{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:50:27Z","timestamp":1792601427557,"version":"4.5.0"},"reference-count":45,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"unspecified","delay-in-days":309,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Law. Med. Ethics"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1073110525101873_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>It is now acknowledged that possible negative effects of cancer therapies on future reproductive autonomy are a major concern. In the bioethics literature, some advocate that the child\u2019s right to fertility preservation (FP) should be recognized as a right to an open future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1073110525101873_sec2\">\n                    <jats:title>Research objectives<\/jats:title>\n                    <jats:p>The aim of this qualitative study is to (1) explore pediatric oncologists\u2019 perceptions regarding barriers and facilitators of OTC in prepubertal girls and (2) analyze the ethical, legal, social, and policy implications of these barriers and facilitators in Canada and France.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1073110525101873_sec3\">\n                    <jats:title>Participants and research design<\/jats:title>\n                    <jats:p>Between November\u00a02022 and August\u00a02023, 10 French and 6 Canadian oncopediatricians took part in semi-directed interviews. The content of the interviews was analyzed using thematic content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1073110525101873_sec4\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>All the participants emphasized the importance of FP, describing it as a fundamental right and central part of care. However, they identified ethical issues associated with the cost and the uncertainties of ovarian tissue cryopreservation (OTC). The majority thought that OTC should be covered by the public healthcare system to promote equity of access. French oncopediatricians of this study considered OTC to be standard of care, while the majority of Canadian oncopediatricians still considered it experimental, due to the risk of reintroducing malignant cells.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1073110525101873_sec5\">\n                    <jats:title>Discussion\/conclusions<\/jats:title>\n                    <jats:p>The results highlight the importance of FP for prepubertal girls as a right, linked to the child\u2019s right to an open future, as described in bioethics literature. According to these findings, the fact that OTC is not systematically discussed, offered, or not covered by the healthcare system constitutes a barrier and fails to protect patients, who may experience future infertility as a consequence of their treatment, thus curtailing their reproductive autonomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/jme.2025.10187","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T08:17:27Z","timestamp":1762417047000},"page":"522-529","source":"Crossref","is-referenced-by-count":1,"title":["Oncofertility in Prepubertal Girls: A Qualitative Study of Canadian and French Pediatric Oncologists\u2019 Perspectives on Ovarian Tissue Cryopreservation"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-4308","authenticated-orcid":false,"given":"Aliya","family":"Affdal","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0161xgx34","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Montreal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Bujold","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0161xgx34","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Montreal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vardit","family":"Ravitsky","sequence":"additional","affiliation":[{"name":"Harvard Medical School"},{"id":[{"id":"https:\/\/ror.org\/02pmr4c75","id-type":"ROR","asserted-by":"publisher"}],"name":"Hastings Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"S1073110525101873_r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2007.09.013"},{"key":"S1073110525101873_r31","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2012.671896"},{"key":"S1073110525101873_r40","unstructured":"40. See Su, \u201cFertility Preservation in People with Cancer.\u201d"},{"key":"S1073110525101873_r33","unstructured":"33. See Thomson, International Profiles of Health Care Systems 2011."},{"key":"S1073110525101873_r15","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2012-301836"},{"key":"S1073110525101873_r2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60834-5"},{"key":"S1073110525101873_r19","unstructured":"19. G.A. Res. 44\/25, Convention on the Right of the Child (November 20, 1989)."},{"key":"#cr-split#-S1073110525101873_r34.1","doi-asserted-by":"crossref","unstructured":"34. Michael K. Gusmano, et al., \"Disparities in Access to Health Care in Three French Regions,\" Health Policy 114, no. 1 (2014): 31-40, https:\/\/doi.org\/10.1016\/j.healthpol.2013.07.011","DOI":"10.1016\/j.healthpol.2013.07.011"},{"key":"#cr-split#-S1073110525101873_r34.2","doi-asserted-by":"crossref","unstructured":"Kathleen L. Frohlich, et al., \"Health Disparities in Canada Today: Some Evidence and a Theoretical Framework,\" Health Policy 79, no. 2-3 (2006): 132-43, https:\/\/doi.org\/10.1016\/j.healthpol.2005.12.010.","DOI":"10.1016\/j.healthpol.2005.12.010"},{"key":"S1073110525101873_r22","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1275292"},{"key":"S1073110525101873_r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2016.04.005"},{"key":"S1073110525101873_r42","doi-asserted-by":"publisher","DOI":"10.1007\/BF01129572"},{"key":"S1073110525101873_r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2024.05.167"},{"key":"S1073110525101873_r35","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-6518-9_30"},{"key":"S1073110525101873_r12","volume-title":"Oser Les D\u00e9fis Des M\u00e9thodes Mixtes En Sciences Sociales Et Sciences De La Sant\u00e9","author":"Pluye","year":"2018"},{"key":"S1073110525101873_r23","doi-asserted-by":"publisher","DOI":"10.5114\/wo.2022.120362"},{"key":"S1073110525101873_r37","doi-asserted-by":"publisher","DOI":"10.1177\/26334941251340517"},{"key":"S1073110525101873_r3","doi-asserted-by":"publisher","DOI":"10.1177\/1933719117702251"},{"key":"S1073110525101873_r29","unstructured":"29. Taylor & Ott, \u201cFertility Preservation after a Cancer Diagnosis.\u201d"},{"key":"S1073110525101873_r18","doi-asserted-by":"publisher","DOI":"10.2307\/3528702"},{"key":"S1073110525101873_r24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2006.00507.x"},{"key":"S1073110525101873_r25","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2584-7"},{"key":"S1073110525101873_r13","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12910-020-00466-6","article-title":"Impact of Legislation and Public Funding on Oncofertility: A Survey of Canadian, French and Moroccan Pediatric Hematologists\/Oncologists","volume":"21","author":"Affdal","year":"2020","journal-title":"BMC Medical Ethics"},{"key":"S1073110525101873_r41","unstructured":"41. See Knapp & Quinn, \u201cHealthcare Provider Perspectives on Fertility Preservation for Cancer Patients.\u201d"},{"key":"S1073110525101873_r14","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S1073110525101873_r9","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22106"},{"key":"S1073110525101873_r16","volume-title":"Whose Child? Children\u2019s Rights, Parental Authority, and State Power","author":"Feinberg","year":"1980"},{"key":"S1073110525101873_r1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2006.08.006"},{"key":"S1073110525101873_r7","unstructured":"7. \u201cLa strat\u00e9gie d\u00e9cennale de lutte contre les cancers 2021\u20132030 [The ten-year strategy to combat cancer 2021\u20132030],\u201d Institut National du Cancer [National Cancer Institute France], https:\/\/www.cancer.fr\/l-institut-national-du-cancer\/la-strategie-de-lutte-contre-les-cancers-en-france\/strategie-decennale-de-lutte-contre-les-cancers-2021-2030\/la-strategie-decennale-de-lutte-contre-les-cancers."},{"key":"S1073110525101873_r8","unstructured":"8. Regulation Respecting the Application of the Health Insurance Act, Que. Reg. A-29, r. 5, 34.9 (Can.)."},{"key":"S1073110525101873_r20","first-page":"193","article-title":"Fertility Preservation for Medical Reasons and Reproductive Justice","volume":"30","author":"Mohapatra","year":"2014","journal-title":"Harvard Journal on Racial and Ethnic Justice"},{"key":"S1073110525101873_r43","first-page":"777","article-title":"The Social Context of Oncofertility Symposium: Changing Conceptions: Exploring the Medical and Legal Advances in Fertility Preservation Twenty-First Annual Law Review Symposium","volume":"61","author":"Roberts","year":"2011","journal-title":"DePaul Law Review"},{"key":"S1073110525101873_r21","unstructured":"21. Loi 2004-800 du 6 ao\u00fbt 2004 relative \u00e1 la bio\u00e9thique [Law 2004-800 of August 6, 2004 regarding bioethics], Journal Officiel de la R\u00e9publique Fran\u00e7aise [J.O.] [Official Gazette of France], Aug. 7, 2004, p. 14040."},{"key":"S1073110525101873_r30","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1515952"},{"key":"#cr-split#-S1073110525101873_r6.1","unstructured":"6. Loi 2004-800 du 6 ao\u00fbt 2004 relative \u00e1 la bio\u00e9thique [Law 2004-800 of August 6, 2004 regarding bioethics], Journal Officiel de la R\u00e9publique Fran\u00e7aise [J.O.] [Official Gazette of France], Aug. 7, 2004, p. 14040"},{"key":"#cr-split#-S1073110525101873_r6.2","unstructured":"Loi 2011-814 du 7 juillet 2011 relative \u00e1 la bio\u00e9thique [Law 2011-814 of July 7, 2011 regarding bioethics], Journal Officiel de la R\u00e9publique Fran\u00e7aise [J.O.] [Official Gazette of France], July 8, 2011, p. 11826."},{"key":"S1073110525101873_r32","volume-title":"International Profiles of Health Care Systems 2011: Australia, Canada, Denmark, England, France, Germany, Iceland,Italy, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States","author":"Thomson","year":"2011"},{"key":"S1073110525101873_r26","unstructured":"26. \u201cPediatric Oncology Fertility Preservation,\u201d CHEO, https:\/\/www.cheo.on.ca\/en\/resources-and-support\/p6264.aspx."},{"key":"S1073110525101873_r36","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.09.013"},{"key":"S1073110525101873_r4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO-24-02782"},{"key":"S1073110525101873_r38","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-025-01388-x"},{"key":"S1073110525101873_r10","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2016.06.010"},{"key":"S1073110525101873_r39","first-page":"95","article-title":"Ethical Consideration of Ovarian and Testicular Tissue Cryopreservation in Pre-Pubertal Children Who Cannot Assent","volume":"36","author":"Lee","year":"2018","journal-title":"Minnesota Journal of Law and Inequality"},{"key":"S1073110525101873_r11","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell","year":"2017"},{"key":"S1073110525101873_r27","unstructured":"27. Position Statement on Ovarian Tissue Cryopreservation (Canadian Fertility & Andrology Society\/Soci\u00e9t\u00e9 canadienne de fertilit\u00e9 et d\u2019andrologie, 2020), https:\/\/cfas.ca\/_Library\/2020positionstatements\/CFAS-Position-Statement-Ovarian-Cryo-Formatted.pdf."}],"container-title":["Journal of Law, Medicine &amp; Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1073110525101873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:22:59Z","timestamp":1770297779000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1073110525101873\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":45,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"alternative-id":["S1073110525101873"],"URL":"https:\/\/doi.org\/10.1017\/jme.2025.10187","relation":{},"ISSN":["1073-1105","1748-720X"],"issn-type":[{"value":"1073-1105","type":"print"},{"value":"1748-720X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]}}}