Irresponsibly Infertile? Obesity, Efficiency, and Exclusion from Treatment

Abstract

Many countries tightly ration access to publicly funded fertility treatments such as in vitro fertilisation (IVF). One basis for excluding people from access to IVF is their body mass index. In this paper, I consider a number of potential justifcations for such a policy, based on claims about efectiveness and cost-efciency, and reject these as unsupported by available evidence. I consider an alternative justifcation: that those whose subfertility results from avoidable behaviours for which they are responsible are less deserving of treatment. I ultimately stop short of endorsing or rejecting such a justifcation, though highlight some reasons for thinking it is unlikely to be practicable.