Attitudes toward Reproductive Tourism and Cross border reproductive care (CBRC): Legal, Economic, Ethical issues and dilemmas, possibilities and limitations

Abstract

The goal of the present study is to discuss the issue of Cross-Border Reproductive Care known as CBRC and Reproductive Tourism. The subject is of great interest as this type of tourism has been flourishing in recent years, without, however, being thoroughly researched, regarding the very important, health, quality of medical care, financial, ethics, legality and transparency or illegality, aspects concerning the processes that are carried out for the desired result of human reproduction. In addition, one of the sharpest-increasing types of Cross-Border Reproductive Care is international surrogacy.  Thousands of interested people travel abroad for IVF and ICSI treatment, or with the aim to employ the paid services of foreign surrogates. The search for solutions has made CBRC a global industry. It is a multibillion-euro international industry introducing unique legal, financial, ethical, and risk-management challenges and disputes. The current study addressed this gap by examining Greek citizens’ attitudes toward Reproductive Tourism and Cross border reproductive and their legal, financial, ethical, consequences. To test the research hypotheses, a survey was conducted on 652 Greek citizens, who answered a questionnaire, which was distributed electronically in the format of a Google form. For the data analysis the study used the multiple correspondence analysis – MCA of sphere of multivariate data analysis. The results discuss, as far as the legal dimensions are concerned, the restriction on specific reproductive treatments in the country of residence. IVF and ICSI are allowed in almost all countries but there are legal restrictions regarding the age of the woman or the couple, unmarried couples, single woman, gay, transgender and same-sex couples. As far as the financial dimension of the CBRC is concerned, the study discusses the lack of financial data that is a natural consequence of the lack of both national and global registers. The cost of infertility treatment seems to be one of the most basic reasons for those interested to seek assisted reproductive services outside the borders of their country of origin and residence, and the commercialization of health is an ethical issue that deserves further study in relation to the country of destination. In addition, the study discusses main ethical issues regarding donors and surrogate mothers, among others, which have to do with their exploitation, their moral and physical harm, possible child abuse, parental rights and the sale of babies which are considered of a major importance. Donor or surrogate mothers may suffer from serious and even life-threatening complications. Donor or surrogate mothers from low and economic backgrounds do not have the possibility of legal support and coverage and cannot claim parental rights. Additionally, the study debates the high cost of treatments, health and care benefits, the economic exploitation of women from countries with weak economies, the instrumentalization of women, the legal issues and rights of descendants born in destination countries and in terms of their repatriation, the correct information and informed consent for the medical procedures to be performed, as well as many others because the list is long. According to the study the need that is obvious, due to the great impact of the CBRC, concerns the creation of a universal protocol through the European Council and the College of Obstetrics and Gynaecology (EBCOG) as well as the American College of Obstetrics and Gynaecology (ACOG) to remove all the above mentioned issues , issues and moral dilemmas that above all will guarantee the good of health, justice, non-harm, the good of justice, autonomy and self-determination and finally, human rights.