Clinical Review

when do we say “no”?

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7471.901-a (Published 14 October 2004) Cite this as: BMJ 2004;329:901
  1. Thomas R Aust (tomaust@doctors.org.uk), research fellow1
  1. 1 Hewitt Centre for Reproductive Medicine, Liverpool Women's Hospital, Liverpool L8 7SS

    Tommy's doctors made the right decision to support her in trying for a natural pregnancy by optimising her diabetic treatment and advising her of the risks of becoming pregnant.1 This is because many patients will carry on and conceive with or without their doctors' blessing. After all, we would prefer it if drug misusers didn't inject heroin, but if they must we would rather they use clean needles.

    Tommy's request for assisted conception was a different matter because all complications of assisted conception are, by definition, iatrogenic. Her doctors …

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