‘What are you going to do, confiscate their passports?’ Professional perspectives on cross-border reproductive travel

Abstract

Objective: This article reports findings from a UK-based study which explored the phenomenon of overseas travel for fertility treatment. The first phase of this project aimed to explore how infertility clinicians and others professionally involved in fertility treatment understand the nature and consequences of crossborder reproductive travel. Background: There are indications that, for a variety of reasons, people from the UK are increasingly travelling across national borders to access assisted reproductive technologies. While research with patients is growing, little is known about how 'fertility tourism' is perceived by health professionals and others with a close association with infertility patients. Methods: Using an interpretivist approach, this exploratory research included focussed discussions with 20 people professionally knowledgeable about patients who had either been abroad or were considering having treatment outside the UK. Semi-structured interviews were recorded, transcribed verbatim and subjected to a thematic analysis. Results: Three conceptual categories are developed from the data: 'the autonomous patient'; 'cross-border travel as risk', and 'professional responsibilities in harm minimisation'. Professionals construct nuanced, complex and sometimes contradictory narratives of the 'fertility traveller', as vulnerable and knowledgeable; as engaged in risky behaviour and in its active minimisation. Conclusions: There is little support for the suggestion that states should seek to prevent cross-border treatment. Rather, an argument is made for less direct strategies to safeguard patient interests. Further research is required to assess the impact of professional views and actions on patient choices and patient experiences of treatment, before, during and after travelling abroad.

Learning from Cross-Border Reproduction

“…In practice, de facto tolerance of the evasion of reproductive travellers may be inevitable; as one of Culley et al's respondents put it: 'what are you going to do, confiscate their passports?' 40 But whether characterised as a pluralistic 'safety value' 41 or as out-and-out hypocrisy, 42 there is at the very least a mixed message being sent about the status of the extra-territorial prohibition of international commercial surrogacy.…”

Cross-border reproductive care for law evasion: should physicians be allowed to help infertility patients evade the law of their own country?

“…It seems that patients who travel for legal reasons receive help from a local physician more readily than patients who travel for quality of care. The results from the ESHRE study correspond to a qualitative study in the UK regarding the perspectives of health care professionals on CBRC, which indicates that they are sympathetic to the needs of cross-border patients and that they are opposed to any suggestion that governments should prevent CBRC [8]. A more detailed look at the data reveals that even though many German patients seek to evade the prohibition of egg donation and French lesbians are denied access to ART, a high level of medical support was reported in Germany (81.7%) and France (79.0%).…”