The New England Journal of Medicine

Reproductive Freedom and the Next President

In a dramatic speech on the floor of the U.S. Senate in July 2006, Senator Barack Obama (D-IL) described a visit from a constituent whose 2-year-old son, Ryan, had cerebral palsy, which had severely impaired the development of his speech and motor skills. Invoking the many children like Ryan, Obama argued that human embryonic stem-cell research is crucially important and that federal funding for such research is needed. Speaking the following day, Senator John McCain (R-AZ) stated, by contrast, that human embryonic stem-cell research raises "serious ethical and moral concerns" and that it should receive federal funding only insofar as it relies on embryos that were "originally created for reproductive purposes and [are] now frozen or slated for destruction by in vitro fertilization clinics."

This disagreement reflects the evolution of the national debate about "reproductive freedom." Whereas election campaigns once focused on abortion as the primary element of reproductive freedom, candidates now find themselves addressing a broader array of arguably related issues, including the use of human embryos for stem-cell research and whether such research should receive federal funding; the extension of eligibility for the State Children's Health Insurance Program (SCHIP) to unborn "children" (but not pregnant women), in keeping with a 2002 federal redefinition of "child" as "an individual under age 19, including the period from conception to birth"; and the assurance of access to family-planning services and comprehensive sex education both in the United States and abroad. Also under discussion are the Partial-Birth Abortion Ban Act and requirements for parental notification or consent for minors to obtain abortions.

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Reprinted with permission from Eli Y. Adashi and Darrell M. West, "Reproductive Freedom and the Next President ," The New England Journal of Medicine, Volume 359:1867-1869, No. 18: October 30, 2008. The New England Journal of Medicine.