HAS 4400 Reproductive Issues Chapter 14 Miller/Hutton

Contraception Adults –1965 Griswold v. Connecticut Minors –1980 Doe v. Irving, 1985 Jane Does v. Utah Dept of Health Litigation (Product liability, inadequate warning of risks) –Negligently prescribe a contraceptive –Negligently insert a contraceptive device –Fail to give adequate information concerning potential side effects –Fail to monitor a patient at risk

Voluntary Sterilization Adults Spousal Consent Minors (varies from state to state) –Getting a court order would be prudent –Federal funds cannot be used to sterilize minors. Conscience Clauses

Involuntary Sterilization 1 st group “Eugenic” Sterilization –Individuals believed to transmit hereditary defects. –Most states have repealed. 2d group –Severely retarded, Sexually active, unable to use other forms of contraception and unable to care properly for their offspring.

Assisted Conception Artificial Insemination –Spousal consent –Donor is not responsible for child support Surrogate Mothers In Vitro Fertilization –1983 California couple die in Chile, 2 frozen embryos in Australia –1989 Tennessee divorce dispute

Abortion “premature expulsion of the products of conception from the uterus.” 1973 Roe v. Wade due process clause – 14 th Amendment 3 stage analysis 1 st trimester-right of privacy precludes state regulation of abortions End of 1 st trimester – viability: states could regulate to protect maternal health After viability states had a compelling interest in the life of the unborn child.

Parties with interest in abortion Fetus Other Parent GrandParents HC Administrators Insurers Government Officials Taxpayers The Media Educators Activists Religious Leaders

Partial-Birth Abortion Ban Act President Bush signed the Act into law on November 5, 2003 The bill bans "partial-birth abortion," it legally defines a partial-birth abortion as any abortion in which the baby is delivered "past the [baby's] navel... outside the body of the mother," OR "in the case of head-first presentation, the entire fetal head is outside the body of the mother,“ The bill allows the method if it was ever necessary to save a mother's life.

Other terms for PBA "dilation and extraction" "intact dilation and evacuation" "intact dilation and extraction"

Partial Birth Abortion Artwork by Tanja Butler, used courtesy of Heathers Place, ,

Artwork by Tanja Butler, used courtesy of Heathers Place, , Partial Birth Abortion

Artwork by Tanja Butler, used courtesy of Heathers Place, , Partial Birth Abortion

Artwork by Tanja Butler, used courtesy of Heathers Place, , Partial Birth Abortion

Artwork by Tanja Butler, used courtesy of Heathers Place, , Partial Birth Abortion

The arguments continue. June 2004: U.S. District Judge Phyllis Hamilton issued a permanent injunction against enforcement of the ban with respect to the groups that filed that lawsuit. August 26, 2004: U.S. District Court in the Southern District of New York issues ruling. September 8, 2004: Federal court in Nebraska issues permanent injunction.

Item Total abortions 1 1,2111, In thousands 4 Per 1000 ages Missing data from Alaska, California, New Hampshire and Oklahoma. Yearly abortion data from CDC Abortion rate

Prenatal Testing and Genetic Screening Amniocentesis Blood test for metabolic disorders (phenylketonuria)

Wrongful: Conception, Birth, Life Suits Wrongful conception –Unwanted pregnancy results from medical negligence –A fetus with a genetic defect is conceived after the parents were not informed or were misinformed of the risk of the genetic condition.

Wrongful: Conception, Birth, Life Suits Wrongful conception Wrongful birth –Birth follows medical negligence –Unsuccessful sterilization or abortion Were not informed of risks Were promised a successful procedure Procedure was performed negligently –Abnormal child who would have been aborted if parents had known of abnormality Were not advised of possibility of condition and availibility of tests Were told there is no risk Testing was negligent

Wrongful: Conception, Birth, Life Suits Wrongful conception Wrongful birth Wrongful life – Children with genetic defects claiming they were injured by being born.

Who gets the money? The state of Utah has received a Medicaid block grant from the federal government for $3,000,000. The stipulation to the grant is that the funds must be used for one program to benefit a targeted group of patients. Once that targeted group is identified the funds cannot be used for another purpose. Two agencies have submitted grant proposals to the use of the money. The first agency has developed a plan which will ensure that all children under the age of five will receive immunization against major childhood diseases and virtually eliminate the existence of diseases such as measles, whooping cough, chicken pox, etc. throughout the state for the next decade. The second agency has developed a proposal that will provide definitive medical care and hospice services to all AIDS patients in Salt Lake County for the next fiscal year.