IVF and the Political Dilemma: Balancing Reproductive Rights, Ethics, and Accessibility

Graphic by Eugene Cho

In vitro fertilization (IVF) has become a focal point of political unrest, especially, because the procedure raises a series of complex and nuanced ethical questions that cannot be easily categorized in binary terms, as some politicians may suggest. IVF, one of the most effective fertility treatments, is one in which doctors collect mature eggs from a woman's ovaries, fertilizing them with sperm to create embryos, and then freeze many of those embryos for future use (1). The embryos are stored by replacing the water in their cells with a protective fluid and freezing them using liquid nitrogen (4), a procedure that is highly controversial over its morality. Since the overturning of Roe v. Wade, opposition to IVF has gained traction, with some anti-abortion groups questioning the ethics of embryo creation and destruction. This division highlights the broader moral dilemma facing lawmakers: balancing the potential benefits of IVF in helping individuals start families against the ethical concerns surrounding embryo creation and destruction.

In February 2024, the Alabama Supreme Court ruled that "embryos are children under law," a decision that threatened the accessibility of IVF (2). In response, many Republicans began to take a stance supporting the procedure, a surprising shift from their previous positions on reproductive rights. These Republicans defended IVF as a “pro-life issue,” but struggled with reconciling this stance with their opposition to abortion. The central dilemma lies in the idea that, as proponents of “life beginning at conception” argue, IVF involves the creation of embryos that may ultimately be discarded—raising ethical concerns about the destruction of potential life (2). Florida Senator Marco Rubio captured this tension, acknowledging that “the ethical dilemma is that, in order to create life, you have to destroy life because you’ll create embryos that are not going to be used” (3). Some, like Emma Waters, a Senior Research Associate in the DeVos Center for Life, Religion, and Family at The Heritage Foundation suggest the U.S. adopt policies limiting the number of embryos created to reduce this ethical conflict. She explains that Republican lawmakers need not be boxed into a strict "binary" choice of fully supporting or opposing IVF (3). While Alabama's legislature has passed a bill protecting IVF providers from legal liability, the legal and ethical questions from the state court's ruling remain unresolved.

IVF treatments typically cost between $12,000 and $25,000 per round, and insurance coverage for the procedure is often inconsistent (5). Many businesses only extend coverage to individuals with infertility, while others, including coverage under Medicaid, often limit fertility treatment access or exclude certain groups, such as LGBTQ+ couples and single women (4). This inconsistency in coverage creates a divide, limiting IVF access to those who can afford the treatment out-of-pocket. During his campaign, Donald Trump promised that IVF would be made free for families, either through insurance coverage or government funding. President Trump, aiming to address the growing concern around the high cost of IVF, signed an executive order on February 18th, 2025, in which he tasked the assistant to the President for domestic policy with providing a list of recommendations to protect IVF access (4). However, Senators like Patty Murray (D-Wash.) have criticized his recent executive order, calling it a "PR stunt" due to the lack of concrete policy action (5). They point to the history of Republican resistance to legislation that would make IVF more affordable and accessible. Senate Democrats, including Senator Tammy Duckworth, argue that if Trump is serious about making IVF free for all, he should urge Senate Republicans to back the "Right to IVF Act," which would require insurance plans to cover the procedure (6). The bill has been blocked by Senate Republicans for over a year due to concerns that its language could be used to justify abortions.

Ultimately, Trump's executive order only requests recommendations to make IVF more affordable but does not guarantee direct action. This cautious approach reflects the complex position Republican lawmakers find themselves in, balancing support for IVF with their anti-abortion stance. As the debate continues, it remains to be seen whether Trump will take more definitive action on IVF accessibility. Until then, the political conversation surrounding IVF will remain deeply divided, with ongoing ethical debates over the potential benefits of wider access to fertility treatments versus concerns over the moral implications of destroying human embryos in the process.

Reviewed by Leya Edwards-Headen

References

[1] “In Vitro Fertilization (IVF).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Sept. 2023, www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716. 

[2] Schapitl, Lexie. “How IVF Is Complicating Republicans’ Abortion Messaging.” NPR, NPR, 16 Mar. 2024, www.npr.org/2024/03/16/1238966404/how-ivf-is-complicating-republicans-abortion-messaging. 

[3] “IVF as an Election and Policy Issue .” KFF, 9 Oct. 2024, www.kff.org/quick-take/ivf-as-an-election-and-policy-issue/. 

[4] Ungar, Laura. “Trump Has Signed an Executive Order on IVF. Here’s What You Should Know about the Procedure.” AP News, AP News, 18 Feb. 2025, apnews.com/article/ivf-vitro-fertilization-trump-executive-order-65972cc1b10151bf1a0d9390fe5754d9. 

[5] Simmons-Duffin, Selena, and Diane Webber. “Trump Wants to Lower the Cost of IVF. New Executive Order Seeks Ideas to Do That.” NPR, NPR, 19 Feb. 2025, www.npr.org/sections/shots-health-news/2025/02/18/nx-s1-5301201/trump-executive-order-ivf-in-vitro-fertilization. 

[6] O’Connell-Domenech, Alejandra. “Trump’s IVF Order: Democrats Allege ‘PR Stunt’ as Anti-Abortion Groups Bristle .” The Hill, The Hill, 19 Feb. 2025, thehill.com/policy/healthcare/5154154-trump-ivf-order-criticized/.

Fueling Change: Dietary Interventions in Epilepsy Treatment

Epilepsy is a disease that affects approximately 50 million people worldwide and is characterized by recurrent seizures. These seizures cause involuntary movement in parts of the body or the entire body and can lead to a loss of consciousness. Although antiepileptic drug (AED) therapy stops seizures in most individuals, studies estimate that 30% to 40% of patients become resistant to treatment with AEDs, a condition known as drug resistant epilepsy (DRE). While the exact cause for DRE is unknown, one potential treatment that has been explored is dietary therapy.

Dietary therapy, used in conjunction with seizure medications, improves the therapeutic effects of AED treatment. It can also be used as a management option for those suffering from DRE. One common diet used for epileptic dietary therapy is the ketogenic diet. The ketogenic diet is a high fat, low carb diet that can be prescribed by a physician and is usually monitored by a dietician. In this diet, the body relies on the breakdown of fats rather than carbs for energy. These fats are metabolized into ketones and ketone bodies, which are able to cross the blood-brain barrier and enter the brain where it can be used for energy. Some food choices specific to this diet include butter, heavy whipping cream, mayonnaise, and oil (e.g., canola or olive). However, this diet is more commonly recommended for children, as it is more difficult for adults to follow such a strict diet plan. 

Despite the difficulty in maintaining the diet, it has proven to be extremely effective. Research has shown that the  ketogenic diet typically reduces the number of seizures by 50% or more in half of patients. This occurs because epilepsy, and seizures in general, are often caused by higher levels of glutamate and GABA—excitatory neurotransmitters—in the brain. However, the ketogenic diet reduces the amount of glutamate in the brain and lowers the production of GABA. The exact mechanism by which this occurs remains an active area of research, but it opens the door to a compelling question: what other diseases might be effectively treated or cured through dietary therapy?

Reviewed By: Ashley Gutierrez-Torres

Citations:

“Drug Resistant Epilepsy.” Epilepsy Society, 3 Aug. 2023, epilepsysociety.org.uk/about-epilepsy/drug-resistant-epilepsy. 

“Ketogenic Diet.” Epilepsy Foundation, www.epilepsy.com/treatment/dietary-therapies/ketogenic-diet. Accessed 30 Nov. 2024. 

“Epilepsy.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/epilepsy. Accessed 30 Nov. 2024. 

Wnuk, Alexis. “How Do Ketogenic Diets Help People with Epilepsy?” BrainFacts.Org, www.brainfacts.org/diseases-and-disorders/epilepsy/2018/how-do-ketogenic-diets-help-people-with-epilepsy-081418. Accessed 30 Nov. 2024. 

The Fast-Food Industry: Ethical Dilemmas, Health Impact and Consumer Autonomy

The fast-food industry stands at the intersection of public health, ethics, and corporate profitability, creating challenges that extend beyond personal diets. Through aggressive and ubiquitous marketing, fast-food companies influence consumer behavior, particularly children’s eating habits. The industry’s convenience and affordability appeal to a broad demographic, but its widespread consumption has raised significant public health concerns. A study in the American Journal of Clinical Nutrition links fast-food consumption to obesity and poor dietary outcomes, which not only affect individual health but also impose a heavy economical burden on healthcare systems.1 Efforts to address these issues through policy have faced resistance, raising pressing questions about the industry’s impact on public health and wellbeing. 

Fast-food thrives on maximizing profitability, often at the expense of public health. Companies invest billions annually in advertising campaigns designed to target vulnerable populations, including children and low-income families. A 2021 study by the Rudd Center for Food Policy and Obesity revealed that fast food advertising expenditures in the United States exceeded $5 billion in 2019 alone.2 These advertisements, using bright colors, catchy songs, and promotional incentives, are designed to foster brand loyalty from an early age. Children, due to limited cognitive development, are particularly vulnerable to such tactics, as they struggle to critically assess the persuasive intent behind these ads. The Rudd Center’s research underscores how these marketing efforts not only increase short-term consumption but also establish lifelong dietary patterns that prioritize convenience over nutrition. This cyclical relationship highlights the deep-rooted public health challenges posed by the fast-food industry.

The rising consumption of calorie-dense, ultra-processed foods with low nutritional value contributes significantly to rising obesity rates in the United States. The CDC reports that over 42% of adults are obese, a condition linked to heart disease, diabetes, and certain cancers.3 Obesity also imposes substantial economic costs, with costs exceeding $173 billion annually. Furthermore, obesity disproportionately impacts marginalized populations, exacerbating existing health disparities and raising ethical questions about the responsibility of corporations in addressing these inequities.

The proximity of fast-food establishments to schools further exacerbates these issues. A study published in the American Journal of Public Health found that schools near fast-food restaurants reported higher adolescent obesity rates.4 The convenience and affordability of these establishments make them especially attractive options to students from low-income families, reinforcing unhealthy eating habits that persist into adulthood. The strategic placements of fast-food outlets exploits the dietary vulnerabilities of youth, entrenching public health challenges associated with obesity and related illnesses.

Efforts to counteract these trends have faced significant resistance from the food industry. Regulatory measures, such as taxes on sugary drinks or restrictions on advertising to children, have been challenged by well-funded legal campaigns. For example, New York City’s 2012 proposal to ban large sugary drinks was struck down after intense lobbying by the beverage industry, which framed the regulation as an infringement on personal freedom.5 This illustrates the influence of corporate lobbying in shaping policy and underscores the ethical dilemmas policymakers face in balancing individual freedoms with the collective need to address the public health crisis.

Food accessibility is another ethical concern. Low-income and marginalized communities often live in “food deserts”, with limited access to affordable, nutritious food options, leading to a reliance on fast food. A 2020 study highlighted that urban poverty restricts access to a healthy diet, contributing to malnutrition and diet-related diseases.6 Moreover, the strategic dense placement of fast-food outlets in low-income neighborhoods worsens health disparities.7 This targeted proliferation raises ethical questions about corporate responsibility and the perpetuation of health inequities through the exploitation of vulnerable populations.

The impact of fast food extends beyond physical health to mental well-being. A 2023 study published in BMC Psychiatry found that diets high in processed and fast foods are linked to increased risks of mental health disorders.8 The inflammatory response triggered by these diets, characterized by elevated markers like C-reactive protein, exacerbates symptoms of anxiety and depression.9 Corporations capitalize on these dietary habits, using engineered flavors and addictive additives to drive consumption. While this ensures profitability, it often harms consumer health. As the American Psychological Association notes, diets dominated by ultra-processed foods not only reduce emotional resilience but also contribute to cognitive decline, particularly in communities with limited access to healthier alternatives.10 Without structural intervention, these patterns—rooted in corporate strategy—will continue to undermine community health and well-being.

The fast-food industry's marketing strategies raise ethical concerns regarding consumer autonomy. While consumers are presumed to make free choices, the industry's deliberate tactics influence purchasing decisions without conscious awareness, thus undermining this autonomy. These tactics can lead individuals to select less healthy, higher-margin items, thereby compromising informed decision-making.11

Moreover, the pervasive advertising of fast food, especially to children, exploits cognitive vulnerabilities. Children lack the developmental capacity to critically evaluate marketing messages, making them particularly susceptible to persuasive advertising. One of the most prominent examples of this is the McDonald’s Happy Meal, which combines toys, colorful packaging, and heavily marketed characters to create a powerful appeal to children. The inclusion of toys fosters an emotional connection with the brand, while the meal’s affordability ensures accessibility for parents. This targeted marketing fosters early brand loyalty and establishes unhealthy eating habits that can persist into adulthood.12

The fast-food industry poses a threat to public health, ethical responsibility, and consumer autonomy. The aggressive marketing strategies, combined with the widespread availability of unhealthy food, exacerbate obesity, diet-related diseases and even mental health disorders. 

Reviewed By: Ashley Gutierrez-Torres

Bibliography

1. Poti, J. M., Duffey, K. J., & Popkin, B. M. (2014). The association of fast food consumption with poor dietary outcomes and obesity among children: Is it the fast food or the remainder of the diet? American Journal of Clinical Nutrition, 99(1), 162–171.

2. Jennifer L. Harris, Frances Fleming-Milici, and Jocelyn Kelly, "Fast Food FACTS 2021: Fast Food Advertising Aimed at Children and Teens," Rudd Center for Food Policy and Obesity, University of Connecticut, December 2021, https://uconnruddcenter.org/research/food-marketing/fast-food-facts/. 

3. Centers for Disease Control and Prevention, "Adult Obesity Facts," https://www.cdc.gov/obesity/data/adult.html. 

4. N. M. Laraia et al., "Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity Rates," American Journal of Public Health 94, no. 9 (September 2004): 1575-81.

5. Margot Sanger-Katz, "Why New York City’s Sugary Drink Ban Was Struck Down," The New York Times, June 26, 2014, https://www.nytimes.com.

6. Elizabeth L. Sweet, "The Urban Food Desert as a Space of Inequity," International Journal for Equity in Health 19, no. 1 (2020): 2-12, https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01330-0. 

7. N. D. Lee, "Fast-Food Restaurants and Obesity Rates in Low-Income Communities," American Journal of Medicine 132, no. 8 (2019): 979-985, https://www.amjmed.com/article/S0002-9343%2819%2930747-8/fulltext. 

8. BMC Psychiatry Editorial Board, "Dietary Patterns and Mental Health Outcomes," BMC Psychiatry 23, no. 3 (2023): 243-255, https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05889-8. 

9. Samantha L. Hodge et al., "The Role of Diet-Induced Inflammation in Depression and Anxiety," Journal of Psychiatric Research 135, no. 4 (2021): 47-57, https://doi.org/10.1016/j.jpsychires.2020.11.015. 

10. American Psychological Association, "Diet and Mental Health: How Food Affects Mood," Monitor on Psychology 48, no. 9 (2017): 28-31, https://www.apa.org/monitor/2017/09/food-mental-health. 

11. Sarah Bowen et al., "Menu Engineering and Consumer Autonomy," Journal of Consumer Research 46, no. 5 (2019): 1123-1138, https://academic.oup.com/jcr/article/46/5/1123/5584408. 

John Quelch, "Marketing Fast Food to Children," Harvard Business Review 89, no. 3 (2011): 102-110, https://hbr.org/2011/03/marketing-fast-food-to-children.