An ethical minefield

There are two thought-provoking articles published side by side in today’s Sunday Times.

The first entitled ‘IVF baby boom for half century mums’ reports that births to mothers over 50 years old have increased by 55% in the past year. These are mainly as a result of relaxed fertility clinics’ rules on treating older women and IVF treatments using eggs donated by younger women. The eggs are normally donated as part of an ‘egg sharing scheme’ allowing the younger donors to receive, in effect, discounted IVF treatment.

Older mothers have to pay privately for this treatment as IVF is not available on the NHS to those over 39 years old. There is growing pressure on the NHS to raise this treatment ceiling as women are fitter and have a longer life expectancy than previous generations. In theory, a ‘middle aged’ mother could expect at least thirty more years of reasonable health as their children grow into adulthood. One of the doctors who treat over fifties patients states that his decision whether or not to offer treatment is based on ‘the woman’s health, the age of the father, the financial security of the couple and whether there is an extended family to help care for the infant’. Fairly arbitrary measures it would seem - if the woman’s health is good, why the question about the extended family? Equally surprising is that a clinician feels suitably qualified to undertake a means test to predict his patients’ financial stability (especially after they have no doubt paid thousands of pounds for several cycles of treatment)?

The second article ‘Online now: five mornings after pill’ reports on the availability of a new pill that can be taken up to five days after unprotected sex and bought over the internet. Family campaigners claim that the pill is, in effect, ‘an abortion agent’ and that under-aged girls will use this inappropriately as a form of contraception.

The rather unreassuring response from the company who market this drug is that purchasers have to complete an online diagnosis form which is reviewed by a doctor. They go on to boast that their doctors are regulated by the General Medical Council. Hardly as USP as in the UK, you must be licensed by the GMC to practice! So the doctors review online forms that could be completed by anyone and on the basis of this form they send the drugs ‘guaranteed next day delivery’ (a rather unfortunate choice of words)

As I read both these articles I couldn’t help thinking with some sadness that maybe the young girls buying the ‘five morning after pill’ will become the desperate women having their last chance at motherhood through IVF in three decades’ time.