Assisted reproduction: who qualifies?

Assisted reproductive technologies (ARTs) have been the focus of considerable debate in which a range of social issues has been addressed, yet the question of who is eligible for ART, who can get access, who is excluded and by what means, has received little attention in comparison with other issues. In Australia social policies presently exist in some (but not all) states which address this question, however several recently publicised cases have highlighted the need for an examination of inclusion/exclusion practices from a social justice perspective. This paper seeks to explore the issue of access and eligibility for ART with a particular interest in exposing the contradictions, inconsistencies and assumptions inherent in arguments put forward for particular inclusions and exclusions. It is my contention that social policy relating to criteria for eligibility and access to ART invests the medical profession with a gatekeeping role which holds the power to define and create different classes of women. Moreover, discourses of 'medical indication' and the 'best interests of children' intersect to inscribe a form of discursive eugenic practice which in turn sustains sexism and discrimination against childless women. Finally, this paper seeks to alert the nursing profession to requirements emerging from social policy which influence practice, interfere in client-nurse relationships, and may ultimately result in unethical conduct.