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Journal of Assisted Reproduction and Genetics
Erschienen in:

26.03.2020 | Commentary

The PGS/PGT-A controversy in IVF addressed as a formal conflict resolution analysis

verfasst von: Lyka Mochizuki, Norbert Gleicher

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 3/2020

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Abstract

Purpose

To use conflict resolution analysis on the conflict between proponents and opponents of preimplantation genetic testing for aneuploidy (PGT-A), previously called preimplantation genetic screening (PGS).

Methods

Considered in conflict analysis a case study, we reviewed the English literature based on key-word searches at www.​pubmed.​com and www.​google.​com, and interviewed professional opinion leaders and other actor-representatives. This analysis was the product of a mandated externship by L.M. at the Foundation for Reproductive Medicine (FRM), as part of the Master of Science Program in Negotiations and Conflict Resolution at Columbia University, New York, NY.

Results

Initially a typical difference of opinion, conflict evolved after proponents rejected studies that failed to confirm expected benefits, and authors felt demeaned by their criticism. Becoming “destructive,” the conflict evolved according to Glasl’s escalation model stages. Proponents became continuous attractors. Unable to produce validations for PGT-A, proponents moved goal posts through 3 stages (PGS 1.0–PGS 3.0). Ultimately concurring that pregnancy and live birth rates are unaffected, they started claiming new benefits.

Conclusions

The FRM underwrote this study as a starting tool for a conflict resolution process. A consensus building conference of stakeholders appears as of this point to represent the most promising potential intervention. The goal of such a conference should be sustainable consensus about clinical utilization of PGS/PGT-A in IVF, based on transparent and validated criteria. A potential date for such a conference is set for 2020.
Glossar
Accelerant
Person or constellation that enhances a conflict.
Actor
Participant in a conflict. In accordance with their respective importance to the conflict, they are designated as primary, secondary, and tertiary actors.
Attractor
Attractors are constellations of conflicts that feed intractability.
Clusters
Graphic depiction of cooperating units in a conflict map.
Conflict analysis
Systematic study of causes, actors, and dynamics of a conflict.
Conflict map
Graphic depiction between actors in a conflict in relationship to problem(s).
Destructive phase of a conflict
According to Deutsch, destructive conflicts are characterized by a tendency to expand and escalate. Whether a conflict is destructive or constructive depends on the behavior of actors. Behaviors that escalate conflicts until they develop a life of their own are considered destructive (M. Deutsch. J Social Issues 1969; 25(1):11–12).
Glasl’s escalation model stages
(1) Hardening; (2) debates and polemics; (3) actions not words; (4) images and coalitions; (5) loss of face; (6) strategies of threats; (7) limited destructive blows; (8) fragmentation of the enemy; and (9) together into the abyss (Jordan T. https://​www.​mediate.​com/​articles/​jordan.​cfm).
Hubs and spokes
Parts of a conflict map that graphically demonstrate “how things work.”
Networks
When the number of actors in a conflict is high, it lends itself to a so-called network analysis.
Stakeholders
Individuals who may be impacted by a conflict’s outcome.
Sustainable consensus
To reach sustainable consensus it is essential for reach sustainable conflict resolution.
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Metadaten
Titel
The PGS/PGT-A controversy in IVF addressed as a formal conflict resolution analysis
verfasst von
Lyka Mochizuki
Norbert Gleicher
Publikationsdatum
26.03.2020
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 3/2020
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-020-01688-8

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