Counselling

Refer to principles 2 and 9

Regulatory principles that apply to licensed centres

  • 2.

    have proper respect for the privacy, confidentiality, dignity, comfort and well being of patients and donors;

  • 9.

    ensure that all staff engaged in licensed activity are competent and recruited in sufficient numbers to guarantee safe clinical and laboratory practice;

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Human Fertilisation and Embryology (HFE) Act 1990 (as amended)

  • 13

    (6) A woman shall not be provided with treatment services of a kind specified in Part 1 of Schedule 3ZA unless she and any man or woman who is to be treated together with her have been given a suitable opportunity to receive proper counselling about the implications of her being provided with treatment services of that kind, and have been provided with such relevant information as is proper.

  • 13

    (6A) A woman shall not be provided with treatment services after the happening of any event falling within any paragraph of Part 2 of Schedule 3ZA unless (before or after the event) she and the intended second parent have been given a suitable opportunity to receive proper counselling about the implications of the woman being provided with treatment services after the happening of that event, and have been provided with such relevant information as is proper.

     

13A Conditions of licences for non-medical fertility services

  • (3)

    A woman shall not be provided with any non-medical fertility services involving the use of sperm other than partner-donated sperm unless the woman being provided with the services has been given a suitable opportunity to receive proper counselling about the implications of taking the proposed steps, and has been provided with such relevant information as is proper.

Schedule 3ZA

  • Part 1:

    Kinds of treatment in relation to which counselling must be offered

    1. The treatment services involve the use of the gametes of any person and that person’s consent is required under paragraph 5 of Schedule 3 for the use in question.

    2. The treatment services involve the use of any embryo the creation of which was brought about in vitro.

    3. The treatment services involve the use of an embryo taken from a woman and the consent of the woman from whom the embryo was taken was required under paragraph 7 of Schedule 3 for the use in question.

     

  • Part 2:

    Events in connection with which counselling must be offered

    4. A man gives the person responsible a notice under paragraph (a) of subsection (1) of section 37 of the Human Fertilisation and Embryology Act 2008 (agreed fatherhood conditions) in a case where the woman for whom the treatment services are provided has previously given a notice under paragraph (b) of that subsection referring to the man.

    5. The woman for whom the treatment services are provided gives the person responsible a notice under paragraph (b) of that subsection in a case where the man to whom the notice relates has previously given a notice under paragraph (a) of that subsection.

    6. A woman gives the person responsible notice under paragraph (a) of subsection (1) of section 44 of that Act (agreed female parenthood conditions) in a case where the woman for whom the treatment services are provided has previously given a notice under paragraph (b) of that subsection referring to her.

    7. The woman for whom the treatment services are provided gives the person responsible a notice under paragraph (b) of that subsection in a case where the other woman to whom the notice relates has previously given a notice under paragraph (a) of that subsection.

Schedule 3

  • 3

    (1) Before a person gives consent under this Schedule -

    (a) he must be given a suitable opportunity to receive proper counselling about the implications of taking the proposed steps, and

    (b) he must be provided with such relevant information as is proper.

Licence conditions

  • T60
    A woman must not be provided with treatment services using embryos or donated gametes unless she and any man or woman who is to be treated together with her have been given a suitable opportunity to receive proper counselling about the implications of her being provided with treatment services of that kind, and have been provided with such relevant information as is proper.
  • T61
    A woman must not be provided with treatment services where there is an intended second parent unless, either before or after both have consented to the man or woman being the intended second parent, she and the intended second parent have been given a suitable opportunity to receive proper counselling about the implications of the woman being provided with treatment services and have been provided with such relevant information as is proper.

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The offer of counselling

3AInterpretation of mandatory requirements

The law requires counselling to be offered when:

(a) a woman or couple seeks treatment with donated gametes or embryos

(b) an individual or couple seeks treatment that will create embryos in vitro

(c) an individual or couple seeks to store their gametes or embryos (for exceptions see Schedule 3 of the HFE Act 1990 (as amended), paragraphs 9 or 10)

(d) an individual or couple seeks to donate their gametes or embryos for the treatment of others

(e) an individual seeks to donate their gametes for use in non-medical fertility services

(f) an individual or couple seeks to donate their embryos for research purposes or for training people in embryo biopsy, embryo storage or other embryological purposes

(g) an individual seeks to provide their gametes or cells for the creation of embryos or human admixed embryos for research (for exceptions see mandatory requirements outlined in guidance note 22 - Research)

(h) a woman provides embryos (obtained by lavage) for any purpose

(i) written notice is served by a man or woman consenting to the man being treated as the legal father or parent of any child born as a result of the woman’s treatment, or

(j) written notice is served by a woman, or her female partner, consenting to the partner being treated as the legal parent of any child born as a result of the woman’s treatment.

  • 3.1

    The centre should normally offer counselling after the individual or couple has received oral and written information about the services to be provided and before they consent to treatment, or to the storage or use of gametes or embryos. The timing and frequency of counselling sessions is up to the counsellor and the person or couple concerned, who should agree this together.

  • 3.2

    The centre should make patients aware that the offer of counselling is routine. The offer should include written information giving the name(s) of the qualified counsellor(s), explaining their role, when they are available and how to access the service. The centre should allow enough time before treatment starts for patients to consider the offer and to take up the opportunity of counselling if they so choose.

  • 3.3
    If the possibility of treatment with donated gametes or embryos arises, the centre should offer counselling about the implications of treatment with donated material separately from counselling about the implications of treatment in general and before treatment with donor gametes starts.
  • 3.4

    If the possibility of donating gametes or embryos for the treatment of others, or donating embryos for research or training arises, the centre should offer counselling about the implications of donation separately from counselling about the implications of treatment before the treatment starts.  If treatment has already begun, it should continue only if the woman and, if applicable, her partner have been offered counselling about the implications of donation. 

  • 3.5

    The centre should take all practicable steps to provide an opportunity for counselling throughout the treatment, donation or storage processes, and afterwards if requested. If a person who has previously donated gametes or embryos, or received treatment, requests further counselling at any point, the centre should take all practicable steps to help them obtain it.

  • 3.6

    The centre should offer people the opportunity to be counselled with a partner, if they have one, individually or both. Group sessions may be offered in addition to individual and couple sessions.

The provision of counselling

  • 3.7

    The provision of counselling should be clearly distinguished from:

    a) the  assessment of a person’s suitability to receive treatment, or to store or donate their gametes or embryos

    b) the provision of information before obtaining consent or providing treatment, and

    c) the normal relationship between clinical staff and patients or donors.

  • 3.8

    The counselling service should comply with current professional guidance on good practice in infertility counselling. Counselling should be provided only by qualified counsellors.

  • 3.9

    Counselling should be available from a counsellor attached to the centre. If this is not possible or if the patient prefers to seek counselling elsewhere, the centre should provide:

    (a) up-to-date lists of local counsellors, with the types of counselling they offer, and

    (b) organisations that can provide relevant information.

  • 3.10

    The centre should ensure that arrangements are in place to provide, or refer people for, specialist counselling if appropriate, taking account of their duty of confidentiality under the HFE Act. This might include genetic counselling, and counselling for oncology patients or others requiring the long-term storage of gametes or embryos.

  • 3.11

    The centre should ensure that counselling facilities provide quiet and comfortable surroundings for private, confidential and uninterrupted sessions.

Counselling records and confidentiality

  • 3.12

    Information obtained during counselling should be confidential (although it may be disclosed in certain circumstances, for example if it gives rise to concerns about the suitability of a person to donate gametes or to receive treatment). The written records of the professional counsellor should be kept in a secure place.

  • 3.13
    The centre should keep a record that it has offered patients counselling, even if they choose not to accept this offer.

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Code of Practice version: 8