The impact of ethical beliefs on decisions about prenatal screening tests: Searching for justification

García, Elisa; Timmermans, Daniëlle R.M.; Leeuwen, Evert van

doi:10.1016/j.socscimed.2007.10.010

Cited by 75 publications

(78 citation statements)

References 23 publications

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“…Some questions were not answered by all participants. DS Down syndrome, PND Prenatal diagnosis condition to justify termination of pregnancy.^Similar results have previously been reported by Garcia et al (2008) and Gottfredsdottir et al (2009b). Moreover, many women declining PND did so because they could not consider terminating the pregnancy, a finding in line with Garcia et al (2008).…”

Section: Discussionsupporting

confidence: 67%

“…In contrast, women accepting PND did not automatically link PND with termination of pregnancy if DS was diagnosed. Rather, they saw it as a way to gain information, to be reassured that the fetus was healthy and to ease their worries, results that resemble observations from previous reports (Santalahti et al 1998;Garcia et al 2008;Ternby et al 2015). Women declining PND more often had someone with DS in their vicinity (Table 3).…”

Section: Discussionsupporting

confidence: 63%

“…In a qualitative study, Garcia et al (2008) found that both women accepting and declining prenatal screening tests described their parental responsibilities as being context dependent, and all admitted that their choice could be different in different circumstances. A substantial difference between those accepting and those declining prenatal screening was the expected burden of the emotional and physical impact that a disabled child would have on them and their family (Garcia et al 2008).…”

Section: Introductionmentioning

confidence: 99%

“…A substantial difference between those accepting and those declining prenatal screening was the expected burden of the emotional and physical impact that a disabled child would have on them and their family (Garcia et al 2008). A prerequisite to estimate such factors concerning DS is knowledge about medical, cognitive and social consequences of DS.…”

Section: Introductionmentioning

confidence: 99%

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Why do pregnant women accept or decline prenatal diagnosis for Down syndrome?

et al. 2016

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To investigate if actual knowledge of Down syndrome (DS), influences the decision to accept or decline prenatal diagnosis (PND). Secondary aims were to elucidate reasons for accepting or declining PND and investigate differences between the accepting and declining group in perceived information, knowing someone with DS and thoughts about decision-making. A questionnaire was completed by 76 pregnant women who underwent invasive testing and 65 women who declined tests for chromosomal aberrations in Uppsala, Sweden. Apart from one question no significant differences were found in knowledge of DS between women declining or accepting PND for DS. Both groups had varying and in several respects low levels of knowledge about DS and its consequences. Most common reasons to accept PND were 'to ease my worries' and 'to do all possible tests to make sure the baby is healthy'. Corresponding statements declining PND were 'termination of pregnancy is not an option' and 'because invasive tests increase the risk of miscarriage'. More women declining PND knew someone with DS. Knowledge of DS at these levels is not a major factor when women decide to accept or decline PND for DS. Their choice is mostly based on opinions and moral values.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Why do pregnant women accept or decline prenatal diagnosis for Down syndrome?

et al. 2016

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“…23 Studies performed after the introduction of the national screening program for Down syndrome in The Netherlands in 2007, showed that women at that time were also wary of effects like routinisation, pressure to test and less acceptance of people with disabities. 24,25 This may imply that these are recurrent concerns that are related to prenatal screening in general. However, the difference with NIPT is that it is likely that more people who currently decline prenatal screening, will now have NIPT and consequently be facing decisions regarding termination of pregnancy where they would not have previously.…”

Section: Discussionmentioning

confidence: 99%

Attitudes of pregnant women and male partners towards non-invasive prenatal testing and widening the scope of prenatal screening

et al. 2014

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Non-invasive prenatal testing (NIPT) and its potential to test for multiple disorders has received much attention. This study explores attitudes of women and men towards NIPT, and their views on widening the scope of prenatal testing in a country with a low uptake of prenatal screening (The Netherlands). Five focus groups with low-risk pregnant women (n ¼ 28), three focus groups with men (n ¼ 19) and 13 interviews with high-and low-risk pregnant women were conducted. Participants felt that current prenatal screening has great disadvantages such as uncertain results and risk of miscarriage from follow-up diagnostics. Characteristics of NIPT (accurate, safe and early testing) could therefore diminish these disadvantages of prenatal screening and help lower the barrier for participation. This suggests that NIPT might allow couples to decide about prenatal testing based mostly on their will to test or not, rather than largely based on fear of miscarriage risk or the uncertainty of results. The lower barrier for participation was also seen as a downside that could lead to uncritical use or pressure to test. Widening the scope of prenatal testing was seen as beneficial for severe disorders, although it was perceived difficult to determine where to draw the line. Participants argued that there should be a limit to the scope of NIPT, avoiding testing for minor abnormalities. The findings suggest that NIPT could enable more meaningful decision-making for prenatal screening. However, to ensure voluntary participation, especially when testing for multiple disorders, safeguards on the basis of informed decision-making will be of utmost importance. INTRODUCTIONNon-invasive prenatal testing (NIPT) allows detection of chromosomal aneuploidies in the foetus by using circulating cell-free foetal DNA (cffDNA) in the plasma of pregnant women. 1 This technique makes it possible to detect foetal trisomies 21, 13 and 18 as early as 9 weeks into the pregnancy, and perhaps even earlier. 2 As the procedure of NIPT consists of only drawing a blood sample, it eliminates the risk of miscarriage associated with invasive diagnostic procedures, that is, chorionic villus sampling (CVS) and amniocentesis. Consequently, NIPT assures both earlier and safer prenatal testing, although diagnostic confirmation of abnormal NIPT results by invasive testing is still required due to the chance of false positive test results. 3 In 2010, Lo et al 4 showed that it is possible to deduce the entire genomic sequence of a foetus through NIPT, implying that NIPT could identify a much wider range of genetic disorders in the future. These major developments in the field of prenatal testing are generating a great amount of debate regarding the potential impact, benefits and drawbacks of NIPT. Greely 5 , for example, provides a summary of the ethical questions that have been raised with regard to the implications of NIPT on the current prenatal screening setting and

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Screening

2012

Reproductive Health Psychology

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The impact of ethical beliefs on decisions about prenatal screening tests: Searching for justification

Cited by 75 publications

References 23 publications

Why do pregnant women accept or decline prenatal diagnosis for Down syndrome?

Why do pregnant women accept or decline prenatal diagnosis for Down syndrome?

Attitudes of pregnant women and male partners towards non-invasive prenatal testing and widening the scope of prenatal screening

Screening

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