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SKI 111~1) Illil~llIS
Private Decisions,
Public Dilemmas
Suzanne Wymelenberg
for the
INSTITUTE OF MEDICINE
NATIONAL ACADEMY PRESS
Washington, DC 1990
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National Academy Press · 2101 Constitution Avenue, N.W. · Washington, D.C. 20418
This publication is based on presentations at the annual meeting of the Institute
of Medicine held in Washington, D.C., on October 19, 1988. The views expressed
are those of the participants and do not necessarily reflect those of the Institute of
Medicine.
The Institute of Medicine was chartered in 1970 by the National Academy of
Sciences to enlist distinguished members of appropriate professions in the examination
of policy matters pertaining to the health of the public. In this, the Institute acts both
under the Academy's 1863 congressional charter responsibility to be an adviser to the
federal government and its own initiative in identifying issues of medical care? research,
and education.
This project was supported by a grant from the R. W. Johnson Pharmaceutical
Research Institute, fonned in a recent reorganization of the research and development
divisions of Ortho Pharmaceutical Corp., Ortho Biotech, McNeil Pharmaceutical, and
Cilag International.
Library of Congress Cataloging-in-Publication Data
Wymelenberg, Suzanne.
Science and babies: private decisions, public dilemmas l Suzanne
Wymelenberg.
p. cm.
Includes bibliographical references.
ISBN 0-309-04140-6. ISBN 0-309-04136-8 (pbk.)
1. Human reproduction Social aspects. 2. Contraception Social
aspects. 3 Teenage pregnancy Social aspects. 4. Human
reproductive technology—Moral and ethical aspects. I. Title.
RG133.W96 1990
176 dc20
Copyright (A 1990 by the National Academy of Sciences
Printed in the United States of America
90-35 1 1 1
CIP
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Preface
Discussion of personal reproductive health is generally reserved for
the most private of settings: between partners, or between health provider
and patient. Yet in the past decade, new developments in reproductive
science and ongoing political conflict have increasingly thrust matters of
conception and contraception squarely into the public spotlight.
At its Annual Meeting, October 19-20, 198S, the Institute of Medicine
devoted a daylong symposium to ``Advances in Reproductive Biology:
Implications for Research, Application, aIld Policy Development." This
book, authored by Suzanne Wymelenberg, draws on that meeting of
experts. It describes the state of our unders~ding of human fertility
and allied issues, such as teenage pregnancy and prenatal care. It is
clear throughout that both evolutionary and revolutionary advances in
reproductive research lie ahead.
The book concludes with chapters highlighting ethical concerns
raised by interventions in human reproduction and public policy issues-
difficult choices that America faces in the 1990s. Forthright public
discussion of sexual topics usually confined to private conversations will
be necessary, if exciting gains in our understanding of reproductive biol-
ogy are to be sensibly translated into gains in reproductive health. This
book is directed toward energizing that process.
SAMUEL O. THIER
President
Institute of Medicine
. . .
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