Wednesday, August 30, 2006

Children Are Messy

Children are messy. I don’t mean, children make a mess – that goes without saying. I mean, the issue of ‘children’ is a messy one. On the one hand, hundreds of thousands are aborted each year in the UK alone; on the other hand, couples undergo thousands of fertility cycles each year in the UK. (Ironically, both the intervention to terminate life and the intervention to create it often – not always, in either case – share the same motivation: “Having a child would get in the way of my self-fulfilment” ; “I need to have a child in order to be self-fulfilled”…) And those who make it enter a lottery, where the pay-out is an emotionally stable home environment, to a lesser or greater extent; but for every ‘winner’ there are the players whose parent/s are unwilling or unable to raise them, those who grow up in dysfunctional or broken homes. Children are messy; and our society is ill-equipped to deal with mess – in this case not helped by the fact that there is no context, other than the lottery of our own childhood experience, where we are taught parenting skills.

Today the British Fertility Society is in the news for proposing changes to the way fertility treatment is offered on the NHS (our “free at the point of use” National Health Service). The BFS proposes that women who are underweight or clinically obese should be denied IVF treatment until they have addressed their weight issues; while single women and lesbian couples should have equal access to IVF as heterosexual couples.

Human fertility is a societal, and pastoral, minefield – and will only become more so as fertility currently plummets among men, at the same time as we are seeing a marked increase in unintentional female sterilisation as a result of STIs. As a father of three loved children – indeed, as a human being – I need to recognise and acknowledge and try to understand how painful it must be to want to have children and not be able to. But, I have also seen the incredible emotional toll of fertility treatment; the way Having A Child becomes all-consuming, even consuming the relationship that entered-into the process; the conversations that run, “If you loved me, you’d keep on trying…” “It’s because I love you that I don’t want to see you go through it all again. If you loved me, you’d be content with what we’ve got…” and on and on…For every lottery winner, there are far, far more tickets bought and hopes destroyed.

Hard though it may be to hear – and even harder to accept coming from a parent – having a child, or children, is not a human right. It is a responsibility – and, arguably, one often not taken seriously enough – and a privilege; but not a right. And that fertility treatment is offered at all on the NHS raises hard questions, even setting aside biomedical ethics. Should the NHS allocate finite funding away from making the sick well to creating more patients – patients who have an increased risk of being born prematurely, with the attending complications – and costs – both at birth and later in life?

Children are messy. And while there are no simple solutions, it seems to me that we need to foster imagination, not to solve the problem of un/wanted children, but to address the un/wanting; the unreality of the if-only; the-grass-is-always-greener-on-the-other-side. Policies and policy proposals fail at this, because by necessity they create standardised groups – obese women, teenage pregnancies, etc. – and cannot recognise individuals: people, with hopes and fears; burdens of guilt or failure; living in a complex mess. Not that any case is an exceptional circumstance, for which we must break the rules; but that every case is exceptional, and the rules don’t address the heart of the matter. Possibilities and policies will come and go. People, in need of pastoral encouragement, care, guidance and correction, remain the same.

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  1. Should the NHS allocate finite funding away from making the sick well to creating more patients …?

    Infertility is a medical condition. Lots of medical conditions are not life-and-death, but still receive treatment through the NHS (or Medicare, its equivalent here in Canada). Cataract surgery, hip replacements, etc. — no one dies from these things — arguably they are just "quality of life" matters — but they are still deemed worthy of treatment.

    I agree that you've touched on some real issues, but I'm not clear what solution you're hinting at. I assume you wouldn't favour the kind of social engineering that goes on in China. And that's the only way to ensure that only "worthy" people are authorized to produce babies.

    A secular society might decide that religious folk like you aren't "worthy" to parent.

  2. q - "Infertility is a medical condition" - absolutely; I agree - and I don't think that I said that the NHS shouldn't help address it. What I was trying to highlight was that this is a complex issue...perhaps blogs aren't a good medium for engaging with complex issues, but, with this blog I want to touch on realities of life, simple or complex, mundane or profound...

    I do believe that IVF is not a miracle cure; nor even as straightforward as cataract surgery or hip replacements routinely are. I don't think anyone is wrong to opt for IVF; but I do think that when it is not successful there are a lot of pieces to be picked up, and that we ought to be there, not in judgement but in compassion.

    I don't advocate social engineering. It is very easy, in our tabloid culture, to make the simplistic claims that it is the working class who have shown themselves incapable of handling the responsibility of raising children and the best solution would be compulsory sterilisation of the poor - sorry if that sounds over-the-top; perhaps you don't have a tabloid press in Canada quite like the one we have here. Social engineering is not the answer; nor is passing judgement on others. But, I do think we need to engage with modelling parenting - and there are some excellent role-models in the UK at present, but we need to move beyond the 'expert' to the practitioner-next-door, from outside help to neighbourhood community...

    I'm glad you care enough to respond to my post. That, rather than the 'satisfaction' of providing a solution, is good enough for me.