When multiples divide

We know a little bit more about the 33-year old who gave birth to eight babies last week.

A former student and divorced single mother who is said to have had all 14 children from implanted embryos, Suleman seems like an irresistible media target. Are you surprised that she's engaged a publicist?

The birth of the octuplets has also sparked an ethical storm, also an appealing media topic. According to a recent Associated Press article, much of the public reaction to the way these multiples were conceived has been negative.

Apparently missing in coverage of the flap to date is a discussion of the ethics of in vitro fertilization-and the agonizing dilemmas multiple embryos can cause potential parents. In addition, we still know almost nothing about Suleman's faith or lack thereof, and how that may have affected her choices. These gaps lead to some odd and often confusing holes in the stories.

Take this one from Wednesday's Washington Post. The writer began with this chatty lede:

Public opinion seems to be cresting against her, her own mother is rattled, and now fertility experts are suggesting the case of Nadya Suleman and her octuplets constitutes a breach of medical guidelines.

Suleman, 33, gave birth to six boys and two girls by Caesarean section Jan. 26 at a Kaiser Permanente Medical Center in Bellflower, Calif. The miraculous event -- reportedly one of only two live octuplet births ever in the United States -- quickly drew criticism after it was revealed that Suleman is single, unemployed, lives with her mother and already has six children -- including twins -- ranging in age from 2 to 7.

"Miraculous"? Possibly -- but that connotes an act of God, doesn't it? At any rate, readers may now believe that they are going to get a good look at the ethics of implanting multiple embryos -- or of in-vitro fertilization, period. What they get instead is, with one telling exception, reaction instead of analysis.

"It was a grave error, whatever happened," said Eleanor Nicoll, a spokeswoman for the American Society for Reproductive Medicine, which along with the Society for Assisted Reproductive Technology provides medical guidelines for fertility treatments. "It should not have happened. Eight children should not have been conceived and born."

I think we figured that one out. What I hoped to read at that point is exactly what the guidelines were--and what usually happens to unused embryos. After all, one of the interesting parts of this story is that, at least according to her mother, Suleman implanted every embryo.

The author does give some details about ASRM guidleines, but not nearly enough, making the "chuckling" fertility doctor Werlin's quotes seem a little ... bizarre.

The writer does get a good quote from David C. Magnus, an ethicist at Stanford University. In fact, Magnus seems to touch on part of the reason the media may be having trouble with this story, making it feel like more of a freak show, a typical American "bad mom" story, than an opportunity to look at the ethics of assisted reproductive methods like in-vitro.

"This is a huge problem," Magnus said. "You've got a virtually unregulated marketplace with tort law serving as regulation in the U.S."

Magnus said that U.S. medical standards are not unlike those of other countries, but that U.S. guidelines are laced with the language of "you should" rather than strict rules and sanctions.

The professional organizations should take a stricter line with doctors and clinics, he said. "They've been very loath to take that action."

Boy, there's a lot of material here for a journalist interested in exploring the broader ethical issues. And in the course of that, it would be really helpful to revisit what some American religious communities have to say about assisted reproduction. Do some traditions deem taking fertility drugs like Clomid ok, but in-vitro, not so much? Do potential parents seek counsel on this issue from clergy? Did Nadya Suleman ever seek advice from a minister?

She's probably saving those details for the book, or the movie.

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