Chapter 14: Issues of Reproduction and Birth Flashcards
What landmark Supreme Court case upheld the constitutionality of eugenic sterilization laws?
Buck v. Bell (1927)
In Buck v. Bell, Justice Oliver Wendell Holmes Jr. famously wrote which controversial statement?
“Three generations of imbeciles are enough.”
Which of the following statements about voluntary sterilization is TRUE?
A) It is illegal in all states
B) It remains illegal in Connecticut and Utah
C) It is legal in all states but may have moral objections in some contexts
D) The procedure can only be performed on individuals over 25
C) It is legal in all states but may have moral objections in some contexts
What case established that states could not restrict the use of contraceptives due to a constitutional “zone of privacy”?
Griswold v. Connecticut (1965)
In the context of sterilization cases, what Supreme Court decision overturned eugenic sterilization of “habitual criminals” based on equal protection concerns?
Skinner v. Oklahoma (1942)
What were the grounds for the Supreme Court’s decision in Skinner v. Oklahoma?
A) Due process violation
B) Cruel and unusual punishment
C) Equal protection violation
D) Right to privacy
C) Equal protection violation
Apply IRAC to analyze Carrie Buck’s situation in Buck v. Bell. What was the legal issue, rule, analysis, and conclusion?
Issue: Whether a state statute permitting the involuntary sterilization of the “feebleminded” violates constitutional rights
Rule: States may exercise police power to protect public health and welfare
Analysis: The Court analogized sterilization to mandatory vaccination, finding that if the state can require vaccination, it can require sterilization of those deemed “unfit”
Conclusion: States have constitutional authority to sterilize individuals deemed genetically unfit to prevent “socially inadequate offspring”
Which federal regulations govern sterilizations performed under programs administered by the US Public Health Service?
A) 42 C.F.R. Part 50
B) 45 C.F.R. Part 46
C) 21 C.F.R. Part 50
D) 24 C.F.R. Part 40
A) 42 C.F.R. Part 50
What minimum age requirement exists for sterilizations performed under US Public Health Service programs?
21 years old
What is the difference between wrongful birth and wrongful life claims?
Wrongful birth: Lawsuit brought by parents claiming negligence prevented them from avoiding the birth of a disabled child
Wrongful life: Lawsuit brought on behalf of the child claiming they shouldn’t have been born
In Speck v. Finegold, what was the unusual sequence of events that led to the lawsuit?
A) Two separate doctors incorrectly diagnosed a fetus as healthy
B) A failed vasectomy was followed by a failed abortion
C) A misdiagnosed genetic disorder led to sterilization
D) The couple was incorrectly told they couldn’t have children
B) A failed vasectomy was followed by a failed abortion
What genetic disease was at issue in the Speck v. Finegold case?
Neurofibromatosis
Courts have had the most difficulty with which element of negligence in wrongful life cases?
A) Duty
B) Breach
C) Causation
D) Damages
D) Damages
Why do most courts reject claims of wrongful life?
A) The child suffered no injury
B) The professional negligence was not the cause of the disease
C) Life, even impaired life, is not considered a legal injury
D) All of the above
D) All of the above
Which state was the first to recognize a cause of action for wrongful life?
California (in Curlender v. Bio-Science Laboratories, Inc.)
In Turpin v. Sortini, what was the court’s approach to damages in a wrongful life case?
A) Allowed general damages for pain and suffering but not medical costs
B) Allowed medical costs but not general damages for pain and suffering
C) Allowed both general damages and medical costs
D) Denied all damages as impossible to calculate
B) Allowed medical costs but not general damages for pain and suffering
Apply the benefit rule to a wrongful birth case where a healthy but unwanted child is born after a failed sterilization.
*The benefit rule requires any damages awarded to be reduced by the value of any benefit bestowed
*In wrongful birth, courts would offset costs of child-rearing with the benefits/joy of having the child
*Some courts only allow the benefit offset if it benefits the same interest that was harmed
*Damages might include pregnancy/delivery costs, but child-rearing costs could be offset by benefits
In cases of wrongful birth involving a disabled child, what damages are courts most likely to award?
A) All costs of raising the child
B) Extraordinary costs related to the disability only
C) Emotional distress damages only
D) No damages at all
B) Extraordinary costs related to the disability only
What is the statute of limitations in wrongful birth cases typically measured from?
The discovery of the pregnancy or when the birth defect becomes known to the parents
What was the case in which the court ruled that a physician had a duty to inform his patient of the risk of bearing a child with Down syndrome and the availability of amniocentesis?
A) Cockrum v. Baumgartner
B) Harbeson v. Parke-Davis
C) Schroeder v. Perkel
D) Not specified by name in the text
D) Not specified by name in the text (The textbook mentions a 1974 case but doesn’t provide the case name)
How does the Minnesota statute handle wrongful birth and wrongful life actions?
- Prohibits actions claiming a child would have been aborted but for negligence
- Permits actions for failure of contraceptive methods or sterilization
- Permits actions for failure to diagnose disease/defect that could have been prevented/cured
- Specifies that abortion is not considered prevention or cure
- States that failure to perform abortion is not a defense
What is the primary ethical concern regarding stem cell research?
A) The potential for genetic mutations
B) The destruction of human embryos
C) The cost of the research
D) The effectiveness of the treatment
B) The destruction of human embryos
What discovery reduced some ethical concerns about stem cell research in the early 21st century?
The discovery that some specialized adult cells could be genetically reprogrammed to assume a stem cell-like state (“induced pluripotent stem cells”)
According to the CDC, what does assisted reproductive technology (ART) include?
A) Any fertility treatment
B) Fertility treatments in which only sperm are handled
C) Only in vitro fertilization (IVF)
D) Fertility treatments in which both eggs and sperm are handled
D) Fertility treatments in which both eggs and sperm are handled
In the 1988 case In re Baby M, what was the legal issue?
Whether a surrogate motherhood contract was valid and enforceable when the surrogate mother refused to surrender the child after birth
How did the New Jersey Supreme Court rule in the Baby M case?
A) The surrogacy contract was valid and enforceable
B) The surrogacy contract was invalid as it conflicted with adoption laws
C) The genetic father had no rights to the child
D) The surrogate mother had exclusive custody rights
B) The surrogacy contract was invalid as it conflicted with adoption laws
What was the central legal issue in Davis v. Davis?
The disposition of frozen embryos in a divorce case where the parties could not agree on what should be done with them
How did the Tennessee Supreme Court classify embryos in Davis v. Davis?
A) As persons entitled to full legal protection
B) As property with no special status
C) As neither persons nor property but deserving special respect
D) As the exclusive property of the female party
C) As neither persons nor property but deserving special respect
What is the purpose of the Uniform Parentage Act (UPA)?
To ensure that “all children and all parents have equal rights with respect to each other” regardless of marital status
Why was the Uniform Parentage Act revised in 2017?
A) To address new reproductive technologies
B) To ensure equal treatment of children born to same-sex couples
C) To address international surrogacy issues
D) To comply with new federal regulations
B) To ensure equal treatment of children born to same-sex couples
Before the 19th century, how was abortion generally treated under English and American common law?
It was not generally prohibited, especially in early stages of pregnancy
When did states begin passing restrictive abortion statutes in America?
A) Mid-18th century
B) Early 19th century
C) Late 19th century
D) Early 20th century
B) Early 19th century
What was the significance of “quickening” in early abortion laws?
It marked the point at which abortion became a more serious offense, with many early laws distinguishing between abortion before and after quickening
In Roe v. Wade, what was the trimester framework established by the Supreme Court?
- First trimester: State cannot restrict abortion
- Second trimester: State can regulate abortion to protect maternal health
- Third trimester: State can prohibit abortion except to save life/health of mother
What companion case was decided alongside Roe v. Wade?
A) Doe v. Bolton
B) Webster v. Reproductive Health Services
C) Planned Parenthood v. Casey
D) Gonzales v. Carhart
A) Doe v. Bolton
What specific Georgia abortion restrictions did the Supreme Court strike down in Doe v. Bolton?
- Requirement that two physicians confirm the attending physician’s judgment
- Requirement that abortion be performed in a hospital accredited by The Joint Commission
- Requirement for approval by a hospital committee
- Requirement that the patient establish Georgia residency
How did the Supreme Court describe the constitutional basis for the right to abortion in Roe v. Wade?
A) First Amendment freedom of religion
B) Fourth Amendment protection against unreasonable searches
C) Right to privacy found in the “penumbras” of the Bill of Rights
D) Fourteenth Amendment equal protection
C) Right to privacy found in the “penumbras” of the Bill of Rights
What criticism did Justice O’Connor raise about Roe’s trimester framework in her City of Akron opinion?
That the framework was “on a collision course with itself” as medical advances move the point of viability earlier while making later abortions safer
In Planned Parenthood v. Casey (1992), what test replaced the trimester framework?
A) Strict scrutiny test
B) Rational basis test
C) Undue burden test
D) Medical necessity test
C) Undue burden testC) Undue burden test
What is the “undue burden” standard established in Planned Parenthood v. Casey?
A regulation is unconstitutional if it has the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion before viability
What abortion restrictions were upheld as constitutional in Planned Parenthood v. Casey?
A) 24-hour waiting period and informed consent requirement
B) Spousal notification requirement
C) Blanket requirement for hospitalization for all abortions
D) Ban on abortion after 12 weeks
A) 24-hour waiting period and informed consent requirement
What was the significance of Whole Woman’s Health v. Hellerstedt (2016)?
It struck down Texas TRAP laws (targeted regulations on abortion providers) requiring admitting privileges and surgical center standards as creating an undue burden on abortion access
What are “TRAP laws” in the context of abortion regulation?
A) Laws requiring comprehensive sex education
B) Targeted Restrictions on Abortion Providers
C) Laws concerning fetal viability testing
D) Taxpayer Restrictions on Abortion Procedures
B) Targeted Restrictions on Abortion Providers
In Whole Woman’s Health v. Hellerstedt, what standard did the Court apply to evaluate the Texas restrictions?
A) Whether they served a legitimate state interest
B) Whether they prevented fetal pain
C) Whether health benefits outweighed burdens on access
D) Whether they were passed with discriminatory intent
C) Whether health benefits outweighed burdens on access
What did the Sixth Circuit Court of Appeals rule in Planned Parenthood v. Hodges regarding state funding?
States may choose not to fund organizations that perform nontherapeutic abortions, as there is no constitutional right to government funding
What is a “conscience clause” in the context of healthcare institutions?
A) A provision requiring healthcare providers to follow their conscience
B) A clause prohibiting abortion in all circumstances
C) A provision allowing hospitals and physicians to refuse to perform abortions on moral or religious grounds
D) A requirement that institutions disclose their moral stance on procedures
C) A provision allowing hospitals and physicians to refuse to perform abortions on moral or religious grounds
Apply IRAC to analyze whether a private religious hospital can be required to provide abortion services.
- Issue: Whether private religious hospitals can be required to perform abortions
- Rule: Private hospitals may decline to provide abortion services based on religious/moral convictions
- Analysis: Courts have generally held that private hospitals are not state actors under the 14th Amendment; conscience clauses and the Health Programs Extension Act protect religious institutions
- Conclusion: Private religious hospitals cannot be required to provide abortion services
What did the Supreme Court rule about Medicaid funding for abortions?
A) States must fund all abortions for Medicaid recipients
B) States must fund only medically necessary abortions
C) States can choose not to fund elective or medically necessary abortions
D) Federal law requires funding only for abortions in cases of rape, incest, or life endangerment
C) States can choose not to fund elective or medically necessary abortions
What is the Hyde Amendment?
A federal provision that prohibits the use of federal funds for abortions except in cases of life endangerment, rape, or incest
What is the standard applied to government-owned hospitals regarding abortion services?
A) They may refuse to provide abortion services based on institutional preference
B) They cannot refuse to permit lawful abortions and sterilizations
C) They must obtain special licenses to provide abortion services
D) They are exempt from providing abortion services if affiliated with religious organizations
B) They cannot refuse to permit lawful abortions and sterilizations
What are the key legal issues with voluntary sterilization?
1) Requires fully informed consent due to permanence
2) Patient must understand irreversibility
3) Federal regulations for Public Health Service programs require:
- Patient be at least 21 years old
- Not institutionalized
- Given specific information (risks, alternatives, irreversibility)
4) Private providers should ensure proper consent procedures
What was Buck v. Bell (1927)?
Famous Supreme Court case that upheld the constitutionality of eugenic sterilization laws. Justice Holmes wrote the infamous opinion allowing forced sterilization of Carrie Buck, writing “three generations of imbeciles are enough.” The case has been widely criticized but never explicitly overruled, though it’s no longer valid precedent after later cases recognized procreation as a fundamental right.
How did Skinner v. Oklahoma (1942) affect sterilization law?
Supreme Court case that struck down Oklahoma’s Habitual Criminal Sterilization Act, which allowed sterilization of repeat offenders but exempted “white collar” crimes like embezzlement. The Court recognized procreation as a “fundamental right” and applied strict scrutiny under equal protection analysis. This effectively undermined Buck v. Bell without explicitly overruling it.
What is “wrongful birth”?
Legal action brought by parents claiming that negligent medical care or advice deprived them of the opportunity to avoid conception or terminate a pregnancy that resulted in a child with disabilities. Damages typically cover pregnancy costs, childbirth expenses, and may include extraordinary costs of raising a disabled child.
What is “wrongful life”?
Legal action brought on behalf of a child with disabilities claiming that but for the defendant’s negligence, the child would not have been born to experience suffering. Most jurisdictions reject these claims because:
1) Medical negligence didn’t cause the disability
2) Life isn’t considered a legal injury
3) Damages comparing impaired life to nonexistence can’t be calculated
Only a few states (California, Washington, New Jersey, Maine) recognize these claims.
How are damages calculated in wrongful birth cases?
Courts generally allow:
1) Expenses for pregnancy and childbirth
2) Lost wages and other economic damages
3) Some allow pain and suffering damages
4) Some allow emotional distress damages
5) Extraordinary costs of raising a disabled child
Most courts apply the “benefit rule” - offsetting damages by the benefits of having the child.
What is stem cell research and what legal issues does it raise?
Stem cells are basic units that can develop into various cell types and serve as an internal repair system. Legal issues involve:
1) Embryonic stem cell research raises ethical objections if embryos are destroyed
2) Federal funding limitations under different administrations
3) State constitutional provisions (like Missouri’s) that protect stem cell research
4) Induced pluripotent stem cells (from adult cells) may avoid some ethical concerns
What is Assisted Reproductive Technology (ART)?
Methods to achieve pregnancy artificially, including:
1) In vitro fertilization (IVF) - eggs and sperm combined outside the body
2) Artificial insemination (AI) - sperm placed in female reproductive tract
3) Gestational surrogacy - woman carries fetus for another person
Legal issues involve determining parentage, validity of surrogacy contracts, disposition of frozen embryos, and rights of donors.
What was the outcome of In re Baby M (1988)?
New Jersey Supreme Court case involving surrogate motherhood. Mary Beth Whitehead was artificially inseminated with William Stern’s sperm but refused to give up the child after birth. Court held:
1) The surrogacy contract was invalid (violated laws prohibiting payment for adoption)
2) Both genetic parents had equal rights to the child
3) Based on “best interests of the child” standard, awarded custody to the Sterns
4) Granted visitation rights to the birth mother
What was decided in Davis v. Davis regarding frozen embryos?
Tennessee Supreme Court case addressing disposition of seven frozen embryos in a divorce. Court held:
1) Embryos are neither persons nor property, but deserve “special respect”
2) When parties disagree, courts should weigh competing interests
3) Right not to procreate usually outweighs right to procreate
4) Mr. Davis’s interest in avoiding unwanted fatherhood outweighed Mrs. Davis’s wish to donate the embryos
What is the Uniform Parentage Act (UPA)?
Model law first created in 1973, updated in 2002 and 2017, that:
1) Ensures equal rights between children and parents regardless of marital status
2) Allows non-judicial acknowledgment of paternity
3) Governs genetic testing
4) Determines parentage for children conceived through ART
5) Authorizes surrogacy agreements
6) 2017 version ensures equal treatment of children born to same-sex couples following Obergefell v. Hodges
What did Roe v. Wade (1973) establish?
Landmark Supreme Court decision that:
1) Established abortion as a constitutional right based on right to privacy
2) Created a trimester framework:
- First trimester: Almost no state restrictions allowed
- Second trimester: Reasonable health-related restrictions permitted
- Third trimester (post-viability): States could prohibit abortions except to protect maternal life/health
3) Struck down Texas law banning all abortions except to save mother’s life
What did Doe v. Bolton (1973) add to abortion jurisprudence?
Companion case to Roe that:
1) Struck down procedural requirements in Georgia’s “liberalized” abortion law:
- Requirement for confirmation by two other physicians
- Hospital committee approval requirement
- Hospital accreditation requirement
- Residency requirement
2) Upheld that physicians should use “best clinical judgment”
3) Allowed states to require abortions be performed in licensed facilities after first trimester
How did Planned Parenthood v. Casey (1992) modify Roe v. Wade?
The Court:
1) Affirmed Roe’s “essential holding” that abortion is a constitutional right
2) Rejected the rigid trimester framework
3) Focused on viability as the key point when state regulation can increase
4) Created the “undue burden” standard - regulations cannot place substantial obstacles in path of woman seeking pre-viability abortion
5) Upheld informed consent requirements and 24-hour waiting periods
6) Upheld parental consent requirements with judicial bypass option
What was significant about Whole Woman’s Health v. Hellerstedt (2016)?
Supreme Court case invalidating Texas “TRAP” laws that:
1) Required abortion providers to have admitting privileges at nearby hospitals
2) Required abortion facilities to meet standards of ambulatory surgical centers
Court found these requirements:
- Provided few if any health benefits
- Imposed substantial obstacles to abortion access (closed half of Texas clinics)
- Created an “undue burden” on constitutional rights
- Failed to show significant health benefits over less restrictive regulations
What is a “justiciable” case?
A case capable of being settled by a court of law. Courts can only decide cases that present an actual controversy, are ripe for decision, aren’t moot, and involve parties with standing. The term appears in the chapter introduction noting that courts must decide reproductive rights cases even though they involve difficult social, moral, and ethical controversies.
What are “TRAP laws”?
Targeted Restrictions on Abortion Providers - state laws that impose regulations specifically on abortion facilities, such as:
1) Requiring providers to have hospital admitting privileges
2) Mandating facilities meet standards of ambulatory surgical centers
3) Imposing specific building requirements
4) Adding burdensome reporting/licensing requirements
Critics argue these laws aim to restrict access rather than improve safety.
What is a “conscience clause” in healthcare law?
Statutory provisions that permit hospitals, healthcare providers, and sometimes insurers to refuse to perform or cover certain procedures (typically abortion or sterilization) on moral or religious grounds. The Health Programs Extension Act of 1973 specifically provides that receipt of Hill-Burton money doesn’t require a hospital to provide abortions or sterilizations if refusal is based on religious beliefs or moral conviction.
Can public hospitals refuse to provide abortion services?
No. Hospitals owned and operated by federal, state, or municipal governments may not refuse to permit lawful abortions and sterilizations because:
1) They are state actors bound by the 14th Amendment
2) They cannot prevent individuals from exercising constitutionally protected rights
3) Doe v. Bolton established this principle
Private hospitals, even those receiving government funding, generally can refuse based on moral/religious convictions.
What was the significance of Griswold v. Connecticut (1965)?
Supreme Court case that:
1) Struck down Connecticut law prohibiting use of contraceptives
2) Established a constitutional “right to privacy” found in the “penumbras” of several amendments
3) Protected marital privacy regarding contraceptive use
4) Created the legal foundation later used in Roe v. Wade
5) Recognized that certain personal decisions are protected from government interference
