Five Questions with Judith Daar

A conversation with the 2020 Lader Lecturer, Judith Daar, JD

Judith Daar will deliver the Lawrence Lader Lectureship on Family Planning and Reproductive Rights, Emerging Dilemmas in Reproductive Medicine: Disputes over embryo transfer on Wednesday, October 7, 2020, at 5 p.m. ET.

Daar is the Ambassador Patricia L. Herbold Dean and Professor of Law at the Chase College of Law at Northern Kentucky University. Her academic career in the health law field focuses on emerging technologies and barriers to equitable access in family formation.
Judith Daar
What inspired your interest in the field of equitable reproductive technology? 
My awakening to the world of assisted reproductive technologies (ART) occurred during a first-of-its-kind course in law school in the 1980s, at a time when most of the techniques I study today did not exist. Even in the early days of IVF, I became aware and concerned about the stratification of access to these life-giving medical procedures that were disproportionately available to and utilized by nonminority women of means. This pattern is particularly troublesome in light of longitudinal evidence that minority women experience higher rates of infertility.

Your recent book, The New Eugenics: Selective Breeding in an Era of Reproductive Technologies, explores the past two decades of advances in reproductive technologies through an intersectional lens. How has access to such technologies changed in that time? Are we moving in the right direction in terms of access? How can we do better? 
We can always do better, given the improving effectiveness of ART and the continuing need for assisted conception among many who aspire to become biological parents. In some ways, the landscape has improved while in other ways it is stagnant. Today far more providers are willing—even anxious—to treat single men and women, same-sex couples, transgender individuals, and patients with disabilities. What hasn’t changed much is the insurance coverage afforded for access to these expensive technologies. A few states have made changes in laws addressing fertility care but most have not and remain silent about the provision of insurance coverage for ART.

You describe some ART practices as a modern form of eugenics. How did we get here? What was missing from institutional or regulatory protections to allow this? 
At its heart, eugenics is a scheme in which law, policy, and public attitudes combine to devalue and suppress reproduction among disfavored groups. Historically, access to ART has followed this pattern by the imposition of a variety of barriers to access. These barriers include the high cost of treatment and its disparate impact on women of color, provider unwillingness to treat single, gay, transgender, disabled patients, and a body of law that fails to protect against discrimination in the health care setting involving targeted treatment denials.

In general, medical technology outpaces the public and legislative understanding of those technologies. How can our legislators and/or the public electorate keep up with emerging reproductive technologies? 
There are no shortage of articulate experts who can educate lawmakers and the public about emerging reproductive technologies. The problem is that inroads into human reproduction are incredibly freighted with emotion, angst, and mistrust such that a dialog on the scientific merits of any advancement has become illusive. History reveals that new reproductive technologies gain public acceptance, if at all, only after years of successful use. Our moral panic at the prospect of altering how we reproduce is soothed only by experiencing how these technologies improve – but don’t fundamentally alter – the basic formula for reproduction. One of the most common misconceptions I hear is that people turn to ART to improve upon what nature allows. The notion is that these technologies empower us to produce healthier, smarter, better children to create an advantage over natural conception. The truth is that nearly everyone who turns to ART does so because they cannot become parents the old-fashioned way. ART supplies the first steps, but in the end it is merely a conduit to bringing life into the world exactly the same way it has always arrived. 

Are there specific technologies, practices, or policies that are particularly concerning to you? What are they and why?
I find the current work in germline gene-editing intriguing for its potential to stave off disease replication in families whose members have suffered under the weight of a heritable illness. Likewise, the prospect of in vitro gametogenesis is fascinating should it enable each of us to produce gametes using stem cell techniques. What is concerning is the federal government’s structural barrier to research and development in the field. Since 1996, federal law has prohibited public funding of most research involving embryos and thus stalled the U.S. in the worldwide quest to improve our reproductive lives.

Register and learn more about the 2020 Lader Lecture here.