These are unsettling and uncertain times. Our lives have effectively been put on hold. And for some people, so too has the opportunity to become a parent – with fertility treatments suspended across a number of countries due to the COVID-19 pandemic. This has left thousands of fertility patients in limbo, experiencing uncertainty and grief.
Following the guidance of the British Fertility Society and the Association of Reproductive and Clinical Scientists, the Human Fertilisation and Embryology Authority has issued directions requiring fertility clinics to suspend all treatments (with the exception of fertility preservation for cancer patients).
This is in part because the impact of COVID-19 on pregnant women is still unclear. Fertility treatments also entail close contact between patients and staff, making it impossible to respect social distancing measures. And as caring for COVID-19 patients takes priority in terms of the distribution of available medical resources, fertility treatments have fallen under the category of non-essential treatments and procedures – which have been halted across the UK.
This has had very severe consequences for fertility patients. For some, this suspension adds an undefined amount of time to the years trying to conceive before becoming eligible for treatment – and to the months on the waiting list for IVF.
For those who have been injecting hormonal medications, closely monitoring their sleep, diet, mental and physical health, all this seems to have been done in vain. The age cutoff to be eligible for IVF varies across the UK. This suspension might mean that women aged 35 in some areas, and 42 in others, will no longer be eligible for treatment.
Essential vs non-essential
This raises questions as to what should be considered “essential treatments”. It could be argued that fertility treatments are indeed non-essential. Trivially, no one is actually dying or missing out on life-saving diagnoses or treatments. Indeed, thinking of having a child during a pandemic, might seem a “vanity of vanities”.
Within discussions on the ethics of reproductive technologies, some criticise fertility treatments for these reasons – especially when they involve the development and use of new technologies. They contend that state funding should be allocated elsewhere and employed for more pressing medical issues. Others also argue that there are many children in need of adoption and that people can become parents in many other ways that do not entail costly and burdensome procedures.
Another critique of reproductive technologies stresses that the decision to undergo fertility treatments is not entirely autonomous and that oppressive societal norms shape people’s preferences. These norms emphasise the value of having genetically related children over other forms of family formation – with women taking the biggest health risks.
The COVID-19 pandemic has put unprecedented strain on healthcare systems. So it would be easy to conclude that fertility treatments should not be a priority. But maybe instead, we should rethink their social value.
Ethics of fertility treatment
Infertility can have profound psychological implications and can lead to self-blame and distress. Halting fertility treatments exacerbates all this. But it’s partly due to social norms that the experience of infertility is so psychologically devastating.
Making fertility treatments a priority during a pandemic and increasing funding in normal times may lend support to the view that a having a genetically related child is the only valuable way of becoming a parent.
This poses a dilemma: should people’s desire to have a genetically related child be fulfilled even if this might promote oppressive social norms?
In her book Resisting Reality: Social Construction and Social Critique, the philosopher Sally Haslanger contends there are two ways to address this difficult problem.
One way is to satisfy people’s desires and bring them as close as possible to fitting social norms. Not halting fertility treatments during the pandemic and increasing funding would be a way to do this. Another way would be to combat the dominance of such social norms, even when there are negative consequences for those involved.
Predominance of genetic ties
In my research, I focus on the ethical and political questions raised by the development and use of reproductive technologies. My view is that neither of these approaches should be excluded when dealing with this dilemma.
Rather, people’s desire to have genetically related children must be respected, along with an understanding of the costs of not satisfying it. But there is also a need to critically engage with oppressive ideologies and the conditions that sustain them.
In this sense then, the predominance of genetic ties must be questioned along with the value it is attributed. But all this should be complementary to offering practical and moral support to people who are currently experiencing infertility. This is essential.