Protect the child from being born: Arguments against IVF from heads of the 13 licensed Dutch fertility centres, ethical and legal perspectives

Single prospective parents or parents of relatively advanced age, lesbian couples, carriers of a genetic disease, or a woman who wishes to conceive the child of her terminally ill or deceased partner are sometimes refused in vitro fertilization (IVF) treatment due to their situation of increased medical and/or psychosocial risk. This study aimed to gain insight into the arguments against IVF treatment and to obtain knowledge to promote a soundly based access policy for these individuals. The directors of 13 licensed Dutch IVF centres were interviewed. Their responses were evaluated from an ethical and legal perspective. The arguments against treatment mainly concerned psychological instability and the quality of life of the future child and were rooted in the harm principle. Additionally, single prospective parents or parents of relatively advanced age were not treated. Most contra-arguments were based on clinical experience, on (as yet) untested assumptions, and team consultation. It is therefore important to make use of existing databases in order to identify special patient groups after IVF treatment to collect data on parenting and the psychosocial functioning of the child.

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