Abstract
The article examines the legal nature of assisted reproductive technologies (ART) as the subject of a contract for the provision of medical services in the context of Directive 2011/24/EU of the European Parliament and of the Council on the application of patients’ rights in cross-border healthcare. The key concepts of the Directive relevant in the context of the study are analyzed, such as “medical care”, “cross-border healthcare”, “patient rights”, and the possibility of their application to contractual relations arising when receiving ART services in another state. The issue of qualifying ART services as planned medical care, which requires obtaining prior permission from the state insurer, is considered, and an attempt is made to outline the legal boundaries of such regulation. Separately, the study examines the contractual relations between the patient and the medical institution (institution) providing ART services, including issues regarding the subject of the contract, the definition of its parties, the scope of the obligations of the medical institution (institution) to the patient and the mechanism for protecting the patient’s rights as such. The provisions of Directive 2011/24/EU of the European Parliament and of the Council on the application of patients’ rights in cross-border healthcare are analyzed in terms of the legal regulation of ART services in Ukraine in the context of the adaptation of national legislation to EU standards within the framework of Ukraine’s implementation of the Association Agreement. Sectoral conclusions and proposals are formulated regarding the possibility of improving the legal regulation of contracts for the provision of ART services in Ukraine, taking into account the European integration course, the requirements of EU legislation and the recodification of civil legislation.
References
1. Ministry of Health of Ukraine. (2013). Pro zatverdzhennia Poriadku zastosuvannia dopomizhnykh reproduktyvnykh tekhnolohii v Ukraini [On approval of the Procedure for the Use of Assisted Reproductive Technologies in Ukraine] (Order No. 787 of September 9, 2013). https://zakon.rada.gov.ua/laws/show/z1697-13 (in Ukrainian)
2. European Parliament, & Council of the European Union. (2011). Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare. Official Journal of the European Union, L 88, 45–65. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:02011L0024-20140101
3. Cabinet of Ministers of Ukraine. (2026). Pro zatverdzhennia Natsionalnoi prohramy adaptatsii zakonodavstva Ukrainy do prava Yevropeiskoho Soiuzu (acquis YeS) [on approval of the National Program for Adaptation of the Legislation of Ukraine to the Law of the European Union (EU Acquis)] (Resolution No. 438 of April 1, 2026). https://www.kmu.gov.ua/npas/pro-zatverdzhennia-natsionalnoi-prohramy-adaptatsii-zakonodavstva-ukrainy-do-prava-t10426 (in Ukrainian)
4. Pennings, G. (2009). International evolution of legislation and guidelines in medically assisted reproduction. Reproductive BioMedicine Online, 18(2), 15–18. https://doi.org/10.1016/S1472-6483(10)60443-9
5. Pennings, G., & de Wert, G. (2003). Evolving ethics in medically assisted reproduction. Human Reproduction Update, 9(4), 397–404. https://doi.org/10.1093/humupd/dmg031
6. de Paor, A. (2017). Genetic Discrimination: A Case for a European Legislative Response? European Journal of Health Law, 24(2), 135–159. https://www.jstor.org/stable/48712309
7. Mulligan A. (2020). A vindicatory approach to tortious liability for mistakes in assisted human reproduction. Legal Studies, 40(1), 55–76. https://doi.org/10.1017/lst.2019.19
8. Cohen, I. G. (2015). Regulating bodies across borders: Medical tourism for services legal in the home and destination country: Legal and ethical issues. In B. Parry, B. Greenhough, T. Brown, & I. Dyck (Eds.), Bodies across borders: The global circulation of body parts, medical tourists and professionals. Ashgate. https://ssrn.com/abstract=2610661
9. Golynker, O. (2014). Patient Mobility and Healthcare in the EU. University of Leicester School of Law Research Paper, 14(33). https://ssrn.com/abstract=2529941
10. de La Rosa, S. (2012). The Directive on cross-border healthcare or the art of codifying complex case law. Common Market Law Review, 49(1), 15–46. https://doi.org/10.54648/cola2012002
11. Jackson, E. (2016). Medical law: Text, cases and materials (4rd ed.). Oxford University Press.
12. Merete, L., Lykke N. (2016). Assisted reproduction across borders: Feminist perspectives on normalizations, disruptions and transmissions (1st Edition). Taylor & Francis. https://doi.org/10.4324/9781315561219
13. Greer, S., Hervey, T., Mackenbach, J. & McKee, M. (2013). Health law and policy in the European Union. The Lancet, (381), 9872, 1135–1144. https://doi.org/10.1016/S0140-6736(12)62083-2
14. Wismar, M., Palm, W., Figueras, J., Ernst К., van Ginneken, Е. (2011). Cross-border health care in the European Union: mapping and analysing practices and policies. World Health Organization. Regional Office for Europe, European Observatory on Health Systems and Policies. https://iris.who.int/handle/10665/327961
15. Campiglio, С. (2023). EU Cross-border Telemedicine: A Partial Harmonisation of Product and Professional Liability? European Papers – A Journal on Law and Integration, 8(3), 1539–1554. https://www.europeanpapers.eu/system/files/pdf_version/EP_EF_2023_I_047_Cristina_Campiglio_00729.pdf
16. European Commission, Directorate-General for Health and Food Safety. (2026, April). Member State data on cross-border patient healthcare following Directive 2011/24/EU: Reference year 2024 (Final version). https://health.ec.europa.eu/document/download/b92c70f2-7415-465d-82c9-508f595fe880_en?filename=crossborder_2024_patient-healthcare_data_en.pdf
17. Cross-Border Healthcare: Why Patients Still Fall Through the Cracks. (February 10, 2026). HealthyEurope: Health & Wellbeing Magazine. https://healthyeurope.eu/cross-border-healthcare-eu/
18. Jain, M., Fang, E., & Singh, M. (2025). Assisted Reproductive Technology (ART) Techniques. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK576409/
19. World Health Organization. (2025, November 28). Infertility. https://www.who.int/news-room/fact-sheets/detail/infertility
20. Shchesiuk, O. V., Shcherbak, Yu. H., Zapalskyi, V. M., Klymenko, M. O., & Netiukhailo, L. H. (2021). Medychna kondytsionuiucha ta kriohenna tekhnika: navchalnyi posibnyk [Medical conditioning and cryogenic technology: a training manual]. Vyd-vo ChNU im. Petra Mohyly. https://surl.li/szktzo
21. European Parliament, & Council of the European Union. (2011). Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients' rights in cross-border healthcare. Official Journal of the European Union, L 88, 45–65. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32011L0024
22. Court of Justice of the European Union. (2006, May 16). The Queen, on the application of Yvonne Watts v. Bedford Primary Care Trust and Secretary of State for Health (Case C-372/04). https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:62004CJ0372
23. Maidanyk, R. (2010). Dohovir pro nadannia medychnykh posluh [Contract for the provision of medical services]. Medychne pravo – Medical law, 5(1), 52–66. https://medicallaw.org.ua/uploads/media/Maydanyk.pdf (in Ukrainian)
24. Posmertne batkivstvo: sud dozvolyv zhintsi narodyty dytynu vid zahybloho viiskovoho za dopomohoiu krioembrioniv [Posthumous paternity: court allows woman to give birth to child from deceased soldier using cryopreserved embryos]. (May 26, 2026). Sudovo-yurydychna hazeta – Judicial and Legal Gazette. https://sud.ua/uk/news/sudebnaya-praktika/362143-posmertnoe-ottsovstvo-sud-razreshil-zhenschine-rodit-rebenka-ot-pogibshego-voennogo-s-pomoschyu-kriomebrionov (in Ukrainian)
25. European Parliament, & Council of the European Union. (2008, June 17). Regulation (EC) No 593/2008 of the European Parliament and of the Council on the law applicable to contractual obligations (Rome I). Official Journal of the European Union, L 177, 6–16. https://eur-lex.europa.eu/eli/reg/2008/593/2008-07-24
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2026 Olena Ustymenko