Source: Duke Health
Writer: Samara Rezwan
Editor: Jessica Kaplan
April 27, 2024
Legal personhood refers to entities with rights, obligations, or the potential to acquire them within a specific legal system. Shifts in legal precedent, such as those following the overturn of Roe v. Wade, have prompted some state lawmakers to challenge the boundaries of this personhood, proposing redefinitions that extend before birth and, in some cases, before pregnancy (American Bar Association, 2022). Examining the background of assisted reproductive technologies, recent issues such as the Alabama Supreme Court ruling, and both the legal and ethical implications of embryos as legal persons reveal the complexities of this redefinition. Challenges include potential liabilities for both healthcare providers and patients, as well as ethical dilemmas arising in surplus embryo management, maintaining legal safeguards toward frozen embryos, and the impact of patient autonomy (Jones, Smith, & Johnson, 2021). By exploring the expansion of legal personhood, especially concerning embryos and assisted reproductive technologies, its complex relationship within the realms of law and ethics can be better understood.
The concept of legal personhood has undergone significant evolution throughout history, influenced by various frames of reference including philosophical thought and legal frameworks. Early scholars like Samuel von Pufendorf and Hugo Grotius laid the groundwork for understanding personhood within legal contexts. Pufendorf introduced the notion of 'compound' or 'fictional' persons, expanding the traditional understanding of personhood to include collective entities with a shared will or purpose. Conversely, Grotius advocated for a more inclusive and adaptable concept of personhood, emphasizing flexibility in legal interpretation to accommodate diverse societal norms and philosophical trends. This is significant because Grotius's differentiation between 'humanity' and 'personality' expanded the boundaries of legal personhood, allowing for greater flexibility in its legal interpretation (Kurki, 2019). This aspect holds particular relevance during its current discussions, especially due to emerging technologies and ethical dilemmas in reproductive medicine. Recent events, like the Alabama Supreme Court's ruling on frozen embryos, also highlight how personhood constantly shifts with changing circumstances and perspectives (Public Health On Call, 2024). This ongoing reinterpretation and redefinition of legal personhood throughout history reflect its evolving nature, adding to its complexity.
The adoption of Assisted Reproductive Technologies (ART) has also raised questions about the status of embryos created through these procedures. With the overturning of Roe v. Wade (2022) and the subsequent Dobbs v. Jackson Women’s Health Organization (2022) ruling, states were given the ability to redefine legal personhood to begin before birth, potentially impacting the regulation of ART practices across the United States; this then gave legislators the ability to expand the definition of legal personhood (National Constitution Center, n.d.). The implications of this ruling, as seen with the court case on frozen embryos in Alabama, have prompted some fertility clinics to adjust their management practices. These actions have been taken to prevent violations of the Wrongful Death of a Minor Act by ensuring that no “unborn children who are not located in utero at the time they are killed” are terminated (Public Health On Call, 2024). This also potentially involves modifications regarding standard procedures such as preimplantation genetic testing, storage of unused embryos, and the disposal of embryos with limited reproductive potential, impacting both patients and providers as they navigate decisions about their frozen embryos. Furthermore, recognizing embryos as persons may compel fertility clinics to prioritize the implantation of multiple embryos during ART procedures, increasing the risk of high-risk multiple births (Letterie & Fox, 2024). The redefinition of legal personhood, particularly its implications for embryos created through Assisted Reproductive Technologies following the Dobbs and Alabama Supreme Court ruling, could, therefore, impact the ethical and legal framework governing ART practices, reshaping how embryos are managed within these contexts.
Since the Dobbs ruling, there has been a notable shift in the legal status of frozen embryos, potentially prompting states to consider recognizing embryos as legal persons from fertilization onwards. This expansion raises legal challenges for both patients and healthcare providers. Patients may experience heightened anxiety and uncertainty concerning the legal consequences of embryo disposition decisions, potentially influencing their willingness to use ART procedures to create a family. Moreover, patient autonomy could be compromised by encountering restrictions on surplus embryo management and disposal methods. Especially in cases such as divorce, disputes over the outcome of frozen embryos may be swayed by the legal recognition of embryos as persons. This legal shift also creates a difficult balance between protecting patients' rights and safeguarding the legal status of embryos. On the healthcare provider front, it creates the likelihood of increased legal responsibilities in managing embryos and administering ART procedures, possibly creating apprehension of facing criminal charges and navigating strict laws; this may lead doctors to adopt defensive practices, potentially compromising patient care and undermining doctor-patient relationships (Machado, 2020). Therefore, the legal status of frozen embryos presents important factors to consider for both patients and healthcare providers, potentially influencing patient decision-making regarding assisted reproductive technologies while also increasing legal responsibilities for providers in managing embryos and administering related procedures.
Recognizing embryos as legal persons, as established by the Alabama Supreme Court ruling, also requires an examination of the ethical and moral considerations alongside their legal ramifications. By recognizing embryos as legal persons, it prompts questions about the beginning of human life, the moral status of potential life, and the rights and protections afforded to embryos. Advocates argue that granting legal personhood acknowledges the inherent worth and dignity of embryos. However, concerns also arise regarding potential infringements on reproductive rights, individual autonomy, and the advancement of medical research, presenting another side to the ethical dilemma. This can be seen through assisted reproductive technologies, such as IVF, and their impact on fertility treatment accessibility due to the regulation of assisted reproductive technology clinics (American Progress, 2022). Additionally, the link between legal personhood and IVF procedures could impact individuals relying on IVF for conception due to infertility. These conflicting factors demonstrate the multifaceted ethical and moral implications of assigning legal personhood to embryos.
The expansion of legal personhood within assisted reproductive technologies ultimately involves a complex intersection of law and ethics. Legal frameworks define personhood and establish rights for both ART users and embryos, while ethics guides moral considerations regarding their treatment. From the legal perspective, this intersection includes implications for fertility clinics and healthcare providers, who must navigate potential consequences in their practices. Ethical perspectives, on the other hand, shape these legal discussions, influencing considerations of human dignity and the moral status of embryos. To address the unresolved ethical and legal questions surrounding ART, ongoing dialogue and research from both perspectives are essential. Continued scientific research into embryonic development and personhood can also inform discussions and decision-making processes in this field (Brezina & Zhao, 2012). The complex intersection of law and ethics in expanding legal personhood within ART ultimately requires finding a balance between both of these realms.
Overall, the expansion of legal personhood, particularly concerning frozen embryos within assisted reproductive technologies, is an issue regarding both law and ethics. As governmental decisions reshape legal definitions, fertility clinics and healthcare providers are expected to adjust their practices while balancing legal compliance with ethical considerations. The implications of granting embryos legal personhood reach beyond legal liabilities, affecting patient autonomy and access to reproductive technologies. To navigate this issue effectively it ultimately requires exploring both legal frameworks and ethical standards, all the while considering the broader impact on patients' access to reproductive technologies and legal safeguards for embryos.
References
American Bar Association. (2022). The Alabama Supreme Court's ruling on frozen embryos.
Retrieved from https://www.americanprogress.org/article/how-the-alabama-ivf-ruling-is-connected-to-upcoming-supreme-court-cases-on-abortion/
Brezina, P. R., & Zhao, Y. (2012). The ethical, legal, and social issues impacted by modern
assisted reproductive technologies. Obstetrical & gynecological survey, 67(9), 537-543.
Jones, A. B., Smith, C. D., & Johnson, E. F. (2021). Legal personhood and frozen embryos:
Implications for fertility patients and providers in post-Roe America. Journal of Law and the Biosciences, 10(1), lsad006. https://doi.org/10.1093/jlb/lsad006
Kurki, M. (2019). Hugo Grotius on Ethics and War: 400 Years Ago Today. E-International
Relations. Retrieved from https://www.e-ir.info/2019/03/27/hugo-grotius-on-ethics-and-war-400-years-ago-today/
Machado, C. S. (2020). The fate of surplus embryos: Ethical and emotional impacts on
assisted reproduction. JBRA assisted reproduction, 24(3), 310-315. https://doi.org/10.5935/1518-0557.20200015
National Constitution Center. (n.d.). Dobbs v. Jackson Women's Health Organization.
Retrieved April 20, 2024, from https://constitutioncenter.org/the-constitution/supreme-court-case-library/dobbs-v-jackson-womens-health-organization
Public Health On Call. (2024). The Alabama Supreme Court's ruling on frozen embryos.
Retrieved from https://publichealth.jhu.edu/2024/the-alabama-supreme-courts-ruling-on-frozen-embryos#:~:text=And%20that%20includes%20unborn%20children,therefore%20proceed%20with%20their%20lawsuit.
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