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- Munthe, Christian, 1962, et al.
(författare)
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Time-lapse in reproductive medicine: ethical prospects and challenges
- 2015
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Ingår i: ESHRE Annual Meeting, Lisbon, June 14-17, 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Study question: What are the ethical prospects and challenges of using time-lapse (TL) for different purposes in research, clinical service, care and commercial marketing in the assisted reproductive context? What possible professional or public policy implications follow from these? Summary answer: The ethics of TL depends on its more exact use. Current knowledge indicates possible clinical benefits, but premature clinical application should be resisted. TL opens for, e.g., patient demands regarding embryo selection and implementation of TL involving display to patients mandates extra caution regarding care, counseling and marketing exploits. What is known already: Using TL to capture the process of in vitro embryo development has quickly entered reproductive medicine, with prospective uses in research and clinical service. It has also been picked up as a possible marketing tool by commercial providers, and as an add-on of patient care and counseling. Assessment of the effects and efficiency of TL is ongoing and, as yet, displaying complex and partly unclear or contradictory results. care and counseling aspects remain uncharted. Study design, size, duration: Explorative theoretical analytical applied ethics study. Participants/materials, setting, methods: Systematic analysis of ethical aspects using literature on TL and relevant aspects of the ethics of assisted reproduction and reproductive medicine. Main results and the role of chance: TL is valuable for research, but trials of TL-interventions aiming at improved IVF should not be launched prematurely or allowed to sneak into routine practice. Offering display of TL documentation of embryo development to patients during ongoing treatment has unclear benefits and risks from a care and counseling perspective and arises the issue of what to display. It may be a vehicle for increasing patient involvement, but may also create conflict between patients and clinicians regarding embryo selection, and will introduce care and counselling challenges as patients form their own reactions. Retrospective offers appear less risky, but may fuel into uncertainty about the outcome. Marketing services with such offers risks biasing patients towards an “entertainment” view and away from more important considerations counseling wise. Limitations, reason for caution: There are many unknowns regarding the more detailed effects on patient experience of incorporating TL display as part of assisted reproductive services. Such additions also have unknown cultural dimensions by making the living in vitro embryo more widely and intimately visible and acquaintable. Wider implications of the findings: Besides the need to structure, monitor and limit attempts at using TL to boost IVF results, the idea of displaying TL output to patients is in need of much probing, not least regarding patient experience and structural effects on the perception of assisted reproductive services, but also clinical policy and counseling requirements. Professional and scientific organizations should act to prevent premature and reckless clinical use.
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