First name
Alma
Last name
Linkeviciute
Year of Study
Research Center
Thesis Title
Cancer during pregnancy: a framework for ethical care
THESIS PROJECT
A Framework for Approaching the Ethical Uncertainties in Cancer and Pregnancy Care
Thesis Abstract
Cancer affects about 1 in 1000 pregnancies, which is estimated to account for
approximately 5000 pregnancies in Europe each year. Despite affluent availability of
clinical practice guidelines for cancer management in the course of pregnancy, there is
very little ethical guidance consolidated for everyday use. Therefore, the aim of this work
is to construct a framework, which would serve healthcare professionals as a reference tool
when addressing ethical issues in cancer care during pregnancy.
The framework is constructed around relational approach to respect for patient’s
autonomy and ethics of care. It combines classical biomedical ethics principles and
relational approaches to patient care. It emphasizes the importance of recognising the
patient as another human being with her views on life, relationships and wishes, as well as
forming a relationship between the patient and healthcare team, which is known as
relational ethics.
However, respect for individual autonomy is not discarded entirely. First and
foremost, evidence-based information disclosure is essential to personalised patient care.
The latter invites to integrate technical aspects of personalised medicine with relational
approach to patient care. Furthermore, protection of the vulnerable also serves as a
safeguard ensuring that patient is not compelled to choices that are not her own.
Overall, this framework is expected to serve as a tool supporting ethical decisionmaking
in cancer care during pregnancy. It can also be utilised by a variety of patient
counselling services.
approximately 5000 pregnancies in Europe each year. Despite affluent availability of
clinical practice guidelines for cancer management in the course of pregnancy, there is
very little ethical guidance consolidated for everyday use. Therefore, the aim of this work
is to construct a framework, which would serve healthcare professionals as a reference tool
when addressing ethical issues in cancer care during pregnancy.
The framework is constructed around relational approach to respect for patient’s
autonomy and ethics of care. It combines classical biomedical ethics principles and
relational approaches to patient care. It emphasizes the importance of recognising the
patient as another human being with her views on life, relationships and wishes, as well as
forming a relationship between the patient and healthcare team, which is known as
relational ethics.
However, respect for individual autonomy is not discarded entirely. First and
foremost, evidence-based information disclosure is essential to personalised patient care.
The latter invites to integrate technical aspects of personalised medicine with relational
approach to patient care. Furthermore, protection of the vulnerable also serves as a
safeguard ensuring that patient is not compelled to choices that are not her own.
Overall, this framework is expected to serve as a tool supporting ethical decisionmaking
in cancer care during pregnancy. It can also be utilised by a variety of patient
counselling services.
Additional Info
Research interests:
Oncofertility (cancer during pregnancy, fertility preservation, prepubertal cancer patients, pregnancy after cancer), human enhancement (cognitive and moral), research ethics (academic honesty), clinical ethics support services (healthcare ethics consultation, moral case deliberation, ethical counselling, decision coaching)
Education:
2011-2012 M.Sc. Bioethics, K. U. Leuven, Belgium (Erasmus Mundus partners R. U. Nijmegen in The Netherlands and University of Padova in Italy)
2006-2012 LL.B. Law and Management, Mykolas Romeris University, Vilnius, Lithuania
2009-2011 Advanced Certificate in Research Ethics, Union Graduate College, Mt Sinai School of Medicine, Schenectedy, NY, USA in partnership with Vilnius University, Lithuania
2006-2008 M.Sc. Neurobiology, Vilnius University, Lithuania
2001-2006 B.Sc. Biology, Vilnius University, Lithuania
Publications in peer-reviewed journals:
Linkeviciute A, Peccatori FA, Sanchini V, Boniolo G; Oocyte cryopreservation beyond cancer: tools for ethical reflection. Journal of Assisted Reproduction and Genetics. 2015 Aug;32(8):1211-20. doi: 10.1007/s10815-015-0524-0. Epub 2015 Jul 3.
Linkeviciute A, Boniolo G, Peccatori FA; Setting up an ethical oncofertility practice in developing countries. Bangladesh Journal of Bioethics, 2014. November; 5 (3):6-17 http://dx.doi.org/10.3329/bioethics.v5i3.21532
Linkeviciute A, Boniolo G, Chiavari L, Peccatori FA; Fertility Preservation in Cancer Patients: The Global Framework. Cancer Treatment Reviews, 2014. September; 40(8):1019-27. doi: 10.1016/j.ctrv.2014.06.001. Epub 2014 Jun 11.
Book chapters:
Ethics consultation services: the scenario by Linkeviciute A, Sanchini V and Oncofertility by Linkeviciute A, Peccatori FA in Ethical counselling and medical decision-making in the era of personalized medicine. A guide. Springer Briefs on Ethical and Legal Issues in Biomedicine and Technology. Boniolo G, Sanchini V(eds). Springer: Heidelberg 2016 (forthcoming).
Comprehending and communicating statistics in breast cancer screening. Ethical implications and potential solutions by Ferretti G, Linkeviciute A, Boniolo G in Prediction and Prognosis: Future Knowledge in Medicine. Sporing F (ed). Springer: 2015 (forthcoming)
Biomedical Enhancement: the ethical dimension by Linkeviciute A in Ethics at the frontiers of biomedicine: for a responsible citizenry (in Italian: Etica alle frontiere della biomedicine: Per una cittadinanza consapevole) Boniolo G, Maugeri P (eds). Mondadori Universita: Milano 2014.
Conference presentations:
"Balancing maternal and fetal interests in cancer during pregnancy care" at international winter school “The Fetus as a Patient – a Sustainable Approach to Clinical Interactions in the Field of New Prenatal Medicine” in Vaals, the Netherlands 2015.
"Ethical issues in autologous egg freezing and donation", invited speaker at Tecnobios Procrezione Symposium in Rome, Italy 2014.
"Regulation of pharmacological substances enhancing cognition: policy proposal", invited speaker at NERRI (Neuro-enhancement, Responsible Research and Innovation) organized by The Nordic Network on Philosophy of Medicine and Medical Ethics, Helsinki, Finland 2014.
"Regulating the Availability of Pharmacological Cognitive Enhancement: European Approach to Future Policies" presentation at 7th Annual Postgraduate Bioethics Conference: Bioethics in Law and Public Policy, King's College London, UK, May 22-24, 2013
Brain activity enhancers: usage, attitude and tendencies among Lithuanian students. Brain Matters: New Directions in Neuroethics. Halifax (Canada) 2009
Training courses and seminars:
Master Course on Ethical Counselling in Oncology, European Institute of Oncology and European School of Oncology, Milan, Italy 2014.
UNESCO Training Course for Teaching Ethics, Vilnius University, Lithuania 2012.
Other professional contributions on voluntary basis:
Stakeholder Advisory Board member for Ethics at ASSEHS (Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services), Project No 20131204 under EU Health Programme 2008-2013. http://assehs.eu/
Public consultation contributions to the documents prepared by ESHRE (European Society of Human Reproduction and Embryology), Nuffield Council on Bioethics and CIOMS (Council for International Organizations of Medical Sciences).
Oncofertility (cancer during pregnancy, fertility preservation, prepubertal cancer patients, pregnancy after cancer), human enhancement (cognitive and moral), research ethics (academic honesty), clinical ethics support services (healthcare ethics consultation, moral case deliberation, ethical counselling, decision coaching)
Education:
2011-2012 M.Sc. Bioethics, K. U. Leuven, Belgium (Erasmus Mundus partners R. U. Nijmegen in The Netherlands and University of Padova in Italy)
2006-2012 LL.B. Law and Management, Mykolas Romeris University, Vilnius, Lithuania
2009-2011 Advanced Certificate in Research Ethics, Union Graduate College, Mt Sinai School of Medicine, Schenectedy, NY, USA in partnership with Vilnius University, Lithuania
2006-2008 M.Sc. Neurobiology, Vilnius University, Lithuania
2001-2006 B.Sc. Biology, Vilnius University, Lithuania
Publications in peer-reviewed journals:
Linkeviciute A, Peccatori FA, Sanchini V, Boniolo G; Oocyte cryopreservation beyond cancer: tools for ethical reflection. Journal of Assisted Reproduction and Genetics. 2015 Aug;32(8):1211-20. doi: 10.1007/s10815-015-0524-0. Epub 2015 Jul 3.
Linkeviciute A, Boniolo G, Peccatori FA; Setting up an ethical oncofertility practice in developing countries. Bangladesh Journal of Bioethics, 2014. November; 5 (3):6-17 http://dx.doi.org/10.3329/bioethics.v5i3.21532
Linkeviciute A, Boniolo G, Chiavari L, Peccatori FA; Fertility Preservation in Cancer Patients: The Global Framework. Cancer Treatment Reviews, 2014. September; 40(8):1019-27. doi: 10.1016/j.ctrv.2014.06.001. Epub 2014 Jun 11.
Book chapters:
Ethics consultation services: the scenario by Linkeviciute A, Sanchini V and Oncofertility by Linkeviciute A, Peccatori FA in Ethical counselling and medical decision-making in the era of personalized medicine. A guide. Springer Briefs on Ethical and Legal Issues in Biomedicine and Technology. Boniolo G, Sanchini V(eds). Springer: Heidelberg 2016 (forthcoming).
Comprehending and communicating statistics in breast cancer screening. Ethical implications and potential solutions by Ferretti G, Linkeviciute A, Boniolo G in Prediction and Prognosis: Future Knowledge in Medicine. Sporing F (ed). Springer: 2015 (forthcoming)
Biomedical Enhancement: the ethical dimension by Linkeviciute A in Ethics at the frontiers of biomedicine: for a responsible citizenry (in Italian: Etica alle frontiere della biomedicine: Per una cittadinanza consapevole) Boniolo G, Maugeri P (eds). Mondadori Universita: Milano 2014.
Conference presentations:
"Balancing maternal and fetal interests in cancer during pregnancy care" at international winter school “The Fetus as a Patient – a Sustainable Approach to Clinical Interactions in the Field of New Prenatal Medicine” in Vaals, the Netherlands 2015.
"Ethical issues in autologous egg freezing and donation", invited speaker at Tecnobios Procrezione Symposium in Rome, Italy 2014.
"Regulation of pharmacological substances enhancing cognition: policy proposal", invited speaker at NERRI (Neuro-enhancement, Responsible Research and Innovation) organized by The Nordic Network on Philosophy of Medicine and Medical Ethics, Helsinki, Finland 2014.
"Regulating the Availability of Pharmacological Cognitive Enhancement: European Approach to Future Policies" presentation at 7th Annual Postgraduate Bioethics Conference: Bioethics in Law and Public Policy, King's College London, UK, May 22-24, 2013
Brain activity enhancers: usage, attitude and tendencies among Lithuanian students. Brain Matters: New Directions in Neuroethics. Halifax (Canada) 2009
Training courses and seminars:
Master Course on Ethical Counselling in Oncology, European Institute of Oncology and European School of Oncology, Milan, Italy 2014.
UNESCO Training Course for Teaching Ethics, Vilnius University, Lithuania 2012.
Other professional contributions on voluntary basis:
Stakeholder Advisory Board member for Ethics at ASSEHS (Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services), Project No 20131204 under EU Health Programme 2008-2013. http://assehs.eu/
Public consultation contributions to the documents prepared by ESHRE (European Society of Human Reproduction and Embryology), Nuffield Council on Bioethics and CIOMS (Council for International Organizations of Medical Sciences).
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