de Vries Martine C, Bresters Dorine, Engberts Dirk P, Wit Jan M, van Leeuwen Evert
Department of Medical Humanities (Metamedica), VU University Medical Centre, Amsterdam, The Netherlands.
Pediatr Blood Cancer. 2009 Sep;53(3):386-91. doi: 10.1002/pbc.22091.
In paediatric oncology, the risk of infertility due to treatment constitutes an important problem. For sexually mature male adolescents, sperm cryopreservation is an option, but discussing the topic is complex because of the sensitive nature and the limited time frame. In this article, we determined attitudes and preferred roles of physicians and parents towards discussing sperm banking with male adolescents.
Qualitative multi-centre study, using in-depth semi-structured interviews with 14 physicians and 15 parents of male adolescents undergoing cancer treatment.
Although physicians and parents agreed that infertility would have a major impact on the future quality of life, they sometimes disagreed on whether the topic should be discussed with adolescents. Physicians always wanted a separate discussion with adolescents because of the sensitive nature and the experience that parents sometimes misjudged the stage of maturity of their son. Parents, however, wanted control over whether physicians discussed the topic with their child and what was said. Physicians did not accept this control and, when necessary, were willing to bypass the parents and discuss the topic with the adolescent even when parents refused consent.
Physicians face the difficult task of balancing between their ideas of what is in the (future) interest of the adolescent and accommodating parental wishes. We argue that, because of the private character of sexuality and the potentially inadequate maturity assessment by parents, semen cryopreservation should be discussed separately with adolescent and parents. In addition, there should be an open communication with parents to address potential discomforts.
在儿科肿瘤学中，治疗导致的不孕风险是一个重要问题。对于性成熟的男性青少年，精子冷冻保存是一种选择，但由于该话题的敏感性和时间限制，讨论起来很复杂。在本文中，我们确定了医生和家长对于与男性青少年讨论精子库问题的态度和偏好角色。
定性多中心研究，对14名医生和15名正在接受癌症治疗的男性青少年的家长进行深入的半结构化访谈。
尽管医生和家长一致认为不孕会对未来生活质量产生重大影响，但他们有时在是否应与青少年讨论该话题上存在分歧。由于话题的敏感性以及家长有时会误判儿子成熟阶段的情况，医生总是希望与青少年单独讨论。然而，家长希望掌控医生是否与他们的孩子讨论该话题以及讨论的内容。医生不接受这种掌控，并且在必要时，即使家长拒绝同意，他们也愿意绕过家长，与青少年讨论该话题。
医生面临着一项艰巨的任务，即要在他们认为对青少年（未来）有益的想法与顺应家长意愿之间取得平衡。我们认为，由于性的隐私特性以及家长对成熟度的评估可能不足，应分别与青少年和家长讨论精液冷冻保存问题。此外，应该与家长进行开放的沟通，以解决潜在的不适问题。
