title: Decisions for the fate of frozen embryos: fresh insights into patients' thinking and their rationales for donating or discarding embryos.
abstract: BACKGROUND
  In the final decision for the disposition of unused IVF embryos patients must choose between options involving either donation or destruction, and this decision must be made in a context where there is tension about the status of embryos (i.e. whether viewed as potential children or as a base for further development) and whether embryo donation is adoption or tissue donation. This study explored the emotive experience of making a decision for either the destruction or donation of unused embryos.
  
  
  METHODS
  Thirty-three patients (9 women and 12 couples) who discarded embryos and 15 (7 women and 4 couples) who donated embryos were interviewed. Interview data were analysed with particular attention to elements of moral deliberation and use of analogy.
  
  
  RESULTS
  Adoption and tissue donation metaphors were both identified, and further, a metaphor of pregnancy termination was identified and found to be highly influential in the decision to donate embryos. Contrary to the majority of current evidence, this study found that participants who discarded embryos emphasized the adoption metaphor while embryo donors emphasized the metaphor of pregnancy termination. For each group the decision was driven by awareness of the option they did not want.
  
  
  CONCLUSIONS
  The pregnancy termination metaphor emerged as morally relevant and this holds implications for defining and discussing embryo discard in counselling and consent processes.
authors.affiliation: Research Centre for Reproductive Health, Discipline of Obstetrics and Gynaecology, University of Adelaide, South Australia 5005, Australia.
authors.forename: Sheryl
authors.initials: S
authors.lastname: de Lacey
mesh_terms: D000328:Adult; D003657:Decision Making; D019924:Embryo Disposition / Q000523:psychology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008875:Middle Aged; D018587:Oocyte Donation / Q000523:psychology*; D011247:Pregnancy