By Katie Gu
Mifepristone’s shifting legal terrain may soon raise new privacy considerations regarding telemedicine data collection, security, and disclosure.
Physician Free Speech and the Doctor-Patient Relationship Post-Dobbs
By Lynette Martins and Scott Schweikart
Laws regulating physicians’ professional speech – i.e., what they can and cannot discuss in the exam room with patients — have made a resurgence in the post-Dobbs era. These so-called “gag laws” have primarily targeted physicians’ speech around firearms, reproductive rights (predominantly abortion), and, less frequently, conversion therapy.
In the abortion context, these restrictive laws impact not only patient access to critical medical services, but also the fundamental underpinnings of the physician-patient relationship.
Going Public – The Future of ART Access Post-Dobbs
By Katherine Kraschel
The loss in Dobbs and the bleak outlook for abortion rights within the federal courts may afford advocates a unique opportunity to fully adopt a reproductive justice framework and apply it to access to fertility care, as other contributors to this symposium have argued.
This article outlines specific strategies for blue states eager to stake a claim in the reproductive justice movement to consider.
Monthly Round-Up of What to Read on Pharma Law and Policy
By Ameet Sarpatwari, Aviva Wang, and Aaron S. Kesselheim
Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues.
Below are the citations for papers identified from the month of April. The selections feature topics ranging from an analysis of government and industry investments for recently approved drugs, to a discussion of court decisions on mifepristone, and an examination of the added therapeutic benefit associated with the top-selling brand-name drugs in Medicare.
A full posting of abstracts/summaries of these articles may be found on our website.
AMA Supports Physicians’ Access to Fertility Preservation
By Scott J. Schweikart*
Many medical professionals in the United States today face a personal dilemma over whether to delay (and potentially forego) starting a family in order to fulfill lengthy medical training. In response to these concerns, the American Medical Association (AMA) recently passed a new policy that supports trainee access to assisted reproductive technologies (ART).
Dobbs as a Catalyst for Reproductive Justice
By Kimberly Mutcherson
As advocates construct arguments for saving and expanding abortion access, they should also think deeply about what it means to deny or refuse would-be mothers from traditionally disfavored groups the access to assisted reproductive technology.
Gamete Regulation and Family Protection in a Post-Dobbs World
By Courtney G. Joslin
Increasing numbers of people are forming families through assisted reproduction. Recently, there has been a push to impose new regulations on various aspects of this process. Some of these new laws open up participants to a range of possible penalties — civil, criminal, and/or professional discipline — for past “misconduct.” Other laws seek proactively to regulate the fertility care process. For example, some laws regulate the collection and dissemination of medical and identifying information about gamete providers — that is, sperm and egg donors. Other proposals seek to require gamete providers to agree to the release of their medical records.
It is surely important to assess and evaluate fertility care practices and to consider whether additional regulation is appropriate in this space. Particularly in the post-Dobbs era — an era marked by increasing attacks on reproductive health care (including access to IVF) and on LGBTQ people — it is also important to proceed cautiously and to consider how these proposals may adversely impact reproductive autonomy and family recognition.
Uterus Transplants and the Right to Experience Pregnancy
By I. Glenn Cohen
It is estimated that roughly one in five hundred U.S. women suffer from Uterine Factor Infertility — they were born without a uterus, they lost their uterus, or their uterus no longer functions. Until very recently, this essentially meant that pregnancy was not an option for these women. Because of uterus transplants, this is beginning to change. Such transplants raise a host of legal and ethical questions, which I will preview in this piece.
The Irony of Pro-life Efforts to Grant Embryos Legal Personhood
By Gerard Letterie and Dov Fox
The overruling of Roe v. Wade has emboldened pro-life lawmakers to confer legal personhood status on early-stage embryos outside of pregnancy as well, including in the context of assisted reproduction. Recognizing embryos as legal persons, it is said, promotes a “culture of life.” And yet treating embryos as persons would actually undermine a promotion of human life, in this critical sense: helping people to have the children they want and are otherwise unable to have.
The Infertility Shift
By Valarie K. Blake and Elizabeth Y. McCuskey
In vitro fertilization (IVF), like most medical care in the U.S., costs far more than most people can afford out-of-pocket: over $12,500 per cycle, with multiple cycles typically required. But, unlike most other expensive medical care, IVF rarely has insurance coverage to defray the cost.
In 2020, only 27% of employers with 500+ employees and 42% of employers with 20,000+ employees covered IVF in their employer plans. Companies like Starbucks and Amazon know this and use it to draw in employees at low (or essentially neutral) wages.
Recent reports reveal women working second shifts for these corporations solely to qualify for employer health benefits that cover infertility treatments. Starbucks, for example, covers IVF for employees who work 240 hours over three months, or roughly 20 hours per week. Frequently, in these low-wage positions, workers earn just enough to pay for their health insurance premiums and sometimes the associated cost-sharing requirements.
How did we get to a place where women must work an “infertility shift” beyond their full-time jobs to access medical care?