Policies and Positions

May 20, 2019: In response to state laws being passed impacting women’s reproductive health, RESOLVE has received a great deal of questions and concerns. RESOLVE does not have a position statement on abortion. RESOLVE is on the frontline of opposing Personhood bills and ballot initiatives that would impact the right of people to access IVF medical treatments. RESOLVE maintains that not only do people have the right to create embryos, they are the only ones who have the right to determine what happens to their embryos. RESOLVE fights for women’s health priorities every day and reaffirms that only the woman and her own physician should decide the best course of treatment for her and condemns any efforts to interfere with or override that relationship.

Board Approved November 16, 2020

Infertility affects millions of people in the U.S. and RESOLVE recognizes that factors like race, ethnicity, sexual orientation, gender, gender identity, socioeconomic status, or marital status can play a major role in people’s infertility/family building experiences. In fact, Black women are disproportionately impacted by infertility and other groups struggle to access care. RESOLVE commits to reaching all people impacted by infertility and will work to ensure the inclusion of the BIPOC (Black, Indigenous, and People of Color) and the LGBTQ+ communities. Ensuring that our staff, board, and volunteers represent the wider community is one important step; including representation of diverse people on RESOLVE’s website and social media is also welcome — but neither is enough. Our goal is bigger: the systems and policies that work against those that are often left out of the infertility conversations must be addressed. RESOLVE’s aim is to ensure that they and other groups see themselves represented in the stories we tell and benefit directly from the policy work we do, feel acknowledged that the lens through which they experience infertility matters to us, and see RESOLVE as a strong partner in making the family building journey more just.

Current practice guidelines established by the American Society for Reproductive Medicine (ASRM) limit the number of embryos that can be transferred to the uterus at any given time. Most couples participating in assisted reproductive technologies understand that it is sometimes necessary to freeze extra embryos for possible later use. Couples who become pregnant and do not wish to have another pregnancy are then faced with the issue of what to do with their embryos. Suddenly, a choice so clearly private has become wrought with controversy.

RESOLVE supports a couple’s right to choose what to do with their remaining frozen embryos — keep them for a future attempt at conception, donate them to another infertile couple, donate them to research or destroy them. It is critical not to cloud this issue of embryo donation with issues of conception. We must hold reproductive biology as a separate topic. A recent article in the New England Journal of Medicine clearly defined the problem that plagues this country, “When panels have helped to forge a consensus abortion has not been an issue; but when abortion has dominated the agenda, virtually no progress has been made. Even though the abortion debate in the U.S. is not likely to be resolved by ethical arguments, it should not be permitted to hold hostage every related issue of medical ethics as it does now. Crucial issues such as embryo research, prenatal diagnosis, and manipulation of embryos before implantation, must be disengaged from the abortion issue to receive the public debate they require.”

RESOLVE recognizes that there are a variety of political, ethical, legal, social and religious viewpoints to consider when discussing embryo donation. Each of the aforementioned having considerable weight and value while not overshadowing the right of the couple to opt for donation. It is essential that the public be informed and educated about the process when discussing issues related to embryo donation and stem cell research. Stem cell research provides unprecedented opportunities for advancement in curing life threatening diseases such as Parkinson’s Disease, Alzheimer’s Disease and various types of cancer and diabetes.

RESOLVE supports the use of donated embryos in stem cell research, conducted within proper medical and ethical guidelines, as this important work holds great promise for advances in a number of medical areas, including treatment of life-threatening diseases and injury. Underlying this position is the fundamental commitment to support a couple’s right to choose to preserve, donate to another couple, donate to research or destroy un-implanted embryos.

Background:

The National Institutes of Health (NIH) is the premier research institution in the world and it is there as well as through many of the NIH funded institutions that breakthrough research takes place. Adequate funding of these key government agencies is necessary to ensure the continued advancement in cutting edge biotechnologies, to maintain a pipeline for innovation and to protect the security of the biotechnology industry’s investment in research and development of life-saving therapeutics.

The NIH’s National Institute of Child Health and Human Development (NICHD) seeks to assure that every individual is born healthy and wanted, that women suffer no adverse consequence from the reproductive process, and that all children have the opportunity to fulfill their potential for a healthy and productive life unhampered by disease or disability. In pursuit of this mission, the NICHD conducts and supports laboratory, clinical, and epidemiological research on the reproductive, neurobiologic, developmental, and behavioral processes that determine and maintain the health of children, adults, families, and populations. NICHD’s work is based on the concept that reproductive processes and the management of fertility is of major concern, not only to the individual, but to society.

The President’s budget plan recommends a 2 percent increase of $549 million to the NIH budget for 2004. This would end the 14 to 15 percent annual increases provided for by the five-year doubling of the agency’s budget. This dramatic decline in the rate of growth for the NIH will threaten the stability of the medical research enterprise.

Working within the congressional budget blueprint, congressional appropriators now must determine the funding levels for these key agencies.

RESOLVE’s Position on NIH Appropriations:

RESOLVE endorses the highest possible allocation of federal dollars and strong, sustained resources for health programs under the jurisdiction of the House and Senate Labor-HHS-Education Appropriations Subcommittees. These programs are where vital biomedical health research takes place, research that in turn guides community-based prevention and health promotion programs as well as specific treatment protocols which benefit our nation’s patient populations. These programs will not succeed in achieving the goal of improved health outcomes for all Americans without strong, sustained resources and the commitment to those resources by Congress. Basic biomedical research is one of the most important roles for the federal government.

To support the extraordinary work of the National Institutes of Health and NIH’s National Institute for Child Health and Human Development, RESOLVE joins the Ad Hoc Group for Medical Research Funding in supporting: A $30 billion budget for NIH, which represents a 10 percent increase over fiscal year 2003. The increase is vital to maintain the progress of the last five years. Only continued, sustained investment in medical technologies will provide therapies and cures for tomorrow.

RESOLVE joins the Friends of NICHD in supporting:

At least $1.33 billion for NICHD in fiscal year (FY) 2004. An appropriation of $1.33 billion, which represents a 10 percent increase, in FY 2004 will ensure that NICHD is able to continue to identify breakthroughs that are on the brink of discovery and to produce new insights into human development.

RESOLVE: The National Infertility Association, is a national non-profit organization whose mission since 1974 has been to provide timely, compassionate support and information to those touched by infertility. RESOLVE works to increase public awareness of the issues surrounding infertility and the various family building options available to those working to resolve their infertility. RESOLVE’s strength lies in its more than 50 volunteer led chapters which provide education and support to the local communities in virtually every state.

Background

Adoption is a wonderful family building option. People decide to adopt for many reasons, but infertility is one of the most common motivating factors. In one study, more than 80% of those adopting independently or through a private agency responded that the inability to have a biological child was the reason they chose to adopt. It is estimated that 11% to 24% of couples who experience difficulty conceiving or carrying a pregnancy to term pursue adoption.

But, couples struggling with infertility face enormous financial burdens in building a family, be it through medical treatment or adoption. Important steps to reduce those financial burdens were realized when President Bush signed into law the Hope for Children Act.

The Hope for Children Act doubled the adoption tax credit to $10,000 for couples who adopt children, increased the income limitations so that more families were eligible for the credit, and liberalized the credit for families adopting children with special needs who may incur little or no expense in connection with the adoption process, but substantial costs associated with raising a child with special needs. Because of politics and budgetary issues, the tax credit is set to expire in 2011.

The adoption of a child is one of the most important legal proceeding in which a person can engage. The adoption process can be a complicated one and will be different depending on the type of adoption (domestic agency (either public or private), domestic independent or international). The process is also dependent on the applicable law of the state in which the adoptive parent(s) resides and the state in which the birth parents reside. Proper legal counsel to clarify all aspects of each state adoption law is crucial. Also crucial is public policy initiatives to encourage successful adoption proceedings.

RESOLVE’s Position on Legislation to Improve the Adoption Process

RESOLVE works to increase benefits available to adoptive families and advocates for reforms in adoption laws that will allow for the creation of more families via adoption. We seek improvements in the institution of adoption, consumer protections for adoptive families and an easing of the financial barriers to adoption.

RESOLVE endorsed the Hope for Children Act and now endorses legislation to improve the adoption tax credit and to make it permanent. However, in order to take advantage of the tax credit, couples must be able to finance an adoption in the first place. Because couples never expect to have an infertility problem, most do not have the resources set aside to finance what is certainly a very expensive family-building plan. Also, many couples have spent their life savings and more on medical treatments before pursuing adoption. RESOLVE therefore endorses the Dave Thomas Adoption Act which would allow penalty free distributions of up to $10,000 from individual retirement accounts (IRA) to finance an adoption. Currently, distributions from IRAs made prior to age 59 ? that are otherwise not allowable by law are subject to a 10 percent tax. . This legislation is very important as it would give couples a means to offset their up front adoption expenses in a way that is more appropriate than other currently available options.

RESOLVE advocates for the elimination of barriers to adoption across jurisdictional boundaries and federal legislation, regulations and best practice protocols to provide the states with a uniform approach to adoption procedures.

RESOLVE is supportive of efforts to increase the number of children moving out of the foster care system and into adoptive families. Many of the children who wait have special needs, and all of them need the security and stability of a permanent family to develop to their full potential. RESOLVE is supportive of legislation to improve shortcomings in state adoption systems that hamper foster care adoptions. RESOLVE urges Congress to ensure that adoption legislation has strong post adoption language and to fully fund the Adoption Opportunities Program which is part of the Child Abuse Prevention and Treatment Act.

RESOLVE encourages the U.S. Department of State to finalize implementation of the Hague Convention on Intercountry Adoption which established uniform standards and procedures for the international adoption of children. The treaty will protect the rights and interests of adoptive children, birth parents, and adoptive parents involved in intercountry adoption by among other things, requiring the State Department to monitor intercountry adoption cases, coordinate with foreign governments on behalf of adoptive parents, accredit adoption service providers and maintain a registry to track all adoptions involving immigration of a child into the U.S.

RESOLVE: The National Infertility Association, is a national non-profit organization whose mission since 1974 has been to provide timely, compassionate support and information to those touched by infertility. RESOLVE works to increase public awareness of the issues surrounding infertility and the various family building options available to those working to resolve their infertility. RESOLVE’s strength lies in its more than 50 volunteer led chapters which provide education and support to the local communities in virtually every state.

Background

Infertility is a disease or condition that results in the abnormal functioning of the male or female reproductive system interfering with the ability to achieve a pregnancy or of a woman to carry a pregnancy to live birth. The duration of the failure to conceive should be 12 or more months before an investigation is undertaken, unless medical history, physical findings or age dictate earlier evaluation and treatment. Infertility affects 6.1 million people in the United States. This figure represents 1 in 10 couples in which the woman is of reproductive age. This very significant number demonstrates that infertility affects a large percentage of our population.

Couples in their most active and productive years are distracted by the physical and emotional hardships of the disease. Infertility is a crisis of the body, a crisis of the mind and a crisis of the spirit and calls into question a person’s view of themselves, their life goals, their faith, their relationship with their spouse and with others. Infertility impacts a couple’s general health, their marriage, job performance and social interactions it brings a deep sense of grief and loss. Infertility also exacts an enormous toll on society. The social norm in the United States is one that heavily encourages, if not expects, married couples to bear and raise children, and questions the values of couples that do not.

Health insurance guarantees that an individual will not have to bear the entire burden of his/her health care expenses. But in the case of infertility, the cost of treatment for the majority of those touched by the disease, is borne exclusively by the patient. Depending on the cause of the fertility problem, and the therapy used to treat the problem, that cost can be considerable. Some of the less invasive therapies such as hormone therapy can range from $200-$3,000 per cycle. Tubal surgery can range from $10,000-$15,000, requires a hospital stay and poses a high risk of complications. Assisted reproductive technologies (ART) can range from $10,000-$18,000, per cycle, but in many infertility cases is the most effective means of treatment.

No one expects to receive the diagnosis of infertility. Yet more than 6 million Americans will. No one expects that their insurance company will deny them coverage for this medical condition. But most do. A major impediment to access to treatment to resolve infertility is insurance coverage. Currently those with access to treatment are a small subset of infertility sufferers: a fraction of the population residing in one of the fifteen states that have passed laws requiring some level of infertility coverage (each states has enacted quite different requirements), those who work for the small number of employers who voluntarily provide such a benefit, or those who have access to resources that will enable them to finance the treatment out of pocket, predominately couples who are Caucasian and upper middle class.

Infertility treatment is an important aspect of reproductive health care, yet only 1/4 of all health plan sponsors with at least 10 employees provide some level of coverage for infertility treatment. Offering a comprehensive infertility treatment benefit with appropriate utilization controls may actually reduce costs and improve outcomes by eliminating the inappropriate use of costly covered procedures and allowing specialists to use the most effective, efficient treatment for a specific type of infertility. The cost of including a well managed infertility benefit is minimal. Massachusetts, the state with the most comprehensive mandate for infertility coverage, found that the cost of coverage was one of the lowest among its mandated benefits at $2.49 per member per year.

A 2002 study published in the New England Journal of Medicine found that the percentage of high-order pregnancies was greater in states that did not mandate insurance coverage for IVF. The authors of the study noted that mandatory coverage is likely to yield better health outcomes for women and their infants since high-order births are associated with higher-risk pregnancies. These pregnancies have a higher frequency of complications and higher rate of preterm delivery, the cost of which can exceed $340,000 (triplet delivery). States with mandates are likely to realize a significant decrease in multiple gestation pregnancies and significant cost savings due to fewer high risk pregnancies and fewer premature babies.

RESOLVE’s Position on Insurance Coverage of Infertility Treatments

Public policymakers, employers and insurers have been slow to recognize infertility as a disease. The time to change this is now. RESOLVE believes that couples should not have to spend their life savings, second mortgage their home, or incur thousands of dollars of debt to treat a disease and to fulfill a fundamental aspect of life the desire to bear children and raise a family.

RESOLVE endorses state and federal legislation that will require insurers to cover the costs of appropriate medical treatment. RESOLVE believes the option to pursue medical treatment for infertility must be available to all those who need treatment, not solely those with the resources to pay for the treatment out of pocket. Decisions made during infertility treatments must be strictly medical decisions, not financial ones removing the financial barriers to treatment will result in safer outcomes for women and their offspring.

While fifteen states have recognized the importance that health insurance include a comprehensive infertility benefit, many of those suffering from the disease of infertility who reside in those states still do not have access to the coverage. A federal law, the Employee Retirement Income and Security Act (ERISA), exempts self-insured health plans, those maintained by the majority of employers, from state insurance regulation. Well financed lobby organizations representing the insurance industry and large employers successfully argued at the time of ERISA’s enactment, and continue to do so today, that it is administratively burdensome and expensive for companies with operations in various different states to abide by 50 different state insurance laws.

Also exempt from state insurance mandates is the Federal Employee Health Benefits Program (FEHBP) – the largest employer-sponsored health insurance program in the nation, covering nearly nine million federal employees, retirees and their dependents. FEHBP is administered by the Office of Personnel Management and is governed by the United States Code. Lobby organizations representing employers with self-insured health plans have been able to successfully preserve ERISA pre-emption and advocate for flexibility in the design of their benefits package while patients who need treatment continue to be denied access to that care. Therefore, RESOLVE works for the enactment of a federal law that would amend ERISA and the United States Code to require insurance coverage across the board for all group health plans.

RESOLVE: The National Infertility Association, is a national non-profit organization whose mission since 1974 has been to provide timely, compassionate support and information to those touched by infertility. RESOLVE works to increase public awareness of the issues surrounding infertility and the various family building options available to those working to resolve their infertility. RESOLVE’s strength lies in its more than 50 volunteer led chapters which provide education and support to the local communities in virtually every state.

The President’s Council on Bioethics was created in 2001 to advise the President on bioethical issues that may emerge due to advances in biomedical science and technology. The Council is chaired by Edmund D. Pellegrino, M.D.  Members of the Council include scientists, doctors, ethicists, social scientists, lawyers, and theologians, all known social conservatives. The Council is examining the human and moral significance of developments in biomedical and behavioral science and technology and exploring ethical and policy questions related to these developments.

August, 2008; revised October, 2010, April, 2012

Introduction and Summary

A number of states have proposed legislation that would define human life as beginning at the moment an egg is fertilized. As shorthand, such measures are referred to as so-called “Personhood legislation”.

Personhood legislation can come about in two ways: (a) via a bill in the state legislature, or (b) via a ballot initiative that the citizens vote on. Sometimes the legislation is designed to amend the state’s Constitution to confer constitutional rights on embryos; sometimes the mechanism is a statute that is “on the books.”

The first stand-alone personhood legislation arose in Colorado in the form of a ballot initiative in 2008. This Constitutional amendment would have given all persons, “from the beginning of [their] biological development,” i.e., from the moment of sperm-egg fertilization, inalienable rights, equality of justice, and due process of law protection under the Colorado Constitution. It was rejected by Colorado voters both in November, 2008, and when presented again in November, 2010, by margins of 2 to 1.

Mississippi’s “Initiative 26”, another ballot initiative, gained the most national media attention. In November 2011, the voters of Mississippi were asked to vote for or against the following proposal:

“As used in this Article III of the state constitution, The term ‘person’ or ‘persons’ shall include every human being from the moment of fertilization, cloning or the functional equivalent thereof.”

Despite polling at 80% popularity about three weeks before the election, the voters of Mississippi ultimately voted down Initiative 26 by a margin of 58-42.

In other states, bills with different language but the same goals have been proposed. Below are examples of the range of linguistic approaches to personhood legislation:

• Georgia, SB 169 (2009): “A living in vitro human embryo is a biological human being who is not the property of any person or entity.”
• Georgia, HB 388 (2009): “…[T]he term ‘child’ shall include a human embryo.”
• South Carolina, S. 450 (2009): “The right to life for each born and preborn human being vests at fertilization.”
• Arizona, SB 1307 (2010): “A person shall not intentionally or knowingly engage in … nontherapeutic research that … results in the injury, death or destruction of an in vitro human embryo.”
• Virginia, HB1 and Oklahoma, SB 1433 (2012): “[T]he term ‘unborn children’… shall include … the offspring of human beings from the moment of conception until birth at every stage of biological development.”
• Oklahoma, HJR 1067 (2012): “[T]he term ‘persons’ … applies to every human being from the beginning of the biological development of that human being…. Only in vitro fertilization and assisted reproduction that kills a person shall be affected by this section.”

RESOLVE has reviewed all of these proposed laws and believes they may seriously impair the ability of citizens with infertility to obtain needed medical treatment. For that reason, RESOLVE opposes Personhood Legislation and urges people who care about infertility to join RESOLVE in defeating these bills.¹ 

Proponents of the original ballot initiative in Colorado stated that the amendment was “meant to lay a foundation for protection of life at every stage.”² Thus, the objective appears to be creation of a constitutional framework to make abortion and embryonic stem cell research illegal.³ Separate from this objective, however, Personhood legislation would produce so many legal uncertainties about the status of embryos that RESOLVE anticipates it would be difficult or impossible for reproductive endocrinologists to treat infertility patients using long-established assisted reproductive treatments (“ART”). As a result, RESOLVE resolutely opposes Personhood legislation.

Infertility and Medical Basics

Infertility affects at least 10-15 percent of couples who desire pregnancy. The Centers for Disease Control and Prevention estimates there are 7.3 million infertile couples in the U.S.⁴  For a number of those with infertility, ART including in vitro fertilization (“IVF”), a treatment pioneered in the late 1970s, is necessary. In IVF, multiple eggs are fertilized in a lab to increase the likelihood of pregnancy. The microscopic fertilized eggs develop for three to five days, and then one or more are transferred to the woman’s uterus in the hope one will implant and develop to birth.

Sometimes extra fertilized eggs remain after a couple becomes pregnant, which is a benefit as many infertile couples require more than one attempt at implantation before a pregnancy occurs; many suffer from miscarriages; and many infertile couples plan on having additional children. Thus, doctors often cryopreserve (freeze) the remaining microscopic embryos.

With Personhood legislation, however, the legality of these effective pro-pregnancy fertility treatments would be called into question: if microscopic fertilized eggs/embryos are full humans, anything that puts an embryo at risk could be a criminal violation, even if its goal is the undeniable social good of helping someone have a baby.

Questions raised by Personhood Legislation

Below are examples of the threats to reproductive medicine and to infertility patients if Personhood legislation were to pass.

• If one or more microscopic embryos from an IVF cycle do not develop normally in the lab or fail to result in live births after transfer (all natural events), could the physician, lab, and/or patient be criminally liable?
• Would non-IVF treatments such as simple inseminations be threatened because they carry a risk of miscarriage?⁵ Would clinics with high miscarriage rates after inseminations be at risk for criminal liability? Could the miscarrying women be subject to criminal charges?
• Would women with fibroids or other uterine abnormalities be forbidden to try to have babies because the problems with their uteruses reduce the chances that an embryo will successfully implant after IVF or an insemination?
• Would women who have ectopic (tubal) pregnancies after IVF be able to receive life-saving treatment, or would the embryo’s legal rights have to balanced against hers?
• What will be the ramifications for fertilized eggs that have been created in the course of fertility treatment but have not been transferred to a woman’s uterus? Who will have legal responsibility for them?
• Will these laws take from people the rights of disposition over their embryos? Could someone claim the embryos require a disposition other than what the parents want? Could couples and their embryos be adversaries in a legal proceeding? Is this a desirable outcome?
• Will cryopreserved embryos have a right to be transferred to someone’s uterus for birth?
• Not all frozen embryos thaw successfully. Could embryo freezing be prohibited as too risky?
• If embryo freezing is prohibited, what will happen to women who experience hyper-stimulation during an IVF cycle and for whom the medical recommendation is to freeze and not transfer the embryos right away? Will they have to transfer the embryos and risk harm to their health?
• Will patients be prevented from donating their frozen embryos to research after they complete infertility treatments?
• Will patients’ medical records be subpoenaed to ensure that no one violated the embryos’ constitutionally guaranteed right to life?
• May women who live in states where personhood laws pass travel to other states for IVF, or would their embryos still be restricted by the law of their home state, such that they could not obtain treatment elsewhere? Would they be forbidden to move any currently frozen embryos to another state to continue their treatment?
• If infertility patients in personhood states cannot afford to live in another state during treatment, will they simply have to forego the dream of having a family?

Conclusion

The effect of Personhood Legislation would be to threaten a medical treatment that has, since being pioneered in 1978, brought some four million babies to loving infertile couples around the world. At a minimum, it would force changes in the practice of reproductive medicine (e.g., limitations on the number of eggs that may be fertilized) that are not in patients’ best interests and constitute inferior medical practice. Whether these results are intended or unintended is not clear; however, legislation proposed in other states such as Georgia, Arizona, Kansas, and New Jersey was designed explicitly to regulate embryos in the context of medical treatment for infertility, so such an intent is not unheard of.

RESOLVE’s position is consistent with that of other experts such as the American Society for Reproductive Medicine, the Society for Assisted Reproductive Technology, the American Academy of ART Attorneys, and the American Congress of Obstetricians and Gynecologists, Colorado Chapter.⁶ The Denver City Council in 2010 approved a proclamation opposing Amendment 62, stating:

“Amendment 62 would codify the beliefs of one religious tradition in the Colorado State Constitution and thereby end or severely limit many standard medical practices in women’s health care, including … infertility treatment….”⁷

The consequences of Personhood Legislation represent such an obstacle to the practice of reproductive endocrinology that valuable and effective infertility treatments such as in vitro fertilization might no longer be available to patients. After due consideration, we at RESOLVE conclude we cannot support these laws and, on behalf of the 7.3 million men and women who are striving to build a family in the face of infertility, we commit to oppose Personhood Legislation.

Notes
(1) The personhood bills in these and other states take a number of different approaches. In South Carolina, the proposed law would have vested Constitutional rights in eggs at the moment of fertilization. Virginia and Oklahoma in their failed attempts in 2012 adopted personhood language from the preamble to a Missouri statute that was at issue in the Supreme Court case, Webster v. Reproductive Health Services. In New Jersey, Arizona, Kansas, and Georgia, the proposed laws were drafted specifically to regulate embryos used in IVF. In Montana, pro-life groups were unable to collect enough signatures to put a Colorado-like personhood initiative on the ballot in 2008; Florida was similarly unsuccessful in 2012. Personhood USA, the primary proponent of personhood legislation nationwide, did gather sufficient signatures to place a Personhood Amendment on Mississippi’s ballot in November, 2011 ballot (MS “Initiative 26”). Despite predictions of easy passage, the citizens of Mississippi ultimately voted Initiative 26 down, 58 to 42%.

(2) Colorado for Equal Rights, Fact Sheet

(3) Surdin, Ashley. “Colorado Voters Will Be Asked When ‘Personhood’ Begins.” The Washington Post, July 13, 2008; p. A04.

(4) Centers for Disease Control and Prevention, National Center for Health Statistics, “National Survey of Family Growth,” (2002).

(5) Note that even without fertility treatment, as many as 50% of all fertilized eggs never fully implant and 10% to 50% of all pregnancies end in miscarriage. The U.S. National Library of Medicine and the National Institutes of Health, “Miscarriage,” Medline Plus at http://www.nlm.nih.gov/medlineplus/ency/article/001488.htm The March of Dimes, “From Hurt to Healing: Dealing with the Loss of a Baby.”

(6) See, e.g., http://www.asrm.org/about-us/media-and-public-affairs/asrm-position-statement-on-personhood-measures

(7) Osher, Christopher. Denver Council Opposed “Personhood Amendment.” The Denver Post, 2010: http://www.denverpost.com/news/ci_163725

Background

Our nation’s elected leaders and the American public at large is involved in a public policy debate regarding the ethical, moral, scientific and societal implications of controversial issues such as stem cell research, cloning, and human genetic engineering and modification.

Stem cells are the building blocks of the body and have the ability to divide indefinitely and differentiate into virtually any type of cell in the human body. Since scientists at the University of Wisconsin and Johns Hopkins University first isolated these cells in 1998, their promise in treating a myriad of chronic diseases has become increasingly evident. Stem cells are special cells found in very early stage embryos (5 days after fertilization of an egg) and in some types of adult tissue. Stem cells are undifferentiated cells (sometimes referred to as pluripotent), which means they have not yet developed into a particular type of cell that performs a specialized function (e.g., skin, heart, or nerve cells) and they can, under certain circumstances, develop into many different types of cells. Stem cell research promises to allow these undifferentiated stem cells to be stimulated to develop into various types of specialized cells or tissue.

Stem cells are derived from human embryos developed for in vitro fertilization that are in excess of the infertile couple’s need. If these excess cells are not used for this research or offered to other, infertile couples (both are ethical options) they will be discarded. Nearly half of infertile couples say they would like to see some good come from their biological tissue that would otherwise become medical waste and feel that use of these cells in research to help save lives is extremely important.

At the crux of policy debates surrounding these issues are important distinctions which must be made between the two applications of somatic cell nuclear transfer (SCNT), or cloning, technologies:

• Reproductive cloning uses the cloning procedure to produce a clonal embryo which is implanted in a woman’s womb with intent to create a fully formed living child.
• Therapeutic cloning uses the cloning procedure to produce a clonal embryo, but instead of being implanted in a womb and brought to term it is used to generate stem cells.

The purpose of using clonal embryos via SCNT technology to generate stem cells is to allow creation of tissues or organs that the clonal donor can use without having these tissues or organs rejected by their body’s immune system. These individual stem cells hold great promise for the treatment and cures of life threatening diseases and illnesses, such as cancer, Parkinson’s, Alzheimer’s, diabetes, ALS and spinal cord injury. The molecular processes discovered in working with stem cells derived from SCNT will be extremely valuable in finding ways to increase the utility and versatility of adult stem cells. Supporters of therapeutic cloning technologies believe that efforts to ban bio-medical research could have an adverse effect for many Americans who hope for access to cures from many diseases.

At stake in the debate also are concerns from the research community that the United States could relinquish its place as the leader in biomedical research and Americans could lose access to cures developed from that research if a ban on therapeutic cloning were to be signed into law.

The Future of Stem Cell Research

In a much-anticipated decision on what he called a “complex and difficult issue,” in August 2001 President Bush cited the “great promise” from embryonic stem cell research and announced he would allow federal funding of a limited amount of research using existing stem cell lines. The president stopped short of allowing federal funding for research using stem cells derived from frozen embryos, about 100,000 of which exist at fertility labs across the country, many awaiting destruction. The decision represents essentially the most restrictive use of federal money the administration could have permitted, short of an outright ban, but the new policy veers away from Bush’s previous outright opposition to federal support of this type of research.

The fight for crucial federal dollars to fund stem cell research is not over. Because the current existing stem cell lines are not sufficient, from the scientists’ perspective, a campaign has begun on Capitol Hill to advocate for more lines and greater funding. It is only through the support of the substantial resources of the federal government that researchers will be able to translate the enormous promise of stem cell research into treatments and cures for millions of Americans suffering from devastating diseases.

RESOLVE’s Position on Stem Cell Research and Cloning

Embryonic stem cells hold tremendous promise and could provide the missing link needed to cure some of the world’s most deadly diseases. Up to 100 million Americans may benefit from this research and the suffering of millions could end.

To date, private funding has been the sole financing mechanism for important stem cell research. RESOLVE supports federal funding of stem cell research, because federal funding and oversight would protect the public interest, result in important safeguards, speed progress of this type of research and would mean that the research is not confined to the for-profit commercial sector. The best approach would be to bring this research under the oversight of the federal government by funding it through the National Institutes of Health. Without federal funding, the nation’s top academic researchers at universities, medical schools and teaching hospitals cannot join in the search for cures.

RESOLVE supports a carefully drafted legislative prohibition on cloning that is scientifically accurate, is limited to reproductive uses and contains a sunset provision so that the issue can be fully examined as advances in technology warrant. Such a limitation on cloning should not limit research into other uses of nuclear transfer technology. RESOLVE supports research into the use of somatic cell nuclear transfer (SCNT) for therapeutic cloning purposes.

RESOLVE has joined forces with the Coalition for the Advancement of Medical Research (CAMR), a lobby coalition comprised of representatives from nationally recognized patient organizations, universities, scientific societies, foundations, and individuals with life-threatening illnesses and disorders. CAMR works to ensure that somatic cell nuclear transfer (SCNT) and therapeutic cloning remain a legal and viable form of scientific research and to protect and preserve continued federal funding of human embryonic stem cell research. While it is doubtful there would be an immediate benefit from this type of research into cures for those touched by infertility, our support of CAMR and its advocacy agenda provides us with opportunities for dialogue with lawmakers who are part of the larger public policy debate about the future of biomedical research. Equally important, RESOLVE and its CAMR partners oppose any effort that would allow reproductive cloning, a technique we believe, at this time, is unsafe, irresponsible and unethical.

In addition, policymakers have looked to RESOLVE to provide information about the ethical issues surrounding egg donation and research on discarded embryos from fertility clinics — we feel we have a unique perspective on that aspect of the debate. RESOLVE’s position on stem cell research and cloning does not mandate the destruction of embryos. Rather, RESOLVE believes that while human embryos at any stage are worthy of special respect and consideration, most of them will never be capable of giving rise to a baby. It is not at all clear that SCNT could ever be used to produce a viable human embryo capable of developing into a normal human being. We think SCNT can produce some very special cells, but not yet a child.

RESOLVE further believes that infertility patients should be free from interference in making the very personal decision about the uses of their own body tissues, including reproductive tissues and fertilized reproductive tissues.

RESOLVE: The National Infertility Association, is a national non-profit organization whose mission since 1974 has been to provide timely, compassionate support and information to those touched by infertility. RESOLVE works to increase public awareness of the issues surrounding infertility and the various family building options available to those working to resolve their infertility. RESOLVE’s strength lies in its more than 50 volunteer led chapters which provide education and support to the local communities in virtually every state.