Whose Responsibility Is It to Define Exceptions in Abortion Bans?

This Viewpoint evaluates Texas' proposals to define the scope of the life exception for the state's abortion ban and argues that these approaches do not allow physicians to follow the national standards of care, avoid criminal liability, or have sufficient notice of what the law permits.

Preimplantation genetic screening: a survey of in vitro fertilization clinics.

PURPOSE: The purpose of this study was to determine which US in vitro fertilization clinics provide preimplantation genetic screening for aneuploidy in treating infertility, and to explore clinic directors' attitudes toward this technique. METHODS: Online survey included 415 US assisted reproductive technology clinics. The survey had a valid response rate of 45% or 186 clinics. RESULTS: Nearly 68% of US in vitro fertilization clinics responding to the survey provided preimplantation genetic screening in an effort to increase success rates of fertility treatment. More than half of these in vitro fertilization clinics (56%) provided preimplantation genetic screening for advanced maternal age and the same percentage provided preimplantation genetic screening to treat repeated in vitro fertilization failure, whereas 66% provided preimplantation genetic screening to treat women with repeated miscarriage. Opinions of the effectiveness of preimplantation genetic screening for these indications varied widely, even among those providing it. Most directors (85%) of clinics providing preimplantation genetic screening believed that more data are needed to determine whether and to whom it should be offered. CONCLUSIONS: Despite the lack of data supporting the use of preimplantation genetic screening for recurrent pregnancy loss, in vitro fertilization failure, and advanced maternal age, a majority of in vitro fertilization clinics in the United States offer preimplantation genetic screening for these purposes. There is significant support among clinic directors for more research into the effectiveness of preimplantation genetic screening and for professional guidelines in this area.

Civilian and military genetics: nondiscrimination policy in a post-GINA world.

Evidence is emerging of a growing societal consensus about appropriate and inappropriate uses of genetic information. The Genetic Information Nondiscrimination Act of 2008 provides new legal protections to Americans by prohibiting the discriminatory use of genetic information by health insurers and employers. Additionally, the United States military recently created new policies for fair use of genetic information in the determination of benefits for servicemen and servicewomen leaving military service. Although critical issues remain, such as the potential for genetic information to be used to deny people other forms of insurance, and how the military will use genetic medicine overall, significant progress has been made.

Genetic testing of embryos: practices and perspectives of US in vitro fertilization clinics.

OBJECTIVE: To better understand the current practices of IVF clinics regarding preimplantation genetic diagnosis (PGD) and explore the attitudes and opinions of clinic directors toward PGD. DESIGN: On-line Survey of 415 assisted reproductive technology (ART) clinics in the United States. The Survey had a valid response rate of 45% (186 clinics). SETTING: Not applicable. PATIENT(S): Respondents were medical directors, laboratory directors, IVF directors, or directors' designees of ART clinics offering IVF. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Practices and beliefs of IVF clinic directors with respect to PGD. RESULT(S): Preimplantation genetic diagnosis is widely provided for a variety of indications, and clinic directors support professional guidelines to guide PGD in the future. CONCLUSION(S): Preimplantation genetic diagnosis is an established technology and medical procedure offered by a majority of US IVF clinics. Many clinics currently provide PGD for controversial indications such as sex selection. Although there is little support for government regulation of PGD, there is significant support among IVF clinics for strong professional guidelines for PGD practice. Ongoing collection of data on PGD practice and outcomes would help patients make informed decisions and aid professionals in developing appropriate guidelines and standards.

Genetic testing of embryos: a critical need for data.

Preimplantation genetic diagnosis (PGD), the genetic testing of embryos developed through IVF is one of the fastest growing techniques in reproductive medicine and IVF. Some suggest that PGD will become part of every IVF cycle in the future. The growing popularity of PGD has highlighted the fact that there are no comprehensive data available about the use of PGD, its accuracy, or the health outcomes of babies born following PGD. For patients, practitioners, and policymakers alike, such information is critical. To address the gaps in knowledge, a working group of the leading experts in the development and practice of PGD and IVF has begun to design a database to collect information about PGD as practised in the United States.