Fertilize-this: Framing Infertility in Quebec, Ontario and England Between 1990 and 2010

Abstract

Infertility politics implies a role for the state in regulating the relationships between different parties involved in the medicalized process of reproduction, namely would-be-parents (infertile couples or individuals), gamete donors, surrogate mothers, fertility specialists, etc. Policies adopted by the Canadian federal government in 2004 as regards assisted reproductive technologies (ARTs) were largely inspired by British regulations. Despite this similar start, Canadian policies never lead to implementation; the province of Quebec rapidly contested the federal Assisted Human Reproduction Act before the courts; and many issues of assisted conception were regulated in a heterogeneous manner by the provinces. Meanwhile in Britain, the implementation of the policies created many disparities among the regions of the country; the principle of the law was thoroughly contested and scrutinized; and the sites of deliberation were multiple in spite of the existence of a national regulatory agency. First, the author argues that assisted reproduction technologies cannot be taken as one policy domain, but is an umbrella label for a variety of policy issues. In that context, ARTs are unpacked in order to study, at the system level, the practices related to the overcoming of infertility. I focus on three sub-issues: access to fertility treatments, including the question of public funding and access criteria; gamete and embryo donation, including the question of filiation and donor conceived children’s right to know their biological origins; and surrogacy or the enforcement of pre-natal gestational surrogacy arrangements. Second, by mapping the variety of discourses and arenas mobilized by a range of actors, this study shows how framing and reframing dynamics influence public policies and their implementation. Third, by comparing frame mobilization and discursive dynamics between Quebec, Ontario and England this analysis demonstrates how frame alignment can be a necessary condition for a frame to be performative and influence policy outcomes. Depending on the context in which it occurs, frame transformation, amplification, extension or bridging can induce stability or trigger a cascade of events that will lead to policy change or to a change in the implementation of a policy.