{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:41:23Z","timestamp":1792845683259,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nurs Ethics"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of assisted reproductive technology (ART) in individuals with intellectual disabilities raises significant ethical tensions between reproductive autonomy and the welfare of future offspring. Global guidelines addressing this dilemma remain absent. In China, nurses frequently encounter these dual responsibilities without clear operational frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore how nursing interventions can support ethical decision-making and reproductive safety for an intellectually disabled patient undergoing ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative, exploratory single-case study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study followed a 27-year-old woman with mild intellectual disability through an in vitro fertilization (IVF) pathway. A nurse-led dual-intervention strategy was implemented: (1) cognitively adaptive decision-making tools (pictogram-based IVF guides, emoji risk charts, visual medication calendars); and (2) government-integrated perinatal care services, including prenatal registration, structured follow-up, and postpartum home visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethical Considerations<\/jats:title>\n                    <jats:p>Ethical approval was obtained, and the study adhered to strict ethical standards, including a tailored informed consent process and robust guarantees of confidentiality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The intervention ensured informed consent completion, medication adherence without errors, and comprehensive prenatal tracking via the national maternal health system. The patient delivered a healthy infant (Apgar score = 10). These outcomes demonstrate that nurse-designed cognitive adaptations, combined with systemic safeguards, enhance patient autonomy and reproductive safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study illustrates an ethical and practical paradigm for reconciling reproductive justice and cognitive equity in ART. Nurse-led innovations, supported by institutional governance, may inform global frameworks for ethically complex fertility care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09697330251393356","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T16:02:07Z","timestamp":1763654527000},"page":"541-551","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethical nursing strategies for ART in intellectual disability: tools and systemic pathways"],"prefix":"10.1177","volume":"33","author":[{"given":"Jia","family":"Wei","sequence":"first","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center Liuzhou Hospital"},{"name":"Liuzhou Maternity and Child Healthcare Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ni","family":"Tang","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center Liuzhou Hospital"},{"name":"Liuzhou Maternity and Child Healthcare Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center Liuzhou Hospital"},{"name":"Liuzhou Maternity and Child Healthcare Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingling","family":"Zhao","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center Liuzhou Hospital"},{"name":"Liuzhou Maternity and Child Healthcare Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Huang","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center Liuzhou Hospital"},{"name":"Liuzhou Maternity and Child Healthcare Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1947-9416","authenticated-orcid":false,"given":"Liuyan","family":"Wei","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center Liuzhou Hospital"},{"name":"Liuzhou Maternity and Child Healthcare Hospital"},{"name":"Guangxi Clinical Research Center for Obstetrics and Gynecology"},{"name":"Liuzhou Key Laboratory of Gynecologic Tumor"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"World Health Organization. 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