PT  - JOURNAL ARTICLE
AU  - Vincent Couture
AU  - Régen Drouin
AU  - Jean-Marie Moutquin
AU  - Patricia Monnier
AU  - Chantal Bouffard
TI  - Reproductive outsourcing: an empirical ethics account of cross-border reproductive care in Canada
AID  - 10.1136/medethics-2017-104515
DP  - 2019 Jan 01
TA  - Journal of Medical Ethics
PG  - 41--47
VI  - 45
IP  - 1
4099  - http://jme.bmj.com/content/45/1/41.short
4100  - http://jme.bmj.com/content/45/1/41.full
SO  - J Med Ethics2019 Jan 01; 45
AB  - 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.