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Series
Volume 33

Fertility, Reproduction and Sexuality: Social and Cultural Perspectives


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Patient-Centred IVF

Bioethics and Care in a Dutch Clinic

Trudie Gerrits

372 pages, 3 tables, bibliog., index

ISBN  978-1-78533-226-5 $120.00/£85.00 Hb Published (August 2016)

eISBN 978-1-78533-227-2 eBook


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“The social scientific study of reproduction is a growing field and scholars in that field will welcome a book on ART in the Dutch context as do a wide range of scholars and general readers interested in either feminism, gender, or health care. Physicians and other medical professionals will be interested in this work due to its clear implications for practice.” · Arthur L. Greil, Alfred University

Contemporary Dutch policy and legislation facilitate the use of high quality, accessible and affordable assisted reproductive technologies (ARTs) to all citizens in need of them, while at the same time setting some strict boundaries on their use in daily clinical practices. Through the ethnographic study of a single clinic in this national context, Patient-Centred IVF examines how this particular form of medicine, aiming to empower its patients, co-shapes the experiences, views and decisions of those using these technologies. Gerrits contends that to understand the use of reproductive technologies in practice and the complexity of processes of medicalization, we need to go beyond ‘easy assumptions’ about the hegemony of biomedicine and the expected impact of patient-centredness.

Trudie Gerrits is Assistant Professor in the Anthropology Department at the University of Amsterdam (UvA), Netherlands, where she is co-director of the Masters in Medical Anthropology and Sociology (MAS).

Subject: Medical Anthropology
Area: Northern Europe

LC: RG133.5

BISAC: MED082000 MEDICAL/Reproductive Medicine & Technology; MED070000 MEDICAL/Perinatology & Neonatology; MED078000 MEDICAL/Public Health

BIC: MBNH Personal & public health; PSXM Medical anthropology




Contents

Acknowledgements
Abbreviations

Introduction

  • Medicalization and Persistence
  • Patient-Centred Medicine
  • Outline of the Book


Chapter 1. Studying ARTs: Theory, Context, the Clinic and Methods    

  • Understanding the Use of ARTs
  • Dutch Context – Families, Children and Childlessness
  • The Radboud Clinic
  • The Study

Chapter 2. ‘Dutch IVF’. Legislation, Guidelines and Health Insurances

  • Legislation and Guidelines
  • Health Insurance Coverage
  • Conclusion

Chapter 3. The Couples and their Quest for a Child

  • Social and Demographic Characteristics
  • Facing Fertility Problems: Diverse Points of Departure
  • Couples’ Quest for a Child: the Process
  • Complementary and Alternative Medicine
  • Adoption as a Last Resort
  • Conclusion

Chapter 4. Daily Practices in the Patient-Centred Clinic

  • Interpersonal Aspects of Care
  • Privacy (or Not)
  • Abundant Information
  • Psycho-Social Support and Empathy
  • Decision Making – Multiple  Dynamics
  • Conclusion

Chapter 5. Information and Interpretation. Risks and Rates

  • IVF Success Rates: What Do They Tell Us?
  • Risks: Facts and Perceptions
  • Beyond Facts – Uncertainty and Trust
  • Conclusion

Chapter 6. The Body and Visualizing Technologies

  • Gaining Insight in the Reproductive Body and its Flaws
  • Visualization of Reproduction through IVF
  • Case: Louise’s Diary
  • Trying Once More? Compelling Technology
  • Conclusion

Chapter 7. Gendered Suffering and Support

  • The Gendered and Unequal Burdens of IVF
  • Sharing the Grief of Loss after IVF
  • Essentializing Genetics and Gender Dynamics
  • Conclusion

Chapter 8. Bioethics in Practice

  • Multi-Disciplinary Ethics Meeting
  • Case: Woman Carrier of a Cancer Gene
  • Concerns in Context
  • Addressing Ethically Sensitive Requests
  • Conclusion

Chapter 9. Conclusion

  • Dutch IVF
  • Bioethics in Practice
  • Patient-Centred Practices
  • Gender Inequality and the Imperative of Genetics
  • Final Thoughts: Implications for the Field and Future Research

Appendices

Appendix I: Methods
Appendix II: Social and Demographic Background Data Of Study  Participants
Appendix III: Patients’ or Couples’ Characteristics or Situations Leading to Concerns among Clinic Staff and their Reasons for Withholding Treatment

Glossary
Reference list
Index

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