Abstract
Is research aimed at preserving the fertility of cancer patients morally justified? A satisfying answer to this question is missing from the literature on oncofertility. Rather than providing an answer, which is impossible to do in a short space, this chapter explains what it would take to provide such justification.
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Notes
- 1.
I do not look at reproductive rights arguments in favor of oncofertility research. I know of one such argument: that of Leilah Backhus and Laurie Zoloth in the last oncofertility volume [3]. According to Backhus and Zoloth, oncofertility research will protect people’s right to reproduce, which they describe as an “important freedom within society that is seldom questioned or restricted” (166). They give a significant amount of weight to this freedom, which they justify by appealing to the work of John Robertson [4], but also by claiming that infertility is a disease or disability that people ought to have the freedom to overcome. I am doubtful that Backhus and Zoloth do enough to show that a right to reproduce justifies this research (especially if the right is negative, which is how a right to reproduce is normally understood, and if the science is publicly funded). But I do not engage with their argument here and thus do not show definitively that compelling arguments in favor of oncofertility science are absent from the literature.
- 2.
I have omitted their responses to reasons others might give for not doing this research; e.g., that patients could not meaningfully consent to it or that potential harms to offspring would be too great (16).
- 3.
Rosoff and Katsur use the expression “biological children” but I prefer instead “genetically-related” or “genetic children.” In my view, the category of biologic children is larger than that of genetic children. Children to whom women give birth but to which they are not genetically related are still the women’s biologic children because of a biological tie created during pregnancy. Fertility preservation can allow oncofertility patients to have genetic children, but may not be necessary for them (particularly for the female patients) to have biologic children.
- 4.
Our society does not strongly encourage reproduction for everyone; it is anti-natalist toward certain groups, such as poor Black women [17].
- 5.
Table 4 in their paper puts the total number “currently childless” at 71 (702), but their discussion reveals that ten of these people had stepchildren and two had adopted a child (701). To suggest that these 12 people are childless, and are therefore not parents, is false and potentially very offensive to them and their children.
- 6.
They also appeal to an article written by Schover alone, which reviews the “psychosocial aspects of infertility and decisions about reproduction in young cancer survivors” [18]. This article simply hypothesizes, however, rather than shows, that infertility is distressing for cancer survivors. Overall, in the oncofertility literature, there appears to be much speculation, and little hard data, about how cancer survivors feel about procreating [19].
- 7.
As with the studies about the desire of cancer survivors to procreate, the sample sizes with these studies are low. But notice that I use them to show only that a certain possibility exists, not that certain claims are true.
- 8.
Some will say that these people would not have achieved such levels of well-being if they had not had the opportunity to resolve their infertility by undergoing infertility treatment. While it may, however, be true that (unsuccessful) treatment can help with resolving infertility, surely a resolution can come about in other ways. As far as I can tell, it is a myth that infertile people need to go through infertility treatment if only to resolve their infertility (see [8]).
References
Nisker J, Baylis F, McLeod C. Preserving the reproductive capacity of girls and young adolescent women with cancer: informed choice. Cancer. 2006; 107(7 Suppl):1686–9.
Rosoff PM, Katsur ML. Preserving fertility in young cancer patients: a medical, ethical and legal challenge. J Philos Sci Law. 2003; 3. http://www6.miami.edu/ethics/jpsl/archives/papers/preservingFert.html. Accessed December 18, 2009.
Backhus LE, Zoloth L. Today’s research, tomorrow’s cures: the ethical implications of oncofertility. In: Woodruff TK, Snyder KA, Eds. Oncofertility: fertility preservation for cancer survivors. New York: Springer; 2007:163–79.
Robertson JA. Children of choice: freedom and the new reproductive technologies. Princeton: Princeton University Press; 1994
Pearson YE. Storks, cabbage patches, and the right to procreate. Bioeth Inq 2007; 4:105–15.
Bartholet E. Family bonds: adoption, infertility, and the new world of child production. Boston: Beacon Press; 1993.
Greil AL. Infertility and psychological distress: a critical review of the literature. Soc Sci Med. 1997; 45(11):1679–704.
Harwood K. The infertility treadmill: feminist ethics, personal choice, and the use of reproductive technologies. Chapel Hill: University of North Carolina Press; 2007.
Schover LR, Rybicki LA, Martin BA, et al. Having children after cancer: a pilot study of survivors’ attitudes and experience. Cancer. 1999; 86(4):697–709.
Powdthavee N. Think having children will make you happy? Psychologist. 2009; 22(4): 308–10.
Kinahan KE, Didwania A, Nieman CL. Childhood cancer: fertility and psychosocial implications. In: Woodruff TA, Snyder KA, Eds. Oncofertility: fertility preservation for cancer survivors. New York: Springer; 2007:191–200.
Gardino S, Russell A, Woodruff TK. Adoption after cancer: adoption agency attitudes and perspectives on the potential to parent post-cancer. In: Woodruff TK, Zoloth L, Campo-Engelstein L, Rodriguez S, Eds. Oncofertility: reflections from the humanities and social sciences. New York: Springer; 2010.
Haslanger S. Forthcoming. Family, ancestry and self: what is the moral significance of biological ties?” Forthcoming In: Adoption and culture. http://www.mit.edu/~shaslang/papers/HaslangerFAS.pdf. Accessed December 18, 2009.
Peddie VL, van Teijlingen E, Bhattacharya S. A qualitative study of women’s decision-making at the end of IVF treatment. Hum Reprod. 2005; 20(7):1944–51.
Bryson CA, Sykes DH, Traub AI. In-vitro fertilization: a long-term follow-up after treatment failure. Hum Fertil 2000; 3:214–20.
Petropanagos A. Reproductive “choice” and egg freezing. In: Woodruff TK, Zoloth L, Campo-Engelstein L, Rodriguez S, Eds. Oncofertility: reflections from the humanities and social sciences. New York: Springer; 2010.
Roberts D. Killing the black body: race, reproduction, and the meaning of liberty. New York: Vintage; 1997.
Schover LR. Psychosocial aspects of infertility and decisions about reproduction in young cancer survivors: a review. Med Pediatr Oncol 1999; 33:53–9.
Snyder KA. Oncofertility and the social sciences. In: Woodruff TK, Snyder KA, Eds. Oncofertility: fertility preservation for cancer survivors. New York: Springer; 2007:137–48.
Acknowledgments
Thanks to the Joseph L. Rotman Institute for Science and Values for funding, to Andrew Botterell for comments on earlier drafts, to the audience for the talk on which this chapter is based, which I gave at the Oncofertility Consortium Summer Summit in 2009, and to organizers of this Summit and the previous one in 2008. For inspiration in thinking ethically about oncofertility and related matters, I am grateful to Teresa Woodruff, who comes to different ethical conclusions than I do, but does so out of a deep concern for the well-being of vulnerable young people: those with cancer, as well as those living in poverty or without parents. This research was supported by the oncofertility consortium NIH 8UL1DE019587, 5RL1HD058296.
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McLeod, C. (2010). Morally Justifying Oncofertility Research. In: Woodruff, T., Zoloth, L., Campo-Engelstein, L., Rodriguez, S. (eds) Oncofertility. Cancer Treatment and Research, vol 156. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6518-9_14
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