Dr Luca Sabatini, from the Centre for Reproductive Medicine at St Bartholomew's Hospital in London, UK, has told the annual conference of the European Society of Human Reproduction and Embryology (ESHRE) in Prague, Czech Republic, that fertility clinics across Europe should take more steps to protect themselves against identity fraud by prospective patients.
Dr Sabatini explained research that his clinic had undertaken following a fraudulent attempt to obtain IVF at his own clinic - what had happened was that someone undergoing treatment had omitted to tell the clinic that they had changed their partner since their treatment began. 'We discovered that a couple who were about to undertake the final step of an IVF treatment were not being honest with us', he said, adding 'luckily we were able to stop the treatment just in time'. Fraud such as this would make consent forms for one of the couple irrelevant, for example, but was probably done to avoid having to 'start again' and have the preliminary investigations undertaken - including an assessment as to the welfare of the prospective child - for the new partner.
Dr Sabatini explained further the reasons why fraud might take place. 'Fraudulent behaviour may be fuelled by financial pressures, as the cost of treatment is high and public resources are limited. A patient may use a false identity in an attempt to have access to public funding from which he or she would otherwise be precluded. Or there may be more personal reasons, such as a change of partner during treatment. A considerable length of time may pass between the couple's referral from the family doctor and the start of treatment, or during the fertility investigations which are necessary before treatment can commence. During this time a relationship break-up may occur, and one partner may try to continue the treatment with a different subject', he said. He added that 'reduced biological options' may also lead people to try and deceive clinics, such as by lying about their age.
The research team surveyed 70 of the licensed clinics in the UK, the sample including both NHS-funded and private units. Forty-five of the clinics responded to the questionnaire, which asked clinics whether they had ever had, or suspected, a case of identity fraud. Of those that responded, 37 per cent answered positively to this question however, 25 per cent of clinics did not routinely check patients' identification. The methods that the clinics used to check a patient's identity at the beginning and throughout various stages of treatment were found to vary considerably - 12 clinics had no policy for checking identification at all. Fourteen clinics required photographic identification, and 13 of these would keep a copy of it. Referral letters from patients' personal doctors, or signatures of the patients, were used by 19 further clinics. Overall, the questionnaire results showed that 53 per cent of clinics did not feel that they had enough protection from identity fraud.
'Although identity fraud among patients is still a relatively infrequent event, it has important medico-legal ramifications', said Sabatini. 'Our overwhelming feeling is that there are insufficient measures to protect the unit, the patient's legal rights, and most importantly the future welfare and wellbeing of the unborn child', he added. The team will send its final results to clinics across the UK and Europe, in the hope it will encourage them to see identity fraud as a serious issue and perhaps to standardise methods of patient identification. They will also carry out a further survey in a year's time, to see if improved measures have been put in place. 'We hope to sensitise professional bodies in the UK and abroad and encourage them to set up study groups to identify solutions and evaluate the clinical, economic, social and ethical implications of this phenomenon', said Sabatini.
