Now that we have painted ourselves in a corner

'Cheaper than a newcomer': on the social production of IVF policy in Israel

This paper explores the shaping of health policy in terms of power relations and group interests, as enacted in Israel's IVF policy. A comparison with the principles of IVF provision in other countries (UK, Canada, USA) shows Israel's policy to be substantially more 'liberal'. In order to explain this exception, the policy is initially located within the context of the state's pro-natalist reproductive policy, women's impaired equality and a complex system of healthcare provision. A Parliament Committee discussion on the subject is then analysed in greater detail, revealing three narratives that are used to account for the state's IVF policy: a nationalised narrative of reproductive medicine as a source of international acclaim, a personalised narrative of compassion for anguished women, and a medicalised narrative of experts as being best capable of regulating IVF. All three narratives have merged within the local IVF discourse, enabling the creation and maintenance of consensus among the participating politicians, physicians, consumers and women activists. Of significance is the muted argument regarding the state's interest in enlarging its Jewish population, which dominated other discussions on this topic. I argue that it is the demographic interest which crucially underlies the state's willingness to sustain its costly IVF policy, and that it is this interest which has enabled the various participants--who all shared an interest in unlimited IVF provision--to present a unanimous agreement. State representatives then used this consensus as a firm civil ground for the development and maintenance of Israel's exceptional IVF policy. The paper concludes with several implications regarding women's health and wellbeing.

Informed consent issues in assisted reproduction

Given the enormous ethicolegal controversies surrounding the use of assisted reproductive technologies (ART) in the United States, the most important role for nurses may be helping couples and third party participants obtain fully informed consent. The high compensation fees for egg donors may place them at special risk of exploitation. New government and professional guidelines, broader representation on ethics committees, and expanded counseling about risks and benefits can help reduce the potential for litigation and enhance patient autonomy.