Jones, Georgina L, Folan, Anne-Mariead, Phillips, Bob orcid.org/0000-0002-4938-9673 et al. (2 more authors) (2023) Reproduction in life and death:should cancer patients with a poor prognosis be offered fertility preservation interventions? Reproduction & fertility. ISSN 2633-8386
Abstract
In the context of a cancer diagnosis, fertility preservation interventions are used to mitigate the potential impact of gonadotoxic cancer treatment upon fertility. They provide patients with cancer the option to freeze their reproductive material to have their own biological child following treatment. The evidence suggests some clinicians are less likely to have fertility preservation discussions with patients who have an aggressive or metastatic cancer which has a poor prognosis. Although this is contrary to current policy recommendations, there is a lack of guidance relating to offering fertility preservation in the context of a poor prognosis to support clinicians. Controversy surrounds posthumous reproduction, and whether the wishes of the cancer patient, when living and deceased should take precedence over others' wellbeing. We consider the question of whether cancer patients with a poor prognosis should be offered FP from an ethics perspective. We structure the paper around key arguments to which multiple ethical principles might pertain, first establishing a central argument in favour of offering fertility preservation based on respect for autonomy, before exploring counterarguments. We conclude by proposing that a defeasible assumption should be adopted in favour of offering fertility preservation to all cancer patients who might benefit from it. It is important to recognise that patients could benefit from fertility preservation in many ways, and these are not limited to having a parenting experience. The burden of proof rests on the clinician in collaboration with their multi-disciplinary team, to show that there are good grounds for withholding the offer.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © the author(s) 2023 |
Dates: |
|
Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Reviews and Dissemination (York) The University of York > Faculty of Sciences (York) > Hull York Medical School (York) |
Depositing User: | Pure (York) |
Date Deposited: | 31 Oct 2023 09:00 |
Last Modified: | 16 Oct 2024 19:34 |
Published Version: | https://doi.org/10.1530/RAF-23-0047 |
Status: | Published online |
Refereed: | Yes |
Identification Number: | 10.1530/RAF-23-0047 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:204761 |