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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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
Mengenai Pengarang
Trudie Gerrits is Assistant Professor in the Anthropology Department at the University of Amsterdam (Uv A), Netherlands, where she is co-director of the Masters in Medical Anthropology and Sociology (MAS).
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