HAS 4400

1. HAS 4400 Reproductive Issues Chapter 14 Miller/Hutton

2. 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

3. 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

4. Involuntary Sterilization • 1st 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 • Most states have repealed.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.

5. 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

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

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

8. 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. 

9. Other terms for PBA • "dilation and extraction" • "intact dilation and evacuation" • "intact dilation and extraction" 

10. Partial Birth Abortion Artwork by Tanja Butler, used courtesy of Heathers Place, 505-521-0105, pla@zianet.com.

11. Partial Birth Abortion Artwork by Tanja Butler, used courtesy of Heathers Place, 505-521-0105, pla@zianet.com.

12. Partial Birth Abortion Artwork by Tanja Butler, used courtesy of Heathers Place, 505-521-0105, pla@zianet.com.

13. Partial Birth Abortion Artwork by Tanja Butler, used courtesy of Heathers Place, 505-521-0105, pla@zianet.com.

14. Partial Birth Abortion Artwork by Tanja Butler, used courtesy of Heathers Place, 505-521-0105, pla@zianet.com.

15. 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.

16. Yearly abortion data from CDC • In thousands • 4 Per 1000 ages 15 - 44 • 6 Missing data from Alaska, California, New Hampshire and Oklahoma.

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

18. 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.

19. 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

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

21. 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.