Issues of autonomy and agency in oncofertility: a socio-bioethical exploration of British adult female cancer patients making oncofertility decisions

Abstract

This thesis examines from a socio-bioethical perspective British premenopausal cancer patients’ experiences with making oncofertility decisions. It uses original empirical research into the experiences of a small group of patients to address social, clinical and ethical concerns about how patients make decisions in the medical context. Several North American studies have noted that the ways in which cancer and fertility concerns are addressed in the medical context may affect patient decision-making. This thesis focuses specifically on how these experiences are influenced by the medical encounters in the UK, by exploring how female cancer patients make decisions about their future fertility. The thesis also examines whether social and bioethical theories of autonomy and agency adequately capture how decisions are made in practice, using empirical data to interrogate existing theory. To address these questions, semi-structured interviews were conducted with premenopausal cancer patients. Data from the interviews were analysed using sociological and bioethical theories in order to improve understandings of how this patient group makes decisions, and how they feel this experience could be improved. This research therefore contributes to the growing body of literature seeking to identify how patients make decisions within the medical context and what types of support are necessary to address the needs identified by patients. Furthermore, the thesis demonstrates how sociology as a discipline can be seen as a constitutive part of bioethics, with this project serving as an example of one way that bioethical research can be conducted through a sociological lens.