Date of Defense

1-16-2026

Date of Graduation

5-2026

Department

Biological Sciences

First Advisor

Jonathan Milgrim

Second Advisor

Tyler Gibb

Abstract

In vitro fertilization is a relatively new medical practice that helps people who face infertility be able to reproduce. Reproductive medicine providers face ethical dilemmas often in their field, only some of which have standards of care. There are questions in the medical landscape pertaining to physician autonomy versus patient autonomy, which heavily apply to reproductive medicine providers. Patient autonomy is highly valued in medical ethics; however, physician autonomy should also be considered. When a physician decides who can and cannot reproduce, ethical considerations must be followed to maintain the practice of reproductive autonomy. Limited policies exist that manage reproductive providers' patient selection. Physicians can be selective of which patients receive IVF treatment, which could be discriminatory, or allow all patients, which could put some at risk of harm. Therefore, this paper will discuss cases where physician refusal should be accepted or denied and argues for a standard of care to be in place to ensure patient autonomy. Specifically, the topics of this paper include physician refusal of treatment for medical reasons, refusal for poor prognosis, refusal for disability, and refusal for the concern of the child’s welfare. Ultimately, I suggest that patient autonomy be prioritized, and physician refusal for IVF treatment only be limited to cases where the parents' or child’s health is at risk. A physician's decision to refuse care should be based in medicine and be backed up by evidence to prevent refusal for discriminatory reasons. This suggestion maintains patient autonomy as a basis for medical care, while allowing physicians to have autonomy in cases where patients could be at risk of harm. A recommendation for a standard of care ensures that this practice is commonplace and practiced throughout clinics. By maintaining patient autonomy and practicing physician autonomy, ethical decisions can become clearer for reproductive providers to decide when to provide IVF care.

Access Setting

Honors Thesis-Open Access

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