Main description:

Contemporary Dutch policy and legislation facilitate the use of high quality, accessible and affordable assisted reproductive technologies (ARTs) to all citizens in need of them, while at the same time setting some strict boundaries on their use in daily clinical practices. Through the ethnographic study of a single clinic in this national context, Patient-Centred IVF examines how this particular form of medicine, aiming to empower its patients, co-shapes the experiences, views and decisions of those using these technologies. Gerrits contends that to understand the use of reproductive technologies in practice and the complexity of processes of medicalization, we need to go beyond 'easy assumptions' about the hegemony of biomedicine and the expected impact of patient-centredness.

Contents:

Acknowledgements

Abbreviations

Introduction

Medicalization and Persistence

Patient-Centred Medicine

Outline of the Book

Chapter 1. Studying ARTs: Theory, Context, the Clinic and Methods

Understanding the Use of ARTs

Dutch Context - Families, Children and Childlessness

The Radboud Clinic

The Study

Chapter 2. 'Dutch IVF'. Legislation, Guidelines and Health Insurances

Legislation and Guidelines

Health Insurance Coverage

Conclusion

Chapter 3. The Couples and their Quest for a Child

Social and Demographic Characteristics

Facing Fertility Problems: Diverse Points of Departure

Couples' Quest for a Child: the Process

Complementary and Alternative Medicine

Adoption as a Last Resort

Conclusion

Chapter 4. Daily Practices in the Patient-Centred Clinic

Interpersonal Aspects of Care

Privacy (or Not)

Abundant Information

Psycho-Social Support and Empathy

Decision Making - Multiple Dynamics

Conclusion

Chapter 5. Information and Interpretation. Risks and Rates

IVF Success Rates: What Do They Tell Us?

Risks: Facts and Perceptions

Beyond Facts - Uncertainty and Trust

Conclusion

Chapter 6. The Body and Visualizing Technologies

Gaining Insight in the Reproductive Body and its Flaws

Visualization of Reproduction through IVF

Case: Louise's Diary

Trying Once More? Compelling Technology

Conclusion

Chapter 7. Gendered Suffering and Support

The Gendered and Unequal Burdens of IVF

Sharing the Grief of Loss after IVF

Essentializing Genetics and Gender Dynamics

Conclusion

Chapter 8. Bioethics in Practice

Multi-Disciplinary Ethics Meeting

Case: Woman Carrier of a Cancer Gene

Concerns in Context

Addressing Ethically Sensitive Requests

Conclusion

Chapter 9. Conclusion

Dutch IVF

Bioethics in Practice

Patient-Centred Practices

Gender Inequality and the Imperative of Genetics

Final Thoughts: Implications for the Field and Future Research

Appendices

Appendix I: Methods

Appendix II: Social and Demographic Background Data Of Study Participants

Appendix III: Patients' or Couples' Characteristics or Situations Leading to Concerns among Clinic Staff and their Reasons for Withholding Treatment

Glossary

Reference list

Index