Tag: voluntary sterilization

Bioethics News

Iran debates birth control restrictions

Iran plans to introduce major restrictions on the availability of birth control methods in a bid to stop rapid population decline. 

The government is currently considering two related bills intended to aid an increase in the birth rate.

One proposed law, bill 446, would curb women’s use of modern contraceptives, outlaw voluntary sterilization [including vasectomies], ban the provision of information on contraceptive methods and dismantle state-funded family planning programs.

Another, bill 315, would mandate that organizations prioritize married men and women with children when hiring for specific jobs. 

International observers have decried the proposed reforms. Amnesty International warned that the bill could have “devastating consequences” for single women or women in abusive relationships.

But many Iranian politicians believe the legislative changes are vital to address a serious demographic crisis.

In October 2014, Iran’s supreme leader, Ayatollah Ali Khamenei urged Iranians to help increase the country’s population, which he described as aging. “If we move forward like this, we will be a country of elderly people in a not too distant future,” Khamenei said (according to the semi-official Fars news agency). “Why do some [couples] prefer to have one … or two children? Why do men or women avoid having children through different means?” the Iranian leader wondered. 

This article is published by Xavier Symons and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees.

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.

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.

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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.

Bioethics Blogs

Assisted Procreation in Quebec: What To Expect?

Marie-France Bureau raises concerns about access to, and funding and regulation of assisted reproductive treatments.

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Quebec Health Minister Gaétan Barrette is expected to introduce new legislation on in vitro fertilization. The costs of the existing program, established in 2010, have skyrocketed to about $70 million annually. Although allocating public funds to reproductive treatments is hard to justify given the burden of health spending in the overall government budget, rumours indicate that Quebec will keep funding some treatments. The bill is expected to limit coverage to medical infertility through a tax credit mechanism.

Provinces are not obligated to implement any fertility program, but once a province has decided to offer a service, it has to offer it in a way that does not discriminate illegally between groups of people. It is unsure whether limiting coverage to “medical infertility” would pass the constitutional test, given the controversial meaning of infertility in our democratic and egalitarian society. Would gay, lesbian and single persons automatically be excluded? Would two fertile persons unable to sexually conceive a child together be excluded, be they in a heterosexual couple? Such questions show that it will be hard to draw lines between medical, social or biological definitions of infertility.

IVF Impact Ethics

Setting up limits to access in order to contain costs is a legitimate objective, but it should not serve as an excuse to exclude people on the basis of stereotypes and prejudice. If Quebec chooses to cover infertility, it should implement limits that are rationally linked to the objectives of the program (helping Quebecers make babies) and that cut across all population groups.

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.

Bioethics Blogs

Quebec’s Assisted Human Reproduction Program

Pamela White provides a brief English-language summary of the recommendations of the recently released report of the Quebec Commission à la santé et au bien-être. 

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On June 6, 2014, the Quebec Commission à la santé et au bien-être released its review of Quebec’s assisted human reproduction program. Since 2009, Quebec has offered public funding of assisted reproductive services. At the heart of the Commission’s report are twelve recommendations, several of which target measures designed to address psychosocial and ethical issues. Others aim to reduce costs, implement health surveillance, and—similar to the process in place in Britain—implement parental suitability screening. At the same time, the Commission rebuffs the model of a centralised governance body as has been established in the UK and France, instead recommending an ostensibly more inclusive and flexible permanent multi-disciplinary committee and Ethics table. The report also addresses the matter of abandoned embryos and recommends consultation on surrogacy.

The first section of the report explains how the Commission undertook the program review. It notes that the population is divided between Quebecers proud of the province’s non-discriminatory delivery of assisted reproduction services and concerned about its continuation. A detailed legal, economic and social portrait of Quebec’s program together with an assessment of its health impacts and costs situates the existing program and sets the stage for the Commission’s recommendations. The first part of the report alone is worth the read. The Commission should be commended for its fulsome program and legal review, its focus on evidence based decision-making, and emphasis on maternal and child health surveillance.

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.