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Adolescent oncofertility discussions: Recommendations from a systematic literature review

Barlevy, Dorit and Elger, Bernice S. and Wangmo, Tenzin and Ravitsky, Vardit. (2017) Adolescent oncofertility discussions: Recommendations from a systematic literature review. AJOB Empirical Bioethics, 8 (2). pp. 106-115.

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Official URL: http://edoc.unibas.ch/57359/

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Abstract

Background: Increasing cancer incidence and survivorship rates have made late-term effects, such as effects on fertility, a salient issue for adolescent cancer patients. While various barriers make it difficult for health care professionals to discuss oncofertility with adolescents and their parents, there are numerous reasons to hold such discussions, based on professional obligations and the ethical principles of respect for autonomy and beneficence. This systematic literature review presents and critically examines recommendations for adolescent oncofertility discussions. Methods: Conducted according to PRISMA guidelines, this systematic literature review includes English, French, and German articles published up until December 31, 2014. Articles were sought via a combination of search terms in four databases. Results: Eighty of 96 articles included in this review address recommendations for improving adolescent oncofertility discussions. These recommendations deal with how, when, what, and with whom professionals ought to have these discussions, as well as various systemic barriers and ways to address them. Conclusions: Based upon the principles of beneficence, respect for autonomy, and justice, we endorse several recommendations for oncofertility discussions with adolescents and their parents, including having a specific professional on the health care team initiate these discussions with all newly diagnosed patients; regularly doing so before, during, and after treatment; allowing adolescents to decide for themselves whom they wish to include in such discussions; employing various forms of communication; obtaining both adolescent assent and parental consent for fertility preservation (FP) procedures, especially at each stage (e.g., procurement and use); properly educating and training professionals to discuss oncofertility; promoting interdisciplinary collaboration; creating and implementing guidelines and policies; and ensuring equity of access to FP. Background: Increasing cancer incidence and survivorship rates have made late-term effects, such aseffects on fertility, a salient issue for adolescent cancer patients. While various barriers make it difficult forhealth care professionals to discuss oncofertility with adolescents and their parents, there are numerousreasons to hold such discussions, based on professional obligations and the ethical principles of respectfor autonomy and beneficence. This systematic literature review presents and critically examinesrecommendations for adolescent oncofertility discussions. Methods: Conducted according to PRISMAguidelines, this systematic literature review includes English, French, and German articles published upuntil December 31, 2014. Articles were sought via a combination of search terms in four databases.Results: Eighty of 96 articles included in this review address recommendations for improving adolescentoncofertility discussions. These recommendations deal with how, when, what, and with whomprofessionals ought to have these discussions, as well as various systemic barriers and ways to addressthem. Conclusions: Based upon the principles of beneficence, respect for autonomy, and justice, weendorse several recommendations for oncofertility discussions with adolescents and their parents,including having a specific professional on the health care team initiate these discussions with all newlydiagnosed patients; regularly doing so before, during, and after treatment; allowing adolescents to decidefor themselves whom they wish to include in such discussions; employing various forms ofcommunication; obtaining both adolescent assent and parental consent for fertility preservation (FP)procedures, especially at each stage (e.g., procurement and use); properly educating and trainingprofessionals to discuss oncofertility; promoting interdisciplinary collaboration; creating andimplementing guidelines and policies; and ensuring equity of access to FP.
Faculties and Departments:08 Cross-disciplinary Subjects > Ethik > Institut für Bio- und Medizinethik > Bio- und Medizinethik (Elger)
03 Faculty of Medicine > Departement Public Health > Ethik in der Medizin > Bio- und Medizinethik (Elger)
UniBasel Contributors:Barlevy, Dorit and Wangmo, Tenzin and Elger, Bernice Simone
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Taylor & Francis
ISSN:2329-4515
e-ISSN:2329-4523
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:17 May 2018 14:19
Deposited On:17 May 2018 14:19

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