Category: Medical Tourism

figurine with a void shape of a child and family of parents with a child. Surrogacy concept.

Regulating International Commercial Surrogacy

Hannah Rahim Leave a comment

By Hannah Rahim

In January 2024, Pope Francis called for a universal ban on surrogacy as a threat to global peace and human dignity, claiming that the practice is a “grave violation” of the mother and child’s dignity and based on the “exploitation of situations of the mother’s material needs.” Surrogacy raises complex ethical and legal issues, particularly in cases of international surrogacy, where people seek surrogacy services from another country. There is currently no regulation of international surrogacy. Creating such regulation is important to allow appropriate access to surrogacy services while mitigating its harmful consequences.

Read More

Miniature of a passenger plane flying on the map of United States of America from south east. Conceptual image for tourism and travel.

The Constitutionality of Banning Interstate Travel for Abortion

Hannah Rahim Leave a comment

By Hannah Rahim

After the Supreme Court eliminated the constitutionally protected right to abortion in Dobbs v. Jackson Women’s Health Organization, right-wing states have begun enacting abortion bans and discussing the possibility of restricting interstate travel for abortion.

Although there is a general presumption against a state’s ability to regulate extraterritorially (i.e., beyond its borders), legal authority suggests that the Constitution does not clearly prohibit a state from regulating abortion travel.

Read More

A Liquid Nitrogen Bank Containing Sperm and Eggs Samples - ivf - in vitro fertilization, egg freezing.

Egg Freezing in Israel: Legal Framework and Women’s Viewpoints

The Petrie-Flom Center Staff Leave a comment

By Yael Hashiloni-Dolev and Nitzan Rimon-Zarfaty

In 2009, Israel was one of the first countries to authorize social egg freezing, before it was declared non-experimental.

Israel is a highly pronatalist familistic society with relatively high marriage rates, low divorce rates, and the highest birth rate among OECD countries. Israeli pronatalism frames the favorable Israeli approach to fertility medicine and preservation. Currently, egg freezing is used for both medical and social reasons, and for transgender men.

Israeli policy views social egg freezing as primarily enabling, based on liberal ideology, “individual autonomy.”

Indeed, on one hand, social egg freezing has been praised as a revolutionary solution for women’s age-related fertility decline, thus providing women with liberating opportunities. On the other hand, it has been criticized for as oriented toward women’s bodies rather than toward taking away social obstacles to their full participation in the labor market and society in general. Giant corporations such as Apple and Facebook have offered funding for social egg freezing to their female employees while provoking ongoing bioethical and public debates regarding their implications, including; medicalization, (dis)empowerment, “appropriate” motherhood, medical risks, and success rates. This post considers these debates with a focus on the Israeli context.

Read More

Protesters holding signs that read My Body My Choice, Human right, Bans Off Our Bodies, Abortion Is Healthcare.

Dobbs v. Jackson Women’s Health and Its Devastating Implications for Immigrants’ Rights

The Petrie-Flom Center Staff Leave a comment

By Asees Bhasin

While reproductive injustice against immigrants is not new, they are now even more vulnerable to reproductive oppression in light of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturning the constitutional right to abortion.

Immigrant reproduction has long been vilified and opposed, with immigrant parents facing accusations of being hyper-fertile and giving birth to “anchor babies.” Additionally, pregnant immigrants have faced additional structural barriers to accessing necessary abortion care. This article explains how these injustices are likely to be exacerbated by the Dobbs ruling.

Read More

Washington, DC, USA, May 5, 2022: people protest the leaked draft Supreme Court opinion overturning Roe v. Wade and the right to abortion

The Leaked Dobbs Opinion, Explained

Chloe Reichel Leave a comment

By Chloe Reichel

On May 2, 2022, Politico published a leaked draft of the majority opinion in Dobbs v. Jackson Women’s Health Organization, which showed the Supreme Court’s intent to overturn the right to abortion as decided in Roe v. Wade.

In response to the leak, the Petrie-Flom Center hosted a discussion with legal historian and Daniel P.S. Paul Visiting Professor of Constitutional Law Mary Ziegler and Petrie-Flom Center Faculty Director, James A. Attwood and Leslie Williams Professor of Law, and Deputy Dean I. Glenn Cohen.

Together, Cohen and Ziegler explained the background of the case, the contents of the draft opinion, and its potential implications not just for abortion access, but also for other constitutionally-protected rights, and for access to reproductive technologies, such as in-vitro fertilization.

The highlights of the conversation have been edited and condensed below.

Read More

people waiting in a line.

How the Government Can Prevent Individuals from Using Wealth to Cut the Vaccine Line

The Petrie-Flom Center Staff Leave a comment

Cross-posted from COVID-19 and The Law, where it originally appeared on January 27, 2021. 

By Kareem Carryl

Since the Food & Drug Administration granted emergency use authorization for the COVID-19 vaccines produced by Pfizer-BioNTech and Moderna in December 2020, there have been many debates on vaccine allocation and prioritization.

As noted by Harvard Law School Professor Glenn Cohen in a recent interview with Annie Kapnick for the COVID-19 and The Law series, the issue of vaccine distribution is “complicated” because of competing factors decision-makers must consider. The relative weights placed on these factors has led to very different prioritization schemes. Initially, the Centers for Disease Control and Prevention (CDC) recommended a hybrid plan that appeared to prioritize individuals who were most likely to contract the virus (e.g., first responders, grocery store workers) over individuals most vulnerable to severe symptoms or death from the virus if contracted (e.g., individuals over the age of 65 not in long-term care facilities). In the United Kingdom, the prioritization groups were primarily based on vulnerability. Similarly, when looking more narrowly at the various plans being implemented at the state level in the United States, there are high degrees of variation.

This post does not seek to evaluate the merits of these or other specific vaccine allocation plans. Rather, it will address a risk that all plans likely face: the potential of individuals using their wealth and access to “cut the line” and be vaccinated ahead of schedule.
Read More

Illustration of mitochondrial donation

Time to Revisit the Prohibition on So-Called “Three-Parent IVF”?

Alex Pearlman Leave a comment

In an editorial appropriately titled, “This Editorial Is Not About Designer Babies,” the New York Times supported efforts by the Petrie-Flom Center and suggested it was time for Congress to consider lifting the effective ban on mitochondrial replacement therapies — sometimes colloquially but inaccurately referred to as “three-parent IVF.”

The piece referred to the Petrie-Flom Center’s upcoming public event and Roundtable, where experts will have a general conversation about the state of the law in the U.S. and elsewhere and to, as a group, discuss whether the prohibition against MRT might be lifted and, if so, how that might be accomplished.

Read More

Initial Quick Thoughts on the Announcement of the Birth Through Mitochondrial Replacement in Mexico

I. Glenn Cohen Leave a comment

The science media is abuzz about the birth of a child using mitochondrial replacement techniques in Mexico to Jordanian parents at the hands of NY Doctors. A few quick reactions (I am heading to this unrelated NAS/IOM Committee meeting tomorrow evening so may have some more thoughts when that settles down).

  • This is the first time this particular technique has been used to produce a live, but I am not sure from an ethical standpoint the arguments are all that different. That said, for those deeply interested in the more philosophical question of harm to children and the propriety of best interests argument in light of Parfit’s Non-Identity Problem (my take here and here) it may matter whether mitochondrial replacement is done through Pronuclear Transfer or Maternal Spindle Transfer as argued quite well here.
  • The fact that the doctors are from New York, the Patients are from Jordan, and the procedure took place in Mexico is not insignificant. This is a form of medical tourism, a topic I wrote a book on, most similar to cases of fertility and stem cell therapy tourism I cover in the latter half of the book. Absent making domestic prohibitions extraterritorial, something that I argue is permitted by international law and justified in some instances, there is very little that a home country can do about this. The going abroad is likely in part at least a function of some U.S. laws on the subject Eli Adashi and I wrote about for JAMA prohibiting FDA from considering approval of the technology.
  • As I wrote on this blog in February in relation to the IOM report “whatever the US policy in a world where medical tourism is possible and other countries adopt their own systems, so long as not everyone adopts the approach of the US some of these problems will manifest no matter what. So this is about harm reduction not harm avoidance.” This was a bit quicker than even I thought, but is not surprising. More generally if your concern about MRT is harm to offspring and transmission to future generations, people born elsewhere through the technology will inevitably enter the United States and/or marry, and procreate with U.S. citizens who themselves become U.S. citizens. To sound a bit X-Files about it “THEY WILL BE AMONG US!” This is a great example of the limits of unilateral regulation in a world of globalized health care.
  • Interesting that it was a male birth. This may be coincidence or in keeping with the IOM recommendation that only male embryos be transferred (to get rid of germ line transmission). Eli Adashi and I raised some ethical questions in Nature about whether that was an ethically problematic form of sex selection or not but in the reporting I have seen so far it has not been clear that they used only male embryos on purpose.
  • I wish we could stop calling it in the media “Three Parent IVF” or “Three Parent Reproduction.” That assumes the answer to what I think of as a subtle and interesting set of questions — is the mitochondrial donor a “parent” and what sense of the word do we mean.

More soon, I hope!