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Biomedical subjects

K R Daniels

Publications and source records attributed to K R Daniels.

At least 19 recordsLinked to original sources
PubMed2001

Guidelines for counselling in infertility: outline version.

The Guidelines for Counselling in Infertility describe the purpose, objectives, typical issues and communication skills involved in providing psychosocial care to individuals using fertility services. The Guidelines are presented in six sections. The first section describes how infertility consultations differ from other medical consultations in obstetrics and gynaecology, whereas the second section addresses fundamental issues in counselling, such as what is counselling in infertility, who should counsel and who is likely to need counselling. Section 3 focuses on how to integrate patient-centred care and counselling into routine medical treatment and section 4 highlights some of the special situations which can provoke the need for counselling (e.g. facing the end of treatment, sexual problems). Section 5 deals exclusively with third party reproduction and the psychosocial implications of gamete donation, surrogacy and adoption for heterosexual and gay couples and single women without partners. The final section of the Guidelines is concerned with psychosocial services that can be used to supplement counselling services in fertility clinics: written psychosocial information, telephone counselling, self-help groups and professionally facilitated group work. This paper summarizes the different sections of the Guidelines and describes how to obtain the complete text of the Guidelines for Counselling in Infertility.

Counseling↗
PubMed2001

Sharing information with donor insemination offspring. A child-conception versus a family-building approach.

This paper suggests an innovative approach to the sharing of information between parents and their donor-conceived offspring. The 'family-building' approach is offered in the hope that it will stimulate discussion and development. Traditionally, the emphasis has been on telling the child about his/her donor conception. This has the potential to unintentionally separate the child from the parents. The family-building approach presents donor conception as an issue concerning all members of the family, thus encouraging the child to see him/herself as an integral part of this family's history. Within this approach, the semen provider is acknowledged for his contribution and for having an ongoing significance in the family. It is important, however, to clearly differentiate between him as the genitor and the child's father as the loving and nurturing male in the family. Implications for professionals include the need to acknowledge that donor insemination does not only enable a woman to become pregnant but that it creates a family with a past, present and future. Therefore it will be helpful to provide information about and explore attitudes towards this type of family-building before couples start treatment.

Disclosure↗
PubMed2000

The best interests of the child in assisted human reproduction: the interplay between the state, professionals, and parents.

Developments in assisted human reproduction (AHR) have aroused considerable debate and interest around the world, with most governments accepting that they are matters of public policy. This politicization of AHR is explored in the context of a consideration of the oft-used term "the best interests of the child." This "rallying call" is frequently cited as the primary concern in the determination of policy. This article is based on the contention that it is important to examine the interplay between the three main groups directly influencing "best interest" outcomes for AHR offspring. These groups are the professionals, the parents, and the state. It seeks to examine how this high-sounding and well-meaning commitment is addressed, advanced, or ignored in the interplay of these groups.

Child↗
PubMed2000

To give or sell human gametes--the interplay between pragmatics, policy and ethics.

The ever-growing acceptance and use of assisted human reproduction techniques has caused demand for "donated" sperm and eggs to outstrip supply. Medical professionals and others argue that monetary reward is the only way to recruit sufficient numbers of "donors". Is this a clash between pragmatics and policy/ethics? Where monetary payments are the norm, alternative recruitment strategies used successfully elsewhere may not have been considered, nor the negative consequences of commercialism on all participants thought through. Considerations leading some countries to ban the buying and selling of sperm, eggs and embryos are outlined and a case made that the collective welfare of all involved parties be the primary consideration in this, at times heated, debate.

Adult Children↗
PubMed1997

Information sharing in semen donation: the views of donors.

The authors report on a comparative questionnaire study of semen donors at two London clinics offering donor insemination (DI). Results presented here include donors' attitudes towards the storage of identifying information on the UK Human Fertilisation and Embryology Authority's central register, the importance of anonymity when donating, feelings about being traced by DI offspring, and views on the release of identifying donor information to mature offspring. Donors from the two clinics were found to differ on some, although not all, of the above points; in particular, donors from one clinic offered more support for the eventual release of identifying information to DI offspring. The discussion brings in the results of other studies and highlights the complexity of the anonymity question. The authors conclude that some donors may be willing to move towards greater openness of information under controlled conditions using the existing central register and a "veto" system.

Adult↗
PubMed1997

Semen donor recruitment strategies--a non-payment based approach.

Actual and projected prohibition of payment for semen donation in the UK and Canada has increased the need to examine alternative methods of donor recruitment. Evidence from a number of sources suggests that there is a large group of current and potential donors who are motivated more by meeting esteem needs than by payment. We develop an argument for using social marketing tools to create systematically an esteem-based approach to donor recruitment as an alternative to the payment approach. We conclude that esteem is a useful method of reciprocating the gift that donors make.

Economics↗
PubMed1997

Access to assisted human reproduction services by minority groups.

This paper looks at the claims of lesbian and single women to have access to Assisted Human Reproduction (AHR) in New Zealand, discusses legislation, rulings and regulations, as well as the opinions of people who have been involved in this issue. These include clinics and health professionals who provide these services, ethics committees and other bodies, and public opinion. Some implications for policy development are also discussed.

Female↗
PubMed1996

Donor insemination: the gifting and selling of semen.

The authors examine the implications for individuals and society of how semen is provided for use in donor insemination treatment. In particular, they focus on whether 'donors' make a gift of their semen or are paid. The role of health professionals in shaping the nature and meaning of semen provision is also explored. The currently predominant practice of buying semen is compared with other reproductive and biomedical exchanges: oocyte and embryo donation, surrogacy, and blood, organ and fetal tissue donation. The authors suggest that the commercialisation of semen determines and reflects the type of men frequently recruited to provide semen. This in turn influences the meaning that donors themselves, recipients, offspring, health professionals and society at large attribute to the provision of semen.

Age Distribution↗
PubMed1996

Semen donor recruitment: a study of donors in two clinics.

We report on a comparative study of semen donors at two London (UK) clinics which have different recruitment and payment policies. Results presented here include data on the demographic characteristics, motivations, means of recruitment and attitudes towards payments of the donors, as well as their disclosure to others about the donation. Donors from the two clinics were found to differ on the above points. Comparisons with other studies are made and implications for donors recruitment are discussed.

Adult↗
PubMed1996

Successful donor insemination and its impact on recipients.

Male and female partners of couples who conceived a child by donor insemination (DI) independently completed a questionnaire. Fifty-seven women and 53 men representing 58 couples taking part. Fifty-one were in a continuing relationship and seven were separated. A likert scale (0-7) of "happiness' before, during and after treatment and their perception of their partner's feelings were used as measures. These feelings were evaluated in relation to demographic and clinical factors. Fifty-one women and 49 men who were in a continuing relationship answered questions about their feelings about DI, compared to six and three, respectively, who had separated. Feelings about DI were consistently low before treatment began. For both continuing and separated couples there was an improvement of their feelings about having DI during treatment, and then again after treatment was complete. For the male partner, factors that were associated with greater unhappiness included difficulties with the relationship prior to treatment, waiting time for treatment and subsequent separation. The women, however, had more positive experiences with no measured factors adversely affecting their feelings about DI. The arrival of the DI child had a significant effect in improving the relation-ship. Our findings suggest that for many couples acceptance of the DI program was less than ideal and only improved with having the treatment and then conceiving. The data highlight the need for psychosocial assistance to be made available to couples prior to the commencement of treatment.

Attitude to Health↗
PubMed1996

Feelings of couples who have had a child by donor insemination: the degree of congruence.

The study aimed to assess the congruence of feelings about donor insemination (DI) in couples who have had a child by this means. Male and female partners of 50 couples (in continuing relationships) who had had a child by DI individually completed a questionnaire. A Likert scale (0, very unhappy to 7, very happy) was used to assess feelings before, during and after treatment, and the perception of their partner's feelings. Individual partner's responses were also compared for views about the donor and assessment of their relationship. For both males and females, their feelings about DI before, during and after treatment did not correlate with their perceived view of their partner's feelings. This difference was much more striking before treatment started with male feelings (mean +/- SD) being 4.1 +/- 1.8 compared to the females' perception of the males' feelings of 3.5 +/- 1.9 (t test, p = 0.004) and females' feelings of 3.7 +/- 2.0 compared to the males' perception of female feelings of 4.3 +/- 2.0 (p = 0.05). In comparing attitudes about the donor, individual couples' views did not correlate well, the exceptions being their views on whether or not to have another child and whether they wanted the same donor. All but one couple agreed that the DI child had brought them closer together as well as agreeing that they confided in each other. The marital interaction assessment showed close compatibility in most issues. The impact of DI on couples affected by male factor infertility raises many issues, the views of which may not be shared between partners. This is especially the case of attitudes about the donor and is of some concern when viewed in the wider context of marital and parent-child relationships. It is not known whether these opposing views have an impact on the later development of these relationships but they should be considered as part of the preparation for beginning treatment.

Attitude to Health↗
PubMed1995

Telling donor insemination offspring about their conception: the nature of couples' decision-making.

The issue of openness and secrecy in the use of donor gametes is the subject of considerable disagreement and debate, not only for social scientists and health professionals, but also for the recipients of donor gametes. This paper has its origins in a study of 58 couples who had a child/children as a result of donor insemination (DI) at the Dunedin Infertility Clinic. Respondents completed questionnaires and took part in an interview during which they were asked whether they intended to tell their offspring about their DI conception. The nature of agreement/disagreement between partners on this issue, the dynamics operating between couples that may affect decision-making, and the views of couples in a time-frame perspective are the focus of this paper. Transcripts from some of the interviews are presented to illustrate the points made and commentary and discussion is provided.

Decision Making↗
PubMed1993

Withdrawal from a donor insemination programme.

The aim of this study was to examine the factors that influenced the withdrawal of couples from a regional donor insemination programme. Demographic, medical, treatment and outcome data were prospectively recorded on 375 referrals. One hundred and eight women had conceived at least 1 normal pregnancy. Withdrawals from the programme, without pregnancy, accounted for 165 couples, whilst 47 had begun treatment, and a further 29 were on the waiting list. Thirty nine (24%) of those withdrawing did so without notice or reason. Most of these (33) were in couples waiting to begin treatment. Natural conception, adoption, identifiable medical or social reasons (including separation) and moving to another region were the predominant causes for withdrawing. Women who had entered the programme because of their partner's oligospermia had a high natural conception rate. Age, socioeconomic status, geographic location and length of infertility did not affect the withdrawal rate.

Adult↗