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Enregistrement W158790181

Legal and ethical issues in ART "outcomes" research.

2005· article· en· W158790181 sur OpenAlexaffabout
Erin Nelson

Notice bibliographique

RevuePubMed · 2005
Typearticle
Langueen
DomaineMedicine
ThématiqueReproductive Health and Technologies
Établissements canadiensLawson Health Research Institute
Organismes subventionnairesnon disponible
Mots-clésThe artsContext (archaeology)Reproductive technologyDiversity (politics)Assisted reproductive technologyBioethicsMedicinePsychologyPolitical scienceLawPregnancyGeography
DOInon disponible

Résumé

récupéré en direct d'OpenAlex

I. Introduction Assisted reproductive technologies (ARTs) have become almost commonplace in the developed world. It is estimated that 1% of American children are now conceived using some form of assisted reproduction, (1) and that over a million children have been born as a result of the use of ARTs (2) In the past several years, however, scientists have begun to sound a cautionary note about the health outcomes of ARTs, as it appears that children conceived using ARTs may be at higher risk of birth defects and certain genetic anomalies than those conceived naturally. As a result of these new findings, a consensus appears to be emerging that research into the safety of assisted reproductive technologies (ARTs) is required. Such research will require a longitudinal, prospective design in order to answer questions about short and long-term health outcomes for those conceived using ARTs. There are a number of scientific issues that require attention before ART outcomes research can be successfully conducted; these include: sample size limitations, the diversity of both types of ARTs and birth defects, and confounding variables such as maternal age and folic acid consumption. (3) But a substantial non-scientific impediment to the conduct of this research also demands consideration: legal and ethical constraints that have the potential to complicate the research enterprise. In particular, given the research context, law and policy relating to the research participation of pregnant women and children must be attended to. The question of whether and to what extent pregnant women and children may participate in health research has been a persistent concern in both legal and ethical circles. (4) On the one hand, current ethical guidelines exhort researchers to include these populations where possible; (5) on the other, the law seems to pose a barrier to their participation. In this article, the intent of which is to raise issues requiring further consideration, I will examine legal and ethical standards relating to consent in the Canadian context, and highlight the legal and ethical concerns that arise at different stages of longitudinal prospective research studies in the ART context. In Part II, I explain the ART context and highlight the concerns that have led to calls for long-term follow-up of children conceived using ARTs. In Part III, I discuss consent to research participation along the continuum of participants in longitudinal ART outcomes research, and in Part IV, I move on to consider legal and ethical regulation of health research generally. I conclude by noting that the legal and ethical parameters around consent to longitudinal ART research must be clarified in order to permit rather than hinder the conduct of this important research. II. The Context: Assisted Reproductive Technologies In the almost 30 years since the birth of the first test-tube baby, (6) the science around reproductive and genetic technologies has exploded, giving rise to new tests and technological breakthroughs on a routine basis. Preimplantation genetic diagnosis (PGD), for example, permits scientists to diagnose genetic conditions in an in vitro embryo, (7) prior to it being implanted in a woman's uterus through in vitro fertilization (IVF), a technology in which an ovum is fertilized with a sperm cell outside the woman's body. (8) And if IVF alone will not suffice to assist a couple to conceive, because of very low sperm count or immotile sperm, a procedure termed intra-cytoplasmic sperm injection (ICSI) might be appropriate--a single sperm cell can be injected directly into the ovum to ensure that fertilization takes place. (9) Other variations on the IVF theme include a procedure called in vitro maturation (or IVM), in which immature oocytes are matured in vitro for 24-48 hours, eliminating the need for risky hormonal stimulation of the ovaries prior to harvesting eggs, (10) and IVF with blastocyst embryo transfer, which involves waiting for five to six days post-fertilization to transfer the embryo(s) to the woman's uterus, which, it is hoped, will lead to a greater likelihood of implantation. …

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction distillée sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,002
score de la tête « metaresearch » (Gemma)0,003
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesaucune
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Observationnel · Signal consensuel: aucune
GenreSignal candidat: Empirique · Signal consensuel: Empirique
Score de désaccord entre enseignants0,602
Score d'incertitude au seuil0,423

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0020,003
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0000,000
Bibliométrie0,0000,000
Études des sciences et des technologies0,0000,000
Communication savante0,0000,000
Science ouverte0,0000,000
Intégrité de la recherche0,0000,001
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,103
Tête enseignante GPT0,424
Écart entre enseignants0,320 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.
Devis d'étudeObservationnel
Domainenon disponible
GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations3
Publié2005
Routes d'admission2
Résumé présentoui

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