Reflections on autonomy in travel for cross border reproductive care

Abstract

Travel for reproductive health care has become a widespread global phenomenon. Within the field, the decision to travel to seek third parties to assist with reproduction is widely assumed to be autonomous. However there has been scant research exploring the application of the principle of autonomy to the experience of the cross-border traveller. Seeking to contribute to the growing, but still small, body of sociological bioethics research, this paper maps the application of the ethical principle of autonomy to the lived experience of infertile individuals who cross borders for reproductive care. It examines their choices as patient, consumer and traveller. It suggests that their experience evidences a contradictory autonomy, which offers them both choice and no choice in their final decision to travel. The paper argues that this lack of meaningful autonomy is enabled by a medicalised framework of infertility which prioritises technology as the cure to infertility. This both shapes expectations of infertile individuals and limits their options of family creation. Ultimately, the paper suggests that sociological bioethics research shows that the liberatory credentials of technology should be questioned, and identifies that this field demands greater scholarly attention.

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Notes

  1. 1.

    51.8 per cent of women aged 25–45 report infertility at some point in their lives and fewer than 50 percent of infertile women receive medical treatment (Greil et al. 2011).

  2. 2.

    While less relevant for Australia’s domestic legal system support for reproductive autonomy is found in international instruments (such as the International Convention on Civil and Political Rights, the Convention on the Elimination of Discrimination Against Women, the International Conference on Population and Development, and the European Convention on Human Rights).

  3. 3.

    This can be seen across medical law; see, for example, the use of the Bolam test for negligence (Brazier and Miola 2000).

  4. 4.

    One journalist calling it “terrifying” (Price 2017).

  5. 5.

    This is supported by research findings that fertility patients highly value interpersonal relationships with doctors, and individualised care, especially given the emotional nature of fertility treatment (see Dancet et al. 2011; Malin et al. 2001; van Empel et al. 2011).

  6. 6.

    Unlike, for example, the fair trade movement (see Davenport and Low 2013: 89).

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Acknowledgements

This research was funded by Australian Research Council Grant DP 1510157. Thanks to Jenni Millbank, Isabel Karpin and Norman O’Dowd for comments on earlier versions of this paper and to Miranda Kaye, Rachel Carr, Norman O’Dowd, Michaela Stockey-Bridge and Susan Chandler for research assistance on the project and to our interview participants for sharing their views and thoughts.

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Stuhmcke, A. Reflections on autonomy in travel for cross border reproductive care. Monash Bioeth. Rev. 39, 1–27 (2021). https://doi.org/10.1007/s40592-020-00125-x

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Keywords

  • Autonomy
  • Cross border reproductive care
  • Bioethics
  • Infertility
  • Reproduction
  • Assisted reproductive technology