Sunday, May 10, 2009

Apologies, I am currently away in beautiful Ilmenau

Folks, I am currently at a conference in picturesque Ilmenau. I'll be back with more frequent entries from May 19 or thereabouts. Apologies for the hiatus.

Meanwhile I reproduce here a piece from the Toronto Star that covers some of my views on IVF and such matters. Following the article is a link to a site where IVF proponents vent their anger and arguments against my views.

The right to bear children


There are two things in Ashley Bulley-Arbos's house she always wanted, but feared she would never see.

"We had them set up at five months," says Bulley-Arbos, now seven months pregnant with twins thanks to in-vitro fertilization. "It was pretty exciting."

Married to her high school sweetheart, Bulley-Arbos never had any doubt she wanted children. Not many, but she knew she would never feel complete if she didn't have kids with the man she loves, Adrian Arbos.

More than that, she says, it's her right to be a mother – and she wasn't going to let a little thing like infertility get in her way.

"It's not a want, it's a need for me," she says. "If I hadn't ever got pregnant, I could never be happy."

The 25-year-old is now an active member of Conceivable Dreams, a support group for couples needing medical help to get pregnant.

Tomorrow, Mother's Day, the group will lead a march at 10 a.m. from City Hall to Queen's Park with 200 women pushing empty strollers to demand that the province fund in-vitro fertilization. Quebec recently announced that it would soon begin funding up to three IVF cycles per couple.

Bulley-Arbos's friends and neighbours rallied to help her and Arbos raise two-thirds of the $15,000 cost for IVF. She will speak at the rally – dubbed the Pram Push – to tell her story of relying on bake sales, community barbecues and a Bands for Babies charity concert to raise the money.

"It took us a while to get over that we were going to charity," she says.

No one, Bulley-Arbos says, should have to rely on handouts to pay for a medical treatment. "It should be anybody's right to have a baby. This is a medical procedure," she says.

Not everyone agrees.

"It's a perfectly private matter, it's a private interest," says Udo Schuklenk, a medical ethicist at Queen's University.

Being a parent is not a right, he says.

It's a personal choice that the rest of society should not have to pay for through their taxes, he says.

"People die from preventable illnesses because of the way health care resources are allocated."

Schuklenk understands the instinctual desire to produce offspring, but says that does not make it a human right.

"From there it does not follow that there is a moral claim on others to foot the bill," he says. "It's selfish."

Christine Overall, a feminist ethicist at Queen's, warns that if women had a right to be mothers, men would have a corresponding right to be fathers. At that, she says, would allow men to demand that a woman become pregnant, throwing out decades of progress on contraception and abortion rights.

"If someone has a right to be a parent, that implies an obligation on the part of someone else (to also be a parent)," she says. "You don't have the right to the gamies of another."

She does, however, support full funding for IVF, saying it would be unethical to deny some women access to a medical procedure on the basis of ability to pay.

"It should be provided on an as-needed basis," Overall says, adding the question of whether a woman has a right to be a mother needs to be separated from the right to IVF.

"It's not a matter of a right to be a parent. It's a matter of a right to access to a medical procedure."

Overall also worries that if women had a right to be mothers, the medical system would become obligated to do everything possible to fulfill that right, including endless rounds of IVF.

"It's wrong to say you have a right to be a mother, because you can never guarantee a baby," she says.

Having worked in medical clinics in South Africa for five years, Schuklenk says there are children around the world growing up orphaned or in terrible conditions who would have a better life if people in the western world chose adoption over IVF.

But that's not likely to happen, he says, if IVF is easy to get. Besides, he says, those who object to paying for IVF on their own should realize that it costs about as much to raise a child as it does to buy a house.

"And yet, they are not willing to make that initial investment (of paying for IVF)," he says.

Bulley-Arbos, whose twins are due Canada Day, is a firm believer that IVF should be covered under medicare. With a household income of about $60,000, she says, the day-to-day costs of raising a child are affordable, but not a medical procedure that would eat up a quarter of their income.

A recent study found that it would actually be cheaper for the Ontario Health Insurance Plan to cover IVF than to continue the current user-pay system.

That's because parents going through IVF tend to get more than one embryo implanted to boost the odds of one going to term. But with IVF improving, more embryos are surviving to birth – leading to a jump in multiple births.

And because multiple birth children tend to have more medical problems throughout their lives, they require more from the medical system.

Health economics analyst Lindy Forte found that each multiple birth child costs medicare an extra $598,000 over its lifetime. Because of that, she says, funding single-implantation IVF cycles would save the Ontario health care system up to $130 million a year.

Beverly Hanck of the Infertility Awareness Association of Canada says any funding of IVF would include limits on the number of embryos being implanted.

"The ultimate goal is one healthy baby," she says.

Back in Tilbury, Bulley-Arbos says it's not just prospective parents who suffer in cases of infertility.

When her brother and his wife found out they were having a child – before Bulley-Arbos was pregnant – he was reluctant to share the good news for fear it might hurt his then-struggling sister.

Likewise, she says, her parents were "devastated" by the troubles she was having becoming pregnant.

"It's not just my husband and me," she says.

Bulley-Arbos says she is trying to give "something back" for all the community support she received in her efforts to get pregnant, and has dedicated herself to pushing for full IVF funding in Ontario so that any woman can become a mother.

"My story has a happy ending," she says. "Not everybody gets their happy ending."

A parenting fitness test?

Some people already have the right to be parents – those able to have children without medical help.

Medical ethicist Udo Schuklenk of Queen's University says a couple's right or fitness to be parents tends to only be raised for those such as infertile or gay couples who can't bear children on their own.

No one, he says, tells a couple that is capable of bearing children that they have no right to do so. And yet newspapers regularly carry stories of parents unwilling or unable to properly care for their children, as well as terrible stories of abuse and neglect.

"Would it not make sense to check whether people are actually fit to be a parent?"

Such tests already exist, he says, for couples trying to adopt children, who must submit to criminal and income checks. Medical tests could also be done to ensure disabilities are not passed on, he says.

He admits, however, that there would likely be a strong reaction to such an idea, as it would raise the spectre of eugenics and selective breeding.

"I can see how what I am saying can be misconstrued," he says. "But if we are really concerned about the welfare of children ... it makes sense for the state to look at these sorts of issues."

- Stuart Laidlaw

... and the link to the IVF user site (it seems that that's what it is):


  1. AnonymousMay 11, 2009

    donorship lets down those it is there for, please see >

  2. Yeah, I'm always worried about the idea that people have a positive right for the state to provide them with whatever resources they need to have children. That's a huge drain on resources that could be used elsewhere. I do support a negative right to use IVF as a private choice, with no irrational bans on it because it's "unnatural", or destroys the discarded embryos, or whatever. But when tax dollars are limited, state subsidy of IVF is not necessarily the best way to spend them. Public funding of health care is important (I'm not a loony libertarian), but the available funds are not a bottomless pit.

    I'm usually reticent about expressing this in the pro-natalist society that I live in, so I'm glad to see someone else doing so.

  3. pebird@pacbell.netMay 29, 2009

    Good lord, how does a "feminist ethicist" reconcile "warns that if women had a right to be mothers ..." with "reproductive rights"? There doesn't seem much left to have a right to when the "reproduction" is removed.

    I guess a male-dominate ethicist would support his "attempt to exercise reproductive rights". What idiocy.

    The right to be left alone by the government is not equivalent with the government requiring that right be exercised. Having a child is a personal decision - the state has decided that providing care to children whose parents cannot afford it is a greater good than the moral hazard of some over-productive poor parents gaming the system. Punish the gaming, if it can be proven, not the children of poor parents (in more than the monetary sense).

    Lets focus this kind of outrage on the financial system, and left fecund poor people out of it.


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