Access to fertility treatment

16 12 2009

To the Editor:

I am in disagreement with the statement of The Ethics Committee of the American Society for Reproductive Medicine on the “Access to fertility treatment by gays, lesbians, and unmarried persons” (1).

In my opinion:

1. Reproduction is the final goal in the continuation of all species, animal and plant.

2. The natural method of reproduction is the fertilization of a female gamete by a male gamete via insemination or a similar process. Reproduction cannot be accomplished in a natural way in the case of a single individual or a same-gender couple.

3. Physicians should prevent, treat and, if possible, correct the deviations, alterations or pathologies of nature. Infertility should be treated with the most appropriate measures after diagnostic research.

4. If infertility is not the problem, I do not think physicians should take part in, much less carry out, measures such as donor artificial insemination or in vitro fertilization charged against the Public Health Administration. In my opinion, this should be the true ethical obligation.

Pedro Acién, M.D., Ph.D.
Service of Obstetrics and Gynecology
San Juan University Hospital
Department/Division of Gynecology
School of Medicine
Miguel Hernández University
Campus of San Juan
Alicante, Spain

References
1. The Ethics Committee of the American Society for Reproductive Medicine. Access to fertility treatment by gays, lesbians, and unmarried persons. Fertil Steril 2009; 92:1190-3.

Published online in Fertility and Sterility doi:10.1016/j.fertnstert.2009.12.042

The Authors Respond:

The American Society for Reproductive Medicine Ethics Committee Report on access to fertility treatment by gays, lesbians, and unmarried persons concludes that ART programs and physicians have a duty to treat all persons regardless of their gender, relationship status or sexual orientation. The Committee’s conclusions are based on and supported by empirical evidence, sociological data, ethical principles, and legal directives. Given the importance to individuals of having children, none of Professor Acién’s comments form a sound ethical basis for denying single persons and gays and lesbians the same rights to reproduce that other individuals enjoy. More fundamentally, the Committee believes that disparate treatment arising from social status of those seeking to have and rear children is deeply offensive to long-standing protections against discrimination on the basis of demographic features in the provision of medical services.

Robert Brzyski, M.D., Ph.D.
Chair, American Society for Reproductive Medicine Ethics Committee
Department of Obstetrics and Gynecology
University of Texas Health Science Center
San Antonio, Texas

Judith Daar, J.D.
Whittier Law School
Costa Mesa, California
and
School of Medicine
University of California, Irvine
Irvine, California

Published online in Fertility and Sterility doi:10.1016/j.fertnstert.2009.12.043

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