h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

I think infertility generally comes hand in hand with some pretty horrific health issues. Admittedly, some of these could perhaps be cured by, say, chemical castration (the pill) or actual castration (a hysterectomy), but that seems a little harsh when, unlike a rapist, they haven't actually hurt else in their illness. I do get, Twiglet, that you have already conceeded that their health problems should be treated in that case, the situation is that in some cases they might be hanging on to their reproductive organs in the face of unprintable screaming agony every month (say) in order to try against quite unlikely odds to have a baby. So that's a new case study for you, should they be treated by other methods when the easiest method would not let them have a kid?

Of course it does come down to how you prioritise and obviously any prioritising is painful. Personally, I think I'd put the self inflicted diseases perhaps up to and including cancer (depending on how ruthless and unpleasant I was feeling that day, and albeit that it's a bit tricky to say for sure that disease X is the result of unwise lifestyle choice Y sometimes) behind infertility treatment. But then that's me.

Christ! I'm glad SoRB doesn't feel strongly enough to want to *do* anything!

And thanks the gods I don;t actually have to make that choice.

"the point those kooky feminists might be trying to make is that it's the power trip those people are getting off on "

To which my immediate response is: if it's the power trip they're getting off on, why did it occur to them to get their knob out? I mean, if what you're doing is about something other than sex, reaching for your genitals is a really, REALLY WEIRD thing to do. Saying rape isn't about sex is like saying prostitution isn't about sex. On one level, you can stroke your chin and say "Ah, yes, it's about exploitation and the transactional nature of male-female interaction." On another level, the kind of beardy prat who says something like that needs a slap, or possibly a blowy.

And I've heard various people say that SoRB's hootoo postings are about sex.

Now...put the tissues down and move away from the screen.

"infertility generally comes hand in hand with some pretty horrific health issues"

Sorry, I don't believe that.

I mean, I believe that there are some pretty horrific health issues that, as a side-effect, make you infertile.

But I think the *vast* majority of couples who can't conceive are generally otherwise healthy. If only there was a qualified doctor posting in this thread...

...

Z?

Certainly the impression one gets of infertility from the media is that for many couples it comes as a surprise - i.e. they did not expect to be infertile, because they believed themselves both to be healthy.

You must be aware of the military use of rape, SoRB?

I agree - its not *un*connected with sex. But I'll betcha there's something else going on, too.

I don't have the stats to hand, nor the time to carry out the necessary search, which I can do later if people want.

I think some of the diseases concerned are often masked by the contracptive pill, so may only become symptomatic once the pill is stopped. IE when you try an conceive.

Endometriosis and PCOS are the two that spring to mind, pelvic inflammatory disease is another.

The causes of infertility of course vary with the population studies, apparently endometial TB is a common cause in India, and malnutrition and aneamia a common cause in sub sarharan africa.

Where on earth should/does this wonderful state of affairs apply ?
Should concern be for a single mother in the UK or a whole family in Somalia. For that matter a whole family in the UK in need of help.
If everyone honored their own immediate obligations to themselves and their families the question of individual rights would not arise.
Families of the world unite, collectively we stand, divided we fall.

All of which raises a question...

Say a woman has a disease which has various sympoms and effects, including infertility.

What counts or doesn't count towards treatment of that disease:

- At least you're not dying?

- You're no longer in excruciating pain?

- You can walk?

- You're not bleeding quite so heavily?

- You can have children?

I can't see any obvious reason to single fertility out from that list. Nor can I see an obvious reasons why the type of treatment the woman receives should depend on her marital status.

I just don't see "not able to have children" as an *illness*.

We're also rather oddly focussed here on the idea that the only way a couple might be infertile is because of some horrible malfunction of the woman's plumbing. Plenty of men are infertile. Again, I wouldn't see that as an illness.

I mean, do you really need to ask that list of questions? Seriously?

If you're dying - you're ill. Duh.
If you're in excruciating pain - you're ill. Duh.
If you can't walk, because of something treatable - you're ill. Duh.
If you're bleeding heavily - you're ill. Or a woman having a period, possibly.

But if you're not in pain, perfectly mobile, not in danger of death, not bleeding, have no symptoms AT ALL... but can't conceive - are you really suggesting you're ILL?

Apart from anything else, we're discussing here an "illness" that you might not even EVER realise you have, depending on the choices you make in life. I could very well be suffering from the "illness" right now. I might well have been "suffering" from it my entire life. I might go to my grave "suffering" from it, never having found out. Which, by my estimation, means I'm not ill, and therefore don't need treating. At least, don't NEED treatment at taxpayers' expense.

Someone I know well recently found out that they have just one kidney. They found this out around age 40, entirely by chance. They aren't "ill" with it, per se. Should they get a donor kidney now? It should be obvious that they should not - they don't NEED a donor kidney. They're not ill. The one they have works just fine, and to have an op would be painful for them and expensive for the rest of us, and would deprive someone else of a potentially lifesaving treatment.

I see this as just the same as IVF, and in particular NHS IVF performed on people who already have children. I simply don't understand how it can be justified in a healthcare system with limited resources.

Got to be careful what I say here as there's clearly a thin-skinned idiot reading this thread and yikesing posts they don't like...

Obviously I'm aware of the military use of rape. And obviously there's "something else going on". But then again, in all the good sex I've ever had there was "something else going on" - brain being the most important sex organ and all that. But that was my point - there was something else going on as a side issue to the main event... which was sex.

"Rape is not about sex" is simply a ridiculous argument. "Rape can have secondary motivations besides the sex" is something I'd be prepared to discuss.

>>But if you're not in pain, perfectly mobile, not in danger of death, not bleeding, have no symptoms AT ALL... but can't conceive - are you really suggesting you're ILL?

To the extent that you have a physiological malfunction that prevents you from doing something that most women would expect to do at sometime in their life...yes.


To take an analogy from psychiatric medicine...believing there are snipers on the rooftops may or may not be an illness. But it's certainly an illness if it stops you going out. Your neurobiology is interfering with your social functioning.

Does it make sense if you think about it that way? Reproductive biology interfering with the normal, expected, mainstream social function of having a family.

Duh back atcha. I don't see what you're not getting here.

'Many' might be overstating the case. I reckon I am allowed a bit of hyperbole though. You, Twiglet, compared the urge to have children with the urge to rape, which regardless of the 'rape/sex/secondary urges' argument (I'd put the 'other things' at primary not secondary is all, and \I suspect is all that the 'it's not about sex' people would do to. Semantics. Pah. Not interesting. You're still wrong if you think the other things are 'secondary' though. ) is probably a bit much. Oooh I want some offensive italics there. Can we get italics in posts in noohootoo?

However, it is more than the zero and yet pretty much zero is, as you say, is the impression we get of infertile women. Actually I think in my acquaintance it's about 2/3. That's anecdotal, of course. I am rather interested in the statistics now.

Anyway, I'm gonna have a bet on the truth being somewhere between my 'generally, and your 'vast majority'. Hopefully marginally on my side of the argument of course.

I don't thinks there's a thin-skinned Yikesed. I'm on pre-mod so my posts will be getting more scrutiny. All but two are now back up, if you'd care to go back and read them.


I anticipate at least one being Yikesed . The other was milder but might go also.

"But it disturbs me that someone earlier simply discounted all ivf treatment (if I understood that point correctly) as being not terribly important priority wise in this day and age of straightened circs. Otto, I think it was. Which was a shame as I had been nodding quite enthusiastically earlier in his (your) post."

Hi Solnushka... I'd like to think my point was slightly more nuanced than that. I said it was difficult to make the case... but let's hear the case.

"But I would have said there are quite a lot of treatments which I'd rather see dropped as less of a priority than infertility treatments."

Well... okay... like what? It's easy to say that X and Y should be funded, but rather harder to say that A and B shouldn't.

Here's what I think we should do about rationing ... it's quite radical, and probably most people will hate it.

A huge proportion of the healthcare budget is spent on healthcare for the elderly. While no-one wants to see old people suffering, why don't we as a society with a publicly-funded NHS, say that we want a healthcare system that prioritises a good quality of life of a certain length for as many people as practically possible. We'd need experts to decide what that length of the standard good quality life should be.

Thus, those who have already lived that length of good quality life would not be a priority. By all means let's have lots of pain management and palliative care - no-one wants to see people suffer. But ultimately, we say that "you've had a good innings, and we want to concentrate resources on those who haven't."

So.... what becomes a priority? Well, conditions that kill young people and/or affect people at a young age. More money for childhood diseases, mental health services, more money for A&E and for accident recovery. IVF might even be a higher priority under these priorities.

Umm, isn't that what happens already? They didn't really treat my Grandad's cancer because he was 87 and the chances of it actually doing any good for a any sensible period of time were, I should think, zero. Palliative care, yes, of course. I'm ok with that - it's not a criticism.

The daily mail reader in me would prefer a system based on the relative health of your lifestyle. The self preservationist in me wouldn't. Plus, It's not as logistically neat as your idea - working out the degrees of damage you'd done to yourself and the level of seriousness and so on would be a bureaucratic nightmare, although since this is the NHS we are talking about.... Mind you, isn't that the situation in the States. I assume that insurance is based on some kind of health assessment.

Ok let's go with your idea. I've got at least twenty odd years before it applies to me, and I can smoke myself to death happily then too.

All of which is...an argument. (and do I suspect a 's avocado?)

But it slightly rests on the assumption of Straitened Times. We *could* run our economy so that we could afford better healthcare.

Now I fully accept that resources are not infinite and that decisions will have to be made. But we should at least try to balance between all the variable rather than taking things like level of funding as a Given. In fact, we shouldn't even think of it as 'level of funding'. Instead we might think of measuring 'Are we doing all the things we really need to do?' Looking after one group at the expense of another would score low on that and to achieve a high score you might need to raise money. That might hit pay packets...but that's part of the balancing act.

It all depends on what variables you choose to measure, and those depend on how you choose to measure societal success*.

Possibly we might decide that if we haven't managed to organise ourselves to give the elderly quality of life then we haven't made much progress.




* See also Wilkinson and Pickett. Should we measure GDP or income distribution?