Detailed Analysis of Arizona bills SB 1360 and 1361

Created February 13, 2012

On February 15, 2012 the Healthcare and Medical Liability Reform Committee of the Arizona Senate s expected to vote on two of the most intrusive, anti-family pieces of legislation RESOLVE: The National Infertility Association has ever seen.  On behalf of the more than 100,000 couples in Arizona who are trying to have babies in the face of infertility, RESOLVE strongly objects to Senate Bills 1360 and 1361.

In vitro fertilization (IVF) has been practiced in this country for over 30 years, bringing more than 50,000 babies to overjoyed couples each year in the U.S. alone, and something approaching 3 million babies worldwide.  This medical treatment is mainstream, medically proven, and accepted. 

Yet, after 30 years of successful IVF therapy, the Arizona legislature has decided to single out this life-giving, pro-family medical treatment from among all others and subject it to a massive regime of Governmental surveillance and publicity.  The Arizona Government proposes to track the procreation of a group of citizens, mandatorily and without their consent. We object.

Among the many intimate details about women that will be tracked, reported, and potentially publicized to the public under SB 1360 and 1361 are -- 

• How many eggs a woman produces, their quality, and fertilization rates – this will be reported to the Government;
• How many embryos a fertility patient produces and how many are transferred to her uterus – this will be reported to the Government;
• The private medical decisions a woman may make in the course of her pregnancy – this will be reported to the Government;
• How a couple decides to handle their unused embryos   (e.g., whether they transfer them to the womb, cryopreserve them, or donate them to research) – this will be reported to the Government.
• The race, ethnicity, prior pregnancies, and number of eggs retrieved from a woman donating her eggs to another – this will be reported to the Government.

And this is only the tip of the iceberg.  It takes pages to list all of the data, statistics, and other information that clinics, laboratories, and third party reproduction facilitators are going to have to report to the Arizona Government on every single patient, donor egg patient, and treatment they encounter. 

But it doesn’t stop with the Government.  Infertility patients’ and egg donors’ pooled medical information is to be published by the Arizona Government on the Internet.  From there, it can be freely copied by anyone, who can publish it anywhere – even on the front page of The Arizona Republic.

Besides constituting an unprecedented violation of the privacy all patients rightfully expect when receiving medical treatment, these complicated reporting requirements will cause medical costs and agency costs to soar.  This will only add to the terrible financial burden faced by most infertility patients in Arizona, since Arizona is one of the states that does not require insurers to cover reproductive medical treatments.

The interests of infertility patients and egg donors are not the goal of this legislation, for indeed, infertility patients already know how many eggs, embryos, etc. they have.  Rather, it looks as if we are being sacrificed for the sake of political ends that have nothing to do with our medical needs and which will run roughshod over our efforts to have families.

The real purpose of the bills is revealed in SB 1360 (Sec. 36-1704(F and G)) and SB 1361 (Sec. 36-2316(D and E), which lists how this collected information will be used.  First, it will be trolled by medical board officials, looking for violations of law in order to bring charges against doctors.  This will predictably discourage doctors from practicing reproductive medicine in Arizona, leaving needy patients with no options.

But Sections F and D are the telltale:  they authorizes the Government to put “the reports[s] on its website for public inspection and copying.”  This is shocking.  The pooled data about infertility patients’ and egg donors’ private medical treatments is allowed to be published on the Internet for anyone to see.  In our opinion, this is sheer exploitation:  to force involuntary disclosure of people’s personal, intimate reproductive medical treatments and then spread it out for anyone to use or misuse.  There is no limitation whatsoever on who can obtain this information and how they can then publicize it.

We are concerned there is a political goal here:  to expose patients’ private information as fodder for people who oppose in vitro fertilization or oppose certain decisions about unused embryos.   Making our private medical treatment and our embryos everyone’s business is the point of the bills.

But we at RESOLVE firmly believe that the fundamental procreative rights of one group – people who are having trouble getting pregnant – should not be up for public debate.  If the Government proposed non-consensual tracking of the procreative practices of people with diabetes or obesity, we as a society would balk.  It is no different with infertility patients. 

Monitoring is itself a message.  That which the Government tracks is “under suspicion.”  Infertility patients do not exaggerate when they say the proposed Governmental tracking of them and their embryos makes them feel like wrongdoers – an ironic result for people whose goal is to have babies, a valuable social good.

There are other provisions in these bills bill that deserves highlighting for their anti-family effects:

SB 1360 would mandate that notices seeking egg donors include language designed to discourage donation, even though advertisement terms could never serve as real “informed consent.”

In Section 36-1702(D) of SB 1360, every single interaction between doctors, egg donor agencies, and patients will be put under a microscope. For example, if a doctor stated in passing to an egg donor patient that the medical procedure was “generally safe,” that could be construed as an incomplete statement of risk and thus “misleading” – leading to an enormous fine or license revocation.

SB 1360 purports to collect data on egg donation complications, but its mechanism falls far short of scientific or public health standards.  Any time any medical professional thinks a woman’s health problem could be related to egg donation, he has to report it to the state or risk losing his license.  But the doctor never has to “prove” the complication was really related to egg donation; the assertion is enough.  Thus, SB 1360 sets up a process where complications may be reported to avoid liability, regardless of whether the connection to egg donation is remotely valid. This unreliable “data” could then be used to justify further limits or even an outright ban on this important family building option.

In SB 1361, the Government would mandate over 80 new, specific statements that have to be part of informed consent for IVF.  They range from medical to legal to individualized disclosures; will be expensive and unwieldy to implement; and, together with the massive reporting requirements, hang the threat of loss of license, fines, and even prison on doctors who trip up on the impossibly complex web of requirements.

Will doctors choose to practice reproductive medicine in a state where incorrect reporting could lead to a prison sentence?  We don’t think so.  We are unaware of any other field of medicine where such criminal penalties loom over doctors’ heads.  Why should that be the case for medicine dedicated to helping people have babies?  Firms that help locate donors will similarly find it too expensive and burdensome to offer services in Arizona.

SB 1360 and 1361 are profoundly anti-family.  Why would Arizona want to pass laws that make it harder for women to become pregnant and couples to have families?  SB 1360 focuses on egg donation.  Would Arizona really want to discourage a treatment that is the standard of care for young women who survive cancer and now want to have a family?

IVF has been practiced worldwide for over 30 years.  Thanks to this medical treatment, millions of wanted babies have been born to loving families.  The Arizona legislature has offered no compelling reason to institute an invasive regime of tracking infertility patients and their treatments at this late date, and at the cost of interfering with medical treatments people need.  We oppose SB 1360 and 1361 strenuously and urge our constituents to tell lawmakers to vote NO on SB 1360 and 1361.  

Arizona residents send your letter today to your state legislature opposing this anti-family legislation.