The Social Context of Oncofertility
23 Pages Posted: 2 Jan 2013 Last revised: 10 Feb 2013
Date Written: 2012
A field known as oncofertility provides female cancer patients with a variety of ways to preserve their fertility so that they may bear genetically related children after successful cancer treatment. Some women delay cancer therapy so doctors can collect their eggs, which are then cryopreserved in an unfertilized state or used to create embryos through in vitro fertilization for freezing. An experimental procedure for preserving the fertility of prepubertal girls, known as ovarian tissue cryopreservation, involves surgically removing their ovarian tissue and growing the immature eggs to a mature state so they can be frozen and stored until the girls are old enough to bear a child. Ethical questions raised by fertility preservation are not confined to the clinic and bedside; rather, these questions extend to the impact of fertility preservation on society and the way social forces influence women's decisions about their fertility. Gender, class, and race inequities help determine the reproductive options available to these women, including their access to assisted reproductive technologies, and the consequences that their childbearing decisions have for them, their families, and their communities. The uses and outcomes of novel technologies like oncofertility treatment are determined by their social context at the same time that these technologies have an impact on society. Considering the role social context plays in the ethics of fertility preservation reveals several paradoxical tensions that policy makers will have to resolve. There are compelling ethical reasons to restore to women cancer survivors the capacity to have a child so easily preserved for men and for the public to support wide access to this restoration. Yet an investigation of the underlying structural injustices that place women in conditions of infertility, poor health, and inadequate access to medical care raise questions about the just distribution of public resources used to pay for oncofertility and other health care services.
Keywords: healthcare, oncology, child brearing, reproduction, reproductive rights, technology, ethics, bioethics, medicine, science, discrimination
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