Bioethics in practice: Addressing ethically sensitive requests in a Dutch fertility clinic

► Shows complex interplay between couples' situation, context, bioethical principles, staff views and medical practices. ► Shows the influence of routine medical practices on ethics decisions. ► At the end the reproductive autonomy of most couples seeking ART was not jeopardized. ► Multidisciplinary ethics meetings diminish the risk that decision making is (too heavily) shaped by staff subjective views.