Informed consent in assisted reproduction: an Ethics Committee opinion

Informed consent in assisted reproduction: an Ethics Committee opinion
Ethics Committee of the American Society for Reproductive Medicine
Fertility and Sterility, 5 May 2023
Summary
Informed consent is a complex topic in bioethics and clinical practice. This opinion focuses on the ethical principles underpinning the provision of informed consent for the clinical care of patients seeking fertility treatment. Although there may be an overlap in the ethical and legal requirements for informed consent, this opinion will focus specifically on the ethical requirements for informed consent. Moreover, unlike legal requirements that may vary by jurisdiction, ethical requirements are universal. Ethical analyses of informed consent also must distinguish whether the consent is for clinical care or for research, because the research goals of obtaining knowledge differ from the goals of treatment. Ethical informed consent for fertility care requires sufficient understanding on the part of the patient to make a well-reasoned decision in furtherance of their values. It is a process in which the patient is supported in developing understanding and coming to an informed, voluntary, and carefully considered decision. Best practices for this process include understanding the patient’s condition; discussing without bias the known and potential risks, benefits, and likely outcomes of available alternatives, including no treatment; eliciting the patient’s values; and considering how alternatives may or may not realize these values. Special care may need to be taken when patients are in stressful situations, such as when they may be subject to pressure from partners or family; when they lack experience with what they may undergo (such as pregnancy or childbirth); when the risks, benefits, and processes of care are difficult to explain and understand; or when their first language is not English. Ethical informed consent may also require the disclosure of information specific to a particular facility, such as conflicts of interest, prior experience, or policies that may be important to patients in making decisions about their care. Education is an important prerequisite to informed consent but is not a substitute for it…