FOR "MARY JAMES," STARTING A FAMILY hadn't been as easy as love, marriage and a baby carriage. For many years she had been unable to conceive, apparently because of her husband's low sperm count, so the couple went to infertility specialist Dr. Cecil Jacobson, who ran a clinic in Vienna, Va. "If you want a kid, you're going to have a kid," she says Jacobson told her. On the third try, using what they thought was a specially treated dose of the husband's sperm for artificial insemination, the Jameses did become parents—of twins. But their joy turned to outrage when they learned late last year that Jacobson had been indicted on fraud and perjury charges for, among other things, allegedly using his own sperm for artificial insemination—and that he was the biological father of their children. Moreover, according to prosecutors, Jacobson had misled other trusting patients and in fact may be the biological father of as many as 75 children.
Three weeks ago, under a pseudonym and a blond wig to protect her family's privacy, Mary James disguised none of her anger as she testified at Jacobson's trial about her sense of betrayal. How would she have reacted to the suggestion that she become pregnant using sperm donated by someone other than her husband? she was asked. "We would never have allowed it," she told a jury in Alexandria, Va. "We would have been out of the office in half a second."
A huge man of some 250 lbs., Jacobson, 55, amply embodies the weighty legal and moral questions raised by his trial in federal court. He was charged with a host of violations, many of them relating to the medical methods he employed in running his fertility practices. But the most explosive allegations concerned the use of his own sperm to impregnate women. Some of the patients allegedly thought they were receiving their husband's sperm, treated in the lab to increase its potency, while other women believed they were receiving it from anonymous donors, who had been carefully selected to match physical traits.
Jacobson concedes that he used his own sperm with patients in "very isolated circumstances," specifically when scheduled donors didn't show up. What is clear is that his activities have touched off an anguished debate among the doctor's former patients. Some, especially fathers who assumed their own sperm had been used, see Jacobson as guilty of the ultimate deception. "I had one of those fathers sit across from me, and I don't think I've ever seen that much pain in someone's face," says Bob Hall, a Fairfax, Va., attorney who has consulted with some of the families. "Another man said it was as though his wile had been raped."
On the other hand, Jacobson's family, and more than a few of his former patients, argue that those women who got pregnant with his help should simply count their blessings, enjoy their children and stop worrying about genetic lineage. "The father is the person there when the baby is born and who nurtures the baby. The sperm doesn't make the father," says Jacob-son's wife, Joyce, 52. "Anyone who got his sperm is lucky."
Born in Salt Lake City, Jacobson won acclaim not only as a brilliant student but also as a star athlete who played football in high school and earned a swimming scholarship to Utah State University in Logan. After completing a two-year stint as a Mormon missionary in Germany, he finished his undergraduate degree at the University of Utah and headed off for medical school at George Washington University in Washington, D.C. Over the years he has published more than 60 papers, most on reproductive genetics, and he had helped develop prenatal tests for detecting birth defects.
The downside was that his hectic schedule left little time for Jacobson to devote to his growing family. (He and his wife now have four sons and three daughters.) Thus in 1976 he decided to set up his own practice, called the Reproductive Genetics Center, closer to home in northern Virginia. The clinic thrived, but in 1988 local television station WRC-TV disclosed that some of Jacobson's patients had been subjected to questionable treatment. The alleged practices included falsely telling patients they were pregnant and then continuing the deceit by the misuse of hormones and ultrasound.
On the stand last week, Jacobson insisted, "I never did anything fraudulent." But early in 1989, the Virginia Board of Medicine moved to revoke Jacobson's medical license. To avoid this, Jacobson agreed to stop practicing for at least five years. In a separate settlement he refunded a total of $250,000 to more than 100 former patients.
By that time, Jacobson had closed his clinic anyway and moved back to Utah. Later, however, the U.S. Attorney's office in Alexandria launched its own investigation of Jacobson. As Jacobson's lawyers point out, there is nothing illegal about a doctor inseminating his patients. They claim he was motivated by nothing more than a selfless desire to help his patients. In fact some of those former patients are furious at the government for dredging up an issue that they think should be left alone. "More than anything we wanted anonymity, that the donor would not become known," testified "Frances Red," a former patient whose husband was sterile and who later discovered that her son had been conceived with Jacobson's sperm. "I have not been damaged by Dr. Jacobson. It was the government that broke that pledge of anonymity to me and my family.
Carole Franda, 51, another former patient of Jacobson's, has a 13-year-old son, Philip, as the result of insemination at the doctor's clinic. Because of Jacobson's trial and notoriety, she says, "There is this shadow and cloud over the paternity of these children. This is tearing families apart. It's hurt the grandparents. Most couples never told their parents about the insemination. You have grandparents who loved and doted on these children. Why burst their bubble?"
By contrast, prosecutors have tried to portray Jacobson as a charlatan, motivated by greed or egomania. They claim he never seriously intended to use outside donors, and they called as witnesses former employees of Jacobson's who testified that they never saw any sperm dropped off by anonymous donors and that they believe he was the only source for the donor inseminations that took place. They described how he would make lengthy visits to the bathroom on afternoons when inseminations were scheduled. Justifying his actions, Jacobson told a reporter for The Washington Post: "I knew my semen was safe because I haven't slept with anyone but my wife in our 30 years of marriage."
But one expert called by the prosecution, Dr. Richard Falk, head of the infertility program at Columbia Hospital for Women in Washington, D.C., ridiculed the notion that Jacobson had done no harm by sowing his seed so energetically. Falk says that at most sperm banks it is standard practice to limit the number of times a donor is used to prevent the possibility of half-siblings unwittingly marrying someday and thus risking retardation and birth defects. To Falk, the suggestion that Jacobson had used his sperm to father so many children in Northern Virginia was shocking. "That's unconscionable in and of itself—to have a bunch of families in one area whereby it's almost sure that there'll be several children in a school who are half-siblings," he testified. "If I was the parent of one of those children, I'd move away." In court, Jacobson called the risk of consanguinity "ludicrous."
Whatever Jacobson's fate, the parents who relied on him must now face the issue of what to tell their children. For Carole Franda, who assumed she was being inseminated with her husband's sperm, the solution is not to have Philip be given a DNA test, which would establish his paternity. And so her son remains just that—her son—a strapping young man who likes hunting, fencing and making Star Trek models. "To tell your child you wanted him to be tested would be horrible," she says. "Your child would know you are questioning his paternity, and the one thing a child trusts is that you are their parent."
LINDA KRAMER in Alexandria
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