Letter to the editor |
Reply: Reproductive exile versus reproductive tourism
Department of Philosophy and Moral Science, Ghent University, Blandijnberg 2, B-9000 Ghent, Belgium
E-mail: Guido.Pennings{at}Ugent.be
Sir,
Concepts, like definitions, play a crucial role in debates. The original term ‘medical tourism’ was used when people went on vacation to exotic places and took advantage of the opportunity to obtain some medical treatment. Tourism was their primary motive. However, this clearly has changed in recent years. Travelling is now mainly motivated by the medical treatment; the exotic and recreational aspect is thrown in as a nice extra. ‘Tourism’ is a derogatory term when used in the medical context. It implies that the desire for which people travel is insignificant or negligible. Moreover, it suggests that these people are looking for something strange and exceptional. Obviously, the term is very much preferred by journalists and opponents of liberal legislations when presenting what are considered as ‘bizarre’ cases. However, a closer look at the movements within Europe reveals that for the overwhelming majority this is not the case. The largest part of the movements can be explained by long waiting lists, lower costs or treatments such as oocyte donation and IVF (Pennings, 2004
).
The term ‘reproductive exile’ proposed by Prof. Matorras is interesting but overemphasizes the opposite position: people are sent or forced into exile as a form of punishment. While this could be correct, it depends on the interpretation. I propose to replace the term ‘reproductive tourism’ by ‘cross-border reproductive care’. This term has a number of advantages: (i) it avoids the negative connotations of ‘tourism’; (ii) it is objective and descriptive since it holds no value judgment regarding the movements; and (iii) it links with the more general term ‘cross-border health care’ that is commonly used when other types of movements for health services are considered. It is indeed remarkable that when policy-makers are considering the use of health care services across borders in the European Union for instance, the term ‘tourism’ is not mentioned once (Commission of the European Communities, 2004). One talks of patient mobility, efficient use of health care capacity etc. These considerations never appear in comments on movements for fertility treatment.
Once we realize the importance of semantics in public debates and policy-making, we should make an effort to clean up our language. Let it be ‘cross-border reproductive care’ from now on.
References
Commission of the European Communities (2004) Follow-up to the high level reflection process on patient mobility and healthcare developments in the European Union. Brussels 20.04.2004 COM(2004)301final. http://europa.eu.int/eur-lex/en/com/cnc/2004/com2004_0301en01.pdf
Pennings G (2004) Legal harmonization and reproductive tourism in Europe. Hum Reprod 19,2689–2694.
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