

 

Tragically, it is often the biological mothers and fathers of these children who are actively participating in the deaths of their children. Even if no lives are lost in the IVF process, by pursuing this act parents are intentionally devaluing the right to life of their children because they know that there is a probability that their children will not make it.[v]

 

Similarly, euthanasia, instead of treating human beings as worthy of continuing to receive the help they need in order to die a natural death, considers human beings disposable. Physicians, in their efforts to help patients “die with dignity,” are purposefully allowing and contributing to deaths which are anything but dignified.

In 2013, Oregon’s annual “death with dignity” reports show that some of the reasons for physicians’ approving assisted suicide include patients being “less able to engage in activities making life enjoyable,” being a “burden on family, friends/caregiver,” “losing autonomy,” and having “inadequate pain control or concern about it.”[vi]

 

These patients who feel they are a burden on their families, friends, and caregivers often feel that it is no longer their option to die, but their duty to die, and so they sacrifice themselves on the altar of the selfish desires of others to live their lives without having to take care of them. This is unacceptable.[vii]

 

Ending your life prematurely is anything but “dying with dignity,” as there is no dignity in valuing your worth as a person so little that you give up before your life is naturally over. There is no dignity in allowing others to convince you that your life is no longer worth living and that you should be killed. If we truly cared about helping people to maintain their dignity, we would do all that we can to help them instead of killing them. The mindset of helping patients to maintain their dignity and to not intentionally take life was especially prevalent in the classic version of the Hippocratic Oath, but this honorable code has since changed to fit the legality of euthanasia and abortion.

 

Hippocratic Oath

The classic version of the Hippocratic Oath stated, “...I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asks for it, nor will I make a suggestion to this effect. Similarly, I will not give to a woman an abortive remedy. In purity and holiness, I will guard my life and my art.”

 

The Declaration of Geneva and the International Code of Medical Ethics has made various changes to the Hippocratic Oath, but the most recent version states, “...I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism...Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God...I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”[viii]

 

Despite the absence of any mention of euthanasia and abortion in the most recent version, these oaths still have a common requirement: physicians are called to treat the sick to the best of their abilities. The most recent version states that physicians must “...apply, for the benefit of the sick, all measures that are required…,” but are euthanasia and IVF really acts which “benefit the sick,” and are these “treatments” required? Treating the sick to the best of their abilities does not include killing the sick when they can no longer treat them, as death is not a requirement for healing. The oath further states that “this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.” Physicians taking the lives, or rather, the deaths of others into their own hands intentionally is precisely “playing at God,” because God is the ultimate giver, and taker, of life---not medical staff. Physicians have special obligations to “those of sound mind and body as well as the infirm.” Those who are infirm deserve the same amount of dignity given to those of sound mind and body, part of which involves not allowing these persons to believe that their lives are no longer worth living despite receiving terminal diagnoses. It can also be argued that none of these individuals are truly “competent” enough to give true consent to die.  After all, can anyone in a state of mental distress severe enough to want to die really be considered to be in a competent state of mind? It is the duty of physicians to heal these distressed mental states, not help their patients to die. Medical professionals have a duty to give and protect life, and deliberately taking the lives of their patients is a violation of this principle.[ix]

 

Benefitting the sick with required treatments, not playing at God, and treating those of sound mind and body as well as the infirm also does not involve sacrificing the lives of others in order to treat others, as is the case with IVF. Medical personnel have an obligation to all “fellow human beings,” and human beings, of course, come into existence at the moment of fertilization, so the obligation should also exist to protect these small embryonic children. Also, infertility is not a sickness that requires necessary treatment in order for a person to live. As emotionally and physically difficult as it is to be unable to have children naturally, being infertile will not kill anyone. The act of creating children in a laboratory is guaranteed to kill human beings, however, and certainly does not “tread with care in matters of life and death.”

Eugenic Practices

The In Vitro Fertilization process often involves the preimplantation screening of blastocysts. These preimplantation screenings not only determine the likelihood of implantation success and the likelihood of miscarriage, but also screen for chromosomal abnormalities such as down syndrome, and inherited genetic diseases such as breast cancer genes, cystic fibrosis, and spinal muscular atrophy.[x] After these blastocysts are screened, only the ones determined “genetically healthy and normal” are transferred with the hopes of implantation.[xi]

 

When discussing the “benefits” of IVF, Dr. Jeffrey Port, the owner of a medical device company, stated “Genetic testing is allowing us to potentially prevent a generation of genetic diseases that we spend tens, if not hundreds, of billions of dollars on...By using genetic testing in the IVF process, people can select embryos that don’t have those mutations and possibly eliminate many of these conditions…”[xii]

 

It is an astonishingly eugenic practice to decide which human beings are unworthy of life because they may have a genetic affliction, and to weed out those children who are “undesirable” for one’s own financial benefits or convenience.

 

Euthanasia and assisted suicide also contain within them eugenic practices, as they seek to weed those out of society who are no longer considered worthy of living. In fact, many disability rights organizations have spoken out time and time again against euthanasia and assisted suicide, because having a disability does not mean that one should “die with dignity.” Rather, the disabled and the otherwise challenged should be assisted to continue living their lives with dignity. While one may think that “death with dignity” acts have plenty of safeguards in place before terminally ill persons can make end-of-life decisions, such as the requirement that a person have six months or less to live, these laws are a slippery slope, as physicians must accurately predict whether someone will die within six months, and can also make the mistake of misjudging quality of life. Physicians can conclude that because those with disabilities are dependent on others and possess more physical and mental challenges, their qualities of life are much worse than a non-disabled, suicide-minded person. In this case, the motivation for seeking services which will address the concerns of the disabled patient, such as financial concerns or concerns about being a burden on others, would not be as prevalent as those without disabilities.

According to doctors Diane Coleman and Carol Gill, “people with disabilities have already been endangered by relaxation of laws and policies protecting their lives. Medical rehabilitation specialists report that quadriplegics and other significantly disabled people are dying wrongfully in increasing numbers because emergency room physicians judge their quality of life as low and, therefore, withhold aggressive treatment. Disabled people who need ventilators are often not offered assisted breathing as an option. Those who already use ventilators report that they are increasingly asked by medical personnel to consider ‘do not resuscitate’ orders and withdrawal of life support...People with relatively mild disabilities are routinely denied lifesaving organ transplants. Many people with disabilities are terrified that managed care will further abridge their already limited options for life-extending treatments.”[xiii]

 

In fact, in March 2020, a woman with an intellectual disability was taken to a hospital in Oregon for Covid-19, where she was denied a ventilator when she was struggling to breathe, and was given a DNR and DNI by a medical provider due to her “low quality of life.” She did not agree to these decisions, as she was unable to understand what was taking place. Hospital staff reached out to the woman’s group home and asked them to write DNRs for all of their clients in case they ended up in the hospital---an obviously biased ruling on the worth of persons with disabilities. In April 2020, a man with severe physical and mental disabilities was refused testing for Covid because a staff member stated that testing him would be “a waste of personal protective equipment.” It was also suggested to his group home that they stop the man’s nutrition and personal care because of his “low quality of life,” despite the fact that this man’s health is fine now after his having been treated for what turned out to be pneumonia during his hospital visit.[xiv]

Much like children being killed through IVF for not meeting certain genetic standards, disability rights activists are also concerned, and rightly so, that “passive euthanasia” could be performed on them since their quality of life is often considered worthless, and that, much like persons with terminal illnesses, disability-related services are “artificially prolonging life.”[xv]

Financial Motivation

In 2020, the IVF services market was valued at $4,905.46 million, and is anticipated to reach $5,563.06 million by the year 2027.[xvi] The global IVF services market was valued at $33 billion in 2019, and is projected to reach $47 billion by 2030.[xvii] These numbers are hardly surprising, given the average cost of IVF is approximately $12,000, and this is without any of the “extras” involved in the process. These extras include approximately $3,000 for “preimplantation genetic screening,” around $3,000-$5,000 for a frozen embryo transfer, and, if it is deemed necessary to pursue intracytoplasmic sperm injection for the fertilization process, an additional few thousands of dollars. For those using gamete donors, the cost will range from $25,000-$30,000 for using an egg donor, and $13,000-$17,000 for use of a sperm donor.[xviii] The medications used to stimulate the ovaries and produce multiple eggs for fertilization can range from $5,000-$7,000,[xix] which is not an issue faced only by women pursuing the IVF process, but one that is also faced by the women who rush to freeze their eggs because the fertility industry feeds their anxieties about being unable to have children at an older age.[xx] Women, on average, will pay between $30,000-$40,000 for egg retrieval, medication, and storage.[xxi]

 

The high cost of fertility treatments and the rising client base have opened the door for investments from private equity firms. While the investments of private equity firms can be beneficial to clinics in helping them with business related matters and acquiring money for start-ups, investors, of course, are always looking for a return on their investment. As stated by Dr. Ravi Gada, co-owner of a fertility clinic in Dallas, Texas, “Physicians go into medicine to take care of patients and provide the best care that they can. I think [private equity] firms are looking at that as well, but by definition they are also looking at the return on investment that they are getting from putting money into this.”[xxii]

The creation of human life should never be motivated by a desire to make money, as seeking to make money off of the conception of human life is commodifying and dehumanizing to these conceived human beings.

Much like the fertility industry’s profiting from the deaths of human beings, insurance companies have refused to cover treatment for terminal illnesses, but would instead cover drugs for assisted suicide as a way to save money. A Californian woman, Stephanie Packer, was told that she had three years to live after being diagnosed with a terminal lung condition. Her insurance company said they would not pay for her chemotherapy treatments, but instead would cover assisted suicide drugs with a co-pay of $1.20. Though there is little information stating whether Stephanie is still alive, she definitely ended up living three times longer than was expected---a total of at least five years past when her life was predicted to end. This is a woman who would have missed out on several more years of life with her husband and children all in the name of insurance companies’ saving money by offering cheaper “solutions.”[xxiii]

In 2017, Dr. Brian Callister of Nevada had two patients requiring life-saving procedures. These patients were not seeking life-extending treatment, as they only needed curative procedures. Dr. Callister was told by the insurance medical directors in the patients’ states that they would not cover these curative procedures, but instead would cover assisted suicide. In their attempts to save money, insurance companies are leaving patients with no other option but to give up and die. Dr. Callister admits that doctors are “often horribly wrong” in their diagnoses about how long terminally ill patients have left to live, as we can of course see was the case with Stephanie Packer.[xxiv] Offering assisted suicide as an alternative to treatment can surely take precious years from someone’s life, despite their illness being terminal.

 

There is also a slippery slope that arises out of insurance companies simply deciding not to pay for certain treatments, as where does this refusal end? Will those persons who are deemed “less valuable” by society be given no choice but to die, such as the elderly, the poor, and those suffering from intellectual and physical disabilities? What about those persons who are depressed and decide they don’t want to live anymore, as was the case with a 24-year-old Belgian woman who suffered from suicidal thoughts and was granted permission to receive a lethal injection.[xxv]

 

Another example of a life that could have been cut short by assisted suicide is a man named J.J. Hanson, who was given four months to live due to brain cancer. He ended up living three years following his diagnosis---three more years he got to spend with his wife and two young sons. J.J. spoke about how vulnerable patients are put at risk by coercion from doctors who suggest prescribing drugs for assisted suicide, as he himself was one of these vulnerable patients. He was depressed after his diagnosis, and, of course, could have given in and taken the easily obtained pills. However, he states that what he really needed was counseling instead of pills to kill himself, and he went on to speak out against assisted suicide in his final years. No matter how many years a person may or may not have left, no persons should be told by having assisted suicide presented to them as an option that their lives are no longer valuable and worth living.

There is also no oversight when patients are prescribed pills to kill themselves. There are no safeguards in place making sure that patients are willingly taking the drugs, and no unbiased third-party witnesses, all of which allows for the concealing of numerous abuses from friends, family members, or abusive caregivers. Patients can be steered towards taking the drugs by those who seek to inherit from them, they can be incompetent at the time the drugs are given to them and unable to give proper consent, or they could be suffering from mild depression and be coerced into taking the drugs even if they truly do not want to take their lives, given that they are not thinking in a level-headed manner.[xxvi]

 

Conclusion

In order to create a culture that values human life at every stage, there must be continued efforts towards creating laws which promote the dignity and worth of persons from the moment of fertilization, starting with the creation of more fetal heartbeat bills,[xxvii] as only then will society reach a point where selective reduction can be banned other than to save the life of the mother.

We also need laws that ban experimentation and gene editing on embryonic persons, laws which ban the use of donor gametes in order to preserve the biological familial foundation that children deserve, and laws limiting the number of embryonic persons allowed to be created at one time during the IVF process in order to reduce the number of “extra” human beings.[xxviii] Parents need to be required to transfer all of their created children, not donate or dispose of them.

When it comes to euthanasia, there should be no motivation from insurance companies to make money off of the promotion of assisted suicide. Instead, the motivation should be for providing patients with the care they need in order to live out their remaining days with dignity.

A large aspect necessary to create a culture of life that respects human life at all stages is that those who identify as “Christians” need to take steps to become more unified on beginning and end of life issues. As those who are supposed to be followers of the God who came to “give life abundantly,” we cannot claim to be examples of Christ and condone the intentional taking of human life, as then where is the motivation for those who are secular to care about these issues? The United Church of Christ, the Unitarian Universalists, and the Episcopal Church in some circumstances are permissive of the act of euthanasia, while the majority of Christian denominations oppose it.[xxix]

 

Many Protestant denominations have little or no objections to abortion.[xxx] However, several denominations which oppose euthanasia do so on the grounds that euthanasia violates “the sanctity of life and its role in God’s plan,” and “a belief in the intrinsic value of human life, the sovereignty of God and the need for health care workers to do no harm.”[xxxi] Does eliminating the life of a developing human being not oppose the sanctity and intrinsic value of human life? Do health care workers eliminating the lives of these human beings not bring them harm?

Several Christian denominations condone IVF as long as no donor gametes are used and there is no embryo wastage. Again, followers of the God who gives life abundantly should not be condoning an act which certainly guarantees the “wastage” of human beings through either death or excess embryos.[xxxii]

 

It is that much harder for Christians to be on the same page when it comes to issues regarding the most basic, natural right to life, when well-known figures who the world perceives as representatives of Christianity are promoting these acts. Recently, Katherine Schwarzenegger interviewed persons who pursued the surrogacy process,[xxxiii] which almost always involves the IVF process. She also interviewed a same-sex couple who not only pursued the IVF and surrogacy process, but the gamete donation process.[xxxiv] Surrogacy brings with it other issues about the dignity of women and disregards how the act of motherhood is more than simply incubation.[xxxv]

 

Christians and secular pro-life advocates must not only disagree with issues that violate the right to life, but actively advocate against the harms of euthanasia, abortion, and reproductive technologies.

 

____________________

[i] All Answers Ltd., “Life or Death Euthanasia Arguments For and Against,” LawTeacher, last modified August 7, 2019, https://www.lawteacher.net/free-law-essays/medical-law/life-or-death-euthanasia-arguments-for-and-against-law-medical-essay.php.

[ii] Orthodox Church in America, “Scripture Readings,” Orthodox Church in America, https://www.oca.org/readings/daily/2023/03/12/3.

[iii] Clowes, Brian, “An Introduction to the Problem of Euthanasia, Human Life International, last modified April 17, 2020, https://www.hli.org/resources/types-of-euthanasia-intro/.

[iv] Diversi, Kristin, “I Got Pregnant With Triplets But Could Only Keep One,” Parents, last modified October 9, 2017, https://www.parents.com/pregnancy/complications/i-got-pregnant-with-triplets-but-could-only-keep-one/.

[v] Pacific Fertility Center Los Angeles, “Fresh vs. frozen embryo transfer success rates,” Pacific Fertility Center Los Angeles, last modified January 11, 2021, https://www.pfcla.com/blog/frozen-embryo-transfer-success-rates-ivf.

[vi] Oregon Public Health Division, “Oregon’s Death with Dignity Act---2013,” Oregon Health Authority, https://www.oregon.gov/oha/ph/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year16.pdf.

[vii] Berger, Helena, Clyde Terry, “When Insurance Companies Refuse Treatment ‘Assisted Suicide’ Is No Choice At All,” American Association of People with Disabilities, last modified January 24, 2017,

https://www.aapd.com/when-insurance-companies-refuse-treatment-assisted-suicide-is-no-choice-at-all/.

[viii] Tyson, Peter, “The Hippocratic Oath Today,” Public Broadcasting Service, last modified March 27, 2001, https://www.pbs.org/wgbh/nova/article/hippocratic-oath-today/.

[ix] OpinionFront, “Difference Between Euthanasia and Assisted Suicide,” OpinionFront, https://opinionfront.com/difference-between-euthanasia-assisted-suicide.

[x]  Fertility Centers of Illinois, “Ask the Doctor: 10 Questions About Genetic Testing,” Fertility Centers of Illinois, last modified March 9, 2019, https://www.fcionline.com/fertility-blog/ask-doctor-10-questions-genetic-testing.

[xi] Extend Fertility, “Preimplantation Genetic Diagnosis and Screening: Genetic Testing for Embryos,” Extend Fertility, last modified February 20, 2020, https://extendfertility.com/preimplantation-genetic-diagnosis-and-screening-genetic-testing-for-embryos/.

[xii] Cantrell, Amanda, “This Venture Capital Fund Wants to Get You Pregnant,” Institutional Investor, last modified May 15, 2019, https://www.institutionalinvestor.com/article/b1ff3x6hcl5wbb/This-Venture-Capital-Fund-Wants-to-Get-You-Pregnant.

[xiii] Mclean, Sheila A.M., Laura Williamson, Impairment and Disability: Law and Ethics at the beginning and end of life, New York, NY: Routledge-Cavendish, 2007.

[xiv] Shapiro, Joseph, “Oregon Hospitals Didn’t Have Shortages. So Why Were Disabled People Denied Care?” National Public Radio, last modified December 21, 2020, https://www.npr.org/2020/12/21/946292119/oregon-hospitals-didnt-have-shortages-so-why-were-disabled-people-denied-care.

[xv] Mclean, Sheila A.M., Laura Williamson, Impairment and Disability: Law and Ethics at the beginning and end of life, New York, NY: Routledge-Cavendish, 2007.

[xvi] Telugunta, Ravi, Smita Nerkar, Onkar Sumant, “U.S IVF Services Market by Cycle Type (Fresh IVF Cycle, Thawed IVF Cycle and Donor egg IVF cycle) and End User (Fertility Clinics, Hospitals, Surgical Centers, and Clinical Research Institutes): Analysis and Industry Forecast, 2019–2027,” Allied Market Research, last modified June 2020, https://www.alliedmarketresearch.com/US-IVF-services-market.

[xvii] Precedence Research, “Fertility Market (By Offering: Assisted Reproductive Technology (IVF, Artificial Insemination, Surrogacy, and Others), Fertility Drugs (Gonadotropin, Anti-estrogen, and Others), Others; By End user: Fertility Clinics, Hospitals, and Clinical Research Institutes) - Global Industry Analysis, Market Size, Share, Growth, Trends, Regional Outlook And Forecasts, 2021 - 2030,” Precedence Research, https://www.precedenceresearch.com/fertility-market.

[xviii] Gurevich, Rachel, “How Much Does IVF Really Cost?” Verywell Family, last modified March 5, 2020, https://www.verywellfamily.com/how-much-does-ivf-cost-1960212.

[xix] Fertility IQ, “Cost,” Fertility IQ, https://www.fertilityiq.com/topics/cost.

[xx] Robbins, Rebecca, “Investors see big money in infertility. And they’re transforming the industry,” Stat, last modified December 4, 2017, https://www.statnews.com/2017/12/04/infertility-industry-investment/.

[xxi] Fertility IQ, “Egg Freezing,” Fertility IQ, https://www.fertilityiq.com/egg-freezing/the-costs-of-egg-freezing#breaking-down-the-likely-costs.

[xxii] Cantrell, Amanda, “This Venture Capital Fund Wants to Get You Pregnant,” Institutional Investor, last modified May 15, 2019, https://www.institutionalinvestor.com/article/b1ff3x6hcl5wbb/This-Venture-Capital-Fund-Wants-to-Get-You-Pregnant.

[xxiii] Berger, Helena, Clyde Terry, “When Insurance Companies Refuse Treatment ‘Assisted Suicide’ Is No Choice At All,” American Association of People with Disabilities, last modified January 24, 2017,

https://www.aapd.com/when-insurance-companies-refuse-treatment-assisted-suicide-is-no-choice-at-all/.

[xxiv] Callister, Brian “Doctor: Health Insurance Wouldn’t Pay for Treatment, But Offered Assisted Suicide,” The Daily Signal, YouTube Video, last modified June 28, 2017, https://www.youtube.com/watch?v=JzafMM9QCAg.

[xxv] Chan, Melissa, “Belgian woman, 24, granted right to die by euthanasia over suicidal thoughts: ‘Life, that's not for me,’” New York Daily News, last modified June 30, 2015,

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[xxvi] Valliere, Matt, “My friend J.J. had a terminal disease. Here’s why assisted suicide was never an option for him,” New Jersey Local News, last modified November 29, 2018, https://www.nj.com/opinion/2018/11/my-friend-jj-had-a-terminal-disease-heres-why-assisted-suicide-was-never-a-option-for-him.html.

[xxvii] Najmabadi, Shannon, “Gov. Greg Abbott signs into law one of nation’s strictest abortion measures, banning procedure as early as six weeks into a pregnancy,” The Texas Tribune, last modified May 19, 2021,

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[xxviii] Breckenridge, Katie, “The Need for More Restrictive IVF Legislation,” Society of St. Sebastian, last modified October 2020, https://www.societyofstsebastian.org/fall2020-ivf-regs-breckenridge

[xxix] Pew Research Center,  “Religious Groups’ Views on End-of-Life Issues,” Pew Research Center, last modified November 21, 2013, https://www.pewforum.org/2013/11/21/religious-groups-views-on-end-of-life-issues/.

[xxx] Masci, David, “Where major religious groups stand on abortion,” Pew Research Center, last modified June 21, 2016, https://www.pewresearch.org/fact-tank/2016/06/21/where-major-religious-groups-stand-on-abortion/.

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[xxxii] IVF Worldwide, “IVF and Christianity,” IVF Worldwide, https://ivf-worldwide.com/education/introduction/ivf-global-perspective-religious/ivf-christianity.html.

[xxxiii] Schwarzenegger, Katherine. Instagram Post. June 15, 2021. https://www.instagram.com/p/CQKE7u1iCLP/.

[xxxiv] Scwarzenegger, Katherine. Instagram Post. July 2, 2021. https://www.instagram.com/p/CQzcKFWl5Cz/.

[xxxv] Breckenridge, Katie, “Women are More Than Incubators: Why Surrogacy is Morally Problematic,” Society of St. Sebastian, last modified November 20, 2019, https://www.societyofstsebastian.org/copy-of-sebastian-s-point-63.

 

Euthanasia | Assisted Suicide | IVF, In Vitro Fertilization | Reproductive Technologies