Provoost V, Pennings G, De Sutter P, Gerris J, Van de Velde A, De Lissnyder E, Dhont M
Bioethics Institute Ghent, Ghent University, Blandijnberg 2 B-9000 Ghent, Belgium.
Hum Reprod. 2009 Apr;24(4):896-905. doi: 10.1093/humrep/den486. Epub 2009 Jan 9.
Little research has been done on how beliefs of infertility patients about their embryos are related to their disposition decisions. The objective of this study was to describe how patients speak about their embryos, in moral (e.g. status) and non-moral terms, and to investigate how patients' narratives are related to their disposition preferences.
In-depth interviews based on the method of interpretative phenomenological analysis were conducted with patients undergoing IVF/ICSI treatment between May and July 2006.
Seven couples and 11 female patients were interviewed. Six major themes emerged from the narratives of the participants when they spoke about their embryos: (i) a medical-technical perspective; (ii) feelings; (iii) genetic link to oneself and/or one's partner; (iv) symbolic meaning of the relationship between the infertile partners; (v) moral status and (vi) instrumental value. All but two participants spontaneously considered the embryo disposition options as a two-stage decision sequence. In the first step, they considered donation to another couple for reproductive purposes. At this stage, the presence of the themes 'genetic link' and 'symbol of the relationship' was linked with a clear reluctance to donate. In the second step of the decision-making process, the option of donation for research and discarding were considered. At this stage, participants' confidence in medical science and the instrumental value they attached to the embryo were related to their decisions.
Patients' conceptualization of their embryos plays an important role in embryo disposition decisions. Our research showed that patients deal with these decisions in a two-stage decision sequence.
关于不孕患者对其胚胎的看法如何与他们的处置决定相关,目前的研究较少。本研究的目的是描述患者如何从道德(如地位)和非道德角度谈论他们的胚胎,并调查患者的叙述如何与他们的处置偏好相关。
2006年5月至7月,对接受体外受精/卵胞浆内单精子注射治疗的患者进行了基于解释性现象学分析方法的深入访谈。
对7对夫妇和11名女性患者进行了访谈。参与者在谈论他们的胚胎时,其叙述中出现了六个主要主题:(i)医学技术视角;(ii)感受;(iii)与自己和/或伴侣的遗传联系;(iv)不孕伴侣之间关系的象征意义;(v)道德地位;(vi)工具价值。除两名参与者外,所有参与者都自发地将胚胎处置选择视为一个两阶段的决策序列。在第一步中,他们考虑将胚胎捐赠给另一对夫妇用于生殖目的。在这个阶段,“遗传联系”和“关系象征”这两个主题的出现与明显的捐赠不情愿有关。在决策过程的第二步中,考虑了用于研究的捐赠和丢弃的选择。在这个阶段,参与者对医学科学的信心以及他们赋予胚胎的工具价值与他们的决定有关。
患者对其胚胎的概念化在胚胎处置决定中起着重要作用。我们的研究表明,患者以两阶段决策序列来处理这些决定。