You are the director of a busy women's clinic in a major health care system. You receive an urgent phone call at 9:00AM from the system compliance and ethics officer andare called upon to chair an emergency meeting of the hospital ethics committee at noon today. The following issue must be resolved. A 45-year-old female patient, in good mental and physical health, and with the support of a significant other, wishes to undergo an in-vitro fertilization procedure. The patient is the mother of sextuplets from a past in-vitro procedure two years ago. There is a high probability of multiple births from the requested procedure.

The procedure will be costly and limited health insurance coverage exists for the patient. However, there is no evidence from social services that the patient cannot provide for the current and possible future children. Your clinic is the only location for the procedure within 350 miles of the patient's home. The Chief of Obstetrics and Reproductive Medicine is refusing to provide the procedure, as she says this is socially irresponsible and an abuse of the use of reproductive technology and science.

How would up respond to this leadership challenge:

[As the leader of this ethics committee meeting, you will need to be well-versed on both sides of this issue.

Please provide a succinct argument for both moving forward of the procedure and for refusal. Consider the 14th Amendment, pro-creative liberty (both to avoid reproduction and to reproduce), social justice and equality, autonomy, beneficence, paternalism, economics of multiple births, the potential cost to society, health policy of reproduction, and other principles of ethics and justice.]