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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…mehr
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.
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Trudie Gerrits is Assistant Professor in the Anthropology Department at the University of Amsterdam (UvA), Netherlands, where she is co-director of the Masters in Medical Anthropology and Sociology (MAS).
Inhaltsangabe
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
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
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