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

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  • García, Elisa
  • Timmermans, Danielle R.M.
  • van Leeuwen, Evert

Abstract

Prenatal screening for Down's syndrome and other chromosomal anomalies has become common obstetrical practice. The purpose of this intervention is to provide women with the information needed to make informed reproductive choices. It is assumed that the ethical beliefs of parents play an important role in decision-making about whether to undergo testing, but little is known about their precise significance. More insight into how women conceptualize their choice of using prenatal screening tests may clarify the impact of personal ethical beliefs. With this aim, we conducted qualitative research consisting of semi-structured interviews with 59 women in the Netherlands who were offered a prenatal screening test. The analysis showed that the ethical views between acceptors and decliners showed similar diversity. In contrast with the currently accepted view, we conclude that ethical beliefs are one of the factors implicated in the decision. Women decide about prenatal testing by balancing the information provided by the test against the risks of further investigation, the emotional burden of a disabled child on their well-being and life perspective, as well as on those of family members. Normative moral principles are introduced once the choice is made, namely as factors in justifying and supporting the decision.

Suggested Citation

  • García, Elisa & Timmermans, Danielle R.M. & van Leeuwen, Evert, 2008. "The impact of ethical beliefs on decisions about prenatal screening tests: Searching for justification," Social Science & Medicine, Elsevier, vol. 66(3), pages 753-764, February.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:3:p:753-764
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    References listed on IDEAS

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    1. Markens, Susan & Browner, C. H. & Press, Nancy, 1999. "'Because of the risks': how US pregnant women account for refusing prenatal screening," Social Science & Medicine, Elsevier, vol. 49(3), pages 359-369, August.
    2. Williams, Clare & Alderson, Priscilla & Farsides, Bobbie, 2002. "Too many choices? Hospital and community staff reflect on the future of prenatal screening," Social Science & Medicine, Elsevier, vol. 55(5), pages 743-753, September.
    3. Press, Nancy & Browner, C. H., 1997. "Why women say yes to prenatal diagnosis," Social Science & Medicine, Elsevier, vol. 45(7), pages 979-989, October.
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    2. Gottfre[eth]sdóttir, Helga & Björnsdóttir, Kristín & Sandall, Jane, 2009. "How do prospective parents who decline prenatal screening account for their decision? A qualitative study," Social Science & Medicine, Elsevier, vol. 69(2), pages 274-277, July.
    3. Hammer, Raphaël P. & Burton-Jeangros, Claudine, 2013. "Tensions around risks in pregnancy: A typology of women's experiences of surveillance medicine," Social Science & Medicine, Elsevier, vol. 93(C), pages 55-63.
    4. Reid, Bernie & Sinclair, Marlene & Barr, Owen & Dobbs, Frank & Crealey, Grainne, 2009. "A meta-synthesis of pregnant women's decision-making processes with regard to antenatal screening for Down syndrome," Social Science & Medicine, Elsevier, vol. 69(11), pages 1561-1573, December.
    5. Ville, Isabelle & Mirlesse, Véronique, 2015. "Prenatal diagnosis: From policy to practice. Two distinct ways of managing prognostic uncertainty and anticipating disability in Brazil and in France," Social Science & Medicine, Elsevier, vol. 141(C), pages 19-26.

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