Medical and Legislative Gatekeeping in ART: Narrow Trajectories in the Realm of Miracles

The techniques of assisted reproduction have the potential to free us from the bodily limitations and open the physical reproduction to people who would not conceive without medical intervention. The access to this type of treatment is regulated by numerous ways, both formally and informally. Reproductive medicine, seemingly firmly anchored in scientific objectivity, and often presented as a revolutionary or miraculous cure for anyone, in its praxis works as a controlling mechanism over bodies and the reproductive capacities of citizens, differentiating between the categories of patients.

            The Czech Republic, with its long tradition of infertility treatment, wide network of infertility clinics, competitive success rates and liberal regulation of the ART regarding the range of procedures allowed, became one of the most popular destination of reproductive tourism. On the other hand, there is a strict regulation of the access to the ART based on the characteristics of patients such as their age, sexuality and partnership. The paper will focus on the process of the legislative and medical gatekeeping as a genuine example of the foucauldian biopower, as a control over bodies, interaction and norms of population performed by the medical professionals and by the administration and regulation of treatment. The paper is based on the two sources of data: interviews with 15 medical professionals working in the field of ART and the analysis of the Czech parliament debate over the new legislative limits of ART (2011). The analysis focused on the following questions: what is the position of various actors in the process, how is nature and normality, in the context of ART, discussed, what kinds of citizens/patients are defined by the clinicians and parliament members as deserving candidates for infertility treatment, and, how these regulatory mechanisms can be reflected in the context of “biotech age” and globalized bipolitics.