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This paper studies the optimal fiscal treatment of assisted reproductive technologies (ART) in an economy where individuals differ in their reproductive capacity (or fecundity) and in their wage. We find that the optimal ART tax policy varies with the postulated social welfare criterion. Utilitarianism redistributes only between individuals with unequal fecundity and wages but not between parents and childless individuals. To the opposite, ex post egalitarianism (which gives absolute priority to the worst‐off in realized terms) redistributes from individuals with children toward those without children, and from individuals with high fecundity toward those with low fecundity, so as to compensate for both the monetary cost of ART and the disutility from involuntary childlessness resulting from unsuccessful ART investments. Under asymmetric information and in order to solve for the incentive problem, utilitarianism recommends to either tax or subsidize ART investments of low‐fecundity‐low‐productivity individuals at the margin, depending on the degree of complementarity between fecundity and ART in the fertility technology. On the opposite, ex post egalitarianism always recommends marginal taxation of ART. [ABSTRACT FROM AUTHOR]

Evidence suggests that one reason doctors provide certain interventions in assisted reproductive technologies (ART) is because of patient demand. This is particularly the case when it comes to unproven interventions such as 'add‐ons' to in vitro fertilisation (IVF) cycles, or providing IVF cycles that are highly unlikely to succeed. Doctors tend to accede to demands for such interventions because patients are willing to do and pay 'whatever it takes' to have a baby. However, there is uncertainty as to what moral weight should be placed on patient‐led demands in ART, including whether it is acceptable for such demands to be invoked as a justification for intervention. We address this issue in this paper. We start by elucidating what we mean by 'patient‐led demand' and synthesise some of the evidence for this phenomenon. We then argue that a doctor's professional role morality (PRM) yields special responsibilities, particularly in commercialised healthcare settings such as ART, because of the nature of professions as social institutions that are distinct from markets. We argue on this basis that, while there may be reasons (consistent with PRM) for doctors to accede to patient demand, this is not always the case. There is often a gap in justification between acceding to patient‐led demands and providing contested interventions, particularly in commercial settings. As a result, acceding to demand in such settings needs a strong justification to be consistent with PRM. [ABSTRACT FROM AUTHOR]