Baglia, Jay, PhD

Larson, Daniel, BA

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of Family MedicineReproductive Technology in the News:Implications for Clinical Practice in Primary Care.Jay Baglia PhDLehigh Valley Health Network, jay.baglia@lvhn.orgDaniel Larson BAFollow this and additional works at: https://scholarlyworks.lvhn.org/family-medicinePart of the Medical Specialties CommonsThis Presentation is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works byan authorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtBaglia, J. Larson, D. (2008, October). Reproductive Technology in the News: Implications for Clinical Practice in Primary Care.Presentation Presented at: Lehigh Valley Health Network, Allentown, PA.Reproductive Technology in the News: Implications for Clinical Practice in Primary CareJay Baglia, PhDDaniel Larson, BADepartment of Family MedicineLehigh Valley Hospital and Health NetworkObjectives for TodayDiscuss the results of an individual research project and its implications for practice.Goals for Today 1)  Define “discourse analysis” as a critical, systematic method for interpreting messages. 2)  Describe themes identified in news stories with “reproductive technology” and “fertility”as the primary search terms.  3)  Detect and express the relationship between news stories and possible patient perceptions of reproductive technology.Preview for Today’s Talk Provide context for the topic of reproductive technology within primary care Literature review Explain method and scope of study Themes identifiedRelationship between media and patient perceptionsQuestions and commentsContext  Thirty years since the birth of Louise Brown Three million babies have been born using I.V.F since 1978 “Infertility” has become a treatable, chronic disease: 50% of married, childless American women between 35 and 44 years old have experienced infertilityContext Continued An explosion in reproductive technology industry including cryobanks, fertility treatment centers, egg donor services, and financial “assistance” The concomitant absence of regulation and oversight within this industry The relatively contemporary phenomenon of postponed motherhoodLiterature reviewCovers depicted above are © by their respective publishers and authors.Scope and Method 76 news articles from two dozen national U.S. newspapers from 2004 to 2006 Each article is at least 700 words long ensuring a narrative quality complete with characters, plot development, and testimony Articles were representative of multiple sections (lifestyle, science, business) and published each day of the weekScope and Method ContinuedDiscourse analysis “In discourse analysis, one seeks to uncover the codes, constructions, cultural assumptions, connotations, values, and beliefs embedded in the text.” Cramer, Janet (1998) Journalism and Mass Communication Monographs 165, 13. Method Continued Identified each instance of testimony, both lay and expert Lay testimony refers specifically to clients and families of reproductive technology Expert testimony refers specifically to individuals granted legitimate, authority, and referent power by virtue of titles Over 600 instances of testimony revealing 6 dominant themesPrevious media analyses Stone, Jennifer (1991) “Contextualizing Biogenetic and Reproductive Technologies,” Critical Studies in Mass Communication, 8. Condit, Celeste (1996) “Media Bias for Reproductive Technologies,” Evaluating Women’s Health Messages. Sage. Dwight, Kirsten (1997). “Sperm Stories: Romantic, Entrepreneurial, and Environmental Narratives about Treating Male Infertility,” Science as Culture, 6.Themes EmotionsBiological DestinyMetaphors of ChanceBrave New World EconomicsEmotions: Shock and Awe Infertility as “a devastating nightmare” (lay) Success as producing “a huge wave of relief” (lay) “The career women especially are so used to getting everything they want, when you tell them what the numbers are, a lot of them are very shocked” (expert) Upon learning of infertility: “They’re not surprised, they’re shocked. Which is shocking to us” (expert)Biological Destiny Infertility “strikes so close to home because this is all about children and sex and family and really the most powerful stuff of human nature” (expert). “I want [my son] to feel like he has one person in the world who is a complete blood relative after I’m gone. I did not want my son to feel deprived, that the other sibling had a father and he didn’t.”Metaphors of Chance “There’s a little anxiety […] You don’t know if the [eggs] you are keeping are going to grow. It’s kind of a crap shoot” (expert). [It depends on] “how we react to the luck of the draw” (lay). “We would have kept going until we got pregnant. It’s almost like gambling” (lay). “[Ovarian tissue transplant success] “is a matter of odds” (expert).Brave New World: God & Technology Gender Selection Technology is “one more step down the line toward crafting children.” “I just thank God there is the technology that there is today. Without it, I wouldn’t have these little guys.” “I’m not playing God. I’m not interfering with God’s work, I’m using my talents to help people.” “Patients say, ‘Don’t you feel like you’re acting like God?’ I say, ‘No I don’t. I’m just the instrument of God to help couples have babies.’ I’m the guardian of technology.”Economics “You don’t want to go completely broke trying to have a baby.” “It wasn’t cheap to have kids, but it was worth it.” “They’re going to make a lot of money, and the more money they make, the more money I’m going to make.” “Yes we’ve spent a lot of money already. But more than that, the emotional toll – you can’t have a dollar figure put on it.”Implications for Primary Care Social Construction Theory stipulates that aspects of our social reality are constructed from communication, including mediated texts. As is the case with WebMD and other electronic sources, patients will consume these texts and appear in the clinician’s office “armed” with information.Implications for Primary Care As is the case with patients, physicians are equally susceptible to an uncritical consumption of mediated discourse. In an effort to enhance the physician/patient relationship, the reflexive primary care physician will ask important questions that should contextualize the patient’s understanding.Questions and Comments

Reproductive Technology in the News: Implications for Clinical Practice in Primary Care

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Reproductive Technology in the News: Implications for Clinical Practice in Primary Care

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