The complexities of decision-making
Risk/benefit analysis
The prize that beckons at the end of the trail that starts with diagnosis is not hard to describe. The medical treatment sublingual viagra 100mg programme on which the young person is due to embark may ensure their survival at the cost of several significant side-effects. One price that the individual may have to pay is that their reproductive capacity may be permanently impaired. Cryopreservation offers the promise of being able to bank tissue or gametes preoperatively so that the individual’s reproductive capability can be safeguarded. Infertility does not threaten the survival of the individual in the way that, for example, treatment-related cardiac complications might. Infertility does not immediately impair the person’s social or intellectual functioning in the manner that damage to the central nervous system might. But infertility can have great personal psychological significance (Dunkel-Schetter and Lobe. Not everyone will want to become a parent but most would like that role to be one of the life-choices open to them. Cryopreservation offers a way to keep young patients ‘in the game’ as it were.
However, the metaphor of buying a ticket or two in life’s reproductive lottery glosses over the many risks and uncertainties involved. There will be immediate concerns about the dangers associated with any additional medical procedures such as anaesthesia. Parents may well be sensitive to the emotional impact on their child of being asked to participate in extra treatments when they are already very sick and frightened (as, for example, when a young man might be asked to provide a semen sample). In the longer term, questions need to be considered concerning the effective-ness of the storage procedures and the likely success rates of attempts to reintroduce the preserved tissue or gametes. Are miscarriages or birth defects likely to be higher than for ‘normally’ conceived babies? Where cyropreserved tissue is used in assisted conception treatment, will there be an increased risk of cancer developing for the newborn child or the tissue donors themselves? Good questions all – to which it currently appears harder to give clear answers to some than others.
Doctors viagra online canada and patients are faced with difficult treatment choices all the time. It is not often that all the necessary information is available and that an evidently ‘right way’ forward beckons. Under less optimal circumstances, the effectiveness of treatment decisions needs to be gauged by the manner in which evidence is weighed rather than the correctness of the conclusions reached (i.e. by process rather than outcome criteria).