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 Yes, if they want to, some ethicists argue in an essay in the
European Journal of Obstetrics and Gynecology and Reproductive
Biology.
“Physicians should abide by national laws,” lead author Wannes Van
Hoof, a bioethicist at Ghent University in Belgium, said by email.
As long as they are providing care that is legal where they
practice, states shouldn’t interfere, Van Hoof added.
More than half of all patients crossing borders for reproductive
care do so to evade the law of their home country, Van Hoof and
colleagues note. In Europe alone, this may account for roughly
15,000 cycles of fertility treatments provided each year.
Cross-border patients are typically seeking treatments such as sperm
or egg donation, pre-implantation genetic screening or reproductive
technologies reserved for heterosexual couples in their home
country, the authors say.
The ethicists say that ideally, to ensure the best care, patients’
regular doctors at home should coordinate with the physicians who
provide care abroad – but they also point out that the doctors at
home can face stiff penalties for their involvement.
They note, for example, that the French Ministry of Health in 2012
warned local physicians that they risk five years of prison and a
fine of 75,000 Euros if they tell patients about the possibility of
egg donations abroad, where compensation to donors is higher and
more donors are available.
In Germany, before 2011, it was illegal for a doctor to refer a
patient abroad for pre-implantation genetic screening. And in
Turkey, physicians who help patients cross borders for egg or sperm
donation risk up to three years in jail.
Good communication and cooperation between doctors in different
countries can help reduce the number of times patients need to
travel for care and potentially help them receive higher quality
treatments at a lower cost, the authors argue.
Many laws that patients seek to evade by crossing borders for care
may have roots in moral beliefs that they and their physicians don’t
share, the authors note.
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The French government, for example, warned physicians about the
consequences of assisting with egg donation overseas out of a moral
belief that human eggs should not be bought or sold anywhere, the
authors point out.
Just because physicians agree to help provide cross-border
reproductive care, however, doesn’t make this risk-free for
patients, cautioned Yuri Hibino, a health researcher at Kanazawa
University in Japan.
Care may be complicated by language barriers, and patients might
also face challenges getting follow-up care when they return home,
Hibino, who wasn’t involved in the essay, said by email.
In Japan, some clinics have started suggesting foreign clinics to
patients seeking egg donations, Hibino noted. But some maternity
hospitals won’t deliver egg-donation babies because they don’t want
to accept the additional risks that might come with older mothers,
pregnancies involving multiples, and egg donation abroad.
SOURCE: http://bit.ly/1Md4SXC European Journal of Obstetrics and
Gynecology and Reproductive Biology, published online September 2,
2015.
(The story was refiled to correct the name of the journal in the
source line at the end of the story)
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