Ethics and Oncofertility: A Call for Religious Sensitivity

Abstract

For patients of reproductive age, treating cancer may come at the price of infertility. Literature regarding fertility preservation recommendations in this population has increased significantly, but this literature too often overlooks or insufficiently considers the relevance of religious preferences. Similarly, practice guidelines do not address the role of religion in the oncofertility discussion. The acceptance of oncofertility practices varies significantly among Christianity, Judaism, and Islam. A patient's faith-based spirituality or secular morality may enhance his or her interpretation of the meaning of illness and should be incorporated into the informed-consent process. In this article, we describe the role of religious sensitivity in oncofertility care and argue for its importance in such care. We briefly summarize the views and moral reasoning about oncofertility in a few religions commonly encountered in many patient populations today. We recommend that clinicians discuss fertility options early in the decision process and, when relevant, incorporate the patient's moral and religious preferences into the treatment plan. We encourage providers to be prepared to offer resources to patients who desire moral and spiritual guidance about fertility preservation options. Hospital chaplains should be able to provide such resources.

Communication and ethical considerations for fertility preservation for patients with childhood, adolescent, and young adult cancer: recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group

“…Similarly, the guideline panel considers that health-care providers need to be prepared to address religious preferences as part of a holistic approach to patient care during counselling for fertility preservation. 131 The strengths of this CPG are the evidence-based approach used, the transparency given in deriving and rating the strength of the recommendations formed, and the wide geographical representation and multidisciplinary expertise of the guideline panel. The ongoing interactive relationship between the academics and clinicians who appraise the evidence and those who formulate recommendations also increases the validity and trustworthiness of our process for guideline development.…”

Exploring onco-fertility perceptions in India: a narrative review of psychosocial factors and implications for patients well-being

“…Thus, addressing the religious dimensions of a patient's sense of meaning is crucial in discussions about fertility preservation options, enhancing the quality of care for cancer patients. 15…”

Filling the Gaps in Oncofertility Care by Addressing Challenges Faced by Patients and Providers

“…In addition, medical societies and bodies at the national level can organize workshops and conferences that can spread information regarding such practices. In relation to other concerns like religious and ethical fronts, although clinicians cannot be expected to be specialized or have similar spiritual views as that of their patient population the least they can do is understand religious beliefs can play an integral role in opting for oncofertility care, ensure that patient receives appropriate counseling resources which helps them choose an option which goes along with their beliefs and help them formulate a treatment plan which respects these principles of the patient [ 39 ]. The gap between cancer and fertility can, however, only be bridged by developing a multidisciplinary network of clinicians across various specialties namely oncology, hematology, reproductive endocrinology, urology, surgery, pathology, and healthcare workers which includes nursing staff and psychologists [ 35 ].…”