Suffering prioritisation, or prioritising suffering? A critique of arguments for and against NHS funded fertility services
Dr Jonathan Ives, Reader in Empirical Bioethics, University of Bristol
Wednesday, 22 January 2020, 11am to 12.30pm
Ethox and the Wellcome Centre for Ethics and Humanities are based at the Big Data Institute, University of Oxford, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, Oxford OX3 7FZ. The talk will be held in seminar room 0.
In recent years, Clinical Commissioning Groups across the UK have begun to decommission fertility services provided on the NHS in an attempt to cut costs. This has been widely reported in the UK media, and has been met with strong resistance. Cutting fertility services has also been criticised by NICE, with Gillian Leng, Director of Health and Social Care at NICE, quoted in The Guardian as saying that infertility can have a “devastating effect on people’s lives, causing depression, severe distress and the break-up of relationships”, and that it was “unacceptable that parts of England are choosing to ignore NICE guidelines”. The case against cuts is summarised well by one service user who, speaking to Fertility Fairness, said “'Infertility is not a choice, treatment is not a luxury, and allocating treatment based on postcode is discriminatory. It astonishes me that following the NICE guideline is not compulsory”.
In this paper I explore arguments for and against the de-prioritisation of IVF. I argue that IVF is good and permissible in its own right, and advance the argument that the best reason to fund it is provided by the ‘argument from suffering’. I then explore a significant problem with the implications of this argument, and argue that it follows that both funding and deprioritising ART is justified. I conclude by attempting to show that, given this, the question ceases to be a prime facie moral one, and becomes a question of preference.