Ethical boundary-work in the infertility clinic.

Infertility practice and reproductive technologies are generally seen as 'controversial' areas of scientific inquiry that raise many complex ethical issues. This paper presents a qualitative study that considered how clinicians constructed the role of the 'ethical' in their everyday practice. We use the concept of ethical boundary-work to develop a theory of 'settled' and 'controversial' morality to illuminate how infertility clinicians drew boundaries between different conceptions of the role ethics played in their practice. An attention to areas of settled morality, usually rendered invisible by their very nature, enables us to see how clinicians manage the 'ethical' in their practice. We argue that by creating a space of 'no-ethics' in their practice--part of a settled morality that does not require articulation--the informants re-appropriate an area of their practice from 'outside' influences and control. Bringing these elements to light can help 'outsiders' to challenge and question these distinctions and therefore bring additional perspectives to debates over morality in the infertility clinic. Illuminating the everyday ethical concerns of infertility clinicians can help direct ethical thinking towards these practical concerns, as well as to more abstract debates.