Illustration of a pregnant Muslim woman in a hijab sitting cross-legged in front of plants

Egg Freezing Permissible in Islam, According to Egypt’s Dar Al-Ifta

By Sarah Alawi

Dar Al-Ifta, Egypt’s Islamic body, issued a statement earlier this month on the legality of egg freezing under Islamic law following a controversial Facebook post by an Egyptian woman, Reem Mahana, on her decision to freeze her eggs.

Mahana said she froze her eggs for “the simple reason” that she wants to build a family when the time is right: “I cannot guarantee when exactly I will get married… I totally reject the idea of getting married to any man [only] to have a child.”

Before Mahana’s Facebook post, there was uncertainty around whether or not egg freezing was lawful (halal) according to Islamic law. Dar Al-Ifta had previously issued a Fatwa saying that embryo freezing, for married couples, is permissible in principle provided that four requirements are met.

Dar Al-Ifta has now declared that the process of egg-freezing is “permissible, and there is no Islamic prohibition of it if it is carried out under four conditions.”  The idea is that women can freeze their eggs provided that the eggs are fertilized within the (future) marriage.  The four requirements are:

  1. Eggs must be fertilized by the sperms of the husband while the couple is married, and not after the marriage is over, such as in cases of divorce, or death;
  2. Fertilized eggs must be kept completely safe and under strict control, preventing intentional or inadvertent mixing with other preserved eggs;
  3. A fertilized egg must not be placed inside the womb of a woman who did not originally produce the egg, and eggs may not be donated;
  4. Egg freezing must not pose negative side effects on the fetus due to the impact of the various factors that they may be exposed to during the process, such as those that could induce birth defects or mental retardation later.

Dar Al-Ifta’s Fatwa goes to the heart of the general premise in Islam that assisted reproductive technology is permissible, and maybe even encouraged, so long as the sperm and egg come from the married couple and no other party is involved. That is why surrogacy, for example, is not permissible (under the Sunni school of thought). Iran is the only Muslim country which has allowed the use of surrogacy, as well as egg, sperm and embryo donation.

Dar Al-Ifta’s Fatwa is a big step in clarifying the position for single women who wish to look to assisted reproductive technology (ART) to preserve their fertility in the face of the “biological clock.” Mahana’s story is not unusual, even in the West. As recent studies have suggested, women are freezing their eggs “waiting for partners, not careers.”

Other countries in the Middle East are in the process of updating their ART laws. Up until this year, UAE laws allowed only married women to freeze their eggs with single women being allowed to take up egg-freezing under special circumstances. The update on ART laws will allow single women to preserve their fertility without the need for special circumstances.

Genetic Discrimination in Education: What’s the Risk?

By Kaitlyn Dowling, based on research by the Cyberlaw Clinic at the Berkman Klein Center for Internet & Society

Illustration of a gavel made out of a DNA helixIn a new, year-long series on Bill of Health, we’ll be exploring the legal scholarship on genetic non-discrimination. We’ll talk more about GINA and state laws protecting citizens from genetic discrimination. We hope these posts help shed light on this complex and ever-more-relevant area for legal scholars, policymakers, and the public at large.

As discussed in our last post, most states regulate the use of genetic information in some way, although usually only in employment and insurance. Comparatively few states have protections against genetic discrimination in other contexts. Today, we’re exploring education protections in eight states: California, Illinois, Massachusetts, Michigan, Utah, Virginia, Washington, and West Virginia.

In comparison with other genetic non-discrimination protections, most states have not acted to implement protections in the education context. California, West Virginia, and Washington are the only states out of the eight surveyed with these types of protections.

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Photograph of a woman lying in a hospital bed holding her newborn wrapped in a blanket

Where Are the Legal Protections for People Mistreated in Childbirth?

By Alexa Richardson

A new study indicates that 28.1% of women birthing in U.S. hospitals experienced mistreatment by providers during labor, with rates even higher for women of color. The multi-stakeholder study, convened in response to World Health Organization efforts to track maternal mistreatment, included more than 2,000 participants, and defined mistreatment as including one or more occurrences of: loss of autonomy; being shouted at, scolded, or threatened; or being ignored, refused, or receiving no response to requests for help. The study newly highlights the lack of legal protections available to for pregnant and birthing people who experience these kinds of mistreatment by providers.

Campaigns like Exposing the Silence have chronicled the outpouring of people’s harrowing birth stories, riddled with abuse and violations of consent. In one typical account, a user named Chastity explained:

I had a room full of student doctors, an OB I never met come in and forcibly give me extremely painful cervical exams while I screamed for them to stop and tried to get away. They had a nurse come and hold me down. There was at least 10 students practicing on me. I was a teen mom and my partner hadn’t gotten off work yet so I was all alone.

Another user named Abriana recounted:

As I was pushing, I got on my side and it was then that I started to feel pain much different from labor pains. I asked, ‘What is going on?’ The nurse replied, ‘I am doing a perineal rub.’ I immediately said, ‘Please stop doing that. You are hurting me.’ The nurse argued, ‘It will help you’ and didn’t move. I asked her again to please stop. I then yelled, while pushing, ‘Get your hands out of me!’ The nurse continued.

The traditional modes of seeking legal recourse have little to offer those who experience these kinds of mistreatment.

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The Week in Health Law podcast logo

New TWIHL; Too Much Information About State Health Insurance Law

By Nicolas Terry

This episode was recorded at the 2019 meeting of the Southeastern Association of Law Schools during a panel reviewing the year in healthcare financing. In this episode I take a look at state regulation of health insurance, first, from the perspective of states playing defense and shoring up their own laws in case the ACA is “disappeared” and, second, how some are playing post-ACA offense, actually seeking to improve upon the ACA baseline. The slides accompanying this talk are here.

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A photograph of miniature figures of people standing on top of piles of coins at different heights

Promoting Health, Not Just Health Care

By David Orentlicher

Once again this past Thursday, the Democratic presidential candidate debate began on the topic of health care reform, and moderator George Stephanopoulos quickly steered the discussion to what he termed “the heart” of the debate. Should the United States increase access to care by building on the Affordable Care Act (ACA) or by replacing ACA with a single-payer, Medicare-for-All system?

While this is an important question, there is an even more important question for the candidates to discuss. We need to hear them talk more about health than about health care.

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First-person perspective photograph of a health care worker holding up a mask used to prevent the spread of germs

The Big Winner in Trump’s Newest Immigration Policies: The Flu

By Robert Field

The influenza virus gained an important ally during the past few weeks: the Trump Administration. If you have been rooting for a widespread and virulent flu epidemic this winter, several of its new immigration policies should give you reason to cheer.

The first bit of good news for flu fans is a decision to withhold vaccination from children held in Customs and Border Protection detention centers. These facilities are supposed to hold migrants for no longer than three days, but many remain much longer, and the centers are often severely overcrowded. Since the flu can be quite serious, this puts the thousands of children held in them at increased risk of major illness or death.

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3-D rendering of an HIV virus

Not Another Scott County?

By Emily Beukema, Aila Hoss, and Nicolas Terry

In November 2014, Scott County, Indiana was the site of a now infamous HIV outbreak linked to intravenous drug use. Syringe service programs (SSP) would not only have curbed that outbreak but also could have prevented it from occurring in the first place. Later analysis found that then Governor Pence of Indiana failed to declare a state of emergency until two months after the peak infection rate and that, even after that declaration, disagreements among stakeholders later delayed the implementation of a temporary SSP. Absent those delays the number of infections could have been dramatically decreased.

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Black and white photograph of adult holding a baby's hand

On the Tyranny of Partners in Posthumous Reproduction Cases

By Shelly Simana

The topic of posthumous reproduction has produced great interest globally due to the fundamental dilemmas it raises. The most controversial cases are the ones in which there is no explicit consent on behalf of the deceased person for using his or her gametes after death. In those cases, courts try to trace the presumed intentions of the deceased person, heavily relying on testimonies of the deceased’s family members and friends.

I recently published an article about this topic, in which I advocate for a more permissive approach toward posthumous reproduction. In this blog post, I would like to focus on a particular issue—the permission for the deceased’s partner, but not the parents, to engage in posthumous reproduction.

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Photograph of protestor holding a hot pink sign that reads "I Stand with Planned Parenthood"

Trump’s Title X Gag Rule: An Ethical Conundrum for Planned Parenthood

By Beatrice Brown

On August 19, Planned Parenthood announced that they would be leaving the Title X family planning program due to the Trump Administration’s new prohibition that restricts those who receive Title X funds from providing or referring patients for abortion. This restriction on Title X funding has unsurprisingly been met with a lot of criticism, namely, that it interferes with a woman’s constitutional right to abortion. This can be seen as a partial victory for those who have been attempting to defund Planned Parenthood for years, an organization that, despite others’ characterizations, is fundamentally committed to providing all women access to quality health care and is not solely an abortion provider.

As a result of this gag rule, Planned Parenthood has faced a huge ethical dilemma: Do they continue to accept Title X funding to assist low-income women with everyday health care, such as yearly routine wellness visits, or do they reject this funding and both 1) take a stand on a woman’s constitutional right to abortion and 2) continue to provide a service (or retain the right to refer patients to a service) that is crucial to women’s health? Planned Parenthood has chosen the latter, and I think that Planned Parenthood’s difficult choice is justified.

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