Bioethics Blogs

Voluntary Sterilization, Personal Responsibility, and IVF Coverage

Katharine Browne argues that exclusion from coverage for IVF on the basis of voluntary sterilization is unjustified.


A rally was held this past weekend in Montreal to protest Bill 20‘s promise to scale back funding for Quebec’s in vitro fertilization (IVF) program. The controversial Bill was introduced in November 2014 as part of Minister of Health Gaétan Barrett’s efforts to reform Quebec’s healthcare system. The Bill will replace coverage of IVF by public health insurance (RAMQ) with sliding tax credits, which vary depending on income. Minister Barrette has indicated that the government will introduce exclusion criteria for those tax credits. Among those who will be excluded are women younger than 18 and older than 42, individuals and couples who have already had a child, those who have not tried to conceive naturally for a fixed period of time, and those who have undergone voluntary sterilization for reasons other than medical necessity.

The limitations imposed by the Bill have been the subject of much debate. Attention has been focused on the upper age limit on access, and whether a variable tax credit, which would require families to pay for IVF treatment upfront, would unfairly disadvantage lower-income families. However, the exclusion of individuals on the basis of voluntary sterilization has gone largely unnoticed, leaving some important questions unaddressed.

Mary Cassatt, Mother and Child (ca. 1889)

To restrict access to IVF funding on the basis of having undergone voluntary sterilization is to make the claim that individuals who have not undergone voluntary sterilization have a greater claim on health resources than those who have.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.