The Role of Providers in Assisted Reproduction

2016 ◽  
Author(s):  
Judith Daar
Keyword(s):  
Assisted Reproduction ◽  
Patient Choice ◽  
Best Interests ◽  
Reproductive Decisions ◽  
Ethical Challenges ◽  
Ethical Considerations ◽  
Medically Assisted Reproduction ◽  
American Society ◽  
Multiple Patients

The need for infertility treatment brings professionals into reproductive decisions that are important private matters for patients. In medically assisted reproduction, providers are brought into roles traditionally regarded as occupied only by nature and into a position to determine which embryos are suitable for transfer in the effort to achieve pregnancy. These powers of judgment present ethical challenges for professionals providing assisted reproduction services. Among these challenges is the potential conflictual involvement of multiple patients in the process: intended parents, gamete donors, and gestational surrogates. Other challenges include the obligation to avoid discrimination in selecting embryos for transfer or in making decisions about which patients to serve. Providers must be informed by ethical discussions such as the ethics opinions of the American Society for Reproductive Medicine. Important ethical considerations include respect for patient choice, the best interests of offspring, nondiscrimination, and social justice.

scholarly journals Depression and Anxiety in Pathways of Medically Assisted Reproduction: The Role of Infertility Stress Dimensions

2019 ◽  
Vol 15 (1) ◽  
pp. 101-109 ◽  
Author(s):  
Andrea Pozza ◽  
Davide Dèttore ◽  
Maria Elisabetta Coccia
Keyword(s):  
Assisted Reproduction ◽  
Psychological Intervention ◽  
Lower State ◽  
Depression And Anxiety ◽  
Psychological Reactions ◽  
Medically Assisted Reproduction ◽  
The Family ◽  
Sexual Concerns ◽  
State And Trait Anxiety

Background: Depressive and anxious symptoms are common psychological reactions to infertility and Medically Assisted Reproduction (MAR). No study compared depressive and anxious symptoms and infertility stress dimensions across homologous and heterologous MAR, nor explored the specific role of the infertility stress dimensions in the two pathways. Homologous MAR may be associated with higher distress as the couple feel that the responsibility to reproduce and carry on the family line falls on them, and they feel inadequate if they are unable to bear children. Objective: We compared depressive/anxious symptoms and infertility stress dimensions between individuals undergoing homologous and heterologous MAR. We also explored the association between the infertility stress dimensions and depressive/anxious symptoms separately in two MAR pathways. Methods: Two-hundred twenty-six individuals participated [mean age = 39.71 years; 54.45% women]: 118 (52.2%) in homologous and 108 (47.8%) in heterologous MAR. The Fertility Problem Inventory, Beck Depression Inventory-II, and State and Trait Anxiety Inventory-Y form were administered. Results: Individuals in homologous MAR had higher depressive/state-trait anxious symptoms, general infertility stress, and infertility-related sexual concerns than those in heterologous MAR. In homologous MAR, social and sexual concerns were associated with depressive/trait anxious symptoms while gender had no effect. In heterologous MAR, male gender was associated with lower state anxious symptoms while infertility stress dimensions had no effect. Conclusion: Individuals in homologous MAR are a more distressed subgroup which requires a tailored supportive psychological intervention specifically on sexual and social concerns.

scholarly journals A picture of medically assisted reproduction activities during the COVID-19 pandemic in Europe

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Nathalie Vermeulen ◽  
◽  
Eduard Hambartsoumian ◽  
Kazem Nouri ◽  
Thomas Ebner ◽  
...  
Keyword(s):  
Assisted Reproduction ◽  
Large Scale ◽  
Health Resources ◽  
Epidemiological Data ◽  
Medically Assisted Reproduction ◽  
Large Scale Data ◽  
Health Authorities ◽  
Current Article ◽  
Competing Interest

Abstract STUDY QUESTION How did coronavirus disease 2019 (COVID-19) impact on medically assisted reproduction (MAR) services in Europe during the COVID-19 pandemic (March to May 2020)? SUMMARY ANSWER MAR services, and hence treatments for infertile couples, were stopped in most European countries for a mean of 7 weeks. WHAT IS KNOWN ALREADY With the outbreak of COVID-19 in Europe, non-urgent medical care was reduced by local authorities to preserve health resources and maintain social distancing. Furthermore, ESHRE and other societies recommended to postpone ART pregnancies as of 14 March 2020. STUDY DESIGN, SIZE, DURATION A structured questionnaire was distributed in April among the ESHRE Committee of National Representatives, followed by further information collection through email. PARTICIPANTS/MATERIALS, SETTING, METHODS The information was collected through the questionnaire and afterwards summarised and aligned with data from the European Centre for Disease Control on the number of COVID-19 cases per country. MAIN RESULTS AND THE ROLE OF CHANCE By aligning the data for each country with respective epidemiological data, we show a large variation in the time and the phase in the epidemic in the curve when MAR/ART treatments were suspended and restarted. Similarly, the duration of interruption varied. Fertility preservation treatments and patient supportive care for patients remained available during the pandemic. LARGE SCALE DATA N/A LIMITATIONS, REASONS FOR CAUTION Data collection was prone to misinterpretation of the questions and replies, and required further follow-up to check the accuracy. Some representatives reported that they, themselves, were not always aware of the situation throughout the country or reported difficulties with providing single generalised replies, for instance when there were regional differences within their country. WIDER IMPLICATIONS OF THE FINDINGS The current article provides a basis for further research of the different strategies developed in response to the COVID-19 crisis. Such conclusions will be invaluable for health authorities and healthcare professionals with respect to future similar situations. STUDY FUNDING/COMPETING INTEREST(S) There was no funding for the study, apart from technical support from ESHRE. The authors had no COI to disclose.

The role of DEFB126 variation in male infertility and medically assisted reproduction technique outcome

2019 ◽  
Vol 39 (4) ◽  
pp. 649-657
Author(s):  
Parnaz Borjian Boroujeni ◽  
Somayeh Ebrahimian ◽  
Maryam Abedini ◽  
Maral Rostami Chayjan ◽  
Mahdye Hassani ◽  
...  
Keyword(s):  
Male Infertility ◽  
Assisted Reproduction ◽  
Assisted Reproduction Technique ◽  
Medically Assisted Reproduction

Medically assisted reproduction and ethical challenges

2005 ◽  
Vol 207 (2) ◽  
pp. 684-688 ◽  
Author(s):  
H KAARIAINEN ◽  
G EVERSKIEBOOMS ◽  
D COVIELLO
Keyword(s):  
Assisted Reproduction ◽  
Ethical Challenges ◽  
Medically Assisted Reproduction

scholarly journals The best interests of the child in medically assisted reproduction: A moral-constitutional overview

2021 ◽  
pp. 37
Author(s):  
Fereniki Panagopoulou - Koutnatzi
Keyword(s):  
Human Rights ◽  
Assisted Reproduction ◽  
Elderly Women ◽  
Single Parents ◽  
Best Interests ◽  
Same Sex ◽  
Borderline Cases ◽  
Medically Assisted Reproduction ◽  
Same Sex Couples

The infinite and constantly developing options of medically assisted reproduction (MAR) reasonably raise the issue of its permitted range. Proponents of human rights fight for the strengthening of the reproductive right, the access to it by even more people, such as single parents, same-sex couples, elderly women, HIV carriers etc. Still concerning, however, is the fact that the defenders of human rights often forget the rights of the fetus or the child, which cannot be expressed with the same intensity. In the framework of the present study, we investigate the true interests of the child in MAR, in relation to the reproductive right in the light of some borderline cases.

Ethical Considerations of Research in Disaster-Stricken Populations

2009 ◽  
Vol 24 (2) ◽  
pp. 109-114 ◽  
Author(s):  
John E. Jesus ◽  
Glen E. Michael
Keyword(s):  
Disaster Response ◽  
Disaster Medicine ◽  
Biomedical Ethics ◽  
Respect For Persons ◽  
Ethical Challenges ◽  
Research Subjects ◽  
Ethical Considerations ◽  
Research Participants ◽  
The Core

AbstractRecently, emphasis has been placed on improving and expanding research in disaster response and the treatment of disaster-stricken populations. However, research in these settings presents unique ethical challenges with which the scientific and biomedical ethics communities continue to struggle. At the core of the controversy is the question of how best to balance the critical need for research with the equally important obligation to respect and protect the interests of research participants within the unique stress of a disaster. This concern stems from the potential of increased vulnerability of individuals stricken by disaster over and above their usual vulnerability to risk and exploitation as research subjects. Ethical principles that must be considered in these situations are the same as those that are important when conducting any human research: respect for persons, non-maleficence, beneficence, and justice. This paper explores the ethical challenges that accompany inadequate resources and personnel, the potential vulnerability of research participants, the dual role of physician-researcher, and the importance of the public's perception and trust are explored. It then proposes a number of potential avenues through which to conduct ethically justifiable research that could answer many of the pressing questions in disaster medicine and response.

International Perspectives on Ethical Issues in Religion and Psychiatry

2018 ◽  
Author(s):  
Walid Sarhan ◽  
Wai Lun Alan Fung
Keyword(s):  
Ethical Issues ◽  
International Perspective ◽  
Ethical Challenges ◽  
Ethical Considerations ◽  
International Context ◽  
Global Ethic ◽  
Clinical Vignettes ◽  
International Perspectives ◽  
Ethics In Psychiatry

This chapter provides international perspectives on ethical issues at the intersection between religion/spirituality and psychiatry. It begins by describing international patterns of spirituality and religion, then discusses the role of professional ethics in psychiatry from an international perspective and the stances of various professional psychiatric associations on the topic. These are illustrated by the case example of terrorism, including suicide and religious terrorism. The chapter also discusses ethical considerations regarding the intersection between religion/spirituality and traditional beliefs & cultures, which are illustrated by the case example of ethics and healing in ancient China and India. The importance of a global ethic and various international attempts at its development are discussed. Several clinical vignettes illustrate these ethical challenges in an international context. The chapter concludes with a discussion of the challenges in developing a global ethic in relation to psychiatry and spirituality/religion.

Race and the Adoption of Children

2019 ◽  
pp. 226-242
Author(s):  
Ralph Richard Banks
Keyword(s):  
Best Interests ◽  
Foster Care System ◽  
Policy Makers ◽  
Guiding Principle ◽  
System P ◽  
Past Half Century ◽  
Official Policy ◽  
The Social ◽  
American Society

This chapter considers the role of race in the adoptive placement of children. In examining the law and policy issues, the chapter raises questions both about the role of race in American society and about the needs of children. These issues are reflected in the interplay in adoption law of two pivotal principles: the best interests of the child standard and the antidiscrimination principle. The best interests of the child standard is the guiding principle of child welfare law; the antidiscrimination principle has been incorporated into family law during the past half-century and disfavors decision making on the basis of race and certain other characteristics. Policy makers confront the challenge of how best to define each of these principles, and also how to balance or choose between them when they conflict. The chapter also identifies an apparent persistent gap in this realm between official policy and the daily practices of the social workers who orchestrate adoptions in the foster care system.

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