- She used donor sperm for all her children, so this isn't a case of the mother taking all the blame and the father getting off free. Like you, those cases infuriate me, but this isn't one of them.
- I mentioned mental illness in the context of Nadya's culpability. If she has a mental illness, which I believe she does, and if that mental illness stripped her of rationality and reasoning, which I'm agnostic about, then she is less culpable IMO.
Nadya's official psychiatric diagnoses, if she has them, are confidential by law. The point is, her request surely raised some red flags. Hence, the doctor should have referred her for a mental health evaluation before the procedure. If he did and the mental health professional said she's okay, then I blame the doctor a lot less.
- Even if Nadya had been psychologically sound, the doctor still violated the guidelines of his medical association, the American Society for Reproductive Medicine, which has revoked his membership. The guidelines exist to protect not just the potential offspring but also the health of the woman. While those guidelines are not law, licensing boards expect physicians to abide by them or at least not deviate to that extent.
- What medical professionals may or may not refuse to do is a huge debate, and laws vary by state. The debate has generally centered around abortion, contraceptives, emergency care, etc. An entirely elective, not time-sensitive procedure like this is not in the gray area of any state.
- As to your question of why her previous children were not taken from her if she were mentally unstable, are you implying that custody be revoked from mentally unstable people? Custody is revoked for abuse or neglect, not just for having a mental illness.