Fertility: Where politics and ethics trump science
Most civilised nations able to afford it offer some assistance to couples struggling with fertility problems, but there are usually a list of stringent criteria based on age, health, previous treatments and more. That is far from the end of the story, however. Just because you can do something doesn’t mean you should. Nowhere is this more keenly felt than with fertility.
The prospective patient considering his or her for-profit options has a range of considerations common to any healthcare service sector: Price. Location. Quality / outcomes. But fertility above all other sectors has additional considerations in particular: The politics (and ethical stance) of the country of treatment. These differences create huge industries just across the border from less accommodating states.
Same sex couples struggling to find treatment in France or Russia have found welcome help in Spain, Czechia and the UK. Overly restrictive regulation in Germany saw entrepreneurial Austrians setting up shop close to the border, while there was similarly a regular flow of patients from Italy to Spain until the former relaxed its rules a few years ago.
In a complex field like fertility a raft of different approaches to everything from anonymity of donors, embryo selection, and genetic screening can create medical tourism in or out of a country. Even the attitude of the general population – say towards surrogacy – can have a profound impact, Czechia and Spain have a long tradition of taking a more relaxed attitude to these things (and Czechia in particular has cornered the market in egg donation).
Are the ‘easy wins’ obvious then? Not really. You might think operators could at least generally assume a path towards liberalisation and relaxation of regulations was being walked, albeit at different paces, by countries across Europe. The Polish government’s recent ‘natural health’ approach the problem (curtailing a generous state-funded programme) suggests that is not universally the case.
It is too much to hope that any measure of uniformity is likely to be struck on what, to many, should be a basic human right supported (morally and financially) by the state. Until – and unless – that is the case, post-COVID patients and operators alike will continue to look favourably on the likes of Spain, the UK, Denmark and Czechia, while hoping more restrictive markets catch up. Whether those markets should catch up – and the morality of them doing so – is an argument we are happy to leave to another date.
We would welcome your thoughts on this story. Email your views to David Farbrother or call 0207 183 3779.
