ethical dilemmas faced by infertility nurses

icudavis · Feb 6, 2004

Well, since no one would like to share......I have read that once an egg becomes fertile, the others are thrown away or stored....what are your thoughts about such...and what are your thoughts about older women 40+ using these procedures...

crankyasanoldma · Feb 8, 2004

Surrogate carrying for someone else: what if the carrier decided to try to keep a baby they are not genetically related to (this seems to happen with some small regularity), or what if the pregnancy doesn't go well and someone blames someone else for it, or what if there is a birth defect or multiples (there was a case where the family didn't want the twin), etc.

Relatives as sperm or egg donors: Would a donor decide they don't like the way the parents parent and try for custody?

Recipients of anonymous donations (mostly sperm) that want to connect with the anonymous donor later on- there are websites dedicated to women trying to find out who the anonymous donor was to let their kids meet their 'sibling's, if any

Just a couple of ideas off the top of my head.

icudavis · Feb 8, 2004

thanks for your response....any problems that include what the nurses have to go through or other staff members. I did do a search that mentioned counseling patients who have lost multiple pregnancies...Does anyone know how this is handled? Is it encouraged to carry on or to retry? I personally, could not imagine encouraging someone to continue trying....costs....unborn babies....emotions.

T

crankyasanoldma · Feb 11, 2004

Oh, well, we once had a case where the family member wanted us to convince another family member to carry for her, and cases of family donors, and cases of known donors, same-sex couples, issues with pregnant staff members. We once had the office defaced- someone placed stickers on the pictures in the lobby that said "these picutes are not appropriate for this office" or something like that.

We had a couple that wanted treatment because their own kids were grown and the had "nothing to do". There was also a couple that seemed as if the one partner was compelling the other toward fertility as 'punishment' for an affair. With the exception of the person who put stickers of the pictures, we would usually sent the potential patients with complications to a specialty counseling service to iron out the details of the concerned parties expectations regarding treatment and after tx issues.

There is alot of psych involved in fertility work. It is actually not a completey safe assumption that someone who appears in a fertility setting actually wants to be pregnant AND have kids! That may sound odd, but some people seemed to only want to prove that they could indeed become pregnant ( or had fertile sperm), and some wanted the end result (children) but didn't really care a great deal how they reached that goal. Some people are pretty much used to having things go their way in life and fertility problems can really throw a serious kink in their life plans. Some folks can be difficult to work with becuase of anger issues, and depression is common in the roller coaster ride, too.

I want to add there there were many normal, happy couple that desire fertility tx with no strange strings attaced, but the unusual folks do stand out in my mind. And of course, there are loss issues all around. We often had to suspended treatment during 'anniversary' times or "bad luck" times for some couples. I have always felt that many people who have trouble getting pregnant have trouble staying pregnant and that that issue is not closely addressed enough.

As far as encouraging couple to try again- we did not really do that because, ethically, as profiting from the treatment, it's better if that decision is left to the couple. We could provided stats and probabilities, but not always outright encouragement. I just had a hospital patient yesterday who was being treated for her 8th ectopic, but was hoping to try again soon. I had a traumatic delivery once myself and fear the thought of a repeat pregnancy. People respond in so many different ways!

I don't work in fertitity now- I've been out for 6 years. There are a ton of great books covering lots of these areas about. You might enjoy a trip to a large bookstore for some research. I had about 6-8 weeks lag time before I started my REI job and read alot in those weeks. I enjoyed the ASRM workshops also.

icudavis · Feb 12, 2004

Wow!! Thank you so much for the information! I'm actually reading a case study book now. It's also interesting to read about in-vitro being used for stem cells....