{"id":28162,"date":"2013-08-05T10:09:19","date_gmt":"2013-08-05T09:09:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=28162"},"modified":"2013-08-05T15:17:07","modified_gmt":"2013-08-05T14:17:07","slug":"aser-garcia-rada-ideological-limits-to-public-assisted-reproduction-in-spain","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/08\/05\/aser-garcia-rada-ideological-limits-to-public-assisted-reproduction-in-spain\/","title":{"rendered":"Aser Garcia Rada: Ideological limits to public assisted reproduction in Spain"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" alt=\"Aser Garcia Rada\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/aser.jpg\" width=\"160\" height=\"160\" align=\"left\" \/> Since the conservative government of Mariano Rajoy\u00b4s People\u00b4s Party (PP) took office with an absolute majority on November 2011, healthcare has\u00a0repeatedly been the setting for implementing ideological decisions that often contradict scientific evidence, social reality, or both.<\/p>\n<p>With the PP collapsing in the polls due to\u00a0its cooperation with <a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.f2363\">the <i>austericide<\/i> imposed by the international authorities<\/a>\u00a0and\u00a0the daily news on the\u00a0 several corruption scandals affecting his party or other national institutions, this trend\u00a0to cover the relevant issues affecting the PP or the government with measures that are more ideological than technical may probably continue till the end of\u00a0 Rajoy&#8217;s\u00a0mandate.<!--more--><\/p>\n<p>The first of those moves was the exclusion of undocumented migrants from public healthcare, a measure whose opportunism and lack of evidence was discussed\u00a0 <a href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/06\/19\/aser-garcia-rada-undocumented-migrants-and-access-to-heathcare\/\">in a previous\u00a0blog<\/a>. The next ongoing polemic has been the debate initiated months ago by the ministry of justice &#8211; not the ministry of health &#8211; to change <a href=\"http:\/\/www.bmj.com\/content\/340\/bmj.c1401\">legislation on abortion, passed by the previous socialist government in 2010<\/a> and working perfectly well\u00a0to date, back to a similar one from\u00a01985, when abortion was still a crime and only legal\u00a0in specific circumstances.<\/p>\n<p>The latest one, in one of the first countries that accepted and legalized gay marriage, has been the exclusion of lesbians and single women from public funded fertility treatments. The decision was taken on July 23 in the periodic meeting between the national and regional health authorities, most of them also conservative. Though the first draft, that stated that funded therapies would be only available to couples &#8220;formed by a man and a woman,&#8221; was finally modified, the final legislation limits them to sterile people. Current legislation dating from 2006 allowed access to people with sterility but also in cases of an ambiguous \u201cclinical established indication.\u201d In practice this\u00a0enabled some hospitals in\u00a0certain regions to offer care to lesbians or single mothers.<\/p>\n<p>According to the government, sterility is\u00a0understood to mean after one year of unsuccessful sexual relations without contraception. I cannot imagine how\u00a0this can\u00a0be proven.\u00a0 Some\u00a0lesbians\u00a0stated they may\u00a0fulfil that criterion. In\u00a0<a href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/04\/05\/aser-garcia-rada-a-good-example-of-transparency-for-spanish-politicians\/\">one of her few<\/a> interventions, Ana Mato, from the Ministry of Health, Social Services and Equality &#8211; has said now that \u201cthe lack of a male [partner] is not a medical issue\u201d, a revealing statement that will be long remembered in the annals of healthcare.<\/p>\n<p>On the one hand, the budgetary saving may be small. According to the Spanish Society of Fertility (Sociedad Espa\u00f1ola de Fertilidad), only 10.000 assisted reproduction interventions were performed last year by the public sector, as\u00a0 <a href=\"http:\/\/sociedad.elpais.com\/sociedad\/2013\/07\/23\/actualidad\/1374611147_796311.html\">80% of therapies are performed in private clinics<\/a>. Lesbians and single mothers demanding them are usually not infertile, so they seldom need more than the cheapest intervention &#8211;\u00a0artificial insemination with\u00a0donor sperm,\u00a0which costs around 1000 euros. However, if austerity is compulsory, why not invite lesbians or single women to find a male partner, as some doctors have already done, or invite <a href=\"http:\/\/sociedad.elpais.com\/sociedad\/2013\/07\/19\/actualidad\/1374254778_124266.html\">infertile couples to find a fertile partner<\/a>. This\u00a0will obviously solve their issue at quite a low cost.<\/p>\n<p>On the other hand and most importantly, this decision is discriminatory.\u00a0<a href=\"http:\/\/sociedad.elpais.com\/sociedad\/2013\/07\/20\/actualidad\/1374336945_579215.html\"> A ruling by\u00a0the Superior Court of Justice\u00a0in the autonomous community of Asturias<\/a>\u00a0based on discrimination arguments, states that the regional socialist government has to\u00a0pay back money spent\u00a0by Silvia Garc\u00eda, a lesbian, on\u00a0fertilization therapies\u00a0after she was denied treatment\u00a0in her public center. Garc\u00eda told a national radio station that when first visiting her doctor with her partner, he asked them if they were lesbians in line with\u00a0regional health department policy.\u00a0 He then told them\u00a0he could not assist them. &#8220;The most important thing is that [the ruling] acknowledges my right,&#8221; she has said.<\/p>\n<p>Opposition parties and civil groups have also denounced\u00a0the new regulation for going against the Constitution, which states in\u00a0<a href=\"http:\/\/www.lamoncloa.gob.es\/IDIOMAS\/9\/Espana\/LeyFundamental\/titulo_primero.htm\">section 14<\/a> that no citizen can be discriminated for, among others, reasons of gender, or any personal or social condition or circumstance. &#8220;It is\u00a0a discrimination against all other models of families different from the heterosexual one,&#8221; said Mariluz V\u00e1zquez, spokesperson from the association of Single Mothers by Choice.<\/p>\n<p>But apart of neglecting\u00a0section 14, with these and other actions taken under the umbrella of austerity, Rajoy is being systematically negligent with the more relevant <a href=\"http:\/\/www.lamoncloa.gob.es\/IDIOMAS\/9\/Espana\/LeyFundamental\/titulo_preliminar.htm\">section 9.2<\/a>. This\u00a0\u00a0one states that &#8220;it is the responsibility of the public authorities to promote conditions ensuring that freedom and equality of individuals and of the groups to which they belong are real and effective, to remove the obstacles preventing or hindering their full enjoyment, and to facilitate the participation of all citizens in political, economic, cultural and social life.&#8221;<\/p>\n<p>This is just the opposite of what they are doing.<\/p>\n<p><em><strong>Aser Garc\u00eda Rada<\/strong> is a paediatrician at the Hospital Infantil Universitario Ni\u00f1o Jes\u00fas in Madrid, Spain, and a freelance journalist.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Since the conservative government of Mariano Rajoy\u00b4s People\u00b4s Party (PP) took office with an absolute majority on November 2011, healthcare has\u00a0repeatedly been the setting for implementing ideological decisions that often [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/08\/05\/aser-garcia-rada-ideological-limits-to-public-assisted-reproduction-in-spain\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-28162","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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