Firstly, a recap:
Spain has a national health system, that provides free healthcare for every Spanish national (plus a few people who don't have Spanish nationality, mainly citizens of the European Union). There are treatments and interventions that are not covered by this "universal" system, and there are also treatments and interventions that are only partially covered.
"Women's health" or "reproductive health" is a controversial subject in Spain. Until recently (2010) our abortion law only contemplated "cases": a woman could have an abortion if she was in grave physical or mental health, if she had been raped, or if the foetus had grave physical or mental malformations. Currently, abortion is not penalised before the 14th week of gestation, and after that, a woman can still have an abortion in certain cases. Contraceptives are not provided for free.
Secondly, the issue at hand:
Assisted reproductive technology has helped many women and couples have children. The wording of the law in Spain up to now went something like this: women could benefit from government financed ART when there was a diagnosis of sterility or an "established clinical indication". This allowed some leeway for single women and women in relationships with other women (someone has mentioned that saying "single women and lesbians" is discriminatory, for lesbians are still women, however I disagree with this: lesbians are still women, but they are not single women, saying "women in a couple" would include heterosexual women. I think I've used the best wording possible here, but please, suggestions would be welcome) to receive finance, since clearly they could not have children without ART even if medically they were not sterile. Now, the ministry for health has made a proposal to change what is covered by the public health. According to the amendments, only couples formed by a man under 55 and a woman under 40, who have no previous healthy progeny and who have been trying to have a child by having sexual relationships with vaginal intercourse for at least 12 months with no success will be eligible for treatment.
According to this new wording, only heterosexual couples will be eligible to have children using ART. And only one child per couple, assuming the child is healthy.
Clearly, this breaches the Spanish Assisted Reproduction law, which states that all women above the age of 18 have the same right to assisted reproduction. But let's forget this for a second. Let's forget the obvious controversy of the suggestion and dig a bit deeper.
First of all, as ever with ART, there is a more fundamental question. If we accept universal free healthcare, we have to accept that it's going to cost taxpayer money. Knowing this, we must accept that there are certain treatments that can be paid for, and certain treatments that will be too expensive for the healthcare system to provide. So if there is going to be universal healthcare, there must be some basic services provided, services that are indispensable, and others that aren't provided because people don't need them. So the question here is: is having biological children necessary? Is it a right?
As much as it pains me to say it, because I am one of those single women who would happily have children via ART, I don't think having biological children is a right. But I do think everyone should be equal. What I'm saying is, I think ART should only be provided to people (men or women, independently of their sexual orientation or relationship status) who are clinically sterile. Everyone else can pay. This may sound insensitive to lesbians, or to women who want to have children on their own, but it truly isn't. Adoption is still an option, and they can still pay for the treatment if they truly want a biological child.
That said, I still feel like there's something not quite right with that: if a girl is unlucky enough not to find a guy she likes, or lucky enough to just a girl she likes, why can't she have children? When the question is put to me this way, I am disarmed. It's true. Why do they have less right than a woman who is sterile but has had the luck to find the right guy? So I come to the following conclusion: no ART for anyone. At least, no ART paid for by the government. I still don't think having biological children is a right.
Secondly, there is the question of men. The discussion has centred exclusively on women because they are the ones affected by the proposal, but the fact remains that if a single heterosexual male or two men in a relationship with each other want to have a child they can't be helped. Surrogate mothers are illegal in Spain (clearly, there are ways to get around this, but in my opinion it shouldn't be something that needs getting around of), so any ART that these males could use is automatically negated unless they happen to have a good friend who will happily carry their child for them. All in all, they are in the same situation as single women or women in relationships with other women, except they're not just not getting financed, but they can't even pay for the treatment.
So, what would I propose? Ideally, in a country where resources are unlimited, I would propose that everyone is eligible for fertility treatments, whoever they are. I would legalise the use of surrogate mothers (though I might regulate it). Less ideally, in a country where resources are limited, and choices have to be made as to treatments, I would legalise the use of surrogate mothers and allow anyone who wanted a child and wasn't able to conceive one to go through the adoption without having to pay fees, but I would not make fertility treatments part of what the national health system provided. They would still be legal, but anyone wanting one would have to pay for it.
In any case, I think the change in the rules in Spain is unfortunate. It is unfair and it provokes more inequality than the previous regulations. And there is the subtext of course: the current governing party in Spain is openly opposed to gay marriage and to abortion, they side with the Catholic Church and have "traditionalist" ideas. Knowing this, it becomes less a question of equality and more a question of the governing party trying to impose their morals on the people they are governing. Of course, this is politics. But it is also discrimination. The Spanish Constitution states that "Spaniards are equal before the law and may not in any way be discriminated against on account of birth, race, sex, religion, opinion or any other personal or social condition or circumstance." The regulations I am speaking about are not strictly "law", but they endanger the equality that the 1978 Constitution awarded the Spanish people. This cannot be allowed to happen.
No comments:
Post a Comment