contribution by NorthBriton45
On Monday night my wife returned from a pleasant evening out with her parents only to be ‘stabbed’ in the thigh by me. It was a normal evening. There was nothing personal about it, indeed, she asked me to do it. I’ve done it all week with a needle kept in the fridge. It’s a vital part of IVF treatment which we’re currently undergoing fortunately with the NHS.
But this week Cristina Odone was exercised at reports that a single woman might have had the cheek to access IVF treatment on the NHS despite living on benefits.
She wrote the following about healthcare funds and the fears of a crisis over our aging population.
To avoid this, the very least the Government (and the next one, and the one after that) has to do is redirect some funding from NHS “lifestyle” operations to elderly care.
Lifestyle operations include pinning back ears, nose jobs, breast reduction and yes, IVF. In a perfect world, with overflowing coffers, perhaps the NHS could once again offer IVF.
I know little of nose jobs or pinning back ears, though a bullied teenager might take issue with Odone’s flippant dismissal of such a procedure. And a woman who seeks a breast reduction in an effort to relieve severe back pain is surely not doing so for ‘lifestyle’ reasons.
But I do know about IVF and it’s not a lifestyle choice.
For three months we have both given up tea, coffee and alcohol but for the odd glass of wine. And while we both take tablets to boost our chances of success and there are frequent trips to the hospital. But the real onus is on my wife.
Twice a day she has to reach for a nasal spray and, as we enter the crunch phase, each evening before we go to bed I’m obliged to ‘stab’ (her word) her with a needle. More is to come with further time in hospital followed by the delightful prospect of pessaries. And even after all that it might not be successful. The idea that any of this is a lifestyle choice is frankly risible.
IVF is a vital medical process, dealing with genuine physical and mental health issues and gives hope to thousands every year.
No one is owed a child by the government or automatically has the right to a family. But the desire to procreate is not a choice either; it is something ingrained into every child. Asking a woman, or indeed a couple, who are struggling to have children to simply shrug their shoulders and say ‘c’est la vie’ is simply not an option.
It’s not possible to breezily dismiss years of failure with such glib abandon whatever the precious Odone might think. It has massive implications and can easily lead to a whole host of other problems such as depression or separation, which are hardly cost free alternatives.
Thankfully, I’m happy to say such prospects will not meet us whatever happens.
I take it adoption and/or fostering are off the table then?
So IVF is a lifestyle choice that entails some discomfort. It’s still a lifestyle choice.
“Asking a woman, or indeed a couple, who are struggling to have children to simply shrug their shoulders and say ‘c’est la vie’ is simply not an option.”
Why not?
@2 XXX
IVF is indeed a lifestyle choice. But it’s a lifestyle choice that is readily available to the majority of couples. It’s the unlucky (or gay) few who have to use an expensive medical procedure if they want to have a baby. It doesn’t seem much of a sacrifice, on the part of the many, to help out those few.
Who cares what Cristina Odone thinks? She is a woman hating Catholic who wants to keep woman locked in a cage.
As usual the Catholic church wants to decide what people should and should not be allowed. There was a time in this country when we did not have to listen to the propaganda of Rome.
“But I do know about IVF and it’s not a lifestyle choice”
Perhaps not, but it’s definitely a luxury.
“Asking a woman, or indeed a couple, who are struggling to have children to simply shrug their shoulders and say ‘c’est la vie’ is simply not an option. ”
That is what the entire race has done for millennia.
“IVF is a vital medical process, dealing with genuine physical and mental health issues and gives hope to thousands every year.”
Agreed. Isn’t it fabulous that we’re a rich enough country, that technology has advanced, to the point that what was previously a “shut up and bear it” thing is now a “Twice a day she has to reach for a nasal spray and, as we enter the crunch phase, each evening before we go to bed I’m obliged to ‘stab’ (her word) her with a needle. More is to come with further time in hospital followed by the delightful prospect of pessaries. ”
Choices, they’re on offer: bear it, bear this other.
Yes, its “a lifestyle choice.” For you get to choose which of these two you would prefer. The stab or the childlessness, something that previous generations did not.
And a luxury. A luxury I’m entirely happy to chip in for, but it is still a luxury.
As previous generations in your situation would have told you. Try chatting to some 60, 70 year old couples you know, childless ones, see what they say, eh?
I find it very very hard to muster sympathy for the OP (and others in similar situations) when there are thousands of children already in existence needing loving families to be adopted into.
If the OP would like to elaborate I am willing to be educated.
Chaise
> It doesn’t seem much of a sacrifice, on the part of the many, to help out those few.
Even the few who look unlikely to be able to bring up the child without more state support – like the single woman?
NorthBriton45′s story is about a married couple – where there is good chance that they’ll be able to bring up the child.
But anyway – Taking NorthBriton’s point further – he thinks infertility is a big issue because: “It has massive implications and can easily lead to a whole host of other problems such as depression or separation, which are hardly cost free alternatives.”
So should the state pay for sex, for those who think they are not getting enough?
Just for those who are depressed as a result of lack of sex – who are the parallels of those depressed through infertility?
That’s a rhetoric question of course.
The point is, the state can’t take away all pain for everyone.
Just a few words to clarify.
There is no question that living in a wealthy country we as a couple are very fortunate to benefit from this treatment. And as a wealthy country it could be described as a ‘luxury’ procedure. The headline was not mine, but I don’t want to quibble too much. I’m interested in the discussion.
The issue is whether it is a ‘lifestyle choice’ as Odone glibly contests. It is not. In no way can it be a ‘lifestyle choice’, like hiring a cleaner, picking a car, wondering whether to eat at a French or Thai restaurant or picking where to holiday. It is a tense, medical procedure which takes years of disappointment before a couple might even become eligible. And it is more likely than not to fail. Adoption certainly hasn’t been ruled out but doing IVF and trying to go through adoption procedures is pretty much impossible to do simultaneously.
As I said above, having a child is not a right, it is a privilege. IVF is a method which can give hope and we are fortunate to be in the programme at an excellent unit. But in no way cannot be described as a ‘lifestyle choice’.
@OP, NorthBriton45: “IVF is a vital medical process, dealing with genuine physical and mental health issues and gives hope to thousands every year.”
This is a tough thread so apologies in advance when I misinterpret or misunderstand. But I acknowledge that my arguments are tough.
IVF is vital for particular individuals; without IVF, “test tube babies” would not have life. IVF does not sustain or extend the lives of those who support children (I’m deliberately jumping the question about people with emotional or psychological problems).
60% or 70% of couples who participate in IVF interventions do not have a child as consequence. For all who participate, there is much invasion. Couples who achieve successful birth following IVF typically have been treated for many years. No wonder that marriages fail under such pressure.
IVF cannot be pushed back into Pandora’s box. However, we can and should not regard IVF (or less invasive treatments) as the only treatment for infertility. The doctor Gods have a poor rate at creating babies. Doctors and care workers should do what they do best: caring about *people*.
But it can help people not to have to go though pain in the first place, I see nothing wrong with helping people say three chances to have their own child.
I see nothing wrong with a single mother, why a single mother has to be on benefits made me smile, just as many married couples have children on benefits.
I have more worry about the elderly being keep in the NHS or actually the NHS being used as a drunk and drug drop in center, when I had my accident the ward I was on had three sections with seventeen beds I was the only patient that week who had an accident or had a serious reason to be in that ward, I was on traction, sixteen other people were in that ward due to bed blocking with a number of elderly waiting for nursing homes, the rest had drink problems and drugs.
Thats where the waste is
@ 8:
“The issue is whether it is a ‘lifestyle choice’ as Odone glibly contests. It is not. In no way can it be a ‘lifestyle choice’”
You keep saying that, but I’m hard-pressed to understand why. You point to all the hardship it involves as proof. Alright then, so it involves hardship; what does that prove? Plenty of choices lead to hardship. Why should IVF be any different?
@ 10:
“I see nothing wrong with a single mother, why a single mother has to be on benefits made me smile,”
If you can’t afford children, you shouldn’t have children.
I know there is only a finite amount of money but I’d rather see these funds, and non-essential plastic surgery (yes, ‘essential’ is debatable but you know what I mean) go towards buying cancer drugs such as herceptin.
The late and very great Tony Wilson couldn’t afford the drug to keep himself alive: He said: “I’ve never paid for private healthcare because I’m a socialist. Now I find you can get tummy tucks and cosmetic surgery on the NHS but not the drugs I need to stay alive. It is a scandal.” I fairly broadly agree.
@13. Wibble Wibble: “The late and very great Tony Wilson couldn’t afford the drug to keep himself alive…”
As a Fall Head, I will inevitably argue with you about Tony Wilson. He was the culture speaking head on Granada in the 1980s and he helped to create a north-west music culture. Good stuff. Wilson’s bands have gone but The Fall persists.
I agree with the OP.
Infertility is a medical problem like any other.
If you have a problem with your leg, the NHS should help you get it fixed. If you have a problem conceiving…. ditto.
good luck with it…..
I can sympathise with the writer, being childless after two ectopic pregnancies, one of which was nearly fatal.
But I chose not to pursue IVF and my life was much easier and happier afterwards.
What causes the misery is the pressure that couples put themselves under because of the delusion that having a child will make them happier or somehow more fulfilled.
When money is short, IVF costs should be one of the first to be reduced.
Having a baby is not a right.
There are many children who need fostering or adopting.
Ah the poor old rich getting annoyed because the poorest want children.
So sad.
Cost of IVF, £4000 – £8000 per cycle. Not much, relatively speaking, but if we are making choices about health spending I would suggest it is one of the easiest options to cut.
What would that money pay for if it wasn’t spent on IVF? One to two people for a week in a care home? A simple operation? Years ago I had to pay £400 for an MRI scan, so 10-20 MRIs? These are tough choices that the NHS has to make, and everyone sees themselves as a special case.
I am very happy to have one child that I can afford to bring up. We lost four. You learn to live with these things.
XXX @ 10
If you can’t afford children, you shouldn’t have children.
Thus spake the ‘pro lifer’.
If you cannot afford a child, is abortion now an option?
Funny how last week you were crying at the thought that innocent babies were dying at the hands of the callous State going around willfully murdering the unborn. Suddenly when people actually WANT to bring new life into the World, the other side of the record plays and it all about money.
Why I am I not suprised that the ‘anti abortionist’ isn’t so ‘pro life’ as he tried to make out?
Surely the ‘Pro life’ brigade should be demanding that these people should be given every chance to bring new life into the World? What could be more natural than peeople who actually WANT kids be given that chance?
Nope, thought not.
Sandy @ 16
But I chose not to pursue IVF and my life was much easier and happier afterwards.
No one is suggesting that IVF be made compulsory, you know. No one has suggested that anyone who can live without children should feel guilty or anything like that.
You are childless and have come to terms with the fact. I have no idea how easy or difficult that was for you, but I cannot think of why we would expect other infertile couple to feel the same way as you do.
Where does describing having babies as a ‘lifestyle choice’ come from? Surely passing our genes into the next generation is the sole reason for our existence? If there is a single aspect of life that is not a ‘lifestyle choice’ then surely it is the urge to reproduce? Eating and drinking aside, is there anything more fundamental than reproduction?
” Asking a woman, or indeed a couple… to simply shrug their shoulders and say ‘c’est la vie’ is simply not an option. ”
Why not , that’s what nature does. Yes we all feel the reproductive urge, but we can’t all reproduce that’s how evolution works.
Hengist @ 22
Why not , that’s what nature does.
And nature would leave a man with a fractured leg a cripple. The point of medicine is to improve on what nature does.
Jim,
Where does describing having babies as a ‘lifestyle choice’ come from? Surely passing our genes into the next generation is the sole reason for our existence? If there is a single aspect of life that is not a ‘lifestyle choice’ then surely it is the urge to reproduce? Eating and drinking aside, is there anything more fundamental than reproduction?
Whilst I agree that there is a genetic imperative, it is probably worth remembering that there is a genetic imperative for both men and women to cheat, for men at least (quite possibly women) to be violent, and a clear genetic imperative for men to sleep with underage women (not children…).
If you want to argue we have to obey our genes, just remember how savage they really are. Me, I prefer the more recent genetic imperatives that make us think and reason. Figuratively, the head and the heart developed later than the groin and the stomach, but that should not let us discount them (none of which really takes the overall debate forward, but hopefully we can see the folly of appealing to genetic imperatives to breed when genetic imperatives to think and rationalise are equally valid).
Flowerpower,
And nature would leave a man with a fractured leg a cripple. The point of medicine is to improve on what nature does.
Yes (to a point – a fracture can set on its own) – and IVF does that. But the point of the NHS is not to offer all medicine to whoever wants it – it is to provide healthcare free at the point of need. Clearly, a fractured leg is a clear and pressing need. Less clear and pressing is infertility, since the need is not clear.
So this is not about medicine, but about whether particular medicine is correct for the NHS. I’d say no, but that is because I believe there is no right to children (indeed, I believe law as constituted gives parents far too much power); children are a responsibility you agree to take on, and if you are prepared to do that, you should be able to adopt. If you believe everyone has the right to have children of their own (in my view a peculiarly conservative and religous – or purely Dawkins-lite – argument) then you will disagree with me.
Incidentally, I have an impression (and a friend going through the adoption process has done nothing to break this) that it is easier to get IVF (not necessarilly to undergo – both processes seem painful in their own way) than to adopt, despite the fact both lead to the same result – a child. Anyone know if this is this the case?
Watchman @ 25
Less clear and pressing is infertility, since the need is not clear.
I think that if you take into account all the physical, psychological and social factors concerning infertility, then there is a much stronger case to be made for providing treatment than there is for many other areas of health expenditure.
Vast amounts of GP time is spent treating trivial complaints that patients could easily sort themselves at the pharmacist. The NHS drugs bill is hugely inflated by the need to prescribe cough and cold remedies, painkillers, sleeping pills and mild anxiolytics that in other european countries are dealt with…. for cash….at the pharmacy. Last time I went to the doc, the women in front was taking her teenage son in because he had (mild and perfectly normal) acne. A topical preparation from Boots would have done the trick.
We could more easily afford IVF if most people took a bit more personal responsibility.
Throwing IVF in with the same crowd as nose-jobs is wrong (clearly there is a distinction between the two), but it’s not a fundamental right. At a push you can call it a lifestyle choice, I guess – but if there is a genuine need for that money elsewhere (i.e. protecting life rather than creating it when there isn’t a need for it economically), then I’m alright with them doing this. That doesn’t mean it’s feel-good policy, though.
@ 7 Just Visiting
“Even the few who look unlikely to be able to bring up the child without more state support – like the single woman?”
I’d be less inclined to support this. In a way, it’s unfortunate that people can have children when they’re not able to look after them – if we had a built-in instinct that made us avoid having kids till we could take care of them properly, life would be better all round.
With state-sponsered IVF, I can definitely see why you wouldn’t provide the treatment to someone whose circumstances weren’t appropriate to child-raising.
“So should the state pay for sex, for those who think they are not getting enough?
Just for those who are depressed as a result of lack of sex – who are the parallels of those depressed through infertility?
That’s a rhetoric question of course.
The point is, the state can’t take away all pain for everyone.”
Of course it can’t, and I think you need to use a subject-by-subject rationale here. Apart from anything else, if the state paid for people to get laid, the service would be horribly oversubscribed, as anyone could claim they weren’t getting enough. Whereas IVF is only for a few people, and those few are hardly likely to want to use it over and over again.
Watchman @ 24
You could argue all of the things till the cows come home and you could even be right with regard to the genetic drive for all of those things. We have designed our society around a broad moral code to prevent or curb many of these things, but it is difficult to see how that applies to the desire to procreate though. I could imagine a scenario where we could apply eugenics to breed out genetic predisposition to violence, for example, over a course of a couple of hundred years, say. Surely we would never do the same with our need to pass our genes through the generations? Would that not be mass suicide?
Chaise @ 28
if we had a built-in instinct that made us avoid having kids till we could take care of them properly, life would be better all round.
That is nonsense. How would we survive things like famine, plague, ice ages etc if the desire was there to only reproduce hen the conditions were right? We would have died out as a species under such conditions.
With state-sponsered IVF, I can definitely see why you wouldn’t provide the treatment to someone whose circumstances weren’t appropriate to child-raising.
Now you are on seriously dodgy ground with that one. It is not within the remit of the NHS to decide whether or not a person is an ‘appropriate’ parent. The job of the doctor is not to look at the house of a paitent and think ‘nah, too chavy for my tastes’ it is the job of the doctor to look at apaitent and decide if he could help that person, not pass judgement on whether it is right to help that person.
@ 30 Jim
“That is nonsense. How would we survive things like famine, plague, ice ages etc if the desire was there to only reproduce hen the conditions were right? We would have died out as a species under such conditions.”
Um, note the use of the present tense in what you’re supposed to be responding to. Of course there are good evolutionary reasons for our reproductive system. But now, in the 21st century, I really don’t think the human race is likely to die out due to a reduced birth rate.
Can we stop dicussing the hypothetical analogy now?
“Now you are on seriously dodgy ground with that one.” ”
Pff.
“It is not within the remit of the NHS to decide whether or not a person is an ‘appropriate’ parent.”
Oh yes it is. Triage, for a start. If a 50-year-old smoker and a 10-year-old non-smoker both need new lungs, and there’s only one set of lungs going, guess who gets it?
“The job of the doctor is not to look at the house of a paitent and think ‘nah, too chavy for my tastes’”
Go tell that to someone who thinks it is. I really hope you’re not going to throw a load of straw men at me again.
“it is the job of the doctor to look at apaitent and decide if he could help that person, not pass judgement on whether it is right to help that person.”
Seriously, dude, do some background research on the NHS. Doctors do NOT automatically provide help when available, treatments have to be cleared via cost/benefit analysis. This is for the simple reason that it’s stupid to spend £50,000 on prolonging one person’s life for a year when that same £50,000 could save ten people’s lives for twenty years.
The closest equivalent to IVF I can think of is adoption, and you have to jump through a lot of hoops before an adoption agency will declare you “suitable”. As unfair as this is, it’s entirely possible for an adoption provider to refuse you because they think you’re too chavvy – although that won’t be the reason they write on the form. I’d be very surpised indeed if the prospective patient’s circumstances weren’t taken into account when doctors decide whether to prescribe IVF.
Jim,
Generally in agreement with you @29 to be honest, although I would suggest substituting moral codes for moral code. However…
Surely we would never do the same with our need to pass our genes through the generations? Would that not be mass suicide?
I have yet to see conclusive evidence that humanity is not capable of just that. More likely though, the need to reproduce to maintain our genes will be replaced by technological solutions over the next century or so. The better technology gets (providing food, averting disaster, providing medical cover) the lower the birthrate gets anyway.
Chaise @ 31
I really don’t think the human race is likely to die out due to a reduced birth rate.
That depends on how long and by how far the birth rate drops.
Triage, for a start. If a 50-year-old smoker and a 10-year-old non-smoker both need new lungs, and there’s only one set of lungs going, guess who gets it?
Triage is a medical term and addresses medical needs, not social outcomes. Your 50-year-old Vs 10 year old will have their respective cases looked at on a whole list of medical issues, like prognosis, (assuming all things like compatibility of the organs, siz etc have been eliminated), life expectancy will have been taken into account. No-one will just be given lungs merely for having lived a more vitreous life.
This is for the simple reason that it’s stupid to spend £50,000 on prolonging one person’s life for a year when that same £50,000 could save ten people’s lives for twenty years.
Again based on medical outcomes, not moral ones.
The closest equivalent to IVF I can think of is adoption, and you have to jump through a lot of hoops before an adoption agency will declare you “suitable”.
Then you have not came up with a very good example. These two cases are almost exact opposites and are judged on complete different criteria. Infertility is an exclusively medical problem caused medical issues and can be fairly judged by medical standards. Adoption is an entirely different kettle of fish and is judged on social policy of the day.
Watchman @ 32
More likely though, the need to reproduce to maintain our genes will be replaced by technological solutions over the next century or so.
But will that change the desire to reproduce those genes, though.
I must declare an interest here. I am the proud parent of 0 children. Their are no junior Jims cutting around. None of my ex-girl friends have children that match up datewise. I am quite happy about that, to be honest and my current partner has a daughter and three grandchildren who call me ‘grandad James’. Being a grandparent is fine in my book.
Had my current partner wanted more kids then I doubt we would have got past a third date. Had she fallen pregnant, I would have stood by her, of course, and I accept that my views would have changed. However, although I was never Paternalistic I do accept that for some the desire to parent a child is foremost for many men and women.
I could not support a policy that would deny such people the chance to father or mother a child of their own, merely because I do not want the same.
Jim,
The closest equivalent to IVF I can think of is adoption, and you have to jump through a lot of hoops before an adoption agency will declare you “suitable”.
Then you have not came up with a very good example. These two cases are almost exact opposites and are judged on complete different criteria. Infertility is an exclusively medical problem caused medical issues and can be fairly judged by medical standards. Adoption is an entirely different kettle of fish and is judged on social policy of the day.
The division into two different sets of criteria is also purely arbitrary, and actually illogical. Whilst some aspects of infertility are purely medical (i.e. those that can be treated by drugs or operations), it is a bad idea to group things like IVF which do much of the work of the human body with a condition that requires treatment which then allows the human body to work normally. The end effects of treatment are different – one is a cure, the other a child. As such IVF is a process more akini in output to adoption; that it was developed and is practised by doctors should not obscure this fact. Insofar as the state controls either IVF (to quite a limited extent) or adoption (much more) then it should surely have consistent standards of access to both made on the same basis?
I’d actually go as far as to argue that allocating IVF and similiar treatments purely on medical grounds is a mistake, unless we believe that psychatrists could allocate adopted children also (actually, that might be better than the present system, at least by repute…). If the state is going to take control over lives (and from the point of view of the children of adoption or IVF, I believe this is justifiable) then it should surely have a consistent approach.
Incidentally, what I do find disturbing about the focus on the urge to procreate justification for IVF on the state is that it rather by implication suggests adopted children are a second best.
@ 33 Jim
“That depends on how long and by how far the birth rate drops.”
Obviously. Can we get back on-topic?
“Triage is a medical term and addresses medical needs, not social outcomes. Your 50-year-old Vs 10 year old will have their respective cases looked at on a whole list of medical issues, like prognosis, (assuming all things like compatibility of the organs, siz etc have been eliminated), life expectancy will have been taken into account. No-one will just be given lungs merely for having lived a more vitreous life. ”
Your post gave the strong impression that you hadn’t heard of triage (claiming that a doctor’s job is to help people regardless of circumstances etc.), so I was attempting to synopsise for you. Obviously age and personal habits will not be the only metrics – if the child is expected to die within months regardless of whether they get the transplant, they probably won’t get it.
What on earth has virtue got to do with it?
“Again based on medical outcomes, not moral ones.”
Who said anything about triage involving moral judgments (beyond the utilitarian morality of trying to help as many people as well as possible)?
“Then you have not came up with a very good example. These two cases are almost exact opposites and are judged on complete different criteria.”
Exact opposites. Yeah, it’s not like they both help childless people to have children or anything.
“Infertility is an exclusively medical problem caused medical issues and can be fairly judged by medical standards. Adoption is an entirely different kettle of fish and is judged on social policy of the day.”
If (and I’m not taking your word for this) no account of circumstance is taken into account when someone requests IVF, then as far as I’m concerned there’s something wrong with the system. What if the person who wants IVF is living on the street?
Again, please explain where you’re getting your ideas about doctors making judgments of an applicant’s virtuousness before giving them IVF. I don’t confuse virtue with affluence, and I hope you don’t either.
I disagree completely – it’s purely a lifestyle choice to choose to undergo IVF. Not everyone wants to have a child and it’s certainly not ingrained into every woman to reproduce.
Our world is overpopulated as it is and there are thousands of babies and children who need to be adopted and fostered.
IVF should certainly not be made available on the NHS, it IS a luxury that it is available and probably something to do with Christian right-wing idiots in power who are terrified that the white race is going to run out.
@ 37
“it IS a luxury that it is available and probably something to do with Christian right-wing idiots in power who are terrified that the white race is going to run out.”
Are you sure it isn’t the saucermen, working with the Rand Corporation, under the supervision of the reverse vampires?
Well, interestingly, UK population growth is declining as are those in many Western countries.
IVF or immigration, then?
@ 39 Why not both?
@ 38
Of course, I’d forgotten all about them! They’ll be working in conjunction no doubt.
@ 39:
“Well, interestingly, UK population growth is declining as are those in many Western countries.”
If we’re already overpopulated, declining population growth would still make the situation worse; it would just get worse slightly less quickly.
@ 38:
“Are you sure it isn’t the saucermen, working with the Rand Corporation, under the supervision of the reverse vampires?”
Nah, my money’s on the International Jewish Conspiracy, helped by the Illuminati, CIA and Knights Templar.
Watchman @ 35
As such IVF is a process more akin in output to adoption;
I would dispute that, to be honest. The first produces a child for the parent(s) that they would preferred to have naturally and will always be their biological child, the latter is a ward of the State and requires adoption in order give that child a better life.
I’d actually go as far as to argue that allocating IVF and similiar treatments purely on medical grounds is a mistake, unless we believe that psychatrists could allocate adopted children also (actually, that might be better than the present system, at least by repute…). If the state is going to take control over lives (and from the point of view of the children of adoption or IVF, I believe this is justifiable) then it should surely have a consistent approach.
I cannot see what the alternative is, to be honest. An infertile person has specific condition(s) that prevent them to have children naturally. In that respect at least, that comes under ‘medical’.
Now, if we think that we should use a persons infertility as an opportunity and intervene in that person’s life to the extent that the State wants to make a de facto decision on whether or not that person should be allowed to reproduce, we are cross a fairly distinct line. We put remarkably small barriers in front of people who want to have children. How could it be any different? We do not give ‘free’ sterilisation to people who fail IQ test or who do not have nice gardens or whatever other criteria we would use, so why use a medical condition against these people in similar circumstance? Doesn’t that count as State interference at the most fundamental level*?
However, adoption is entirely a different matter. Adoption is part of ‘social policy’ and quite separate from a natural birth. We are now asking the State to entrust that child to people with (in most cases) no blood ties to the child. We are not asking if these people would make ‘good parents’ we are asking if they would be good ‘adoptive parents’, which is a different question entirely. Here, we DO put barriers in front of people who adopt. We put pretty strict barriers on people who want to adopt and everyone who wants to adopt is forced to jump those barriers with ease. All adoptive parents are expected to meet a criteria. We wouldn’t take away existing children from a couple because they ‘failed’ an adoption interview, would we?
*Obviously, it goes without saying that if someone with a mental age of nine turns up looking for IVF the medical profession would be able to take the patients likely medical outcome into account.
@ 44:
“We put remarkably small barriers in front of people who want to have children.”
There’s a difference between the State not stopping people from doing something (e.g., having a child when you can’t really look after it), and the State actively helping people to do something. I think most people here would oppose attempts to censor extreme opinions, but that doesn’t mean that the government should actively help every white supremacist and Neo-Nazi to spread their opinions.
katie,
IVF should certainly not be made available on the NHS, it IS a luxury that it is available and probably something to do with Christian right-wing idiots in power who are terrified that the white race is going to run out.
Funny – as a right-winger (albeit non-Christian) I always thought it was something to do with the left-wing social do-gooders in power (not sure if the current lot are or not – give me a couple more years to decide) who seem to be terrified they may be upsetting somebody.
Maybe this is one of those beyond politics things – it’s actually engendered a rational debate between me and Jim, which is unusual enough.
Jim @44,
As such IVF is a process more akin in output to adoption;
I would dispute that, to be honest. The first produces a child for the parent(s) that they would preferred to have naturally and will always be their biological child, the latter is a ward of the State and requires adoption in order give that child a better life.
I did say output – you are correct the input (egg + sperm versus preexisting child) differs, as clearly does the process. My concern is that surely the output is the logical place to examine what measures of control are needed. This is not fixing a broken leg or a blocked tube; it is helping someone become a parent, and whilst the threshold for that is normally low, the threshold for the state doing that need not be equally low (note that I do not oppose the existence of IVF – however cheap it may become – I am concerned only with the existence of state-funded IVF).
As such, I don’t see the difference between adoption and IVF being so very great; if a child is yours, it is yours to love and nurture regardless of genes – the same capacity to provide good and loving care is required in both cases, and the same risk of a parent being incapable exists also (note most of the horror stories the tabloids thrive on about small children abused have at least one natural parent involved). The state believes people can act as parents to step-children quite happily after divorce for example (as marriage and divorce are licensed by the state, they could be a point of intervention), so it is not consistently focussed on a higher level of proof for non-genetic children. It is simply that no consistent measures have been applied, because marriage law (and wardship/guardianship), laws on adoption and the use of IVF and the NHS all have very different histories and rationales, and it is these which govern how the measures governing them develop. It is possible to end up as a parent in a number of ways, and since no-one has set out to regulate this specifically, the depth of hurdle to be cleared varies for no logical reason.
In effect, I suppose I see IVF as something that should not be on the NHS anyway, but if it must be (because I am not always right according to the voting population) then surely the key test (other than will it work anyway, which is the medical issue that doctors can make a decision on) is whether there is a social benefit in these potential parents having a child of their own. The same question as underlies adoption. Unless the state exists to cater to our whims, it surely should only undertake actions that contribute to the general good of society (note that I actually tend to believe that is making individuals happy, but not necessarily specific individuals).
You do realise this whole debate is making me argue for an agressively interventionist state? Out of my normal character I’m afraid…
Watchman @ 47
Time for another bite at the cherry, I am afraid. Here goes.
A baby born via natural or IVF are indistinguishable because the parents both have contributed to the genetic make up of the child. Although the conception is contrived the actual process from the zygote becoming implanted in the womb to birth is identical. Once established, the actual rigmarole is pretty much the same for each birth shapes up the same. The actual medical procedure is only a small part of it, a pretty false separation in my view.
I cannot see what business it is of the State (other than at the point of providing healthcare) why that child is being born. If two people go into a G.P. surgery with a medical problem, the doctor diagnoses the problem and issues a course of action, I cannot possibly understand why any other (non medical) organ of the State need be asked for comments or expected to put their views in. Patient confidentiality is not just a nice idea; it is something that I, as a (small ‘l’) libertarian think is sacrosanct. We have a Mr and Mrs Smith in our office and we are just phoning up to see what you think what kind of parents you think they would make?
I am concerned only with the existence of state-funded IVF
So, you are not really bothered if people are going to be bad parents or not,you can be a child molester as long as you can afford the IVF out of your own pocket? Tsk.
Okay, let us take it to the next level. Let us suppose that a natural conception suddenly takes a turn for the worse. The medical tem then look at the medical issues/solutions. There is simply no way that we would expect social services, the dole, local housing authority et al would be asked to comment. No one at the LEA is going to say, ‘brain damage? Why, our special needs school is full to the rafters as it is’, or the LHA is going to say ‘Paralysis? Sorry, no ground floor flats left’. That is left to the doctor and the patient (or the patients parents) to explore the options.
It is not the NHS’ job to decide social policy, nor it is it their job to devise subjective criteria to judge patients, either. It is their sole job to provide the best treatment, to the best of their ability.
is whether there is a social benefit in these potential parents having a child of their own.
When was it decided that the NHS get to decide what is and what is not a social benefit? The NHS are just providers of medical services and not the owners of the Country’s morals. Who voted for that? What about the local council? Are they too be given the moral compass on what constitute ‘social benefit’? We could have ‘social benefit committees’ on every street? Come on now Watchman, that is a feeble attempt and you know it. Did you type that with a straight face?
Adoption is a completely different, er, concept. A child is taken into care by the State and the State has a duty of care towards that child. The State has an interest in making sure that child is given over to people who it thinks will be the best adoptive parents and can set the selection criteria as narrow or broadly as it likes.
‘But the desire to procreate is not a choice either; it is something ingrained into every child.’
Total nonsense — I have never desired the slightest to be a father, and my sister has never wanted to be a mother, despite our having parents who would have liked to have had grandchildren. I know many people who have the same feelings about this.
Having children is a lifestyle choice; it is no different to wishing to do all manner of other things. There are many things that I would have liked to do, but for various reasons have remained beyond my grasp. I find it much more rewarding to engage in things that I can do than live in the shadow of regret about those things I couldn’t do.
Dark times are these when I agree with Tim Worstall @5
Jim,
I think we are seeing this from different ends – you the process and me the outcomes (for clarification, the outcome is of the state spending, not the parental activities), so the debate is going nowhere fast.
My point is simply that by allowing doctors to perscribe IVF (not actually an efficient medical process) we are judging them fit to allocate a child to people, according to essentially the same logic as adoption agencies use (albeit with less chance of success). I do not expect doctors to assess patient suitability, but I can see a prefectly good argument for requiring non-medical assent in this case.
And of course I have no problem with private medical IVF, because I have no problem with private medicine. If someone is a child abuser, they can still have children normally anyway mostly – social services will probably take them away, but they would for an IVF conception also. Lets be clear – doctors can determine whether a patient might benefit from IVF, but I do not think doctors should be able to determine whether an expensive, fallible and ultimately life-creating treatment should be used.
I’m also generally a small l libertarian, but I do strongly argue one role of the state is the protection of children (there seems to be a strand of pseudo-Libertarian thinking that children ‘belong’ to their parent, which seems oddly un-libertarian to me) – hence my normal advocacy of unlimited abortion, contraception, sex education etc which would reduce the state’s power without removing the responsibility. This clearly applies where the state can involve itself to conception of children, and I would define ‘where the state can involve itself’ as where there is either a) a pressing need to protect a child (I actually think the state fails on this one nowadays – too often neglected children in some areas are sent back to their parents or never even addressed at all) or b) where the state is providing a financial interest (i.e. where the state has used taxpayers’ money to some end).
Obviously this means that privately-provided IVF is outside of immediate state supervision – the state can only intervene if there is a successful conception and birth and they can judge the child to be in need of protection. But as this thread is about the NHS, my view is clearly that the state has a right and a duty to make decisions here. But, to make this clear, this is not to fall to the doctors who should not (again in my view) actually be agents of the state anyway – that would give them a social role I think we both agree would be wrong. It is this decision about the allocation of state resources to possibly create a child that is akin to the decision on adoption – that state has a child in need of parenting (or the possibility of a child) and has to decide whether the possible parents are good enough. I fail to see how there is a substantive difference in the thresholds required in general (in specific cases for adoption, I can understand particular thresholds, but as a general principle?)
Social benefit was loose choice of words – hopefully I have explained what this was a shorthand for. But it is a bit disingeneous to suggest we would need to set up social benefit committees, when the mechanism already exists for adoption (and for social services), and is ultimately based on law.
Watchman @ 51
In the context of the NHS the only thing that matters is the medical process and its success/failure rate. The ‘outcome’ in terms of government spending is not the remit for the NHS.
I wonder if you are attempting a ‘foot in the door’ argument here? I get the distinct impression that you are allowing the ‘ideological’ ends to justify the pretty insidious (albeit hypothetical) means.
It appears that you are advocating some kind of (and that word again) economic eugenics here. You are suggesting that when I go into the office of my G.P. the doctor then takes a note of my symptoms and then he calls up the ‘Government’ as to whether or not he should treat my symptoms.
I personally, think that is a pretty disgusting turn of events and a considerable line to cross.
Lets not kid ourselves here; we both know what we are driving at here. There is a desire among the Right to prevent ‘economically undesirable’ people from breeding. That is the unvarnished truth, and I am not knocking you for it.
At every other juncture the emphasis is to free the health/education/police etc professions from undue bureaucracy or political interference, yet here we are with someone on the Right demanding that every other arm of the State should get there oar into a question of health/medicine in order that the politically correct answer.
BTW the ‘social benefit committee’ thing was merely a tongue in check nose tweaking exercise. I was intending to rub your bristles up the wrong way by suggesting that everyone’s decisions should be subject social benefit committees.
there are thousands of babies and children who need to be adopted and fostered.
Not true. Virtually no babies are put up for adoption. Most successful UK adoptions are of children 5 years or over. The process is drawn out, extremely complicated, invasive and with a real chance of a poor outcome for both would-be adoptive parents and children. It is a good choice for some people but it is a very serious undertaking, not straightforward logic like it’s often presented (usually by people with no experience of struggling to make a family). Why should infertile couples be expected to be more inclined to adopt than non-infertiles?