Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

Journal of Medical Ethics
Rosalind J McDougallYasmin Jayasinghe

Abstract

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. 'Fertility preservation' for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such 'experimental' procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically ...Continue Reading

References

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Citations

Aug 23, 2018·The American Journal of Bioethics : AJOB·Rosalind McDougallLynn Gillam
Jun 25, 2019·Current Opinion in Urology·Richard N Yu
Nov 5, 2019·Frontiers in Endocrinology·Seido TakaeNao Suzuki
Dec 13, 2019·Journal of Assisted Reproduction and Genetics·Sharrόn L ManuelMary Ellen Pavone
May 8, 2018·Journal of Adolescent and Young Adult Oncology·Meredith HandYasmin Jayasinghe
Jun 13, 2020·Human Reproduction Open·E GoossensJ B Stukenborg
May 12, 2020·Journal of Assisted Reproduction and Genetics·Leena NahataMolly Moravek
Jul 5, 2018·Pediatric Blood & Cancer·Antoinette AnazodoTeresa K Woodruff
Jan 17, 2021·Journal of Assisted Reproduction and Genetics·UNKNOWN Practice Committee of the Oncofertility Consortium
Jul 23, 2021·Journal of Assisted Reproduction and Genetics·Samuel KhiatBlandine Courbiere

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