lunes, 8 de agosto de 2016

BioEdge: IVF doctors issue new ethical guidelines for errors

BioEdge: IVF doctors issue new ethical guidelines for errors

-IVF doctors issue new ethical guidelines for errors

Some IVF clinics are run like "like a 19th-century grocery", says Art Caplan   
Cases of mix-ups, losses and genetic defects have given IVF clinics and sperm banks a black eye in the past year in the United States. A recent story in the New York Times was headlined “Sperm Banks Accused of Losing Samples and Lying About Donors”. The Times spoke of “a new wave of lawsuits against sperm banks, highlighting claims of deception and negligence, and adding an array of challenges beyond the longstanding issue of undetected genetic problems”.

Quality control has often been poor in the clinics. “Even in New York, when they inspect, they’re looking at hygienic conditions not record-keeping,” said bioethicist Arthur Caplan, of New York University. “Nobody confirms that you have what you say you have… It’s absurd that we have these materials so valuable that people pay to store them, but we run it like a 19th-century grocery. Cryopreservation has historically operated in a casual laissez-faire environment, where people were just supposed to trust.”

Now the American Society for Reproductive Medicine, the peak IVF body in the US, has issued non-binding ethical guidelines for its members. It states that clinics are ethically obliged to inform people of mistakes “of respect for patient autonomy and in fairness to patients”. Clinics should inform patients as soon as a mistake is discovered. And clinics should also foster “a culture of truth-telling”.

The temptation to avoid informing patients about mistakes must be great, but the ASRM insists that mistakes must be acknowledged as soon as possible:

“Principles of open and honest communication with patients have special significance in reproductive medicine. Fertility treatments are often stressful, and patients may be particularly sensitive to the statements of their health-care providers. In addition, errors in reproductive medicine may affect the couple's ability to have a child. In situations in which errors are particularly serious—where embryos are mistakenly transferred to the wrong patient—the error may lead to the birth of a different child than was intended. Such births can lead to significant emotional turmoil and the burdens of parentage or custody lawsuits, which can adversely affect all involved parties, including the children.”
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The Games of the XXXI Olympiad have just started in Rio de Janeiro. A few thousand young men and women will be sweating in their competitions; a few billion people will be watching them on television screens; and a few bioethicists will be disputing the merits of taking drugs and human enhancement. Stretching the body to its limits, going "Faster, Higher, Stronger", is a thrilling spectacle. But -- this is just a personal crochet -- I've always sought out the human drama in the Olympics, which sometimes has nothing to do with record books. 
My favourite Olympic moment comes from the marathon at the 1968 Games in Mexico. John Stephen Akhwari, of Tanzania, began to cramp up because of the high altitude conditions. And then at the 19 kilometre mark, he fell and badly injured his knee and shoulder. But on he ran, or stumbled, and as dusk was falling, he hobbled into the nearly empty stadium, a bandage flapping around his leg, and crossed the finish line an hour after the winner. When they asked him why he bothered, he replied, "My country did not send me 5,000 miles to start the race; they sent me 5,000 miles to finish the race."
You can enhance stamina and speed, but can you enhance courage and loyalty? 
Have you any favourite Olympic stories? 

Michael Cook



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