不孕症患者和患者倡导者长期以来一直主张将不孕症归类为一种疾病,希望这种认可将改善生育治疗的覆盖面和获得机会。然而,对于许多生育患者来说,包括老年妇女,单身女性和同性伴侣,不孕症并不代表真正的疾病状态。因此,虽然称不孕症为“疾病”似乎在政治上是有利的,它实际上可能将患有“社会”或“关系”不孕症的患者排除在治疗之外。需要的是一个新的不孕症概念框架,更好地反映出许多人不育的深远意义以及解决不孕症以改善他们生活的重要性。在本文中,我们认为能力方法提供了这种道德基础。能力方法关注的是人们能够做什么,以及他们是否能够以符合自己价值观和目标的方式行事。生育和建立家庭的能力是一种基本能力,可以成为自我实现的重要组成部分,不管性取向或家庭安排。由于能力方法要求我们从能力平等的角度来构想平等,它为社会提供了强大的道德动力,以帮助那些无法自行怀孕的人进行辅助生殖。
Infertility patients and patient advocates have long argued for classifying infertility as a disease, in the hopes that this recognition would improve coverage for and access to fertility treatment. However, for many fertility patients, including older women, single women and same-sex couples, infertility does not represent a true disease state. Therefore, while calling infertility a \'disease\' may seem politically advantageous, it might actually exclude patients with \'social\' or \'relational\' infertility from treatment. What is needed is a new conceptual framing of infertility that better reflects the profound significance of being infertile for many people and the importance of addressing infertility in order to improve their lives. In this paper, we argue that the capability approach provides this moral underpinning. The capability approach is concerned with what people are able to do, and whether they are able to act in a way that is in keeping with their own values and goals. The ability to procreate and build a family is a fundamental capacity and can be a major part of self-fulfilment, regardless of sexual orientation or family arrangement. Since the capability approach asks us to conceive of equality in terms of equal capabilities, it provides a strong ethical impetus for society to help those who cannot conceive on their own to do so with assisted reproduction.