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Interpretations of informed choice in antenatal screening: A cross-cultural, Q-methodology study

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  • Ahmed, Shenaz
  • Bryant, Louise D.
  • Tizro, Zahra
  • Shickle, Darren

Abstract

Informed choice is internationally recognised and accepted as an important aspect of ethical healthcare. In the UK, NHS antenatal screening policies state that their primary aim is to facilitate reproductive informed choices. These policies, implemented within a multiethnic population, are largely guided by the ethical principle of autonomy. This study was carried out in 2009 in the UK and used Q-methodology to explore diversity in the value attached to autonomous informed choice in antenatal screening for genetic disorders and similarities and differences in this value in women from different ethnic origins. Ninety-eight participants of African, British White, Caribbean, Chinese and Pakistani origin completed a 41-statement Q-sort in English, French, Mandarin or Urdu. Q-Factor analysis produced five statistically independent viewpoints of the value of informed choice: choice as an individual right; choice informed by religious values; choice as a shared responsibility; choice advised by health professionals; and choice within the family context. The findings show that women hold a variety of views on the nature of informed choice, and that, contradictory to policies of autonomous informed choice, many women seek and value the advice of health professionals. The findings have implications for the role of health professionals in facilitating informed choice, quality of care and equity of access.

Suggested Citation

  • Ahmed, Shenaz & Bryant, Louise D. & Tizro, Zahra & Shickle, Darren, 2012. "Interpretations of informed choice in antenatal screening: A cross-cultural, Q-methodology study," Social Science & Medicine, Elsevier, vol. 74(7), pages 997-1004.
    • Handle: RePEc:eee:socmed:v:74:y:2012:i:7:p:997-1004
    DOI: 10.1016/j.socscimed.2011.12.021
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    References listed on IDEAS

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    1. Stenner, Paul H. D. & Cooper, Deborah & Skevington, Suzanne M., 2003. "Putting the Q into quality of life; the identification of subjective constructions of health-related quality of life using Q methodology," Social Science & Medicine, Elsevier, vol. 57(11), pages 2161-2172, December.
    2. Bryant, Louise D. & Green, Josephine M. & Hewison, Jenny, 2006. "Understandings of Down's syndrome: A Q methodological investigation," Social Science & Medicine, Elsevier, vol. 63(5), pages 1188-1200, September.
    3. Williams, Clare & Alderson, Priscilla & Farsides, Bobbie, 2002. "Is nondirectiveness possible within the context of antenatal screening and testing?," Social Science & Medicine, Elsevier, vol. 54(3), pages 339-347, February.
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    2. Matinga, Margaret N. & Pinedo-Pascua, Irene & Vervaeke, Jonathan & Monforti-Ferrario, Fabio & Szabó, Sándor, 2014. "Do African and European energy stakeholders agree on key energy drivers in Africa? Using Q methodology to understand perceptions on energy access debates," Energy Policy, Elsevier, vol. 69(C), pages 154-164.
    3. Wild, Kayli & Maypilama, Elaine Lawurrpa & Kildea, Sue & Boyle, Jacqueline & Barclay, Lesley & Rumbold, Alice, 2013. "‘Give us the full story’: Overcoming the challenges to achieving informed choice about fetal anomaly screening in Australian Aboriginal communities," Social Science & Medicine, Elsevier, vol. 98(C), pages 351-360.

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