Patient advocacy: health, money or both?
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* Henry J. Conter

Dr. Bouzayen, in her recent editorial calling for public funding of in vitro fertilization (IVF), 1 makes a convincing argument that the current high cost of IVF acts as an incentive for women to request multiple embryo transfers to increase their chance of pregnancy, despite the risk of multiple gestation and its associated complications. But why are their physicians performing these potentially hazardous procedures? It would appear these doctors are acting in a manner that is at least as “shortsighted” as those who do not support funding IVF. This article may have inadvertently highlighted a deeper concern than the funding: Are doctors capable of advocating for a patient’s health in the setting of competing patient-related factors? At a minimum, Dr. Bouzayen seems to have shown that we need serious improvement in this area.

## Footnotes

*   **For the full letter, go to:** [www.cmaj.ca/cgi/eletters/181/5/243#210888](http://www.cmaj.ca/cgi/eletters/181/5/243#210888)

## REFERENCE

1.  1. Bouzayen R, Eggertson L. In vitro fertilization: A private matter becomes public. CMAJ 2009;181: 243.
    
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