New ethical guidelines for fertility preservation of ill children

Doctors treating children with life-threatening illnesses now have a new tool to help them grapple with the tough ethical questions surrounding fertility preservation for their young patients. University of Melbourne bioethicist Dr Rosalind McDougall says treatments such as chemotherapy, while potentially life-saving, sometimes also caused infertility, even in pre-pubertal children. "There is a new technique that aims to preserve children's fertility, but it is ethically complex because it is unproven," Dr McDougall says.  "This is a crisis in each family's life and it can be quite challenging for the doctors too." Working with the bioethics team and medical staff at Melbourne's Royal Children's Hospital, Dr McDougall and her colleagues developed what is believed to be the world's first ethical framework to support doctors when deciding whether to offer fertility-preserving procedures to children. This procedure involves removing and then freezing a sample of ovarian or testicular. When the child grows up it might be possible for the tissue to be re-implanted and to develop sperm or eggs. The Royal Children's Hospital is one of just 26 hospitals around the world that offers such procedures to pre-pubertal girls and 16 hospitals that offer it to boys. Dr McDougall says the framework, published in today's  Journal of Medical Ethics , grew from a series of questions that repeatedly arose with doctors working with childhood cancer patients.