WIN A CHANCE AT HAVING A BABY: A surtax on desperation?

A controversial IVF lottery is due to be launched in Britain. Britain’s Gambling Commission has granted the fertility charity, To Hatch, a license to run the game from July 30. On a monthly basis, winners can scoop £25,000 worth of tailor-made treatments at one of the UK’stop five fertility clinics for the price of a £20 ticket, which can be purchased online (with a plan to be available at newsagents in due course). The lottery is open to single, gay, and heterosexual couples struggling to start a family. If standard IVF fails, individuals can be offered reproductive surgery, donor eggs and sperm or a surrogate birth, though the winner will only be able to choose one of these treatments. Winners will also be given accommodation at a luxury hotel before being chauffeur-driven to the treatment centre. They will also be given a mobile phone and a personal assistant to help with queries throughout the procedure.

Camille Strachan, founder and chair of the charity, asserts that she has set up the organisation to help those battling through the fertility minefield. She said that the result of many NHS trustshaving axed IVF treatments due to budget restrictions is that thousands of couples have been left unable to afford the £5000-a-time treatment:

“We hope the To Hatch Lottery can ease the burden of the NHS and reduce the stress slightly on some of those who are struggling.”

One out of every seven couples suffers from fertility problems in England and one percent of babies that are born in Britain each year are conceived with IVF. Latest figures show that 40,000 patients were treated with IVF in 2008 which led to 15,000 babies being born as a result of that treatment. Strachan said she wanted to create the ‘ultimate wish list’ for those struggling with the stress of being unable to conceive (especially in light of recent government health service budget cuts). The 37-year-old mother of one says that she was inspired to instigate the competition following her personal struggles with conception:

“This lottery will at last offer some hope to those who cannot afford to attend private fertility treatment clinics in areas where IVF has been stopped by the NHS… Sadly, health service cuts are likely to get more severe. When you are trying to conceive every month that passes without treatment is a month wasted. I know because I have been through it myself.”

After a failed round of IVF, Miss Strachan conceived naturally while waiting for private treatment and is now bringing up a young son, running her charity, which is self-funded, from her home in West London.

Camille Strachan, founder and chair of the charity To Hatch.

The lottery scheme – cynically dubbed by the media as the ‘win a baby’ lottery – has already instigated criticism on ethical grounds, with some of the most outspoken critics labelling it ‘demeaning’ to human reproduction. Similarly, numerous medical and ethical groups have condemned the game and the Gambling Commission said the issues it had thrown up may need further scrutiny, but that it had no regulatory powersto intervene and that any decision to revoke a license would be a governmental one.

Britain’s fertility regulator, The Human Fertilisation and Embryology Authority (HFEA) insists that using IVF as a prize was not only ‘wrong’ but ‘entirely inappropriate’ also, releasing the following statement:

“To do so runs counter to the ethos that underpins our regulatory system and clinical practice. It trivialises what is for many people a central part of their lives… We understand and sympathise with those who face the financial burden of treatment which we know from patients can be considerable… We will be in touch with the charity concerned and the centres that seem to be involved to ensure they are aware of our view.”

The British Fertility Society (BFS) have issued a similar statement, insisting that they are ‘very troubled by the announcement’. Alison McTavish, secretary of the BFS, stated:

“Although access to effective fertility treatment on the NHS remains patchy, and expensive for those who take the private route, we cannot condone this kind of activity… A competition like this, where only the lucky few will be given the chance to start a family, mirrors the ‘postcode lottery’ of IVF provision on the NHS and is equally unfair.”

The scheme has also been submitted to criticism from religious groups, who view the lottery as a means of ‘selling’ precious human life. LIFE, for example, has deemed the IVF prize as frivolous. The official statement runs as follows:

“LIFE cannot believe this is for real, or that the Gambling Commission has actually granted this licence. Lotteries are associated with luck, frivolity and fun, yet this is the blatant trading of human beingsand exploitation of people’s suffering, and is no solution to the problem of infertility… Such a scheme demeans the nature of human reproduction, using babies as prize giveaways. It also demeans those struggling to conceive, preying on their vulnerability and suffering glossing over the risks and difficulties of IVF treatment: its high failure rate, its stress on the couple, the risks to a woman’s health and the health of her baby. Studies consistently show that there are significant increased risks of IVF children being born prematurely, with low birth weight and all the complications this can cause, including increased risk of cerebral palsy.”

Moreover, detractors of the scheme suggest that by granting winners access to donor sperm, donor eggs or surrogacy for the price of a £20 ticket, the IVF Lottery promotes a kind of human trafficking, as if a woman is taken off the street and offered £20 for the use of her eggs or womb. In actuality, all participants would still be subject to the regulations and medical ethics in force in the UK, including regulations on compensation. Whether that compensation comes directly from the recipient of the donation or from Lottery funds is unlikely to matter to the donor.

What seems to be particularly offensive to detractors is the aspect of gambling, evidenced in the following statement made by LIFE:

“This totally irresponsible decision of the Gambling Commission has to be challenged. The Codes of Practice that regulate facilities used for gambling, stated in the Gambling Act 2005 Section 24(2)(b), stipulates the necessity of protecting children and other vulnerable persons from being harmed or exploited by gambling. This lottery scheme is callous exploitation of vulnerable people and babies and is no answer to the postcode lottery of IVF treatment. How can society have sunk to this level?”

Judging by the reactions to Camille Strachan’s new enterprise, you would think she was engaging in the act of incubating babies in hell. Instead, she is offering the chance at a prize of £25,000 worth of fertility treatment. To Hatch is not offering anything that is not readily available (to those who can afford it). These treatments have been around for years, yet so many people remain uncomfortable. This discomfort is rooted in the fact that the lottery represents a collision of two cultures that religion assumes should never co-exist: gambling and procreation. Yet, for most of us, having babies is a game of chance. People are too puritanical, still, in this postmodern world. The truth is that the game of life has always involved the odd gamble; a split condom or forgetting to take the morning after pill, for example. The question here is; should it involve money?

Many are offended by the fact that the rich have a better chance of fertility through endless treatments. In light of this, should we not sympathise with Strachan’s claim that her lottery will offer some hope to those who cannot afford to attend private fertility treatment clinics in areas where IVF has been stopped by the NHS? While the arguments rage, many seem to miss the point that Strachan has devised a system in which the many poor (or at least not rich) can support the very few poor to go through the treatment (and, in the process, raises money for her charity). Nevertheless, many don’t like to think that having a baby might be the equivalent of winning a cash rollover. The idea of winning a baby has already been shown as controversial by the outrage at a recent American TV show in which couples competed to adopt a baby boy. The To Hatch lottery is being understood as worse because of the moralistic notion that gambling is tainted by association with sin, immorality, and addiction. This brings us to the crux of the matter: the false hope that is integral to any lottery, but is proving particularly potent in relation to the IVF lottery. Millions of people play the National Lottery every week and hope to win, despite the odds being stacked against them. Research shows that even those few individuals who win do not necessarily achieve happiness. Swap a cash rollover with the chance of a longed-for child, and the odds for disappointment increase. This lottery, after all, might possibly send the winner on a journey of hope but result in failure. There are no guarantees.

Another inherent danger is that the offer of a child as a (potential) prize heightens a false notion that is rife in our cultural genetics; the idea that children are the route to happiness and self-fulfilment. Research will show that people are actually less content after having children than they would have been had they not done so. The desire to have a baby may be, in part, an instinctive want, but it is also a cultural notion instilled in the individual, passed down through generations and fostered by peer groups. Offering a baby as a prize can only intensify this belief. In this context, it is not surprising that Camille Strachan, given her own experiences, might want to propagate this notion. But as the world becomes increasingly over-populated, shouldn’t we be emphasising that children are a responsibility and burden? Is the idea of a child as a gift exacerbating a rapidly expanding fertility industry?

Similarly to LIFE, other groups have voiced criticism of the lottery, including the ethical dilemma group Comment on Reproductive Ethics. Its spokeswoman, Josephine Quintavalle, has commented:

“This demeans the whole nature of human reproduction… Creation of human life should not be reduced to a public lottery. Instead of this, shouldn’t more be spent on research into fertility problems?”

While these groups attest to their sympathy for those with difficulty conceiving, they argue that there should be proper investment in the UK in understanding the causes of infertility instead of resorting to ‘baby lotteries’. As Quintavalle states:

“We have the greatest sympathy for those who have difficulty in conceiving… There should be proper investment in the United Kingdom in understanding and addressing the causes of infertility, which are most frequently associated with age, body weight, other lifestyle issues… But this latest initiative, turning the process of reproduction into a buy-your-ticket lottery, is absolutely unacceptable and quite possibly breaks European Law on the commercialisation of human tissue…”

She continues:

“The more one looks at it, the more one is horrified… ‘If you look at the claims that are being made, if you won and you were not eligible for IVF, they will offer surrogate motherhood, embryos and eggs, so they are actually involving other parties as well.”

Not only has the lottery been deemed unacceptable, but it has been accused of being a form of exploitation. Dr. Gillian Lockwood, director of the Midland Fertility Service, writing for The Sun says:

“This sounds like a rather exploitative way of drawing attention to their [referring to To Hatch] website… It is a reflection of the poor provision of IVF in the same country which created the technique… But this is not the answer.”

It might not be the answer, but can the lottery really be categorised as ethically wrong? Think about this, prescribed sense of ethics aside. Charities host lotteries all the time; silent auctions of all sorts. Why has the fertility charity raised so many eyebrows for its recent announcement of the IVF lottery? Why has it been condemned to be ‘demeaning’? Dea Birkett, writing for The Guardian, has argued that it is not the lottery that is demeaning but, rather, the way in which IVF seekers are treated:

“The tabloids are taking a high moral stance, quoting critics who condemn the gamble as demeaning to the nature of human reproduction… But what’s demeaning is the desperate measures people with fertility problems have to take to become a parent.”

She claims that the real problem is that the media ‘hate assisted motherhood’:

“Women who simply want a little help to have a baby are portrayed as unnatural, evil and downright selfish… As health costs are cut, fewer health authorities are offering free cycles; others are imposing more restrictions on who’s entitled to receive them. Infertile women aren’t deemed worthy of public money…. Yet the IVF price tag is a pittance in the total public bill for raising a child.”

She may have a point. The fact that the media are referring to the phrase ‘baby lottery’ in reference to the scheme speaks volumes. This is, after all, only a chance to win £25,000 worth of IVF treatment; there is no guarantee of a baby at the end of it and yet the tabloids continue to hammer home their ‘baby lotto’ punch lines.

Whatever your view on the subject, the IVF Lottery is proving useful in itself as it will undoubtedly continue to provoke increased public awareness and opinions of infertility and focus more attention on the unfair delivery of fertility treatment in the UK. Josephine Quintavalle and her ilk will continue in their insistence that the IVF lottery ‘demeans the whole nature of human reproduction’. However, assisted reproduction is a dominant form of procreation in modern society. The fact that it is such an area of debate and contention is because neither science nor the arts have totally conceived of the consequences of sex in the age of mechanical reproduction, let alone the fact that the effective treatment of genetic infertility has made the unattainable imminently attainable.

RELATED SOURCES

http://www.thesun.co.uk/sol/homepage/news/3679596/Worlds-first-IVF-lottery-begins-in-UK-this-month-offering-chance-to-win-a-baby.html#ixzz1RJFE64kZ
http://news.sky.com/skynews/Home/UK-News/IVF-Lottery-Charity-Launches-Competition-To-Win-Fertility-Treatment-At-Top-Hospitals/Article/201107116025198?
http://www.dailymail.co.uk/news/article-2011676/IVF-lottery-launching-Britain-Win-baby-buying-20-ticket.html#ixzz1RuTSiddj
http://www.bionews.org.uk/page_101406.asp
http://www.independent.co.uk/life-style/health-and-families/health-news/ivf-lottery-is-entirely-inappropriate-says-fertility-watchdog-2308095.html

IMAGE SOURCES

http://www.google.co.uk/imgres?imgurl=http://newstonight.net/assets/imagecache/article/To_Hatch.jpg
http://www.independent.co.uk/life-style/health-and-families/health-news/ivf-lottery-is-entirely-inappropriate-says-fertility-watchdog-2308095.html
http://gawker.com/5818453/britains-baby-lottery-begins-this-month
http://www.guardian.co.uk/money/blog/2008/mar/25/lotteryblog
http://www.tntmagazine.com/tnt-today/archive/2011/07/06/baby-lottery-launched-win-163-25-000-of-ivf-treatment.aspx