No governmental agency or authority seriously polices reproductive negligence. The best practices set forth by industry organizations are completely voluntary and routinely ignored, and there isn’t even any reliable or comprehensive system to track the wrongful thwarting of family planning. The breakneck pace of reproductive advances isn’t the only reason that test tubes and tube ties have eluded meaningful oversight: Four factors explain this regulatory vacuum. First, many are wary of ceding the state control on any matter involving procreation—red tape would raise prices on valuable services, making it harder for poor people to pay for them. Second is the political economy of reproductive technology in the United States: The free-market origins of infertility treatment let it develop unimpeded by government oversight, in the private sphere of for-profit clinics that function less as medical practices than trade businesses. A third factor that cuts against regulation is its murky electoral implications, even in reliably red or blue districts—fear of fracturing their political bases leads prudent officials to avoid wading into the morass. Fourth and finally is the limited public outcry to address reproductive negligence. Besides, steep costs and selective treatment coverage leaves many patients unable even to fund a legal challenge if things go wrong. State legislatures place damage caps and other barriers in the way of bringing suit. And trials can be a spectacle for plaintiffs wary of exposing personal matters to the public glare of open court.
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