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conditions. 111 In response, it must be noted that States routinely regulate medical treatments and
pharmaceuticals, allowing some procedures, restricting or even banning others. It does not make
the regulations automatically discriminatory, although some such measures may be found to
arbitrarily interfere with the patients’ right to private life, as was the case herein.
5.
The majority singles out the fact that the named victims are married, functionallyinfertile couples who are only able to procreate, if at all, through in vitro fertilization. However,
neither the fact of marriage nor the fact of infertility distinguishes these persons from other
individuals and couples in society whose situations preclude sexual reproduction: medically infertile
individuals or couples who are not married, homosexual couples who cannot legally marry or
sexually reproduce, and married fertile couples who – for reasons entirely within their private lives –
do not have sexual relations. All of these persons may be considered either functionally or
structurally infertile and are equally barred from in vitro fertilization techniques by the Constitutional
Chamber decision. Thus, those named in the petition constitute an under-inclusive group as far as
the claimed lack of equal treatment is concerned.
6.
The victims may also be an over-inclusive group. Some of them might be ineligible
for in vitro fertilization under appropriate State regulations, despite having been previously on a
waiting list for the procedure. Assisted reproductive technologies such as IVF inject third parties
into the reproductive process and this necessarily impacts the scope of privacy and the regulatory
powers of the state.
“Whether these third parties are physicians specializing in infertility care, or strangers willing
to provide the missing ingredients for the conception and birth of a child, the addition of one
or more actors to the traditional two-party procreative process exponentially increases its
complexity. The necessity of third parties in assisted conception means that the conception
process is no longer purely internal to the couple, but rather is externalized, forcing
prospective parents to seek out and procure services essential to their procreation.” 112
While the State in this instance regulated in order to protect human embryos, nothing in the decision
suggests that the State is precluded from also regulating to protect maternal health and life.
Indeed, States have been instructed to take measures to improve maternal health and reduce
maternal mortality. 113 The risks of pregnancy increase with age and the State may very well set an
upper age limit (as well as a lower one to protect girls from abuse). It may enact appropriate
regulations on record-keeping and laboratory procedures to ensure that embryos are not mistakenly
implanted in the wrong person, and to ensure the quality of medical treatment afforded. With all
these possibilities, it is not clear that the victims in this case constitute a cohesive and similarlysituated group.
7.
If the majority is correct that the named victims constitute a distinct category denied
equal treatment, then it seems implicit that the State can rectify the problem by allowing only that
category (medically infertile married couples) access to in vitro fertilization. Such a result seems
inconsistent with the right to private life enjoyed by all persons in society. Indeed, it would serve to
create discrimination rather than cure it.
111
The United States Center for Disease Control (CDC) considers a couple infertile if they have not used
contraception and have not become pregnant for twelve months or more. See Nat'l Ctr. for Health Statistics, 1995 National
Survey of Family Growth (1995). Note that the definition does not imply that there is an identifiable medical cause; infertility
is the inability to conceive for whatever known or unknown reason.
112
Judith F. Daar, “Accessing Reproductive Technologies: Invisible Barriers, Indelible Harms,” 23 Berkeley J.
Gender L. & Just. 18, 21 (2008).
113
See, e.g. ICESCR, General Comment No. 14: The Right to the Highest Attainable Standard of Health (art. 12)
paras. 14, 21.