Autonomous decisions by couples in reproductive care

Area of Science:

• Reproductive genetics
• Bioethics
• Clinical psychology

Background:

• Preconception Expanded Carrier Screening (ECS) offers genetic testing to couples without known risks for hereditary diseases.
• The ethical basis for ECS lies in enhancing reproductive autonomy, traditionally viewed as individualistic.
• Clinical practice involves couples making joint decisions regarding preconception ECS.

Purpose of the Study:

• To understand autonomous decision-making by couples regarding preconception ECS.
• To explore couple decision-making within reproductive technologies.
• To provide insights for healthcare professionals in reproductive clinics.

Main Methods:

• Conceptualizing couple autonomy based on relational autonomy.
• Outlining features of couple autonomy: individual autonomy, communicative process, free expression of concerns, adequate negotiation time, consensus without coercion.
• Applying the concept of couple autonomy to clinical scenarios.

Main Results:

• Couple autonomy requires both partners to be individually autonomous and engage in open communication.
• Decision-making should allow for negotiation and consensus, free from manipulation or miscommunication.
• The concept was applied to various clinical situations involving reproductive technologies.

Conclusions:

• Couple autonomy provides a framework for healthcare professionals supporting joint decisions on preconception ECS.
• Healthcare providers should allocate sufficient time for decision-making.
• Promoting dialogue can empower less dominant partners in the couple's decision-making process.