Education And Debate

An Ethical Debate: Should older women be offered in vitro fertilisation? The interests of the potential child

BMJ 1995; 310 doi: (Published 03 June 1995) Cite this as: BMJ 1995;310:1455
  1. Tony Hope, leader, Oxford practice skills projecta,
  2. Gill Lockwood, clinical research fellow in infertilityb,
  3. Michael Lockwood, lecturer in philosophyc
  1. a Medical School, John Radcliffe Hospital, Oxford OX3 9DU
  2. b John Radcliffe Hospital
  3. c Green College, University of Oxford, Oxford
  1. Correspondence to: Dr Hope.
  • Accepted 18 January 1995

In most discussions of the ethics of fertility treatment it is claimed that the interests of the potential child are of major if not paramount importance. The practical significance of this consideration has been grossly overestimated. Contrary to conventional wisdom, the interests of the potential child hardly ever constitute an adequate reason for withholding fertility treatment.

Modern fertility treatments became the focus of much media attention in 1993 after the widely publicised case in which a 59 year old woman was enabled to give birth to twins by means of in vitro fertilisation with donated eggs and her partner's sperm. Fertility treatments raise a wide range of ethical and social issues. We focus on one specific issue: the interests and welfare of the potential child. These factors are often cited as important reasons for withholding fertility treatment. We contend that they are almost never relevant, and moreover, we support a wider provision of fertility treatment.

The Human Fertilisation and Embryology Act 1991 states that “centres considering treatment must take into account the welfare of any child who may be born.” Robert Winston, professor of fertility studies at the Hammersmith Hospital, argued that it is wrong to offer in vitro fertilisation to most postmenopausal women.1 One of his reasons concerned the potential child. Hugh Whittall of the Human Embryology and Fertilisation Authority said that although there was no upper age limit for …

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