Abstract
This article discusses how research in bioethics can be conducted through a sociological lens, using not only methods, but social and sociological theory and methodology to reflect on those bioethics theories that currently inform policy and practice in the healthcare setting. Using selected findings from a research project investigating the experiences of British premenopausal cancer patients making decisions to undergo fertility damaging cancer treatments, this chapter provides a case study of how sociology is an important field to include in the interdisciplinary field of bioethics. The results from interviews with cancer survivors showed that older premenopausal women (aged 35–50) attach importance to their fertility status for non-childbearing reasons. Participants felt that their healthcare professionals made assumptions about their fertility/ovarian preservation needs, which kept participants from making fully informed decisions about their cancer treatments. This research uses the experience of older oncofertility patients to highlight the need to address the persistent lack of effective communication between healthcare professionals and patients about oncofertility options, in order to better support autonomous, informed decision-making in the clinical context.
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Notes
- 1.
Corney and Swinglehurst’s (2014) research adds to the growing body of literature on the experiences of British female patients, arguing that these patients require more detailed information on FP, and an in-depth explanation of whether they, as individual patients, are eligible or not to attempt FP before cancer treatment.
- 2.
All participant names and identifying details have been changed to protect anonymity.
References
Annandale, E. 1998. The Sociology of Health and Medicine: A Critical Introduction. Cambridge: Polity Press.
Anspach, R.R. (1993). Deciding Who Lives: Fateful Choices in the Intensive Care Nursery. Berkeley: University of California Press.
Attride-Stirling, J. 2001. Thematic Networks: An Analytical Tool for Qualitative Research. Qualitative Research 1: 385–405.
Beauchamp, T.L., and J.F. Childress. 2009. Principles of Biomedical Ethics. 6th ed. Oxford: Oxford University Press.
Borry, P., P. Shotsmans, and K. Dierickx. 2005. The Birth of the Empirical Turn in Bioethics. Bioethics 19 (1): 49–71.
Brewer, J. 2000. Ethnography. Buckingham: Open University Press.
British Fertility Society. 2003. A Strategy for Fertility Services for Survivors of Childhood Cancer. Human Fertility 6: A1–A40.
Cancer Research UK. 2014. All Cancers Combined Key Facts. Retrieved from http://www.cancerresearchuk.org/cancer-info/cancerstats/keyfacts/Allcancerscombined/. Accessed 8 Sept 2014.
Charles, C., A. Gafni, and T. Whelan. 1997. Shared Decision-Making in the Medical Encounter: What Does It Mean? (or It Takes At Least Two to Tango). Social Science and Medicine 44 (5): 681–692.
Charles, C., C. Redko, T. Whelan, A. Gafni, and L. Reyno. 1998. Doing Nothing Is No Choice: Lay Constructions of Treatment Decision-Making Among Women with Early-Stage Breast Cancer. Sociology of Health & Illness 20 (1): 71–95.
Charles, C., A. Gafni, and T. Whelan. 1999. Decision-Making in the Physician-Patient Encounter: Revisiting the Shared Treatment Decision-Making Model. Social Science and Medicine 49: 651–661.
Charmaz, K. 2006. Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks: Sage Publications.
Corney, R.H., and A.J. Swinglehurst. 2014. Young childless women with breast cancer in the UK: a qualitative study of their fertility‐related experiences, options, and the information given by health professionals. Psycho-Oncology 23: 20–26.
Cope, D. 2002. Patients’ and Physicians’ Experiences with Sperm Banking and Infertility Issues Related to Cancer Treatment. Clinical Journal of Oncology Nursing 6 (5): 293–295.
Corrigan, O. 2003. Empty Ethics: The Problem with Informed Consent. Sociology of Health & Illness 25: 768–792.
Crawshaw, M., A. Glaser, J. Hale, and P. Sloper. 2009. Male and Female Experiences of Having Fertility Matters Raised Alongside a Cancer Diagnosis During the Teenage and Young Adult Years. European Journal of Cancer Care 18: 381–390.
Emanuel, E.J., and L.L. Emanuel. 1992. Four Models of the Physician-Patient Relationship. The Journal of the American Medical Association 267 (16): 2221–2229.
Frith, L. 2012. Symbiotic Empirical Ethics: A Practical Methodology. Bioethics 26 (4): 198–206.
Frongillo, M., S. Feibelmann, J. Belkora, C. Lee, and K. Sepucha. 2013. Is There Shared Decision Making When the Provider Makes a Recommendation? Patient Education and Counselling 90: 69–73.
Goodwin, T., B.E. Oosterhuis, M. Kiernan, M.M. Hudson, and G.V. Dahl. 2007. Attitudes and Practices of Pediatric Oncology Providers Regarding Fertility Issues. Pediatric Blood Cancer 48: 80–85.
Haimes, E. 2002. What Can the Social Sciences Contribute to the Study of Ethics? Theoretical, Empirical and Substantive Considerations. Bioethics 16 (2): 89–113.
Haimes, E., and K. Taylor. 2013. What Is the Role of Reduced IVF Fees in Persuading Women to Volunteer to Provide Eggs for Research? Insights from IVF Patients Volunteering to a UK ‘Egg Sharing for Research’ Scheme. Human Fertility 16 (4): 246–251.
Haimes, E., and R. Williams. 2007. Sociology, Ethics and the Priority of the Particular: Learning from a Case Study of Genetic Deliberation. British Journal of Sociology 58 (3): 457–476.
Hedgecoe, A. 2004. Critical Bioethics: Beyond the Social Science Critique of Applied Ethics. Bioethics 18 (2): 120–143.
Hoffmaster, B., ed. 2001. Bioethics in social context. Philadelphia: Temple University Press.
Kim, J., A.M. Deal, U. Balthazar, L.A. Kondapalli, C. Gracia, and J.E. Mersereau. 2013. Fertility Preservation Consultation for Women with Cancer: Are We Helping Patients Make High-Quality Decisions? Reproductive Biomedicine Online 27: 96–103.
Letourneau, J.M., E.E. Ebbel, P.P. Katz, K.H. Oktay, C.E. McCulloch, W.Z. Ai, A.J. Chien, M.E. Melisko, M.I. Cedars, and M.P. Rosen. 2012. Acute Ovarian Failure Underestimates Age-Specific Reproductive Impairment for Young Women Undergoing Chemotherapy for Cancer. Cancer 118 (7): 1933–1939.
Loren, A.W., P.B. Mangu, L.N. Beck, L. Brennan, A.J. Magdalinski, A.H. Partridge, G. Quinn, W.H. Wallace, and K. Oktay. 2013. Fertility Preservation for Patients with Cancer: American Society of Clinical Oncology Clinical Practice Guidelines Update. Journal of Clinical Oncology 31 (19): 2500–2510.
Mackenzie, C., and N. Stoljar. 2000. Relational Autonomy: Feminist Perspectives on Autonomy, Agency and the Social Self. New York: Oxford University Press.
Mason, J. 2002. Qualitative Researching. 2nd ed. London: Sage Publications.
McMullen, L.M. 2012. Discourses of Influence and Autonomy in Physicians’ Accounts of Treatment Decision Making for Depression. Qualitative Health Research 22 (2): 238–249.
Morse, J.M., M. Barret, M. Mayan, K. Olsen, and J. Spiers. 2002. Verification Strategies for Establishing Reliability and Validity in Qualitative Research. International Journal of Qualitative Methods 1 (2): 13–22.
National Institute for Health and Care Excellence. 2013. Fertility: Assessment and Treatment for People with Fertility Problems. Retrieved from http://www.nice.org.uk/guidance/cg156/chapter/recommendations#people-with-cancer-who-wish-to-preserve-fertility. Accessed 8 Sept 2014.
Nettleton, S. 2013. The Sociology of Health & Illness. 3rd ed. Cambridge: Polity Press.
Nisker, J., F. Baylis, and C. McLeod. 2006. Choice in Fertility Preservation in Girls and Adolescent Women with Cancer. Supplement to Cancer 107 (7): 1686–1689.
Paton, A. 2017. No Longer “Handmaiden”: The Role of Social and Sociological Theory in Bioethics. IJFAB 10 (1): 30–49.
Peddie, V., M. Porter, R. Barbour, D. Culligan, G. MacDonald, D. King, J. Horn, and S. Bhattacharya. 2012. Factors Affecting Decision Making About Fertility Preservation After Cancer Diagnosis: A Qualitative Study. BJOG 119: 1049–1057.
Quinn, G.P., and S.T. Vadaparampil. 2009. Fertility Preservation and Adolescent/Young Adult Cancer Patients: Physician Communication Challenges. Journal of Adolescent Health 44: 394–400.
Quinn, G.P., S.T. Vadaparampil, C.K. Gwede, C.A. Miree, L.M. King, H. Clayton, C. Wilson, and P. Munster. 2007. Discussion of Fertility Preservation with Newly Diagnosed Patients: Oncologists’ Views. Journal of Cancer Survivorship 1: 146–155.
Royal College of Physicians, The Royal College of Radiologists, Royal College of Obstetricians and Gynaecologists. 2007. The Effects of Cancer Treatment on Reproductive Functions: Guidance on Management (Report of a Working Party). London: Royal College of Physicians.
Schover, L.R. 1999. Psychological Aspects of Infertility and Decisions About Reproduction in Young Cancer Survivors: A Review. Medical and Pediatric Oncology 33: 53–59.
Schover, L.R., K. Brey, A. Lichtin, L.I. Lipshultz, and S. Jeha. 2002a. Knowledge and Experience Regarding Cancer, Infertility, and Sperm Banking in Younger Male Survivors. Journal of Clinical Oncology 20 (7): 1880–1889.
———. 2002b. Oncologists’ Attitudes and Practices Regarding Banking Sperm Before Cancer Treatment. Journal of Clinical Oncology 20 (7): 1890–1897.
Sherwin, S. 1992. No Longer Patient: Feminist Ethics and Health Care. Philadelphia: Temple University Press.
———. 1998. A Relational Approach to Autonomy in Health Care. Philadelphia: Temple University Press.
Silverman, D. 2004. Qualitative Research: Theory, Method and Practice. London: Sage Publications.
Siminoff, L.A., G.C. Graham, and N.H. Gordon. 2006. Cancer Communication Patterns and the Influence of Patient Characteristics: Disparities in Information-Giving and Affective Behaviours. Patient Education and Counseling 62: 355–360.
Street, R.L., Jr., H. Gordon, and P. Haidet. 2007. Physicians’ Communication and Perceptions of Patients: Is It How They Look, How They Talk, or Is It Just the Doctor? Social Science and Medicine 65: 587–598.
Whittemore, R., S.K. Chase, and C.L. Mandle. 2001. Validity in Qualitative Research. Qualitative Health Research 11 (4): 522–537.
Wilkes, S., S. Coulson, A. Crosland, G. Rubin, and J. Stewart. 2010. Experience of Fertility Preservation Among Younger People Diagnosed with Cancer. Human Fertility 13 (3): 151–158.
Zikmund-Fisher, B., M.P. Couper, and A. Fagerlin. 2012. Disparities in Patient Reports of Communications to Inform Decision Making in the DECISIONS survey. Patient Education and Counseling 87: 198–205.
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Paton, A. (2018). ‘It’s Not Just About Having Babies’: A Socio-bioethical Exploration of Older Women’s Experiences of Making Oncofertility Decisions in Britain. In: Riesch, H., Emmerich, N., Wainwright, S. (eds) Philosophies and Sociologies of Bioethics. Springer, Cham. https://doi.org/10.1007/978-3-319-92738-1_6
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