Jones Rounds – How It Works

Jones Rounds is designed as a 2-party modality: (1) Grand Rounds lectures focus on the legal and ethical aspects of the ARTs, including 3rd party ART, and (2) separate Didactics Modules explore a case study that highlights a specific timely, challenging ART medicine, law and ethics topic.

Grand Rounds

An introductory Law and Ethics overview paired with one of two Lectures (each Grand Rounds totals 50 minutes)

  • Grand Rounds 1: “ART Law and Ethics: Understanding the backdrop and context surrounding ART Medicine”
  • Grand Rounds 2: “3rd Party ART:  Legal and Ethical Issues and Challenges”
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Didactics

Highly interactive (currently virtual) 90-minute modules on specific inter-professional topics, designed specifically for Reproductive Endocrinology Fellows and can also be adapted for Ob/Gyn, Family Medicine, and other residency programs.

  • Modules are designed to meet many of the ACGME Requirements
  • Each module starts with a short expert presentation, case-study, discussion break-outs using innovative design tools, a large group guided discussion and “take-aways”
  • Each module has adapted innovative methods developed by the Kennedy Institute of Ethics to engage learners in delving into the perspectives of the multiple participants involved in ART and the ethical and legal aspects of ART medical care.
  • Up to 3 Didactics modules may be “stacked“ for programs that wish to address multiple topics in a single day
  • Program Director involvement (e.g. break-out facilitator, discussant)
  • Virtual Didactics Module can be made available to participants from multiple fellowship programs for cross-program learning opportunities
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Didactics Modules-Topics

Currently Available

  • Fertility Preservation/Oncofertility:
    • Designed to raise the legal and ethical issues, interests and potential conflicts arising during a woman’s cancer diagnosis and urgent need to consider fertility preservation options.
    • Identifies three impacted groups of people: the woman; her partner; and both oncology and REI specialists called in to counsel and/or provide fertility preservation treatment options.
    • Based on reported and unreported cases that have reached contradictory legal conclusions.
  • Posthumous reproduction:
    • Designed to raise the legal and ethical issues, interests and potential conflicts following a man’s unanticipated death.
    • Identifies four impacted groups of people: the deceased; his surviving partner; his parents; and medical personnel called in to retrieve and preserve his sperm for future procreative use.
    • Based on two court cases from NY and CA that reached opposite legal conclusions.

Under Development

  • Embryo disposition: program preparedness and protocols
  • Surrogacy: understanding multiple patient dynamics and complex issues
  • Gamete and embryo donation
  • Repro-genetics
  • Same-sex patients
  • Transgender patients
  • Program specific suggested topics

Dr. Jones interview on the origins of the ASRM Ethics Committee, 2015

Louise Brown, Susan Crockin, & Elizabeth Carr, 2017

The Origins of Jones Rounds

By Susan L. Crockin

As the ARTs continually expand both the opportunities and challenges for those who work to make previously inconceivable families both possible and secure, the idea of Jones Rounds emerged as a way to both honor the late Howard W. Jones, Jr., MD. (1910-2015) and, more importantly, further his legacy of teaching through spirited, interactive and interdisciplinary exchanges of ideas to a new generation of REI Fellows and others.  Jones Rounds, including footage from my two days of interviews with him in 2015, strives to capture and share his unparalleled curiosity and passion for learning and advancing all aspects of the ARTs.

Often called the “father of IVF,” Dr. Howard (as he was known by all who trained under him and his late wife and career partner, “Dr. Georgeanna”) was an ethical visionary as well as a medical pioneer in his lifelong approach to reproductive medicine. In 1978, after being mandatorily retired from Johns Hopkins, he and Dr. Georgeanna were persuaded to defer a well-earned retirement and instead chair the Ob/Gyn department at the newly established Eastern Virginia Medical School (EVMS) in Norfolk, VA. Arriving as Louise Brown was born in the UK, they quickly established the Jones Institute of Reproductive Medicine at EVMS, and were responsible for the first US IVF baby, Elizabeth Carr, in 1981.

In 1984, Dr. Howard urged the American Fertility Society (now the American Society of Reproductive Medicine (ASRM)) to create an Ethics Committee, became its first chair, and oversaw the Committee’s inaugural publication, “Ethical Considerations of the New Assisted Reproductive Technologies.” The committee’s definition of an IVF embryo as a unique entity “deserving of special respect” due to its unique ability to form a human being, was adopted in the first US court case resolving a frozen embryo dispute, Davis v. Davis (Tenn. 1992), and continues to shape the legal frameworks for the ARTs today.  Up until his death at 104 in 2015, Dr. Howard remained a passionate and impactful voice on the medical, legal and ethical aspects of IVF and its progeny

In 1986, I had the privilege of meeting both Drs. Jones, and over the next three decades to work with him. In 1990, as the country’s first frozen embryo divorce dispute was erupting, he encouraged my decision to start a legal column for the medical community explaining how the law was reacting to and shaping the ARTS. “Legally Speaking: a column highlighting recent court decisions affecting the Assisted Reproductive Technologies and the families they create,” has run in ASRM (then AFS) News since that time.

Over the next two decades, Dr. Howard and I co-authored a number of articles, and one book, on interdisciplinary issues related to the ARTs, including access to care. On what became annual trips to Norfolk to lecture to the EVMS embryology masters students, we would carry on lively discussions over tough, thought-provoking ART issues large and small. And whether in the lecture hall, afterwards at his desk, or over the phone, I knew his baritone voice was always the beginning of a fascinating, imaginative, and wide-ranging debate over critical issues surrounding the ARTs.  In 2010 we co-authored the textbook, Legal Conceptions: the evolving law and policy of Assisted Reproductive Technologies (Johns Hopkins 2010).  Dr. Howard’s introduction to each substantive legal chapter reveals his remarkable insights on the legal issues of the ARTs.

In 2015, he agreed to be interviewed, giving me the privilege of spending two days asking him about his work, his life, and his views of IVF and the ARTs, past, present and future. Until his death, Dr. Howard continued to be a passionate and impactful voice on emerging legal, ethical and policy perspectives – including the serious health risks of multi-fetal pregnancies for both mothers and children, insurance coverage for infertility treatments, and the impact on IVF of so-called “personhood” initiatives.

An undergraduate student of Robert Frost at Amherst College, he was fond of often reciting one particular poem of his:

“…Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.”

Robert Frost, 1916

For those, like myself, who had the “less traveled” privilege of knowing and working with Dr. Howard, it has, indeed, made all the difference. I hope Jones Rounds will give future physicians a small opportunity to share in that legacy.

SLC

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