Preying on the infertile

ARTHUR CAPLAN

February 13, 1992|By Arthur Caplan

DR. CECIL JACOBSON is on trial this week in federal court in Alexandria, Va. He was indicted on 53 counts of fraud and perjury.

The 55-year-old general practitioner faces these charges not because he bilked Medicaid or practiced with a phony medical degree. Dr. Jacobson is alleged to have used his own sperm 75 times to artificially inseminate women without telling them or anyone else that he was the donor. He also stands accused of administering hormones to women to falsely convince them that they were pregnant.

Dr. Jacobson has his defenders. One of his former patients credits him with helping her to have a baby when she had been told by many other doctors that she was hopelessly infertile. His lawyer, James Tate, says that while Dr. Jacobson may be guilty of poor judgment in not disclosing the use of his own sperm and in making his patients believe they were pregnant when he knew they were not, he did nothing criminal.

Now at this point, some readers might be expecting a discourse on why Dr. Jacobson deserves sympathy and understanding. After all, there are two sides to every ethical issue in medicine, right?

Forget it.

If Dr. Jacobson, who strode about his Vienna, Va., clinic calling himself "The Babymaker," did what his outraged patients say he did, he should be directed toward the slammer without delay for a nice long stay while his bank account is drained to the last penny. What Dr. Jacobson is alleged to have done is morally repugnant and ethically despicable.

Anyone who would deceive couples into believing pregnancy had been achieved when it had not, especially women and men distraught and desperate over their infertility, does them grievous harm. And a doctor who chooses to repeatedly use his own sperm to artificially inseminate women has lost his moral compass in a swamp of ego.

Couples who choose to use artificial insemination to overcome their infertility problems have every right not to know who the donor is. In some cases, the sperm of the husband is mixed with the sperm of another donor in order to leave some desirable uncertainty about who is the father of any children that result. When couples know they must use only donor sperm, they do so only on the condition that they not learn the identity of the donor and vice versa.

Many couples will only use artificial insemination with the assurance that the donor will never enter into their lives in any way. If Dr. Jacobson selected himself as the man best suited to procreate, he threw any chance for anonymity out the window. Not only would he have hurt his patients, but he also would have imposed his wacky presence into the lives of a bunch of innocent kids.

How is it that fruit-ball physicians can get away with this sort of tragically nutty conduct? The sole reason is inadequate regulation of sperm banks.

Anyone who is a physician can hang out a shingle and claim to be a fertility specialist. There are no national regulations requiring the disclosure of success rates or the screening of potential donors for infectious diseases. There isn't even a rule prohibiting doctors from being donors.

The price of total freedom in making babies is that a few unscrupulous doctors can prey upon the infertile. That price is too high.

(Arthur Caplan is director of the Center for Biomedical Ethics at the University of Minnesota and a columnist for the Saint Paul Pioneer Press.)

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