What do you think? Doctors say one thing, patients want another, and insurance dictates yet another. In the Feb. 2015 article by Pacific Standard titled When it Comes to IVF Who Should Call the Shots? they state, “The problem is that in the field of assisted reproduction, it’s not just that a patient’s wishes may go against a doctor’s better judgment—it’s that fertility specialists can’t even agree on best practices amongst themselves.” There is a lot of grey area in reproductive medicine, especially when it comes to “what is best”. The U.S. practices little control over fertility treatment so when desires collide, who gets to make decisions about fertility care is the question we all want to know.
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If the goal was to heal a patients body its clear that the patient has bodily autonomy and calls the shots on whether or not they wish to take medicine or have surgery or alter their lifestyle as instructed by their physician.
If the doctor can’t heal them with either medicine or surgery the doctor really should not venture into trying to get them a baby anyway because it ceases to be the practice of medicine at that point and it’s more like arranging for other people to have kids and give them up to the patient. Obviously for even healthy people getting a baby requires the participation of another person who has bodily autonomy and a choice in whether or not they wish to reproduce. That person calls the shots for their body and whether or not they take medicine, have surgery or want to mate with someone. That person’s consent and participation in the process can be an obstacle to getting them a baby because now they are not the only person calling the shots and it’s also no longer a medical treatment kind of issue. Go a step further and need two people to consent to agree to whatever all it would take to give you a baby and things get even more complicated because obviously now those two people call the shots for their own bodies and your relying on them to give you the baby you are completely out of control over the situation at that point, but again, that is no longer medicine treating your health problem when other people consent gets involved and what they are consenting to is not the transplant of a kidney or something. Go a step further and involve a third person and her consent to carry a baby and now there are lots of people calling the shots over their own bodies and reproduction and also capacity to gestate and there are obviously lots of others calling the shots because they have to remain in charge of their own bodies.
Medical insurance should remain in the business of insuring people for treatments that medically or surgically improve their body’s condition which is not what happens with many of the things they say are treatments for the infertile. The treatments are actually being given to fertile people who are promising not to raise the child when born so really it’s those people receiving treatment and their medical insurance should be paying, not the insurance of the person who is trying to get the baby but is not the one whose eggs are being fertilized for instance.
It is kind of shady to go get someone else’s genes and then apply for fertility treatment as if they are your own genes because the medical consent forms for the treatment still have to be signed by the person who is actually receiving the treatment and will be reproducing which is the donor when a donor is involved and whoever they are reproducing with – those two are the ones getting the treatment and not the person who is infertile. So it’s reasonable for an insurance company to say no to that.