IVF Lottery Raises Eyebrows in U.K.
July 8, 2011— -- Starting next month, couples in the U.K. will be able to slightly raise their odds of having a baby -- by buying into an in-vitro fertilization lottery.
The country's gambling commission recently approved the lotto, run by a U.K. charity called To Hatch. A ticket price of $32 (£20) will hold the promise of about $40,000 (£25,000) in fertility treatments.
Yet the lotto, dubbed "win a baby" by the British press, has already raised eyebrows in the medical ethics community.
"Childbirth is already a lottery of good fortune. Now they're just compounding the lottery effect," Felicia Cohn, bioethics director for Kaiser Permanente in California's Orange County, told MedPage Today. "When you make a lottery out of any healthcare resource, it's a social lottery."
But Camille Strachan, founder and chair of To Hatch, said in a Reuters report that the idea is to provide resources for a treatment that has traditionally received spotty coverage by the National Health Service (NHS).
She said IVF is "first on the hit list" for many of the country's 162 Primary Care Trusts in light of recent budget cuts.
In a statement, Alison McTavish, secretary of the British Fertility Society, said that IVF coverage in the U.K. is indeed "patchy, and expensive for those who take the private route," though she remains "troubled" by the charity's lottery.
"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," she said.
Instead, she urged primary care trusts across the country to provide three full cycles of IVF -- the amount recommended by National Institute for Health and Clinical Excellence (NICE) guidelines issued in 2004.
Strachan did not return requests for comment, but wrote on her charity's Twitter account that she "respects all views on the lottery -- to each their own."
She told Reuters that if the lottery winners fail standard IVF, they can have reproductive surgery, donor eggs and sperm, or a surrogate birth -- but will only be able to choose one treatment.
The article also stated that lotto winners will be put up in a luxury hotel before the procedure, and will be driven by a chauffeur to a treatment center. They're also entitled to a cell phone and a personal assistant.
It is not yet clear where the tickets will be sold when the license goes into effect on July 30.
Most ethicists roundly reject the lottery, claiming it is exploitative and demeaning to human reproduction.
"It preys on the hopes and frustrations of people who face an agonizing burden," Robert Field, professor of law at Drexel University, told MedPage Today in an email. "In order for a lottery to work financially, most of those who play it must lose. However, people suffering from infertility may ignore this fact of mathematics in their desperation. The lottery takes advantage of their vulnerability."
Field said it is "especially disturbing that the lottery could earn a profit based on the suffering of its customers."
James Coyne, a health psychologist at the University of Pennsylvania, said that U.K. charities -- which are somewhat similar to U.S. nonprofits -- do play a large role in the financing of health services and research.
On its website, To Hatch says its mission is to provide information on fertility treatments among the various primary care trusts. As of press time, it had no information available on the lottery program specifically.
However, Coyne said the charities "are in quite aggressive competition among themselves" -- meaning any publicity could be a boon to business.
"Whether intended or not," Coyne said, "the lottery will attract a lot of interest from vulnerable and unrealistically hopeful people at risk for disappointment and exploitation."
Rosamond Rhodes, director of bioethics education at Mount Sinai School of Medicine in New York, said that while she's concerned about where the proceeds end up, she ultimately dissents from other ethicists.
"From the point of view of women who need artificial reproductive technology services," she said, "having an affordable, small chance of attaining them is better than having no chance."
