What's the message? A content analysis of newspaper articles about assisted reproductive technology from 2005 to 2011.

Infertility and its treatment is the subject of considerable media coverage. In order to evaluate the representation of assisted reproductive technology (ART) in the popular media, we conducted a content analysis of North American newspaper articles. We also explored whether different themes emerged in relation to the implementation of public funding for ART in Quebec, Canada. Print and online newspaper articles from 2005 to 2011 were retrieved using the terms "in-vitro fertilization", "infertility treatment", "assisted reproductive technology", and "IVF treatment". Totally, 719 newspaper articles met inclusion criteria and were coded according to predetermined categories. Risks (63%) and ethical issues (61%) related to ART were most commonly featured. Quebec-based articles were mostly concerned with the politics and financial issues governing ART, and were less likely to report the risks and emotional impact of ART than other North American press. Newspapers tended to emphasize extreme scenarios as well as controversial cases that may not represent the everyday realities of ART. Changes in public policy may also engender shifts in the tone and content of media reports. It is important to establish resources that can inform the public as well as prospective infertility patients about their condition and potential treatment options.

Culture, ethics, and pediatric surgery.

This report considers the impact of cultural disparities between patient and physician when the patient is a child and when the physician is a surgeon. The meaning of culture, what an ethics perspective involves, and features of pediatric surgery that are relevant to discussions about culture, ethics, and pediatric surgery are reviewed. Some of the ethical challenges that pediatric surgeons may face when they and their patients have different cultural understandings are explored.

Shifting the autonomy debate to theory as ideology.

Some feminists have been critical about the dominant conception of autonomy, questioning, for example, its conception of persons and ideal of personhood. Tom Beauchamp and James Childress (B&C), the major proponents of the dominant conception of autonomy, believe that these feminists have misunderstood their theory and, moreover, that their theory is immune to feminist attack. Their response to feminist critics, however, has been dismissive and does nothing to assuage these critics' concerns. In this paper I briefly review the state of play in this debate about autonomy, showing that B&C are not without positive rejoinders to objections raised by feminist critics. These rejoinders rest on the notion that feminist concerns are a matter of what is logically entailed by B&C's theory of autonomy and attempt to show that feminist commitments are logically consistent with that theory. However, these rejoinders are less than convincing for reasons illuminated by Cheshire Calhoun. Calhoun reminds us that feminists are sensitive to ways in which the shape of discourse is influenced by non-epistemic considerations. In particular, Calhoun draws our attention to the cumulative effect of a whole tradition of moral reasoning that focuses on too narrow a range of moral problems and too narrow an understanding of people and the human condition. B&C's conception of autonomy relies on and reinforces ideologies of the moral life created in just this way. Following Calhoun, I show that criticism of their theory as ideology is not criticism of its logical implications, but something far more damaging, something without available rejoinders.

Preventing and resolving ethical conflicts: more help for policy makers.

Institutional policy makers have a useful resource in the "Joint Statement on Preventing and Resolving Ethical Conflicts Involving Healthcare Providers and Persons Receiving Care". Yet, some aspects of the joint statement pose challenges for institutional policy development and merit further reflection. With the aim of clarifying and augmenting the recommendations in the joint statement, this paper gives additional guidance on the issues of benefit, power imbalance, and legitimate decisional authority.