by: ASRM Office of Public Affairs
Published in ASRM Bulletin Volume 16, Number 5
In this new report, the Committee identifies potential areas of misconduct by individuals participating in third-party reproductive arrangements and discusses the range of responses available to ART practitioners.
Assisted reproductive technology (ART) inherently involves the activities of others in addition to the patients who are trying to have children. These include physicians and members of the medical team, and may also include gamete donors, gestational carriers, agents and attorneys. The Ethics Committee has addressed the issue of malfeasance and mishaps by ART practitioners in a prior report, Disclosure of Medical Errors Involving Gametes and Embryos.
Often, physicians identifying misconduct by third-parties will need to reconcile their conflicting professional duties, such as the duty to obtain informed consent and the duty to maintain patient confidentiality. While each scenario involving third-party misconduct is unique and requires an individualized response, the Committee recommends ways to analyze and approach these situations.
Among the possible scenarios addressed in the report are conflicts involving gamete donors, which may take the form of a donor’s intent to parent or previously unrevealed donor health information; misconduct by a gestational carrier; misconduct by intended parents in relation to a gestational carrier; and misconduct by agents and attorneys. The Committee notes that, ideally, “all potential conduct by the parties to a collaborative reproduction arrangement should be addressed by a preconception agreement in which all parties participate voluntarily.”
When a third-party ART arrangement presents an actual, or potential, conflict of interest between the intended parents and their collaborators, physicians need to consider to whom they owe professional duties and the extent of those duties. When a physician discovers or is given information that would be material to another party’s participation in the ART arrangement, he or she should encourage disclosure to that party and, in some instances, is ethically and legally permitted to disclose the material information to the affected party or to transfer care of a patient to another willing provider. The Committee advises that in all cases involving the legal status or rights of the parties, they should be referred to legal professionals.
Rebecca Sokol, M.D., M.P.H., Acting President of ASRM, commented, “In collaborative reproduction cases, physicians may find themselves learning of circumstances or information related to third-parties that have the potential to affect their patients’ health, well-being or chances of conceiving a successful pregnancy. This ethics opinion provides guidance to help practitioners chart a course through conflicting obligations and uphold their responsibility to their patients to avoid harm.”
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