Reproductive outsourcing: an empirical ethics account of cross-border reproductive care in Canada

Abstract

Cross-border reproductive care (CBRC) can be defined as the movement from one jurisdiction to another for medically assisted reproduction (MAR). CBRC raises many ethical concerns that have been addressed extensively. However, the conclusions are still based on scarce evidence even considering the global scale of CBRC. Empirical ethics appears as a way to foster this ethical reflection on CBRC while attuning it with the experiences of its main actors. To better understand the ‘in and out’ situation of CBRC in Canada, we conducted an ethnographic study taking a ‘critically applied ethics’ approach. This article presents a part of the findings of this research, obtained by data triangulation from qualitative analysis of pertinent literature, participant observation in two Canadian fertility clinics and 40 semidirected interviews. Based on participants’ perceptions, four themes emerged: (1) inconsistencies of the Canadian legal framework; (2) autonomy and the necessity to resort to CBRC; (3) safety and the management of CBRC individual risks; and (4) justice and solidarity. The interaction between these four themes highlights the problematic of ‘reproductive outsourcing’ that characterised the Canadian situation, a system where the controversial aspects of MAR are knowingly pushed outside the borders.

Not Worth the Wait: Why the Long-Awaited Regulations Under the AHRA Don’t Address Egg Donor Concerns

“…Now, improvements in the oocyte vitrification process have made it such that Canadian intended parents can pay American clinics and agencies to simply ship them frozen eggs from across the border. 131 This means that Canadian intended parents no longer even have to travel to the United States for donor eggs. Canadian egg donors are also working with American fertility clinics and agencies.…”

Commercial Surrogacy: An Overview

“…Due to the absence of uniform international legislation, cross-border surrogacy treatments may pose legal issues when returning to the home country of IPs with children who, according to the legislation of the receiving country, have been conceived illegally. [144][145][146][147] The main steps where IPs face difficulties most frequently in their home countries are when requiring a passport or any travel documentation at their consular authorities overseas to return home with the child, and when the IPs, back home, wish to register their children as a national citizen. 148 If their native countries do not recognize surrogacy, patients may struggle to register the child as theirs.…”

Grounded ethical analysis

“…In this issue, Couture et al report on empirical work they conducted about the implications of cross border medically assisted reproduction between Canadian provinces 6. They set out to understand the ‘moral world’ of the main actors in cross border medically assisted reproduction.…”