Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.
J Med Ethics. 2019 May;45(5):346-350. doi: 10.1136/medethics-2018-104983. Epub 2019 Feb 11.
In vitro fertilisation (IVF) 'add-ons' are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical-namely, morally good and righteous, the question was considered in relation to three key values of medical ethics-autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child.
体外受精（IVF）“附加物”是为了提高不孕治疗成功率而开发的治疗或诊断工具。然而，没有确凿的证据表明这些干预措施是辅助生殖技术的有益或有效辅助手段。此外，IVF 附加物通常在其安全性得到充分确定之前就在临床实践中实施。然而，患者仍然要求并支付大量费用来获得这些额外的 IVF 工具。因此，本文旨在探讨在没有证据表明患者有获益的情况下，是否可以提供 IVF 附加物。为了确定什么是合乎道德的——即道德上的善和正义，这个问题是根据医学伦理学的三个关键价值观来考虑的——自主性、善行和不伤害。如果能够给予真正的知情同意，如果有潜在的经济有效的生理或心理获益，并且风险很小，特别是对未出生的孩子，那么在特定情况下提供 IVF 附加物可能在道德上是可以接受的。
