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Yıldız M, Felix EO, Ademiju O, Noibi TO, Gomes RF, Tanimowo A, Tayyeb M, Khadka RB, Rhino A, Yildiz R, Ramazanzadegan K, Yildirim MS, Solmaz E, Haylı ÇM, Şengan A. Attitudes of Different Religions Toward Surrogacy: Analysis of 11 Countries' Situation Using Machine Learning Approach and Artificial Neural Networks. JOURNAL OF RELIGION AND HEALTH 2023; 62:3230-3251. [PMID: 36913055 DOI: 10.1007/s10943-023-01782-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Individuals may develop different attitudes on bioethics in general and reproductive ethics in particular, due to the effects of different sociocultural environments. Individuals' attitudes toward surrogacy are affected positively or negatively depending on religious and cultural environments. This study was conducted to determine and compare the attitudes of different religions toward surrogacy. This study is cross-sectional and collected from individuals living in Turkey, India, Iran, the Turkish Republic of Northern Cyprus, Madagascar, Nepal, Nigeria, Pakistan, Mexico, England, and Japan between May 2022 and December 2022. The study was conducted with individuals belonging to Islam, Christianity, Hinduism, Buddhism, and Atheism. The study was conducted with 1177 individuals from different religions who agreed to participate in the study by snowball sampling method. The introductory Information Form and "Attitude Questionnaire Toward Surrogacy" were used as data collection tools. R programming language 4.1.3 was used for regression analysis with machine learning approach and artificial neural networks, and SPSS-25 was used for other statistical analyses. There was a significant difference between the total mean score of the individuals' Attitudes toward Surrogacy Questionnaire and their religious beliefs (p < 0.05). When the results of the analysis of the regression model with the dummy variable, which was carried out with the aim of revealing the effects of religious belief on the attitude toward surrogacy, are examined, statistical estimates of the regression model show that the model is significant and usable F(4,1172) = 5.005, p = 0.001). It explains 1.7% of the total variance of the level of religious belief's attitude toward surrogacy. In the regression model, when the t-test results regarding the significance of the regression coefficient are examined, among the participants, it was determined that the mean score of those who believed in Islam (t = - 3.827, p < 0.001) and those who believed in Christianity (t = - 2.548, p < 0.001) was lower than the mean score of those who believed in Hinduism (Constant) (p < 0.05). Individuals' attitudes toward surrogacy differ according to their religion. The best performing algorithm for the prediction model was random forest (RF) regression. The contributions of the variables to the model were calculated with Shapley values (Shapley Additive Explanations (SHAP)). The SHAP values of the variables in the best performing model were examined to avoid bias in terms of comparison in the performance criterion. SHAP values (Shapley Additive Explanations) show the contribution or importance of each variable in the estimation of the model. It is determined that the most important variable that should be in the model to predict the Attitude Toward Surrogacy Survey variable is the Nationality variable. It is recommended that studies on attitudes toward surrogacy should be conducted by taking religious and cultural values into consideration.
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Affiliation(s)
- Metin Yıldız
- Department of Nursing, Sakarya University, Serdivan, Sakarya, Turkey.
| | | | | | | | | | - Abraham Tanimowo
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Muhammed Tayyeb
- Anaesthesiology, Medical Teaching Institution, Bacha Khan Medical College BKMC, Maran, Pakistan
| | - Ram Bahadur Khadka
- Faculty of Management, Tribhuvan University, Kathmandu, Bagmati Province, Nepal
| | - Andrianirina Rhino
- Management, Economy, Finance, Catholıc Unıversıty of Madagascar, Antananarivo, Madagascar
| | - Rabia Yildiz
- Faculty of Theology, Sakarya University, Serdiven, Turkey
| | | | - Mehmet Salih Yildirim
- Vocational School of Health Services, Agri Ibrahim Cecen University School of Health, Agri, Turkey
| | - Ebru Solmaz
- Department of Midwifery, Agri Ibrahim Cecen University, Agri, Turkey
| | | | - Aylin Şengan
- Department of Midwifery, Sakarya University, Serdiven, Turkey
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Lutkiewicz K, Bieleninik Ł, Jurek P, Bidzan M. Development and validation of the attitude towards Surrogacy Scale in a polish sample. BMC Pregnancy Childbirth 2023; 23:413. [PMID: 37270565 DOI: 10.1186/s12884-023-05751-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/30/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Surrogacy is one of the options in reproductive medicine that raises a lot of ethical, legal and psychological controversy. Surveying attitudes toward surrogacy plays an important role in building awareness of this phenomenon in the society, which may help eliminate its stigma. In this study authors aimed to develop and validate a scale to assess the attitudes towards surrogacy. METHODS In this study cross-sectional design was implemented. Development process of the Attitude towards Surrogacy Scale (ATSS) included items development based on literature reviews, other existing questionnaires, confirmatory factor analysis (CFA), and reliability analysis using internal consistence coefficients. A pilot study using adult members of the public was conducted after consultation with the Expert Advisory Panel Board. The final survey, which was used in this study, consisted of 24 items, which were organized into the four subscales: general opinion on surrogacy and its social context (7 items), financing and legalizing surrogacy (8 items), the acceptance of surrogacy (4 items), and attitudes towards the intended parents and children born through surrogacy (5 items). 442 individuals participated in this study. RESULTS The final version of Attitude towards Surrogacy Scale (ATSS) consists of 15 items, grouped in three subscales. Final version of the ATSS showed that the three-factor model indicated an acceptable model fit: Chi-square = 320.46, p < 0.01, df = 87, CFI = 0.94, TLI = 0.92, RMSEA = 0.078 (90% C.I.: 0.070-0.086), SRMR = 0.040 Reliability was assessed by calculating the McDonald's omega that ranged from 0.74 for the Surrogacy ethical context subscale to 0.94 for the overall ATSS score. CONCLUSION ATSS was developed to measure general attitude toward surrogacy with satisfying psychometric properties. The analysis of socio-demographic variables with ATSS showed that the most significant predictor of the general attitude towards surrogacy, and three aspects of surrogacy was being a religious person (profess a Catholic religion or profess another religion).
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Affiliation(s)
| | - Łucja Bieleninik
- Institute of Psychology, University of Gdansk, 80-309, Gdansk, Poland
- GAMUT-The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Paweł Jurek
- Institute of Psychology, University of Gdansk, 80-309, Gdansk, Poland
| | - Mariola Bidzan
- Institute of Psychology, University of Gdansk, 80-309, Gdansk, Poland
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Yee S, Goodman CV, Librach CL. Determinants of gestational surrogates’ satisfaction in relation to the characteristics of surrogacy cases. Reprod Biomed Online 2019; 39:249-261. [DOI: 10.1016/j.rbmo.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/15/2019] [Accepted: 04/01/2019] [Indexed: 11/16/2022]
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Armuand G, Sydsjö G, Skoog Svanberg A, Lampic C. Attitudes towards embryo donation among healthcare professionals working in child healthcare: a survey study. BMC Pediatr 2019; 19:209. [PMID: 31238888 PMCID: PMC6591860 DOI: 10.1186/s12887-019-1578-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 06/06/2019] [Indexed: 01/15/2023] Open
Abstract
Background The aim of this study was to investigate attitudes towards embryo donation and embryo donation families among professionals working in primary child healthcare, and their experiences of these families. Methods A cross-sectional online survey was conducted in Sweden between April and November 2016. A total of 712 primary healthcare physicians, registered nurses and psychologists were approached to participate in this study. The study-specific questionnaire measured attitudes and experiences in the following four domains: legalisation and financing, the family and the child’s health, clinical experience of meeting families following embryo donation, and knowledge of embryo donation. Results Of the 189 women and 18 men who completed the questionnaire (response rate 29%), relatively few (13%) had clinical experience of caring for families following embryo donation. Overall, 69% supported legalisation of embryo donation for infertile couples, and 54% agreed it should be publicly funded. The majority (88%) agreed the child should have the right to know the donors’ identity. Respondents did not believe that children conceived through embryo donation are as healthy as other children (50%), citing the risks of poor mental health (17%) and social stigmatization (18%). Approximately half reported low confidence in their own knowledge of embryo donation (47%) and wanted to know more (58%). Conclusions These results indicate relatively large support among healthcare professionals in Sweden for the legalisation of embryo donation. In order to provide adequate healthcare to families following embryo donation, there is a need to develop educational resources to increase knowledge about the medical and psychosocial consequences of embryo donation among healthcare professionals working in primary healthcare.
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Affiliation(s)
- Gabriela Armuand
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.
| | - Gunilla Sydsjö
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.,Department of Gynaecology and Obstetrics in Linköping, County Council of Östergötland, Linköping, Sweden
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, SE-171 77, Stockholm, Sweden
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Sydsjö G, Skoog Svanberg A, Lampic C. Cross-border surrogacy: Experiences of heterosexual and gay parents in Sweden. Acta Obstet Gynecol Scand 2018; 98:68-76. [PMID: 30176177 DOI: 10.1111/aogs.13456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/29/2018] [Accepted: 08/04/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Surrogacy is a controversial method of assisted reproduction that is not permitted in many countries. While there is some evidence that families following surrogacy seem to fare well, there is limited knowledge about the experiences of parents who turn to cross-border surrogacy. The aim of the present study was therefore to investigate the experiences of heterosexual parents and gay fathers who chose cross-border surrogacy to have a child. MATERIAL AND METHODS This cross-sectional survey describes the experiences of 30 families (18 heterosexual parent and 12 gay father families). Participants were recruited through a website for a Swedish surrogacy interest group. The participants were requested individually to complete a postal questionnaire including study-specific questions on their experiences of disclosure and the Swedish Parenting Stress Questionnaire. RESULTS All couples but one were still living together and had a child (3 months to 5 years). Parenting stress levels were generally low and were not related to sexual orientation. While almost all parents were open about the child's mode of conception in contacts with health care, gay fathers were significantly more open about using surrogacy in contacts with preschool (P = 0.004) and child recreational activities (P = 0.005) compared with heterosexual parents. A majority described being treated positively or "as any other parent" in these contexts. CONCLUSIONS Heterosexual and gay parents reported low levels of parenting stress and generally experienced positive or neutral reactions to their parenthood in contacts with healthcare providers, in preschool, and in the child's recreational activities.
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Affiliation(s)
- Gunilla Sydsjö
- Department of Obstetrics and Gynecology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
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Stenfelt C, Armuand G, Wånggren K, Skoog Svanberg A, Sydsjö G. Attitudes toward surrogacy among doctors working in reproductive medicine and obstetric care in Sweden. Acta Obstet Gynecol Scand 2018. [PMID: 29512820 DOI: 10.1111/aogs.13342] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to investigate attitudes and opinions towards surrogacy among physicians working within obstetrics and reproductive medicine in Sweden. MATERIAL AND METHODS Physicians working within medically assisted reproduction (MAR), antenatal care and obstetrics were invited to participate in a cross-sectional nationwide survey study. The study-specific questionnaire measured attitudes and experiences in three domains: attitudes towards surrogacy, assessment of prospective surrogate mothers, and antenatal and obstetric care for surrogate mothers. RESULTS Of the 103 physicians who participated (response rate 74%), 63% were positive or neutral towards altruistic surrogacy being introduced in Sweden. However, only 28% thought that it should be publicly financed. Physicians working at fertility clinics were more positive towards legalization as well as public financing of surrogacy compared than were those working within antenatal and delivery care. The majority of the physicians agreed that surrogacy involves the risk of exploitation of women's bodies (60%) and that there is a risk that the commissioning couple might pay the surrogate mother "under the table" (82%). They also expressed concerns about potential surrogate mothers not being able to understand fully the risks of entering pregnancy on behalf of someone else. CONCLUSION There is a relatively strong support among physicians working within obstetrics and reproductive medicine for the introduction of surrogacy in Sweden. However, the physicians expressed concerns about the surrogate mothers' health as well as the risk of coercion. Further discussions about legalization of surrogacy should include views from individuals within a wide field of different medical professions and laymen.
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Affiliation(s)
- Camilla Stenfelt
- Fertilitetscentrum Stockholm, Stockholm, Sweden.,Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Gabriela Armuand
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Kjell Wånggren
- Department of Clinical Science Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Gunilla Sydsjö
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Gynecology and Obstetrics in Linköping, County Council of Östergötland, Linköping, Sweden
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