Andrew M. Courtwright, MA and Mia Wechsler Doron, MTS, MD
A positive right to parenthood obligates others to support a person’s attempt to become a parent. Do physicians have a duty to assist their patients’ procreative efforts, and, if so, in what ways?
Barriers to effective prognosis conversations include knowledge deficits, misconceptions, cultural differences, and lack of motivation. These can be addressed head-on by good communication interventions.
AMA J Ethics. 2018;20(8):E757-765. doi:
10.1001/amajethics.2018.757.
Marcia C. Inhorn, PhD, MPH and Pasquale Patrizio, MD, MBE
Low-cost in vitro fertilization (LCIVF) is better than no infertility treatment in countries that prohibit adoption and third-party reproductive assistance.
AMA J Ethics. 2018;20(3):228-237. doi:
10.1001/journalofethics.2018.20.3.ecas1-1803.
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.
The FDA’s approval for over-the-counter sales of emergency contraception marked a departure from its standard approval process and obstructed access to a safe and effective drug. That departure could set a dangerous precedent for future decisions.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.