Informed choice, regulation and ambiguity: A socio-legal exploration of how service users and providers experience social egg freezing

Social egg freezing (SEF) has grown significantly in popularity in the UK in recent years, offering women the opportunity to delay motherhood. The technology has been welcomed by some for its liberatory potential, giving women more choice and control over when to have a child. However, others have questioned the extent of the benefits SEF can offer due to high costs and limitations, and the complexities involved in the 'choice' to delay motherhood or freeze eggs. Emily Jackson describes SEF as an 'ambiguous technology', noting that its benefits are 'speculative' and there are no guarantees of successful thawing or use of the eggs in fertility treatment in future.

Many authors in the sociological, legal and ethics literature, and empirical work, have drawn attention to the importance of clear communication of risks, benefits and limitations of SEF, and informed consent, to address these concerns and enable women to make informed decisions about SEF. However, no empirical work has yet examined whether informed consent is able to do the work expected of it in safeguarding the autonomy interests of service users (SUs) and effectively managing the ambiguities of this technology in practice.

In this thesis, I argue that the concept of ambiguity provides a helpful framework to explore how people engage with and understand service provision of SEF in practice. Through qualitative interviews with SUs and service providers (SPs), I explore tensions and differing or competing meanings within and between how SUs and SPs experience SEF and identify and explore any challenges for regulation.

Drawing on this data, I argue that there is tension between the groups' understandings of what it means to be informed in this context, as SPs and SUs prioritise different types and sources of information. I argue that both groups navigate the differing and competing roles of SUs in this context as consumer, patient and project manager at different stages of the process. I argue that the dual position of SPs in offering both healthcare and a commercial service disrupts the SP position as an expert information provider in the clinic.

Too much weight has been placed on autonomy and informed consent as offering a solution to the issues raised by SEF at the expense of other concerns and ethical values, and I argue that there is no simple legal reform that would solve the issues raised. Instead, any reform should focus on how to make patients feel cared for in the clinic and well-supported to navigate this technology.