IVF and the Lottery of Life

by Dr. Nileema Conlon Vaswani in


Could your chances of IVF treatment be affected by how old you are, how young you are, whether or not you smoke, if either partner is already a parent, how long you have known your partner, or simply by where you live? This is not just a random collection of criteria; all these are being used somewhere or the other by Primary Care Trusts in the country to determine who gets IVF on the NHS. Many PCTs all over the country are so strapped for funds that they are creating their own eligibility requirements for couples who wish to undergo IVF.  In real terms this means that it is not just medical need but also postcode luck that determines one's likelihood of having a child via IVF.

As frustrating as it might be for couples who are denied the chance of IVF, the issue is compounded by the inconsistency in criteria.  If PCTs are short of money and decide that certain other areas of medicine deserve priority, it might be helpful if the criteria for eligibility could possibly be the same across the country.  However, at the heart of this debate lies the issue of whether treatments for many other medical problems are more important than IVF.  Is IVF a medical necessity or a medical luxury?

The answer to this question lies not in the postcode lottery but in the lottery of life. Without knowing which medical problems life has in store for us or those who matter most to us, we do not know how important or trivial these problems are to us.  As hard as we may try to be objective in ranking medical problems, and thereby determining which treatments deserve more funding on the NHS, this task is determined largely by how we are affected by different medical problems. 

How important a particular medical need is to us depends on how morally close or distant we are from it.  If we or someone close to us is affected by a certain medical condition, we are bound to feel more passionately than we otherwise would that treatments for this condition be available on the NHS.

Whether IVF is a medical necessity or a medical luxury will depend on whom you ask. And what they say and when they say it will depend on the moral distance between them and IVF.