12 - Elective fertility: think high-tech, think evidence and values!

Summary

Topics covered in this chapter

The Science-driven Principle – that advances in medical science and technology drive the need equally for values-based as for evidence-based practice – is illustrated by the experience of a couple seeking treatment for infertility.

Other topics include:

• Patients' experiences of infertility treatment

• Clinicians' experiences of infertility treatment

• NICE guidelines

• Spiritual direction

• Importance of the extended multidisciplinary team.

Take-away message for practic

It is above all in a high-tech area of medicine (like IVF) that it is important to adopt a balanced “values plus evidence” approach. So, “think high-tech, think values and evidence!”

Organ transplants, prosthetic limbs, laser surgery, in vitro fertilization – these are just some of the growing list of new high-tech resources now available in everyday clinical practice driven by the unprecedented advances in medical science and technology in recent decades. Nor is there any sign of the rate of advance slowing. Gene therapy, it is true, heralded over 20 years ago as the next big thing, is only just beginning to get under way, but getting underway it is.

Two high-tech challenges

Advances in high-tech medicine clearly hold out the promise of great benefits for patients. But these same advances raise many challenges for practitioners, both scientific and ethical. On the science side, there is the challenge of keeping up to date with the evidence: here the resources of evidence-based practice guidelines are helpful. Whatever the limitations of locally or nationally agreed guidelines, they at least set mutual limits on our options.