How are legal rules on advanced parental age and access to Assistive Reproductive Technologies experienced by Swiss care professionals? A qualitative interview-based study

Assisted Reproductive Technologies (ART) are increasingly used to conceive a child. Starting a family using ART requires the collaboration of healthcare professionals and medical interventions, and is thus heavily regulated. The law plays a central role in determining which patients and upon fulfilling which conditions can access ART. Although the law sets the general rules, it is care professionals who need to apply and enforce them in concrete cases as part of their interaction with patients. To investigate how professionals experience applying and interpreting ART law, in particular when assisting older patients, we conducted an explorative study in Switzerland based on semi-structured qualitative interviews. Using thematic analysis and integrating it with an analysis of the Swiss legal framework for ART, we identified two main themes in our data. On the one hand, participants debated the implications of legal prohibitions in relation to cross-border reproductive care. On the other hand, they reflected on the legal rules in Switzerland and their interplay with moral practices and ethical convictions. Discussing these results, we highlighted the challenges of professionals in managing legal bans, given the cross-border nature of reproductive care. Moreover, we reflected on the government’s choice to regulate ART through criminal law and on the complex interactions between the legal framework and commonly-held moral convictions in the field of ART and family law.