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为何选择 UD?评估将宫内节育器作为女性患者选择性绝育条件的需求。

Why-UD? Assessing the requirement to trial an intrauterine device as a condition for elective sterilisation in female patients.

机构信息

Philosophy, University of Nottingham, Nottingham, UK

出版信息

J Med Ethics. 2024 Sep 20;50(10):708-711. doi: 10.1136/jme-2023-109264.

Abstract

Some National Health Service healthcare boards in the UK will approve a request for female sterilisation only if the patient first accepts a trial period of 1 year with an intrauterine device (IUD), a form of long-acting reversible contraception. In this article, I argue that this requirement is not justified by appeal to any of (or any combination of) promotion of informed consent, paternalistic concerns regarding patient regret in later life and health service budgetary considerations. Informed consent and patient autonomy may be promoted by a mandatory waiting period, but the concomitant imposition of an IUD trial during this period cannot be justified on these grounds. As long as elective vasectomy is offered by the healthcare system, elective female sterilisation should be accessible under reasonably similar-even if not identical-conditions.

摘要

英国的一些国民保健服务医疗委员会仅在患者首先接受宫内节育器 (IUD) 为期 1 年的试用期后,才会批准女性绝育的请求,IUD 是一种长效可逆避孕措施。在本文中,我认为,这种要求没有得到任何(或任何组合)理由的支持,包括促进知情同意、对患者晚年后悔的家长式关切以及对医疗服务预算考虑的关切。通过强制性等待期可以促进知情同意和患者自主权,但在此期间强制进行 IUD 试验不能以此为理由。只要医疗系统提供选择性输精管切除术,那么在合理相似的条件下——即使不完全相同——也应该可以进行选择性女性绝育。

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本文引用的文献

1
Voluntary sterilisation of young childless women: not so fast.年轻未育女性的自愿绝育:别急着下结论。
J Med Ethics. 2022 Jan;48(1):46-49. doi: 10.1136/medethics-2019-105933. Epub 2020 Mar 17.
2
Regret, shame, and denials of women's voluntary sterilization.对女性自愿绝育的悔恨、羞耻与否认。
Bioethics. 2018 Jun;32(5):281-288. doi: 10.1111/bioe.12431. Epub 2018 Apr 23.
3
The role of anticipated decision regret and the patient's best interest in sterilisation and medically assisted reproduction.
J Med Ethics. 2017 May;43(5):314-318. doi: 10.1136/medethics-2016-103551. Epub 2016 Oct 7.
4
Autonomy, age and sterilisation requests.自主权、年龄与绝育请求。
J Med Ethics. 2017 May;43(5):310-313. doi: 10.1136/medethics-2016-103664. Epub 2016 Nov 22.
5
Regret following female sterilization in Slovenia.斯洛文尼亚女性绝育术后的遗憾。
Int J Gynaecol Obstet. 2015 Jul;130(1):45-8. doi: 10.1016/j.ijgo.2015.02.024. Epub 2015 Apr 14.
6
Intrauterine contraception in nulliparous women: a prospective survey.未育女性的宫内避孕:一项前瞻性调查。
J Fam Plann Reprod Health Care. 2016 Jan;42(1):36-42. doi: 10.1136/jfprhc-2014-101046. Epub 2015 Apr 8.
7
Long-acting reversible contraception for adolescents.长效可逆避孕措施(LARC)在青少年中的应用。
Curr Opin Obstet Gynecol. 2012 Oct;24(5):293-8. doi: 10.1097/GCO.0b013e32835686d5.

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