TY - JOUR
T1 - Unmet communication needs and moral work in the disposition decision concerning surplus frozen embryos
T2 - The perspectives of IVF users
AU - Raz, Aviad
AU - Vardi, Jasmine
AU - Reisner Vain, Shelly
AU - Meiri, Amir
AU - Barkan, Gali
AU - Azem, Foad
AU - Amir, Hadar
N1 - Funding Information:
We are grateful to the women who participated in this study and agreed to share their views and concerns with us. This study was funded by The Israel National Institute for Health Policy Research (NIHP) grant # 2017/3R . We thank the anonymous reviewers for their helpful suggestions. We thank Roy Gilbar and Sivan Tamir for their helpful comments on the legal setting.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/4/1
Y1 - 2021/4/1
N2 - The disposition decision is a frequently unresolved issue for many IVF users with surplus frozen embryos (SFEs), and this study draws attention to their experiences and moral work, locating it in the Jewish-Israeli context that legally enables the donation of SFEs to research but prohibits donation to other infertile people. To explore the (mis)understandings and (mis)communication underlying IVF users’ decisions concerning the fate of their SFEs, the records of 674 IVF users with SFEs stored for more than 5 years during 1996–2011 were analyzed, and 89 IVF users with different disposition decisions were recruited for semi-structured interviews. With an average of 5.1 SFEs, after an average of 8 years of storage, no response to a written request for a disposition decision came from 60% (n = 404) of IVF users with SFEs. Payment for storage and defrosting were the two most frequent choices (13%, n = 89 and 89, respectively) followed by donation to research and transfer (7%, n = 47 and 45, respectively). Three themes emerged from the interviews: misunderstanding the consequences of not returning the disposition form, communication gaps regarding donation to research, and the unmet wish to donate embryos to infertile people. We conclude by discussing the experiences and views of IVF users as reflecting the implications of the liminality and boundary-work surrounding the frozen embryo as a moral work object, and their consequences for policy recommendations.
AB - The disposition decision is a frequently unresolved issue for many IVF users with surplus frozen embryos (SFEs), and this study draws attention to their experiences and moral work, locating it in the Jewish-Israeli context that legally enables the donation of SFEs to research but prohibits donation to other infertile people. To explore the (mis)understandings and (mis)communication underlying IVF users’ decisions concerning the fate of their SFEs, the records of 674 IVF users with SFEs stored for more than 5 years during 1996–2011 were analyzed, and 89 IVF users with different disposition decisions were recruited for semi-structured interviews. With an average of 5.1 SFEs, after an average of 8 years of storage, no response to a written request for a disposition decision came from 60% (n = 404) of IVF users with SFEs. Payment for storage and defrosting were the two most frequent choices (13%, n = 89 and 89, respectively) followed by donation to research and transfer (7%, n = 47 and 45, respectively). Three themes emerged from the interviews: misunderstanding the consequences of not returning the disposition form, communication gaps regarding donation to research, and the unmet wish to donate embryos to infertile people. We conclude by discussing the experiences and views of IVF users as reflecting the implications of the liminality and boundary-work surrounding the frozen embryo as a moral work object, and their consequences for policy recommendations.
KW - Cryopreservation
KW - Embryo disposition
KW - IVF
KW - Israel
KW - Judaism
KW - Moral work object
UR - http://www.scopus.com/inward/record.url?scp=85101959816&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2021.113804
DO - 10.1016/j.socscimed.2021.113804
M3 - Article
C2 - 33677202
AN - SCOPUS:85101959816
SN - 0277-9536
VL - 274
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 113804
ER -