Ethical and Legal Considerations for Sterilization Refusal in Nulliparous Women.

Autor:	Izatt A; Department of Philosophy and the W. Maurice Young Centre for Applied Ethics, University of British Columbia, Vancouver, British Columbia, the Department of Paediatrics, University of Toronto and Trillium Health Partners, the Department of Obstetrics & Gynaecology, Women's College Hospital and University of Toronto, and Sinai Health, University of Toronto, Toronto, Ontario, and the Schulich School of Law, Dalhousie University, Halifax, Nova Scotia, Canada., Greenberg RA, Thorne J, Erdman J, Chauhan N
Jazyk:	angličtina
Zdroj:	Obstetrics and gynecology [Obstet Gynecol] 2023 Dec 01; Vol. 142 (6), pp. 1316-1321. Date of Electronic Publication: 2023 Oct 26.
DOI:	10.1097/AOG.0000000000005414
Abstrakt:	We address the ethical and legal considerations for elective tubal sterilization in young, nulliparous women in Canada, with comparison with the United States and the United Kingdom. Professional guidelines recommend that age and parity should not be obstacles for receiving elective permanent contraception; however, many physicians hesitate to provide this procedure to young women because of the permanence of the procedure and the speculative possibility of regret. At the practice level, this means that there are barriers for young women to access elective sterilization; they are questioned or not taken seriously, or their desire for sterilization is more generally belittled by health care professionals. This article argues for further consideration of these requests and considers the ethical and legal issues that arise when preventing regret is prioritized over autonomy in medical practice. In Canada, there is a paucity of professional guidelines and articles offering practical considerations for handling such requests. Compared with the U.S. and U.K. policy contexts, we propose a patient-centered approach for practice to address requests for tubal sterilization that prioritizes informed consent and respect for patient autonomy. We ultimately aim to assure physicians that when the conditions of informed consent are met and documented, they practice within the limits of the law and in line with best ethical practice by respecting their patients' choice of contraceptive interventions and by ensuring their access to care. Competing Interests: Financial Disclosure Julie Thorne belongs to the Bayer Canada LNG-IUS medical advisory board and is a master trainer for Nexplanon with Organon Canada. Neither organization has participated in or is involved in funding this research. She also disclosed that her registration was paid by the SOGC for the 2023 Annual Clinical and Scientific Conference for the Society of Obstetricians & Gynaecologists of Canada, as she was an invited speaker for a lecture on off-label uses of the LNG-IUS. The other authors did not report any potential conflicts of interest. (Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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