Proposed regulation of fertility clinics raises questions Many fear government will intrude too far

November 23, 1995|By ORANGE COUNTY REGISTER

SANTA ANA, Calif. -- When the fertility industry opened its arms to outside regulation this week, it was an extraordinary move that pleased some critics but also prompted concerns about higher costs for patients and new levels of bureaucracy for doctors.

Among the physicians who welcomed the call for the independent licensing of fertility clinics was Dr. Richard Paulson, chief of the Division of Reproductive Endocrinology and Infertility at the University of Southern California School of Medicine.

"My reaction is, 'Oh great, here is going to be a good way to make sure that everyone is going to practice at the same level,' " he said.

But he also noted the potential downside to increased regulation: "When the government sticks its nose into things, it tends to mess things up."

Dr. Paulson and other fertility specialists said the recent scandal in California, in which dozens of women's eggs were allegedly taken without consent and transferred to other patients, apparently hastened the industry's invitation to regulation.

But in calling for an independent licensing authority, the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology did not describe how such a program would be structured, nor whether it would be mandatory or publicly financed.

Dr. Alan H. DeCherney, past president of ASRM, said that it likely would be a government-based authority, perhaps similar to Britain's licensing body.

"In Britain, they set up a commission," Dr. DeCherney said. "They go through everything once a year in the center, check the procedures, make sure your lab's OK, make sure they aren't giving away embryos."

Experts say it is unusual that the call for regulations would come from the industry group affected.

"To have a doctor's group saying, 'Please watch over us, please make us pay fees, please regulate us,' I've never heard of such a thing," said Foone Louie, legal counsel to the Medical Board of California.

Dr. Arthur Caplan, a University of Pennsylvania biomedical ethicist who has been critical of the industry's lack of regulation, said the call for outside licensing "may be just in the nick of time" in light of the California scandal.

"A voluntary licensing authority -- if it has teeth, if it truly has authority, and if it has open and accountable meetings and procedures and policies -- is just what the field needs," he said.

But Dr. Caplan said he would not favor turning over the licensing function to state or federal authorities. He prefers the establishment of a private-sector organization similar to those that oversee organ- and blood donation.

Not everyone who has been involved in the debate over regulation was as enthusiastic.

John Robertson, a University of Texas law professor who specializes in reproductive issues, questioned the need for more bureaucracy at "a time when we're trying to shrink government."

"My concern would be that it would end up increasing the cost to consumers, which is already very high," he said.

State Sen. Tom Hayden, who this year chaired a Senate hearing into the fertility clinic scandal, said licensing is overdue. But he called the ASRM proposal a modest step because the independent body that will regulate and license likely will be controlled by the fertility industry.

"The question is who will do the regulating," Mr. Hayden said. "It's important this is not in the place of government regulation, and that the fertility industry not be left to regulate itself."

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