Introduction
“Should we publicly fund IVF in Canada?” written by Francesca Scale (2019), explains the reason for investing in in-vitro fertilization (IVF) treatment. The IVF treatment has undergone a series of developments since introducing the first test-tube baby in England in 1978 (Gunby et al., 2010). In the in-vitro fertilization, treatment eggs are extracted from a woman’s ovary and fertilized with sperm in a laboratory. Then, later on, the embryos are implanted in the woman’s uterus for development. The fertilized eggs can also be donated to another couple or utilized for scientific study. Canada’s universal healthcare system is frequently panegyrized globally for outstanding care systems. However, there is no complete coverage for assisted fertility therapies such as in vitro fertilization (IVF). According to (Francesca 2019), in a country where about one in every six Canadian couples has infertility, many couples face a significant financial barrier. As such, the government must fund IVF treatment in order to make it accessible to all humans.
According to (Williamson, & Lawson, 2021), individuals can incur more than $10,000 every cycle on reproductive therapy, depending on their province. Due to the high expense of IVF, many couples or singles in need of assisted reproduction therapy are unable to obtain fertility treatment. However, infertility is becoming more widely acknowledged as a sickness, prompting some governments, such as Canada, to support fertility therapy. Public funding of IVF creates additional concerns about who should receive treatment and how they should obtain it. Regardless, Francesca (2019) observes that public funding of IVF would improve monitoring of the operation and increase access to treatments for underprivileged and marginalized individuals.
This study is essential in highlighting the advantage of expanding access to fertility treatment. According to (Francesca 2019), income inequality is a significant obstacle to IVF therapy. In every society, there is a group of the affluent who can afford fertility treatment and a group of the impoverished who cannot. By supporting IVF, the government contributes to eliminating this inequality in society. Due to the increased likelihood of minority families being low-income, these communities are doubly at risk of infertility. The disadvantaged individuals frequently carry a greater share of the costs of seeking infertility treatment. According to (Chambers, Adamson, & Eijkemans, 2013), this disparity in fertility rates is explained by infertility’s “cumulative impact.” Women from disadvantaged backgrounds are at high risk of infertility due to underlying medical disorders and environmental factors. Without continuous access to high-quality health care, these difficulties may go untreated, eventually resulting in the inability to conceive a baby. Infertility can be caused by a variety of circumstances, including medical, environmental, and genetic factors. Therefore, funding the IVF would help this demographic access treatment for their fertility conditions.
Similarly, Francesca (2019) emphasizes the importance of extending access to IVF to raise the population’s birth rate considerably. Between 2010 and 2015, when Quebec granted government support for IVF, the provincial birth rate jumped dramatically, over one percent (Williamson, & Lawson, 2021). Considering the birth rate is diminishing in the communities, it is essential to invest in treatment programs. In order to sustain its population, the state needs more than 2.2 children born from every couple. According to (Winsor et al. 2020), a decline in births is often associated with economic anxiety, as it results in fewer employees and taxes decades later. The two primary approaches to assist individuals in having the babies they desire are to provide them with time and money. A nation can assist an infertile couple financially by covering the cost of IVF therapy. Expensive therapy explains why some infertile individuals who desire children delay having them: they cannot finance IVF.
Infertility is a condition that results from procreative malfunction. Thus, infertility is an illness, at least for specific age groups. Certain people require reproductive therapies such as IVF to avoid or treat this condition. As a result, these procedures are medically required. In this context, “medical need” refers to what humans require to achieve species-typical normal functioning. Infertility is an illness, and so, to the extent that states are responsible for their citizens’ healthcare, fertility therapy should be paid as one component of such care. Indeed, healthcare is frequently viewed as a necessary service that states should supply. This reason is frequently used by individuals supporting the funding of fertility therapy. Francesca (2019) asserts that fertility treatment satisfies a medical need and should be considered another healthcare component.
A study by McLeod (2017), “The Medical Nonnecessity of In-Vitro Fertilization,” explains the reason why the government should not fund IVF treatment. Although the CHA requires provinces to pay for all medically required health care services, McLeod (2017) argues that IVF should not be government-funded. According to the author, infertility as a disease provides an inadequate rational explanation for financing fertility treatment. Infertility does not qualify as a disease in the relevant sense required to justify funding, and the resulting distribution pattern generated by this justification is undesirable in any case. Thus, it is not fair for a government to subsidize IVF based on medical needs in order to promote the preference many individuals have for biological children. IVF is costly, risky, and stressful. Thus, the government should not see procreation as critical enough to justify funding IVF based on medical needs. This would imply that becoming a parent through reproduction is better than other parenthood methods, such as adoption. The government cannot support such a perspective without breaking its duties to equity and justice and without causing harm to individuals, especially children awaiting adoption (McLeod, 2017).
Many philosophers agree that parenting is critical for many people; yet, the benefits of parenting are not contingent on procreation (Romanski et al., 2020). Adoption, for example, is one way to achieve parenting. Others believe that parenthood, or the ability to become a parent, is not necessary for a happy life and that it would be better for the world and the people who live on it if we procreated less (McLeod, 2017). According to the philosophical literature on parenting, having biological children or having the potential to procreate is a simple desire, not a basic necessity or an objective goal. As such, the government is not obligated to finance people’s attempts to reproduce through IVF using this definition of procreation.
Compared to other modern treatment models for fertility, the worth of procreation is unclear. While few individuals would argue that being able to breathe comfortably is important, many would doubt the worth of procreation. For other people, the capacity to reproduce is a barrier to living a fulfilling life, which means a life without children. On the other hand, many others find infertility to be a severe hindrance to happiness (McLeod, 2017). In the midst, some individuals find infertility frustrating but not sad. It’s easy to think that infertility affects everyone in the same manner as the second category above: as a severe impediment to happiness. However, most of the research cited for funding IVF focuses on persons seeking or who have sought treatment for infertility (Chambers, Adamson, & Eijkemans, 2013). It is biased to use the information from infertility people to generalize every individual ( McLeod 2017).
Chambers, Adamson, & Eijkemans (2013) observe that IVF is not publicly supported, partly because, is not regarded as a medical need. In the opinion of McLeod (2017), medically essential reproductive services should only be utilized by persons who have an underlying ailment, not by those who merely have a profound desire to reproduce that they are unable to fulfill on their own and hence require the assistance of others. It appears that sponsoring IVF would appear to endorse uneven access to these services systems, in which only heterosexual couples are eligible for publically financed treatment (Gunby et al., 2010). Second, the reasoning argues that all medically required therapies for sickness are also ethically permissible (McLeod, 2017). However, certain therapies are not medically essential, and some treatments are not medically necessary. Only from a purely financial standpoint are some superior to others. Improved social surroundings for persons with physical impairments, achieved via making these settings more available to them, can serve as a nonmedical approach to medical intervention in treating their medical conditions. Furthermore, depending upon the type of medical treatment, it may be a preferable option to surgery. A nonmedical alternative to fertility therapy is adoption, which can be an equal or better alternative depending on the nature of the suggested medical treatment
On the other hand, Francesca (2019) contends that the CHA requires governments to fund only “medically essential” treatments and services. However, the phrase is undefined under the Act. Provinces are given great discretion in determining the services they must provide. While other governments reimburse for therapies like surgery to address infertility’s underlying reasons, only Ontario considers IVF medically essential (Gunby et al., 2010). There are various repercussions of not publically supporting IVF. To begin, governments have unintentionally turned IVF into a private commodity rather than a medical service by not insuring it. The CHA advised against privatizing IVF procedures in its 1993 report. Notwithstanding the ministry’s caution, finance continues to determine individuals who are eligible for reproductive therapy. Access is restricted to wealthier, primarily white couples, excluding underprivileged minorities unable to finance the private clinic’s fees.
With the exception of Quebec, there is very no government regulation of IVF centers. The federal Assisted Human Reproduction Act (AHRA) of 2006 did include measures for regulating and monitoring IVF facilities, but the Supreme Court of Canada overturned those provisions in 2010 because they were judged to impinge on provinces’ rights (Williamson, & Lawson, 2021). Because governments might apply constraints, public funding of IVF could provide an additional means of improving the safety and quality of IVF treatments while also potentially lowering healthcare costs in the long run. Countries like Sweden, for instance, discourage more than one birth using IVF treatment since they pose greater health risks and increase the burden on the healthcare system. In the same manner, the Canadian government has the authority to compel single embryo transfers for patients under the age of 18. Ontario’s program, prompted by similar concerns, only allows for single embryo transfers. When individuals are not financially constrained, they are less likely to feel compelled to perform many embryo transfers in the hope of achieving a successful pregnancy.
Francesca (2019) notes that IVF eligibility standards differ per clinic. While recommendations from medical organizations such as the Canadian Fertility exist, clinics may impose their own age and weight restrictions (Romanski et al., 2020). In Ontario, for example, some clinics evaluate eligibility based on body mass index, while others have no cut-offs at all (Williamson, & Lawson, 2021). Public financing would contribute to developing more consistent, uniform, and transparent standards among clinics operating within the same jurisdiction. Lastly, while (McLeod 2017) claims that individuals cannot access IVF based on their sexual orientation or marital status, hurdles persist for poor or marginalized populations. For instance, IVF facilities frequently exclude LGBTQ individuals from their services and information materials. By extending public coverage to IVF, the government can guarantee that clinics do not perpetuate health disparities based on race, ethnic origin, gender identity, or sexual orientation.
Conclusion
By making IVF therapy available to low-income people and couples, public funding can help level the playing field in terms of childbirth. Additionally, it can provide increased supervision and protection of patients and more standardized qualifying rules. Nonetheless, public coverage of IVF would not close all of the shortcomings in existing assisted human reproduction policies. For instance, IVF financing cannot address problems about elective fertility treatment, the legality of frozen eggs, donor compensation for egg or sperm, or parenting agreements. To close this divide, both levels of government must step up their efforts and unite to create a regulatory framework for enhanced human reproduction.
Having one’s offspring is best characterized as one of several projects that can contribute to a useful or meaningful existence, such as jobs, personal relationships, or religious activities. As with citizens’ notions of the good, there are many ideas regarding what constitutes a good life. Thus, although having fulfilling work may be important to one person, raising a family or traveling to new places may be important to another. At the same time, trips to the gym and lunches with friends may be important to another. Additionally, not all meaningful or successful lives need raising children, much less having children of one’s own in the way that reproductive therapy enables. To refute this is to deny that persons who choose to remain childless or adopt rather than undergo reproductive therapy may have fulfilling lives. Reproductive therapy is one of several goods that nations may supply to enable individuals to pursue a variety of worthwhile life goals or have access to activities that help their lives run smoothly or appear important.
Reference
Chambers, G. M., Adamson, G. D., & Eijkemans, M. J. (2013). Acceptable cost for the patient and society. Fertility and sterility, 100(2), 319-327.
Francesca Scala (2019). Should we publicly fund IVF in Canada?April 30, 2019https://policyoptions.irpp.org/magazines/april-2019/publicly-fund-ivf-canada/
Gunby, J., Bissonnette, F., Librach, C., Cowan, L., & of the Canadian, I. D. G. (2010). Assisted reproductive technologies (ART) in Canada: 2006 results from the Canadian ART Register. Fertility and sterility, 93(7), 2189-2201.
McLeod, C. (2017). The medical nonnecessity of in vitro fertilization. IJFAB: International Journal of Feminist Approaches to Bioethics, 10(1), 78-102.
Romanski, P. A., Bortoletto, P., Rosenwaks, Z., & Schattman, G. L. (2020). Delay in IVF treatment up to 180 days does not affect pregnancy outcomes in women with diminished ovarian reserve. Human reproduction, 35(7), 1630-1636.
Williamson, L. E., & Lawson, K. L. (2021). Canadian Support for IVF Access and Use. Journal of Obstetrics and Gynaecology Canada, 43(2), 175-181.
Winsor, S. P., Ala-Leppilampi, K., Spitzer, K., Edney, D. R., Petropanagos, A., Cadesky, K. I., … & Laskin, C. (2020). The Affordability and Accessibility of Ontario’s Publicly Funded IVF Program: A Survey of Patients. Journal of Obstetrics and Gynaecology Canada, 42(5), 568-575.
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