Showing posts with label IVF. Show all posts
Showing posts with label IVF. Show all posts

Monday, January 19, 2009

ACOG: Abort or refer

The American College of Obstetricians and Gynecologists (ACOG) have finalized and published their Ethics Statement # 385. It looks like they ignored the ruling from the Department of Human Services on Conscience -- or believe it will soon be overturned.

The ACOG pdf is set so that it is not possible to copy and paste - I have typed in the first bit, myself. Click here for the full document.

ABSTRACT: Health care providers occasionally may find that providing indicated, even standare, care would present for them a personal moral problem – a conflict of conscience – particularly in the field of reproductive medicine. Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient’s health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities. Conscientious refusals that conflict with patient well-being should be accommodated only if the primary duty to the patient can be fulfilled. All health care providers must provide accurate and unbiased information so that patients can make informed decisions. Where conscience implores physicians to deviate from standard practices, they must provide potential patients with accurate and prior notice of their personal moral commitments. Physicians and other health care providers have the duty to refer patients in atimely manner to other providers if they do not feel that they can in conscience provide the standard reproductive services that patients request. In resource-poor areas, access to safe and legal reproductive services should be maintained. Providers with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place. In an emergency in which referral is not possible or might negatively have an impact on a patient’s physical or mental health, providers have an obligation to provide medically indicated and requested care.

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Physicians and other providers may not always agree with the decisions patients make about their own health and health care. Such differences are expected – and, indeed, underlie the American model of informed consent and respect for patient autonomy. Occasionally, however, providers anticipate that providing indicated, even standard, care would present for them a personal moral problem – a conflict of conscience. In such cases, some providers claim a right to refuse to provide certain services, refuse to refer patients to another provider for these services, or even decline to inform patients of their existing options.

Conscientious refusals have been particularly widespread in the arena of reproductive medicine, in which there are deep divisions regarding the moral acceptability of pregnancy termination and contraception.


For more on the controversy, here are my posts on Conscience, and here is a history of the ACOG and DHHS statements.

Wednesday, August 27, 2008

The Stem Cell Debate Heats Up

Here's a great review about those new "induced pleuripotent stem cells" (iPS) we've been hearing about. iPS's are truly "patient specific stem cells" since they come from the patient himself or herself. The cells are manipulated in the lab, using viral particles and specific environments to make the able to become many different types of cells.

It would be very difficult, in my opinion, to make these cells become embryos, with all the structures that would allow them to function as individual organisms. From what I understand, the cells return to a state that allows them to become tissues with several different types of cells and cell groups, but they are never organized.

In my opinion (again), the induction process can't be more of a problem than the risk of immune rejection and the manipulations that embryos derived from In Vitro fertilization go through or the changes that are bound to be inherent with cloned cells derived through Somatic Cell Nuclear Transfer. On the other hand, volunteers and tissue samples for IPC experiments ought to be abundant.

And no one has to die for it.

Tuesday, July 22, 2008

30 years: In Vitro Fertilization,Bioethics and Public Health

My own first child is a little older than Louise Brown, the first child born from in vitro fertilization (IVF). This incidental pioneer celebrates her 30th birthday this month, calling for reviews and editorials on what her birth has meant to culture and to individuals, such as this one from the UK's Telegraph.

It's good to hear that Ms. Brown has a child of her own, "naturally conceived" with her husband. Full circle.