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General ethics
State-funded IVF will make us rich… or will it?
  1. Anna Smajdor
  1. Correspondence to:
 Anna Smajdor
 Medical Ethics Unit, Imperial College, The Reynolds Building, St. Dunstan’s Road, London W6 8RP; anna.smajdor{at}imperial.ac.uk

https://doi.org/10.1136/jme.2006.018309

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    Recently, several claims have been made that free provision of in vitro fertilisation (IVF) will boost our economy. This is premised on the assumption that people provide more in terms of tax and insurance than they consume in resources, leaving an overall gain. Even where these ‘replacement’ people are created by means of IVF, it is argued that the costs involved are easily offset by the financial contribution we can expect IVF-conceived adults to make to our economy. However, although it may be true that the creation of a new person constitutes an overall financial gain to the state, I question the degree to which the arithmetic involved is as simple as the reports suggest.

    Research presented by a group of scientists at the annual conference of the European Society of Human Reproduction and Embryology in Prague, which has been widely reported in the media, has suggested that it is in our society’s economic interests to fund access to in vitro fertilisation (IVF) treatments.1,2 The team, led by Professor William Ledger from the University of Sheffield, claims that for each IVF baby born, the economy makes a net gain. But can this possibly be true? IVF is an expensive procedure, which by its very nature creates more claimants on state funds and National Health Service (NHS) resources. IVF also takes a financial and physical toll on all those involved: the women, their partners, and the children born as a result. It might be assumed that state funding of IVF would be a drain on public resources, rather than boosting them. However, the researchers have suggested otherwise. Their claim is that the average £13 000 that it costs to create a baby using IVF is far exceeded by the average of £160 000 in taxes and insurance that will …

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    Footnotes

    • ↵i In fact, since the first draft of this paper was written, the HFEA has decided to allow women to receive subsidised fertility treatment in return for eggs donated for research. This seems to be a step along exactly the lines that I have criticised here, whereby the possibility of profiting from a patient’s resources in one context expedites medical treatment in another.

    • ↵ii Levitt and Dubner6 argue that Ceausescu’s pronatalist policy in Romania had an unexpectedly detrimental effect on the country’s economic and social stability, as the children of women who are unable to procure abortion are, it is claimed, statistically more likely to become criminals. This claim is controversial; however, the point of interest remains whether or not one accepts this view—namely, that the results of addressing social or economic difficulties by means of a pronatalist policy are at best unpredictable, and at worst self-defeating.

    • Competing interests: None declared.

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