The complexities of decision-making
When young people themselves, or the parents in the case of a younger child, are faced with the prospect of agreeing to a medical intervention that might preserve their reproductive options in the future, they must contend with many uncertainties. What is the status of the intervention on offer? What are the potential risks and benefits of participating – or not? Who is to make this momentous decision and how might they be best advised?
In addition, there is the potential in fertility preservation services for the blurring of the boundaries between research and treatment. Are young people and parents being asked to opt for an established treatment? Are they being invited to participate in a formal research project?
Research or treatment Canadian pharmacy online?
There is a sound scientific basis for the belief that cryopreserved tissue taken from young people prior to treatment for childhood cancer might allow them to beget their own children in the foreseeable future. However, there are many more links to be demonstrated in the evidence chain before these procedures can achieve the status of an established treatment. So the honest way to describe the interventions on offer might be promising, but experimental. This is precisely the sort of option offered to individuals who are invited to participate in clinical research trials. Indeed, it is arguable that the improvement in survival rates in childhood cancer over the last three decades is a stunning example of the benefits to be gained by the collaboration of medical scientists and informed patients in formal research trials.
Whenever treatment trials are conducted, the researchers are obliged to subject their proposals to external ethical scrutiny. A major concern of any ethics committee will be the manner in which information is to be provided for any potential participants in the study. For example, information sheets will need to be designed to meet the needs of specific groups such as children or those for whom English is not their first language. Usually, steps will be taken to separate therapeutic and research roles so that patients can be confident that decisions about participating in research trials will not jeopardize the quality of their ongoing treatment. Emphasis will be given to the right of any participant (of whatever age) to rescind a decision to become involved in a research project. Overall, great care will have to be taken to ensure that patients appreciate the difference between ‘treatment as usual’ and informed participation in a formally designed research trial.
In each of these scenarios, the family or the individual has difficult choices to make but at least they know where they stand. Consider a third alternative viagra online in Canada. A clinical team is aware of the promise that cryopreservation procedures might have in safeguarding future procreative options for their young patients. They feel they have a moral responsibility to explain the current position and future possibilities to the families or individuals in their care. However, since they are not working within an agreed research proto-col, they have no standardized way of managing the decision-making procedure. Practice inevitably varies as clinicians follow their established consultative styles. A situation already riven with uncertainty becomes even more confused for all concerned.