Religious Beliefs and Refusal of Assisted Reproductive Technologies: A Qualitative Case Study

This exploratory and descriptive qualitative case study examined how religious beliefs shaped decision-making and emotional experiences in a couple facing infertility who re-fused assisted reproductive technologies (ART), with partic-ular attention to moral distress concerning embryo status and the psychosocial implications of treatment refusal. Psy-chological follow-up in the context of reproductive counseling involved a heterosexual couple and a potential gestational carrier. Data were obtained from semi-structured interviews and projective graphic techniques within the House-Tree-Person framework, emphasizing human figure and family drawings. Interpretive qualitative analysis was used to iden-tify thematic categories and integrate narrative data with psychological assessment material. Three central processes emerged: moral distress anchored in the perceived moral status and anticipated fate of surplus embryos; value-based boundary-setting, in which embryo donation or disposal was considered morally unacceptable; and relational coping characterized by asymmetrical expressions of distress with-in the couple. Psychoeducation elicited repeated questions about embryo status, the number of embryos transferred, cryopreservation, and uterus transplantation, which func-tioned as markers of moral conflict. Projective material was interpreted as consistent with vulnerability, perceived impo-tence, and conflict between life projects and moral impera-tives. In this case, religiosity operated not only as a coping resource but also as a decisive framework that constrained acceptable reproductive options. Clinicians should provide non-coercive, empathic, and value-sensitive counseling that supports informed refusal while addressing grief, identity disruption, and moral distress.