Ethical Dilemmas in Fertility Counseling

Ethical Dilemmas in Fertility Counseling addresses the many quandaries encountered by mental health professionals who practice in the field of reproductive medicine. This book sets the standard for psychologists who work with donors and recipients of gametes and embryos, gestational surrogates, intended parents, and children conceived through assisted reproduction.

Through a series of thoughtfully analyzed case vignettes, readers will learn a template that can help them navigate with their clients issues such as:

• Access to assisted reproductive technology
• What to do with unused embryos
• Whether to risk initiating or reducing a multifetal pregnancy
• Whether to disclose information about the use of collaborative reproductive technologies
• Balancing law compliance, practice guidelines, and ethical principles within the context of values held by the patients' culture, religion, society, and family.

As background to their step-by-step strategy for resolving ethical dilemmas in fertility counseling, the authors provide reviews of medical, psychological, sociological, and bioethical literature in relation to assisted reproductive technologies, as well as a comparison of international and religious approaches.

This book will help psychologists already working in the field as well as those wishing to develop a niche practice in the area of reproductive medicine and health to base their practices on empirical evidence and to consistently work in an ethical manner.

Acknowledgements

Introduction: Defining the Role of Mental Health Professionals in Reproductive Medicine

1. Psychological Theories of Distress and Models of Treatment for Infertility
2. Issues of Access to Issues
3. Embryo Disposition
4. Multifetal Pregnancies
5. Oocyte Donation and Recipiency
6. Sperm Donation and Recipiency
7. Surrogacy
8. Offspring Born of Collaborative Reproductive Arrangements: Issues of Disclosure and Third-Party Identification
9. New Frontiers in Reproductive Technology and Ethics for Psychologists

Appendix A: Sample of Religious Approaches to Assisted Reproductive Technologies (ART)

Appendix B: Sample of International Approaches to Assisted Reproductive Technologies

References

Index

About the Authors

Judith E. Horowitz, PhD, is a licensed psychologist in private practice in Broward County, Florida. After graduating Phi Beta Kappa from the University of Florida, Gainesville, she received her doctoral degree from the University of Florida as well.

Dr. Horowitz is a member of the American Society for Reproductive Medicine and is a certified sexual therapist and diplomate of the American Association of Sex Educators, Counselors, and Therapists. She is also a diplomate of the American Board of Medical Psychotherapists and Psychodiagnosticians.

As an active member of the American Society for Reproductive Medicine (ASRM) since 1994, Dr. Horowitz was instrumental in establishing and developing the Mentoring Task Force of the Mental Health Professional Group (MHPG) and serves as its chair. She also served on the MHPG Membership Committee as well as on the ASRM Membership Committee and recently was appointed to the Steering Committee for Funding Development of the ASRM. In addition, she is chair of the Electronic (E)-Communications Committee of the MHPG.

Dr. Horowitz is a member of the American Psychological Association, the Florida Psychological Association, and the Broward County Psychological Association. She is also a member of the American Fertility Association and Fertile Hope.

Dr. Horowitz is a contributing author for the Parklander Magazine and writes a monthly column. She has published numerous articles on the psychological impact of infertility and has lectured nationally.

Joann Paley Galst, PhD, is a psychologist in private practice in New York City specializing in reproductive health issues. She is a past chair of the Mental Health Professional Group of the American Society for Reproductive Medicine. She was a founding member of the American Fertility Association (AFA) and received an AFA Family Building Award in 2002. She currently serves as the chair of the Mental Health Advisory Council and cochair of Support Services for the AFA.

She is also a member of the Advisory Board of the Pregnancy Loss Support Program of the National Council of Jewish Women–New York Section. Her other professional affiliations include the American Psychological Association, the New York State Psychological Association, and the Association for Behavioral and Cognitive Therapies.

Dr. Galst graduated Phi Beta Kappa from the University of Wisconsin and received her doctoral degree from Columbia University, Teachers College, in New York City. She has written and spoken extensively on numerous topics regarding fertility, pregnancy loss, third-party reproduction, disclosure and parenting issues in third-party reproduction, and ethical issues in fertility counseling.

She wrote an "Ask the Expert" mental health column for RESOLVE during 1997–1998 as well as a similar monthly column in the AFA National Newsletter during 2001–2003. She is coauthor of two chapters ("Women Treating Women: Behaviorists View the Case" and "Women Treating Men: Behaviorists View the Case" with E. T. Klass) in Women as Therapists: A Multi-Theoretical Casebook.

Nanette Elster, JD, MPH, is a visiting professor at DePaul University College of Law and the Health Law Institute at the College of Law in Chicago, where she teaches courses such as Genetics and the Law, Public Health Law, and Assisted Reproduction and the Law. She is also vice president of Spence & Elster, PA, a Chicago-area law firm working in the area of fertility law. She holds an adjunct faculty appointment at the University of Illinois at the Chicago School of Public Health.

Ms. Elster is an affiliate scholar at the Institute for Biotechnology and the Human Future. She holds a bachelor of arts degree from the University of Illinois at Urbana–Champaign, a law degree from Loyola University School of Law in Chicago, and a master of public health degree from Boston University School of Public Health.

Ms. Elster currently serves on the Board of Directors of the Chicago Center for Jewish Genetic Disorders, as a member of the University of Illinois at Chicago Embryo Stem Cell Research Oversight Committee, and as a member of the American Bar Association Coordinating Group on Bioethics and the Law.

She has spoken nationally and internationally and is the author of numerous articles on genetic and reproductive health with a particular focus on the legal and ethical implications.