Beyond informed choice: Prenatal risk assessment, decision-making and trust
In 2004 prenatal risk assessment (PRA) was implemented as a routine offer to all pregnant women in Denmark. It was argued that primarily the new programme would give all pregnant women an informed choice about whether to undergo prenatal testing. On the basis of ethnographic fieldwork in an ultrasou...
| Main Authors: | , , |
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| Format: | Article |
| Language: | Danish |
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Norwegian University of Science and Technology Library
2008-05-01
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| Series: | Etikk i Praksis: Nordic Journal of Applied Ethics |
| Subjects: | |
| Online Access: | https://www.ntnu.no/ojs/index.php/etikk_i_praksis/article/view/1687 |
| _version_ | 1811319432142651392 |
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| author | Nete Schwennesen Mette Nordahl Svendsen Lene Koch |
| author_facet | Nete Schwennesen Mette Nordahl Svendsen Lene Koch |
| author_sort | Nete Schwennesen |
| collection | DOAJ |
| description | In 2004 prenatal risk assessment (PRA) was implemented as a routine offer to all pregnant women in Denmark. It was argued that primarily the new programme would give all pregnant women an informed choice about whether to undergo prenatal testing. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, we call into question the assumption underlying the new guidelines that more choice and more objective information is a source of empowerment and control. We focus on one couple's experience of PRA. This case makes it evident how supposed choices in the context of PRA may not be experienced as such. Rather, they are experienced as complicated processes of meaning-making in the relational space between the clinical setting, professional authority and the social life of the couples. PRA users are reluctant to make choices and abandon health professionals as authoritative experts in the face of complex risk knowledge. When assumptions about autonomy and self-determination are inscribed into the social practice of PRA, authority is transferred to the couple undergoing PRA and a new configuration of responsibility evolves between the couple and their relationship to the foetus. It is argued that al-though the new programme of prenatal testing in Denmark presents itself in opposition to quasi-eugenic and paternalistic forms of governing couples' decisions it represents another form of government that works through the notion of choice. An ethics of a shared responsibility of PRA and its outcome would be more in agreement with how decisions are actually made. |
| first_indexed | 2024-04-13T12:42:11Z |
| format | Article |
| id | doaj.art-d26429da1e824ea1aa556d917362e121 |
| institution | Directory Open Access Journal |
| issn | 1890-3991 1890-4009 |
| language | Danish |
| last_indexed | 2024-04-13T12:42:11Z |
| publishDate | 2008-05-01 |
| publisher | Norwegian University of Science and Technology Library |
| record_format | Article |
| series | Etikk i Praksis: Nordic Journal of Applied Ethics |
| spelling | doaj.art-d26429da1e824ea1aa556d917362e1212022-12-22T02:46:29ZdanNorwegian University of Science and Technology LibraryEtikk i Praksis: Nordic Journal of Applied Ethics1890-39911890-40092008-05-012110.5324/eip.v2i1.16871511Beyond informed choice: Prenatal risk assessment, decision-making and trustNete Schwennesen0Mette Nordahl Svendsen1Lene Koch2Institute of Public Health, University of CopenhagenInstitute of Public Health, University of CopenhagenInstitute of Public Health, University of CopenhagenIn 2004 prenatal risk assessment (PRA) was implemented as a routine offer to all pregnant women in Denmark. It was argued that primarily the new programme would give all pregnant women an informed choice about whether to undergo prenatal testing. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, we call into question the assumption underlying the new guidelines that more choice and more objective information is a source of empowerment and control. We focus on one couple's experience of PRA. This case makes it evident how supposed choices in the context of PRA may not be experienced as such. Rather, they are experienced as complicated processes of meaning-making in the relational space between the clinical setting, professional authority and the social life of the couples. PRA users are reluctant to make choices and abandon health professionals as authoritative experts in the face of complex risk knowledge. When assumptions about autonomy and self-determination are inscribed into the social practice of PRA, authority is transferred to the couple undergoing PRA and a new configuration of responsibility evolves between the couple and their relationship to the foetus. It is argued that al-though the new programme of prenatal testing in Denmark presents itself in opposition to quasi-eugenic and paternalistic forms of governing couples' decisions it represents another form of government that works through the notion of choice. An ethics of a shared responsibility of PRA and its outcome would be more in agreement with how decisions are actually made.https://www.ntnu.no/ojs/index.php/etikk_i_praksis/article/view/1687informed choiceinstitutional framing of choiceprenatal risk assessmentpreventionprocesses of decision-makingtrust |
| spellingShingle | Nete Schwennesen Mette Nordahl Svendsen Lene Koch Beyond informed choice: Prenatal risk assessment, decision-making and trust Etikk i Praksis: Nordic Journal of Applied Ethics informed choice institutional framing of choice prenatal risk assessment prevention processes of decision-making trust |
| title | Beyond informed choice: Prenatal risk assessment, decision-making and trust |
| title_full | Beyond informed choice: Prenatal risk assessment, decision-making and trust |
| title_fullStr | Beyond informed choice: Prenatal risk assessment, decision-making and trust |
| title_full_unstemmed | Beyond informed choice: Prenatal risk assessment, decision-making and trust |
| title_short | Beyond informed choice: Prenatal risk assessment, decision-making and trust |
| title_sort | beyond informed choice prenatal risk assessment decision making and trust |
| topic | informed choice institutional framing of choice prenatal risk assessment prevention processes of decision-making trust |
| url | https://www.ntnu.no/ojs/index.php/etikk_i_praksis/article/view/1687 |
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