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Bewley S, Rabe H, Burleigh A, Hutchon D, James CP. The BBC should not normalise practices that harm babies. BMJ 2024; 384:q464. [PMID: 38413136 DOI: 10.1136/bmj.q464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Susan Bewley
- Department of Women and Children's Health, King's College London, London, UK
| | - Heike Rabe
- Brighton and Sussex Medical School, Falmer, UK
| | | | | | - Catherine P James
- UCL Institute for Women's Health, University College London, London, UK
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2
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Clarke V, Goddard A, Wellings K, Hirve R, Casanovas M, Bewley S, Viner R, Kramer T, Khadr S. Medium-term health and social outcomes in adolescents following sexual assault: a prospective mixed-methods cohort study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1777-1793. [PMID: 34370051 PMCID: PMC10627884 DOI: 10.1007/s00127-021-02127-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe medium-term physical and mental health and social outcomes following adolescent sexual assault, and examine users' perceived needs and experiences. METHOD Longitudinal, mixed methods cohort study of adolescents aged 13-17 years recruited within 6 weeks of sexual assault (study entry) and followed to study end, 13-15 months post-assault. RESULTS 75/141 participants were followed to study end (53% retention; 71 females) and 19 completed an in-depth qualitative interview. Despite many participants accessing support services, 54%, 59% and 72% remained at risk for depressive, anxiety and post-traumatic stress disorders 13-15 months post-assault. Physical symptoms were reported more frequently. Persistent (> 30 days) absence from school doubled between study entry and end, from 22 to 47%. Enduring mental ill-health and disengagement from education/employment were associated with psychosocial risk factors rather than assault characteristics. Qualitative data suggested inter-relationships between mental ill-health, physical health problems and disengagement from school, and poor understanding from schools regarding how to support young people post-assault. Baseline levels of smoking, alcohol and ever drug use were high and increased during the study period (only significantly for alcohol use). CONCLUSION Adolescents presenting after sexual assault have high levels of vulnerability over a year post-assault. Many remain at risk for mental health disorders, highlighting the need for specialist intervention and ongoing support. A key concern for young people is disruption to their education. Multi-faceted support is needed to prevent social exclusion and further widening of health inequalities in this population, and to support young people in their immediate and long-term recovery.
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Affiliation(s)
- Venetia Clarke
- The Havens Sexual Assault Referral Centres, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - Andrea Goddard
- The Havens Sexual Assault Referral Centres, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Kaye Wellings
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Raeena Hirve
- Department of Women and Children's Health, King's College London, c/o 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7NH, UK
| | - Marta Casanovas
- Division of Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, c/o 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7NH, UK
| | - Russell Viner
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 3EH, UK
| | - Tami Kramer
- Division of Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Sophie Khadr
- The Havens Sexual Assault Referral Centres, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
- Department of Women and Children's Health, King's College London, c/o 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7NH, UK.
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 3EH, UK.
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3
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Dawda G, Weeks AD, Bewley S. 'It must be right, I saw it on TV!': An observational study of third stage birth practices in popular television programmes. JRSM Open 2023; 14:20542704231205385. [PMID: 37869445 PMCID: PMC10588410 DOI: 10.1177/20542704231205385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
Objectives To examine modern media depictions of the third stage of birth in a selection of UK television representations. Design Observational study of a sample of televised fictional and real births, audited against current National Institute of Health and Social Care Excellence (NICE) guidance. Setting UK television channels BBC (Call The Midwife and This Is Going To Hurt) and Channel 4 (One Born Every Minute). Participants 87 births from 48 episodes, sampled from the three shows. Main outcome measures The primary outcome was the number of births where the cord was clamped at more than 1 min after birth. Secondary outcomes included place and type of birth, measures of dignity and paternal involvement. Results Overall, the timing of cord clamping was clearly shown in 25/87 (29%) of births, of which only 4/25 (16%) occurred at more than 1 min in screen time. The place of birth and caesarean section (CS) rate changed according to the series perspective and era; graphic explicit images were shown, but these related to CS detail. Conclusions UK television shows have accurately depicted changes in place, culture and type of birth over the last century. They provide the public with a view of new rituals but an inaccurate picture of good quality care. Early cord clamping was shown in most births, even those set after 2014. No programme informed viewers about the safety aspects. When showing outdated practices, broadcasters have a public health duty to inform viewers that this is no longer recommended.
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Affiliation(s)
- Gati Dawda
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Andrew D Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Susan Bewley
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
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4
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Braillon A, Bewley S, Blumsohn A, Naudet F. Correction to: Comment on: "Should Antidepressants be Avoided in Pregnancy?". Drug Saf 2023; 46:817. [PMID: 37193849 DOI: 10.1007/s40264-023-01318-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Affiliation(s)
| | - Susan Bewley
- Obstetrics and Women's Health, King's College London, London, UK
| | | | - Florian Naudet
- Therapeutics, Adult Psychiatry Department and Clinical Investigation Center (INSERM 1414), University Hospital, Rennes, France
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5
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Bushell SH, Spitzer D, Whittaker P, Nexus A, Maskrey N, Helliway M, Price N, Pope L, Etherington C, Larcombe J, Grigg J, Bewley S, Taylor D. Prostate cancer screening: well intentioned initiatives may use up resources but not improve health outcomes. BMJ 2023; 381:p1389. [PMID: 37343958 DOI: 10.1136/bmj.p1389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Affiliation(s)
| | | | | | - Avril Nexus
- Health Education England North West, Manchester, UK
| | | | | | | | | | | | - James Larcombe
- Royal College of General Practitioners North East England Faculty, UK
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6
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Braillon A, Bewley S, Blumsohn A, Naudet F. Comment on: "Should Antidepressants be Avoided in Pregnancy?". Drug Saf 2023; 46:615-616. [PMID: 37103644 DOI: 10.1007/s40264-023-01308-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Affiliation(s)
| | - Susan Bewley
- Obstetrics and Women's Health, King's College London, London, UK
| | | | - Florian Naudet
- Therapeutics, Adult Psychiatry Department and Clinical Investigation Center (INSERM 1414), University Hospital, Rennes, France
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7
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Gribble KD, Bewley S, Dahlen HG. Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm. Front Glob Womens Health 2023; 4:1073053. [PMID: 36817034 PMCID: PMC9936190 DOI: 10.3389/fgwh.2023.1073053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
An increasing number of young females are undergoing chest masculinsation mastectomy to affirm a gender identity and/or to relieve gender dysphoria. Some desist in their transgender identification and/or become reconciled with their sex, and then revert (or detransition). To the best of our knowledge, this report presents the first published case of a woman who had chest masculinisation surgery to affirm a gender identity as a trans man, but who later detransitioned, became pregnant and grieved her inability to breastfeed. She described a lack of understanding by maternity health providers of her experience and the importance she placed on breastfeeding. Subsequent poor maternity care contributed to her distress. The absence of breast function as a consideration in transgender surgical literature is highlighted. That breastfeeding is missing in counselling and consent guidelines for chest masculinisation mastectomy is also described as is the poor quality of existing research on detransition rates and benefit or otherwise of chest masculinising mastectomy. Recommendations are made for improving maternity care for detransitioned women. Increasing numbers of chest masculinsation mastectomies will likely be followed by more new mothers without functioning breasts who will require honest, knowledgeable, and compassionate support.
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Affiliation(s)
- Karleen D. Gribble
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia,Correspondence: Karleen D. Gribble
| | - Susan Bewley
- Department of Women and Children’s Health, King’s College London, London, United Kingdom
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
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8
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Wilmshurst P, Bewley S, Murray P. Hyperbaric oxygen therapy for the treatment of long COVID. Clin Med (Lond) 2023; 23:99-100. [PMID: 36697009 PMCID: PMC11046540 DOI: 10.7861/clinmed.let.23.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
| | - Susan Bewley
- King's College London, UK, and trustee of HealthSense-UK
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9
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Allotey J, Bewley S, Kenny LC, Magee LA, Morris RK, O'Donoghue K, Paul A, van Smeden M, Thangaratinam S, Thornton JG, Von Dadelszen P, Zamora J. Re: Reducing health inequality in Black, Asian and other minority ethnic pregnant women: Impact of first-trimester combined screening for placental dysfunction on perinatal mortality. BJOG 2022; 129:1614-1615. [PMID: 35446464 DOI: 10.1111/1471-0528.17161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Affiliation(s)
- John Allotey
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Susan Bewley
- Department of Women & Children's Health, King's College London, London, UK
| | - Louise C Kenny
- Department of Women's and Children's Health, University of Liverpool School of Life Sciences, Liverpool, UK
| | - Laura Ann Magee
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Rachel K Morris
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Ash Paul
- NHS South West London CCG, London, UK
| | | | - Shakila Thangaratinam
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Peter Von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Javier Zamora
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
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10
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Affiliation(s)
- Susan Bewley
- Department of Women and Children's Health, King's College London, London SE1 7NH, UK.
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11
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Hodson N, Howell F, Parker J, Bewley S. The rupture of anonymity for sperm donors-a tangled web of conflicting rights. BMJ 2022; 376:o658. [PMID: 35277382 DOI: 10.1136/bmj.o658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Braillon A, Bewley S. Underplaying the dangers of cannabis for women of childbearing age is sexist and pregnancy discrimination. BMJ 2022; 376:o464. [PMID: 35217508 DOI: 10.1136/bmj.o464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, London, UK
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13
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Gribble KD, Bewley S, Bartick MC, Mathisen R, Walker S, Gamble J, Bergman NJ, Gupta A, Hocking JJ, Dahlen HG. Effective Communication About Pregnancy, Birth, Lactation, Breastfeeding and Newborn Care: The Importance of Sexed Language. Front Glob Womens Health 2022; 3:818856. [PMID: 35224545 PMCID: PMC8864964 DOI: 10.3389/fgwh.2022.818856] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/10/2022] [Indexed: 01/12/2023] Open
Affiliation(s)
- Karleen D. Gribble
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
- *Correspondence: Karleen D. Gribble
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | - Melissa C. Bartick
- Mount Auburn Hospital, Cambridge, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Roger Mathisen
- Alive & Thrive Southeast Asia, FHI Solutions, Hanoi, Vietnam
| | - Shawn Walker
- Department of Women and Children's Health, King's College London, London, United Kingdom
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Jenny Gamble
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia
- Centre for Health Care Research, Coventry University, Coventry, United Kingdom
| | - Nils J. Bergman
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Arun Gupta
- Breastfeeding Promotion Network of India, New Delhi, India
| | - Jennifer J. Hocking
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, VIC, Australia
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
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14
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Affiliation(s)
- Susan Bewley
- Obstetrics and Women's Health, King's College London, London, UK
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15
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Braillon A, Bewley S, Blumsohn A, Naudet F, Montastruc JL, Lexchin JR. Antidepressants are not safe during pregnancy and in women of child-bearing age. Br J Clin Pharmacol 2021; 88:2447-2448. [PMID: 34904264 DOI: 10.1111/bcp.15142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/08/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Susan Bewley
- Department of Women & Children's Health, King's College London, London, UK
| | - Aubrey Blumsohn
- Previously Senior Lecturer in Medicine, University of Sheffield, Sheffield, UK
| | - Florian Naudet
- University of Rennes 1, Rennes, France Clinical Investigation Center (INSERM 1414) and Adult Psychiatry Department, Rennes University Hospital, Rennes, France
| | - Jean-Louis Montastruc
- Medical and Clinical Pharmacology, Faculty of Medicine, University Hospital, Toulouse, France
| | - Joel R Lexchin
- School of Health Policy and Management Faculty of Health, York University, Toronto, Ontario, Canada
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16
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Martin M, Hill C, Bewley S, MacLennan AH, Braillon A. Transgenerational adverse effects of valproate? A patient report from 90 affected families. Birth Defects Res 2021; 114:13-16. [PMID: 34866359 DOI: 10.1002/bdr2.1967] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/12/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Valproate use during pregnancy increases risk in malformations and neurodevelopmental disorders. Data from the experimental setting in mice showed valproate is a direct inhibitor of histone deacetylase, inducing histone hyperacetylation, histone methylation, and DNA demethylation causing congenital malformations with an epigenetic inheritance. We investigated potential transgenerational adverse effects of valproate. METHODS We questioned 108 individuals (from 90 families) suffering complications due to valproate exposure in utero who were parents themselves (85 women and 23 men) about the occurrence of malformations and neurodevelopmental disorders in their children. All were member of Aide aux Parents d'Enfants souffrants du Syndrome de l'AntiConvulsivant (APESAC), a charity created in 2011 to provide personal assistance and support to families suffering complications due to valproate exposure during pregnancy. RESULTS Among their 187 children they reported 43 (23%) children with malformation(s) (26 hand or foot malformations; 15 dysmorphic facial features; 10 renal/urologic malformations; 6 spina bifida; 4 cardiac malformation; 2 craniosynostosis; 2 cleft lip and palate) and 82 (44%) children with neurodevelopmental disorders (63 problematic behaviors and autism; 41 psychomotor disorders; 16 language problems; 16 attention deficit; 5 mental retardation). Only 88 (47%) children had neither malformation nor developmental disorders. CONCLUSION These data add to the need for funding pharmacoepidemiological investigations of epigenetic inheritance caused by drugs causing malformations or neurodevelopmental disorders. Individuals exposed in utero to valproate must be informed about the risk, so they can consider fertility options, antenatal diagnosis, and adequate early surveillance.
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Affiliation(s)
- Marine Martin
- Aide aux Parents d'Enfants souffrants du Syndrome de l'AntiConvulsivant, Pollestres, France
| | - Catherine Hill
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Susan Bewley
- Department of Women & Children's Health, King's College London, London, UK
| | - Alastair H MacLennan
- Australian Collaborative Cerebral Palsy Research Group, Robinson Research Institute, University of Adelaide, Adelaide, Australia
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17
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Affiliation(s)
| | - Susan Bewley
- Emeritus Professor of Obstetrics and Women's Health. Department of Women & Children's Health, King's College London, London, UK
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18
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Meads C, Thorogood LR, Lindemann K, Bewley S. Why Are the Proportions of In-Vitro Fertilisation Interventions for Same Sex Female Couples Increasing? Healthcare (Basel) 2021; 9:healthcare9121657. [PMID: 34946383 PMCID: PMC8702152 DOI: 10.3390/healthcare9121657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022] Open
Abstract
Same-sex female couples who wish to become pregnant can choose donor insemination or in-vitro fertilization (IVF)-a technique intended for infertile women. In general, women in same-sex female partnerships are no more likely to be infertile than those in opposite sex partnerships. This article investigates data available from the Government Regulator of UK fertility clinics-the Human Fertilization and Embryology Authority, which is the only data available worldwide on same-sex female couples and their fertility choices. IVF is increasing both in absolute numbers and relative proportions year on year in the UK, compared to licensed donor insemination for same-sex female couples. As IVF has greater human and financial costs than donor insemination, policies should not encourage it as the first choice for fertile women requiring sperm. Commercial transactions are taking place where fertile lesbians receive cut price, and arguably unnecessary, IVF intervention in exchange for selling their eggs to be used for other infertile customers. If women are not told about the efficacy of fresh vs. frozen semen, and the risks of egg 'sharing' or intra-couple donation, exploitation becomes possible.
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Affiliation(s)
- Catherine Meads
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge CB1 1PT, UK
- Correspondence:
| | | | | | - Susan Bewley
- Department of Women and Children’s Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London SE1 7EH, UK;
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19
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Bewley S. Assisted dying doesn't require doctors but due legal process to protect patients, doctors, and society. BMJ 2021; 375:n2437. [PMID: 34635539 DOI: 10.1136/bmj.n2437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Susan Bewley
- Department of Women and Children's Health, King's College London, London, UK
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20
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Griffin L, Clyde K, Byng R, Bewley S. Authors' reply. BJPsych Bull 2021; 45:310-311. [PMID: 34556199 PMCID: PMC8477161 DOI: 10.1192/bjb.2021.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Lucy Griffin
- Psychiatrist, Royal College of Psychiatrists, UK;
| | - Katie Clyde
- Psychiatrist, Royal College of Psychiatrists, UK
| | - Richard Byng
- Psychiatrist, Royal College of Psychiatrists, UK
| | - Susan Bewley
- Psychiatrist, Royal College of Psychiatrists, UK
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21
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Griffin L, Clyde K, Byng R, Bewley S. Authors' reply. BJPsych Bull 2021; 45:312-313. [PMID: 34556201 PMCID: PMC8477151 DOI: 10.1192/bjb.2021.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Lucy Griffin
- Psychiatrist, Royal College of Psychiatrists, UK.
| | - Katie Clyde
- Psychiatrist, Royal College of Psychiatrists, UK.
| | - Richard Byng
- Psychiatrist, Royal College of Psychiatrists, UK.
| | - Susan Bewley
- Psychiatrist, Royal College of Psychiatrists, UK.
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Abstract
In the past decade there has been a rapid increase in gender diversity, particularly in children and young people, with referrals to specialist gender clinics rising. In this article, the evolving terminology around transgender health is considered and the role of psychiatry is explored now that this condition is no longer classified as a mental illness. The concept of conversion therapy with reference to alternative gender identities is examined critically and with reference to psychiatry's historical relationship with conversion therapy for homosexuality. The authors consider the uncertainties that clinicians face when dealing with something that is no longer a disorder nor a mental condition and yet for which medical interventions are frequently sought and in which mental health comorbidities are common.
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Affiliation(s)
| | - Katie Clyde
- Southern Health NHS Foundation Trust, Hampshire, UK
| | | | - Susan Bewley
- Department of Women & Children's Health, King's College London, UK
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23
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Affiliation(s)
- Sue Pavord
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Beverley J Hunt
- Thrombosis & Haemophilia Centre, Guy's & St Thomas NHS Foundation Trust & King's College London, UK
| | - Daniel Horner
- Critical Care Unit, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, UK
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, UK
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24
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Braillon A, Bewley S. Re: Antidepressant use and pregnancy: promoting risk minimisation for all teratogens is overdue. BJOG 2021; 129:171-172. [PMID: 34490998 DOI: 10.1111/1471-0528.16876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | - Susan Bewley
- Department of Women & Children's Health, King's College London, London, UK
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Bewley S, Dahlen S, Connolly D, Arif I, Junejo M, Catherine M. International Clinical Practice Guidelines for Gender Minority/Trans People: Systematic Review & Quality Assessment. How Does the Endocrine Society Fare? J Endocr Soc 2021. [DOI: 10.1210/jendso/bvab048.1609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Aim: High quality care depends on evidence being used in clinical practice guidelines (CPGs) & processes to create recommendations. This study identified & critically appraised published international CPGs regarding health care of gender minority/ trans people. Methods: Prospectively registered systematic review(1); searched 6 databases & 6 CPG websites & approached international key opinion leaders; quality assessment using AGREE II, Appraisal of Guidelines for Research & Evaluation tool(2); & stakeholder domain prioritization. CPGs relating to gender minority/ trans adults &/or children were included, with any health-related intervention connected to their care & no exclusions for comorbidities except differences in sex development. Outcome measures: number & quality of relevant international CPGs, information on estimated changes in mortality or quality of life (QoL), recommendation consistency across CPGs & appraisal of key messages for patients. Results: A 2017 Endocrine Society Guideline(3) was one of 12 international CPGs found. Five higher-quality CPGs focused on HIV & other blood-borne infections (overall assessment scores 69-94%). Six lower-quality CPGs concerned transition-specific interventions (overall assessment scores 11-56%). None dealt with primary care, mental health, or longer-term medical issues. Sparse information on estimated changes in mortality & QoL was conflicting. None provided key messages for patients. Endocrine Society was ranked 6th by overall assessment score (56%), the highest of CPGs addressing transition-related care. Domain scores were; scope & purpose 65%, stakeholder involvement 40%, rigour of development 41%, clarity & presentation 73%, applicability 29%, editorial independence 65%. Conclusion: Future iterations of the Endocrine Society CPG might be strengthened by referencing AGREE II, greater use of systematic reviews, considering applicability, independent external review, encouraging stakeholder participation & producing patient facing material. Lack of primary research into gender minority/trans health was noted & ought to be addressed.
References: 1. PROSPERO CRD42019154361, 2. AGREE Next Steps Consortium (2017) The AGREE II Instrument [Electronic version]. http://www.agreetrust.org, 3. Hembree WC, Cohen-Kettenis PT, Gooren L, et al (2017) Endocrine treatment of gender-dysphoric/ gender-incongruent persons: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 102:3869-3903
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Dahlen S, Connolly D, Arif I, Junejo MH, Bewley S, Meads C. International clinical practice guidelines for gender minority/trans people: systematic review and quality assessment. BMJ Open 2021; 11:e048943. [PMID: 33926984 PMCID: PMC8094331 DOI: 10.1136/bmjopen-2021-048943] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/22/2021] [Accepted: 04/12/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To identify and critically appraise published clinical practice guidelines (CPGs) regarding healthcare of gender minority/trans people. DESIGN Systematic review and quality appraisal using AGREE II (Appraisal of Guidelines for Research and Evaluation tool), including stakeholder domain prioritisation. SETTING Six databases and six CPG websites were searched, and international key opinion leaders approached. PARTICIPANTS CPGs relating to adults and/or children who are gender minority/trans with no exclusions due to comorbidities, except differences in sex development. INTERVENTION Any health-related intervention connected to the care of gender minority/trans people. MAIN OUTCOME MEASURES Number and quality of international CPGs addressing the health of gender minority/trans people, information on estimated changes in mortality or quality of life (QoL), consistency of recommended interventions across CPGs, and appraisal of key messages for patients. RESULTS Twelve international CPGs address gender minority/trans people's healthcare as complete (n=5), partial (n=4) or marginal (n=3) focus of guidance. The quality scores have a wide range and heterogeneity whichever AGREE II domain is prioritised. Five higher-quality CPGs focus on HIV and other blood-borne infections (overall assessment scores 69%-94%). Six lower-quality CPGs concern transition-specific interventions (overall assessment scores 11%-56%). None deal with primary care, mental health or longer-term medical issues. Sparse information on estimated changes in mortality and QoL is conflicting. Consistency between CPGs could not be examined due to unclear recommendations within the World Professional Association for Transgender Health Standards of Care Version 7 and a lack of overlap between other CPGs. None provide key messages for patients. CONCLUSIONS A paucity of high-quality guidance for gender minority/trans people exists, largely limited to HIV and transition, but not wider aspects of healthcare, mortality or QoL. Reference to AGREE II, use of systematic reviews, independent external review, stakeholder participation and patient facing material might improve future CPG quality. PROSPERO REGISTRATION NUMBER CRD42019154361.
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Affiliation(s)
- Sara Dahlen
- Department of Global Health & Social Medicine, King's College London, London, UK
| | - Dean Connolly
- Barts Health NHS Trust, London, UK
- Addictions Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - Muhammad Hyder Junejo
- Genitourinary Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
- 56 Dean St, London, UK
| | - Susan Bewley
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Catherine Meads
- Faculty of Health, Medicine, Education and Social Care, Anglia Ruskin University - Cambridge Campus, Cambridge, UK
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Briley AL, Silverio SA, Singh C, Sandall J, Bewley S. "It's like a bus, going downhill, without a driver": A qualitative study of how postpartum haemorrhage is experienced by women, their birth partners, and healthcare professionals. Women Birth 2020; 34:e599-e607. [PMID: 33358131 DOI: 10.1016/j.wombi.2020.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
PROBLEM Postpartum haemorrhage [PPH] remains a major cause of maternal morbidity and mortality. Whilst low-resource settings bear the greatest burden of deaths, women live with associated morbidities in all healthcare settings. Limited data exists regarding the experience for women, their partners, or healthcare professionals [HCPs], affected by PPH. AIM To qualitatively investigate the experience of PPH, for women (n=9), birth partners (n=4), and HCPs (n=9) in an inner-city tertiary referral centre. To provide multi-faceted insight into PPH and improve understanding and future care practices. METHODS Participants were interviewed about their experiences within two weeks of a PPH. Data were analysed using thematic analysis. FINDINGS Four distinct, but related, themes were identified: 'Knowledge specific to PPH'; 'Effective and appropriate responses to PPH'; 'Communication of risk factors'; and 'Quantifying blood loss'; which collected around a central organising concept of 'Explaining the indescribable'. DISCUSSION PPH was viewed as a 'crisis-style emergency', generating respectful fear in HCPs, whilst women and partners had little-to-no prior knowledge. Specific PPH knowledge dictated HCPs' response and risk communication. PPH risks were typically linked to quantification of blood loss, assessment of which varied with acknowledged questionable accuracy. Women's and partners' confidence in HCPs' ability to deal with PPH was unquestionable. Non-verbal communication was highlighted, with HCP body language betraying professional confidence. CONCLUSION Information about blood loss during childbirth must be imparted in a sensitive, timely manner. Whilst training for HCPs results in effective PPH management, consideration should be given to their non-verbal cues and the impact of dealing with this stressful, 'everyday emergency'.
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Affiliation(s)
- Annette L Briley
- Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, Adelaide, Australia; Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom.
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom; Elizabeth Garrett Anderson Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, United Kingdom. https://twitter.com/Silverio_SA_?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
| | - Claire Singh
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom; Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom; Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, University of Technology, Sydney, Australia. https://twitter.com/SandallJane?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
| | - Susan Bewley
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom. https://twitter.com/susan_bewley?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
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Silverio SA, Bewley S, Montgomery E, Roberts C, Richens Y, Maxted F, Sandall J, Montgomery J. Disclosure of non-recent (historic) childhood sexual abuse: What should researchers do? J Med Ethics 2020; 47:medethics-2020-106343. [PMID: 33172909 PMCID: PMC8639901 DOI: 10.1136/medethics-2020-106343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 05/02/2023]
Abstract
Non-recent (historic) childhood sexual abuse is an important issue to research, though often regarded as taboo and frequently met with caution, avoidance or even opposition from research ethics committees. Sensitive research, such as that which asks victim-survivors to recount experiences of abuse or harm, has the propensity to be emotionally challenging for both the participant and the researcher. However, most research suggests that any distress experienced is usually momentary and not of any clinical significance. Moreover, this type of research offers a platform for voices which have often been silenced, and many participants report the cathartic effect of recounting their experiences in a safe, non-judgemental space. With regard to the course of such research, lines of inquiry which ask adult participants to discuss their experiences of childhood sexual abuse may result in a first-time disclosure of that abuse by the victim-survivor to the researcher. Guidance about how researchers should respond to first-time disclosure is lacking. In this article, we discuss our response to one research ethics committee which had suggested that for a qualitative study for which we were seeking ethical approval (investigating experiences of pregnancy and childbirth having previously survived childhood sexual abuse), any disclosure of non-recent (historic) childhood sexual abuse which had not been previously reported would result in the researcher being obliged to report it to relevant authorities. We assess this to be inconsistent with both law and professional guidance in the United Kingdom; and provide information and recommendations for researchers and research ethics committees to consider.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, King's College London, Westminster, London, UK
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Bloomsbury, London, UK
| | - Susan Bewley
- Department of Women & Children's Health, King's College London, Westminster, London, UK
| | - Elsa Montgomery
- Department of Midwifery, King's College London, Waterloo, London, UK
| | - Chelsey Roberts
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Bloomsbury, London, UK
| | - Yana Richens
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Bloomsbury, London, UK
- Maternity Services, University College London Hospitals NHS Foundation Trust, Fitzrovia, London, UK
| | - Fay Maxted
- The Survivors Trust, Rugby, Warwickshire, UK
| | - Jane Sandall
- Department of Women & Children's Health, King's College London, Westminster, London, UK
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Harris A, Bewley S, Meads C. Sex Hormone Levels in Lesbian, Bisexual, and Heterosexual Women: Systematic Review and Exploratory Meta-Analysis. Arch Sex Behav 2020; 49:2405-2420. [PMID: 32405900 DOI: 10.1007/s10508-020-01717-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 04/07/2020] [Accepted: 04/11/2020] [Indexed: 06/11/2023]
Abstract
Lesbian and bisexual women may have different levels of sex hormones compared to heterosexual women. We systematically reviewed comparative studies measuring any sex hormones. A protocol was prospectively registered (PROSPERO-CRD42017072436) and searches conducted in six databases. Any relevant empirical studies published within the last 50 years reporting any circulating sex hormones in sexual minority women compared to heterosexual women were included, with no language or setting restrictions. Inclusions, data extraction, and quality assessment were conducted in duplicate. Random-effects meta-analyses of hormone levels, using standardized-mean-differences (SMD) were conducted where five or more studies reported results. From 1236 citations, 24 full papers were examined and 14 studies of mixed designs included, 12 in women without known ovarian problems. Hormones were measured in plasma (n = 9), saliva (n = 4), and urine (n = 2) and included androstenedione, luteinizing hormone, estradiol, pregnanediol, progesterone, testosterone, and several other hormones. Most studies were small, biased, and had considerable heterogeneity. Few found statistically significant differences between groups. All-sample meta-analysis showed increased testosterone in sexual minority women compared to heterosexual women (n = 9; SMD = 0.90; 95% Confidence interval (CI) 0.22, 1.57, I2 = 84%). This was the only difference found. We conclude that the small amount of heterogeneous research, from 50 years to date, suggests little discernable difference in sex hormone levels between lesbian, bisexual, and heterosexual women excepting possibly higher testosterone. A large-scale primary study would be required before placing any certainty in the findings or their implications.
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Affiliation(s)
- Alexandra Harris
- Division of Women's Health, Women's Health Academic Centre, King's College London and King's Health Partners, London, UK
| | - Susan Bewley
- Department of Women and Children's Health, King's College London and King's Health Partners, London, UK
| | - Catherine Meads
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK.
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Hodson N, Bewley S. Is one narrative enough? Analytical tools should match the problems they address. J Med Ethics 2020:medethics-2020-106309. [PMID: 32900845 DOI: 10.1136/medethics-2020-106309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
Jeff Nisker describes his personal experience of a diagnosis of advanced prostate cancer and the kindnesses he received from friendly doctors. He claims that this narrative account supports the promotion of Prostate Specific Antigen (PSA) screening for asymptomatic men and impugns statisticians, mistakenly thinking that their opposition to PSA screening derives from concerns about financial cost. The account inadvertently demonstrates the danger of over-reliance on a single ethical tool for critical analysis. In the first part of this response, we describe the statistical evidence. The most reliable Cochrane meta-analyses have not shown that PSA screening saves lives overall. Moreover, the high false positive rate of PSA screening leads to overinvestigation which results in unnecessary anxiety and increased cases of unnecessary sepsis, urinary incontinence and sexual dysfunction. Then we describe how narrative ethics alone is an insufficient tool to make claims about policies, such as PSA screening, which have hidden harms. Although Nisker's story-telling is compelling and evokes emotions, narrative ethics of this sort have an inherent bias against people who would be harmed by the counterfactual. Particular care must be taken to look for and consider those untellable stories. Ethicists who only consider narratives which are readily at hand risk harming those who are voiceless or protected by the status quo. PSA screening is the wrong tool to reduce prostate cancer deaths and narrative ethics is the wrong tool to appraise this policy. It is vital that the correct theoretical tools are applied to the medical and ethical questions under scrutiny.
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Affiliation(s)
- Nathan Hodson
- Department of Health Policy and Management, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, London, UK
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McCormack T, Harrisingh MC, Horner D, Bewley S. Venous thromboembolism in adults: summary of updated NICE guidance on diagnosis, management, and thrombophilia testing. BMJ 2020; 369:m1565. [PMID: 32430311 DOI: 10.1136/bmj.m1565] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Terry McCormack
- Institute of Clinical and Applied Health Research, Hull York Medical School, Hull, UK
| | | | - Daniel Horner
- Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Susan Bewley
- Division of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
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Affiliation(s)
- S Bewley
- King's College London, London, UK
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Braillon A, Bewley S. Medical device postmarket clinical follow-up in Europe: Getting priorities right. Pharmacoepidemiol Drug Saf 2019; 29:226-227. [PMID: 31802557 DOI: 10.1002/pds.4935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/06/2019] [Accepted: 11/17/2019] [Indexed: 11/07/2022]
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Byng R, Bewley S. Gender dysphoria: scientific oversight falling between responsible institutions should worry us all. BMJ 2019; 367:l6439. [PMID: 31801731 DOI: 10.1136/bmj.l6439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Richard Byng
- Community and Primary Care Research Group, University of Plymouth, Plymouth Science Park, Plymouth PL6 8BX, UK
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Braillon A, Bewley S. Re: Association between maternal alcohol consumption during pregnancy and risk of preterm delivery: the Japan Environment and Children's Study: Avoiding alcohol and pregnancy: the earlier the better. BJOG 2019; 127:426-427. [PMID: 31746137 DOI: 10.1111/1471-0528.16003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 11/28/2022]
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Affiliation(s)
- Nathan Hodson
- Harvard TH Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA, USA
| | - Brian D Earp
- Yale-Hastings Program in Ethics and Health Policy, Yale University, New Haven, CT, USA and The Hastings Center, Garrison, NY, USA
| | - Lynne Townley
- Department of Law, The City Law School, University of London, London, UK
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, London, UK
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McCartney M, Bewley S, Clifford D, Byng R. Gender incongruence in children, adolescents, and adults: response to Dr White. Br J Gen Pract 2019; 69:379. [PMID: 31345801 PMCID: PMC6650118 DOI: 10.3399/bjgp19x704753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Hodson N, Bewley S. Abuse in assisted reproductive technology: A systematic qualitative review and typology. Eur J Obstet Gynecol Reprod Biol 2019; 238:170-177. [DOI: 10.1016/j.ejogrb.2019.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/18/2019] [Accepted: 05/23/2019] [Indexed: 12/17/2022]
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Littleton F, Bewley S. Honouring 'Patient 38' - a mother of all IVF mothers? Reprod Biomed Soc Online 2019; 8:7-9. [PMID: 30859140 PMCID: PMC6395826 DOI: 10.1016/j.rbms.2018.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 06/09/2023]
Abstract
This commentary addresses one aspect of the early history of IVF in Britain. Specific data are re-examined from the recently published, anonymized database of medical records from the Oldham period of research conducted by Robert Edwards, Patrick Steptoe and their team of assistants between 1969 and 1978. By focusing on a reformulation of the 'scheduled treatment cycles per patient', attention is drawn to the small, but nevertheless not insignificant, number of subjects who returned to Oldham at least five times or more to undergo innovative procedures and/or receive other experimental treatments over the duration of the research project. These multiple efforts are contrasted with the single or double treatment cycles received by the majority of the infertile women involved, including the only two experiencing live births, Lesley Brown and Grace Montgomery. The re-presented data facilitates new interpretations and raises fresh research questions about the nature of contemporary and present characterisations of the major protagonists in the 'IVF story', the identity of those women who originally took part and the origin of and reasons for discrepancies in the records maintained about research subjects.
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Affiliation(s)
- Fiona Littleton
- University College London Institute of Education, London, UK
| | - Susan Bewley
- Department of Women and Children's Health, St Thomas' Hospital, London, UK
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Cox-George C, Bewley S. Authors' response to Dr John Eggleton's letter. BMJ Sex Reprod Health 2019; 45:169. [PMID: 31000573 DOI: 10.1136/bmjsrh-2018-200289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
| | - Susan Bewley
- Women's Health Academic Centre, King's College London, London, UK
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Affiliation(s)
- Richard Byng
- Community and Primary Care Research Group, University of Plymouth, Plymouth PL4 8AA, UK.
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, London, UK
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Affiliation(s)
- Richard Byng
- Faculty of Medicine and Dentistry, University of Plymouth, ITTC Building, Plymouth Science Park, Plymouth PL6 8BX, UK
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Affiliation(s)
| | - S Bewley
- Women's Health Academic CentreKing's College LondonLondon, UK
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Braillon A, Bewley S. EURAP registry: inadequate monitoring of prescribed drugs in pregnancy. Lancet Neurol 2018; 17:741. [PMID: 30129471 DOI: 10.1016/s1474-4422(18)30280-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/08/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Alain Braillon
- Department of Medicine, University Hospital, 80000 Amiens, France.
| | - Susan Bewley
- Women's Health Academic Centre, King's College London, London, UK
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Affiliation(s)
| | - Susan Bewley
- Department of Women's Health, St Thomas' Hospital, London, United Kingdom
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