Against withdrawing government and insurance subsidies for ARTs from fertile people, with special reference to lesbian and gay individuals.

One way to help ensure the future of human life on the planet is to reduce the total number of people alive as a hedge against dangers to the environment. One commentator has proposed withdrawing government and insurance subsidies from all fertile people to help reduce the number of births. Any proposal of this kind does not, however, offer a solution commensurate with current problems of resource use and carbon emissions. Closing off fertility medicine to some people-or even to all-would have only negligible effects on environmental protection. Moreover, the proposal to withdraw financial subsidies from fertile individuals would have prejudicial effects on lesbian and gay people, who must always reach beyond their same-sex relationships for help in having children. It is, moreover, entirely unclear why some people turning to fertility medicine for help in having children should have to pay their own way even though they contribute to the pool of money available for government and insurance subsidies. Entitlements based on an alleged moral difference between the 'fertile' and the 'infertile' cannot support such a conclusion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.