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奥地利女性对卵子冷冻的看法:一项在线Q方法研究。

Women's viewpoints on egg freezing in Austria: an online Q-methodology study.

作者信息

Kostenzer Johanna, de Bont Antoinette, van Exel Job

机构信息

Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.

Erasmus School of Economics, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.

出版信息

BMC Med Ethics. 2021 Jan 6;22(1):4. doi: 10.1186/s12910-020-00571-6.

Abstract

BACKGROUND

Egg freezing has emerged as a technology of assisted reproductive medicine that allows women to plan for the anticipated loss of fertility and hence to preserve the option to conceive with their own eggs. The technology is surrounded by value-conflicts and is subject to ongoing discussions. This study aims at contributing to the empirical-ethical debate by exploring women's viewpoints on egg freezing in Austria, where egg freezing for social reasons is currently not allowed.

METHODS

Q-methodology was used to identify prevailing viewpoints on egg freezing. 46 female participants ranked a set of 40 statements onto a 9-column forced choice ranking grid according to the level of agreement. Participants were asked to explain their ranking in a follow-up survey. By-person factor analysis was used to identify distinct viewpoints which were interpreted using both the quantitative and the qualitative data.

RESULTS

Three distinct viewpoints were identified: (1) "women should decide for themselves", (2) "we should accept nature but change policy", and (3) "we need an informed societal debate". These viewpoints provide insights into how biomedical innovations such as egg freezing are perceived by women in Austria and illustrate the normative tensions regarding such innovations.

CONCLUSIONS

Acknowledging the different prioritizations of values regarding assisted reproductive technologies is important to better understand the underlying normative tensions in a country where egg freezing for social reasons is currently not allowed. The study adds new empirical insights to the ongoing debate by outlining and discussing viewpoints of those directly affected: women. Following up on the lay persons perspective is particularly important in the context of future biomedical innovations that may challenge established norms and create new tensions. It therefore also adds to the societal debate and supports evidence-informed policy making in that regard.

摘要

背景

卵子冷冻已成为辅助生殖医学的一项技术,它使女性能够为预期的生育能力丧失做好规划,从而保留使用自身卵子受孕的选择。这项技术存在价值冲突,且仍在持续讨论中。本研究旨在通过探索奥地利女性对卵子冷冻的观点,为实证伦理辩论做出贡献,在奥地利,目前出于社会原因的卵子冷冻是不被允许的。

方法

采用Q方法来确定关于卵子冷冻的主流观点。46名女性参与者根据认同程度,将一组40条陈述排列在一个9列的强制选择排序网格上。参与者被要求在后续调查中解释她们的排序。通过个体因素分析来识别不同的观点,并利用定量和定性数据对其进行解读。

结果

确定了三种不同的观点:(1)“女性应该自己做决定”,(2)“我们应该接受自然但改变政策”,以及(3)“我们需要一场信息充分的社会辩论”。这些观点为奥地利女性如何看待卵子冷冻等生物医学创新提供了见解,并说明了围绕此类创新的规范张力。

结论

认识到辅助生殖技术在价值观上的不同优先排序,对于更好地理解在一个目前不允许出于社会原因进行卵子冷冻的国家中潜在的规范张力很重要。该研究通过概述和讨论直接受影响者即女性的观点,为正在进行的辩论增添了新的实证见解。在未来可能挑战既定规范并产生新张力的生物医学创新背景下,关注外行的观点尤为重要。因此,它也为社会辩论做出了贡献,并支持在这方面基于证据的政策制定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ea/7789674/52594f1e4ff6/12910_2020_571_Fig1_HTML.jpg

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