Dealing with treatment and transfer requests: how PGD-professionals discuss ethical challenges arising in everyday practice

Melisa Soto-Lafontaine, Wybo Dondorp*, Veerle Provoost, Guido de Wert

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

Abstract

How do professionals working in pre-implantation genetic diagnosis (PGD) reflect upon their decision making with regard to ethical challenges arising in everyday practice? Two focus group discussions were held with staff of reproductive genetic clinics: one in Utrecht (The Netherlands) with PGD-professionals from Dutch PGD-centres and one in Prague (Czech Republic) with PGD-professionals working in centres in different European countries. Both meetings consisted of two parts, exploring participants' views regarding (1) treatment requests for conditions that may not fulfill traditional indications criteria for PGD, and (2) treatment and transfer requests involving welfare-of-the-child considerations. There was general support for the view that people who come for PGD will have their own good reasons to consider the condition they wish to avoid as serious. But whereas PGD-professionals in the international group tended to stress the applicants' legal right to eventually have the treatment they want (whatever the views of the professional), participants in the Dutch group sketched a picture of shared decision-making, where professionals would go ahead with treatment in cases where they are able to understand the reasonableness of the request in the light of the couple's reproductive history or family experience. In the international focus group there was little support for guidance stating that welfare-of-the child considerations should be taken into account. This was different in the Dutch focus group, where shared decision-making also had the role of reassuring professionals that applicants had adequately considered possible implications for the welfare of the child.

Original languageEnglish
Pages (from-to)375-386
Number of pages12
JournalMedicine Health Care and Philosophy
Volume21
Issue number3
DOIs
Publication statusPublished - Sep 2018

Keywords

  • Preimplantation genetic diagnosis (PGD)
  • Indications
  • Embryo selection
  • Ethics
  • Stakeholder views
  • PREIMPLANTATION GENETIC DIAGNOSIS
  • ASSISTED REPRODUCTIVE TECHNOLOGIES
  • ESHRE TASK-FORCE
  • PRACTICE GUIDELINES
  • CHILD
  • WELFARE
  • CONSORTIUM
  • BIOETHICS
  • FAMILIES
  • ACCESS

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