Egeland Tone, Ruud Tor Kristian, Hanevik Hans Ivar, Magelssen Morten
Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway.
Fertility Department Sør, Telemark Hospital Trust, Porsgrunn, Norway, and Centre for Fertility and Health, National Institute of Public Health, Oslo, Norway.
Reprod Biomed Online. 2023 Dec;47(6):103368. doi: 10.1016/j.rbmo.2023.103368. Epub 2023 Aug 25.
How do Norwegian fertility doctors assess the parenting capacity of applicants, and how do they experience and evaluate the assessment practice?
Qualitative interview study with 14 Norwegian fertility doctors. Interviews were analysed with systematic text condensation, a qualitative analysis framework.
Norwegian fertility doctors deem parenting capacity assessments of applicants to be straightforward and simple in most cases. Yet, some cases of doubt pose difficulties. Physicians can then draw on resources such as colleagues, physicians from other specialties who know the patient and patient records. All the participating physicians agreed with the principle of parenting capacity assessment for patients seeking fertility treatment. The assessment enabled physicians to refuse patients whom they thought should definitely not have responsibility for children. The physicians' main argument was their own felt responsibility for the future child. Even though assessments could be challenging, the participants all thought of themselves as competent to perform them. Indeed, some thought that delegating the assessments would imply abdicating a responsibility that was properly theirs. Although national guidelines might aid decision-making, the physicians would not want guidelines to curtail the significant discretion that they exercised.
Whether societies should assess applicants' capacity for parenthood before fertility treatment is an ethical and political question. Although sometimes a difficult task, Norwegian fertility doctors see it as important, and as something they are competent and suited to undertake.
挪威的生育医生如何评估申请人的育儿能力,以及他们如何体验和评价这种评估实践?
对14名挪威生育医生进行定性访谈研究。采用系统文本浓缩这一定性分析框架对访谈进行分析。
挪威生育医生认为,在大多数情况下,对申请人的育儿能力评估直接且简单。然而,一些存在疑问的案例会带来困难。此时,医生可以利用同事、了解患者情况的其他专科医生以及患者病历等资源。所有参与的医生都认同对寻求生育治疗的患者进行育儿能力评估这一原则。这种评估使医生能够拒绝那些他们认为绝对不适合承担养育孩子责任的患者。医生们的主要理由是他们对未来孩子的责任感。尽管评估可能具有挑战性,但所有参与者都认为自己有能力进行评估。事实上,一些人认为委托他人进行评估意味着放弃他们应有的责任。尽管国家指南可能有助于决策,但医生们不希望指南限制他们所拥有的重要自由裁量权。
社会是否应该在生育治疗前评估申请人的育儿能力是一个伦理和政治问题。尽管有时是一项艰巨的任务,但挪威生育医生认为这很重要,且是他们有能力且适合承担的任务。