Wanda Ronner (my sister and long-time co-author) and I have received an Investigator Award in Health Policy Research from the Robert Wood Johnson Foundation for our current project on the recent history of infertility, reproductive medicine, and reproductive technology. We are both very excited about the opportunity to bring our joint expertise in the history of infertility and reproductive sexuality, developed over the past two-plus decades in our prior collaborations, to address these issues in the context of contemporary conversations over national health policy.
Since the 1970s, when the federal government declared a temporary “moratorium” on the funding of human embryo research — a ban that is still in effect, by the way — the United States has experienced one conflict after another related to reproduction in its myriad aspects. One result of our failure to resolve these matters is that this country is the only developed nation with virtually no national policies on assisted reproduction. By default, we’ve agreed to let the market determine access to these services, earning us the moniker of the “wild west of reproductive medicine.”
For more than three decades now, health policy leaders, legislators, practitioners, academics, and lawyers, as well as families and friends sitting around the dinner table, have been discussing – often heatedly – the ethics, medical consequences, costs, and social and political implications of the new reproductive technologies, but so far, to little avail, at least in terms of policy-making. Dr. Ronner and I want to understand both how our current situation came about and what might be done to change it. We realize that the debates over reproductive medicine and technology in this country are not simply political or religious but that they reach to the core of what it means to be a family. Who gets to decide which groups can have access to reproductive services? Is infertility a disease and if so who should pay for its treatment? Should there be limits to the lengths to which couples and individuals can pursue assisted reproduction to make their idea of family a reality? Should decisions about whether and how to reproduce be made by individuals, determined by societal norms, regulated by professional bodies, be left up to individual states, or be enshrined in national law? And if we leave the decision up to individuals or couples, or to the states, can we do so without maintaining longstanding racial, socioeconomic, and other disparities? These are fascinating, important, and tough questions, and we are looking forward to spending the next few years working on them.