Article Text
Abstract
Objective Routine prenatal screening for Down syndrome challenges professional non-directiveness and patient autonomy in daily clinical practices. This paper aims to describe how professionals negotiate their role when a pregnant woman asks them to become involved in the decision-making process implied by screening.
Methods Forty-one semi-structured interviews were conducted with gynaecologists–obstetricians (n=26) and midwives (n=15) in a large Swiss city.
Results Three professional profiles were constructed along a continuum that defines the relative distance or proximity towards patients’ demands for professional involvement in the decision-making process. The first profile insists on enforcing patient responsibility, wherein the healthcare provider avoids any form of professional participation. A second profile defends the idea of a shared decision making between patients and professionals. The third highlights the intervening factors that justify professionals’ involvement in decisions.
Conclusions These results illustrate various applications of the principle of autonomy and highlight the complexity of the doctor–patient relationship amidst medical decisions today.
- Autonomy
- Genetic Counselling/Prenatal Diagnosis
- Sociology
Statistics from Altmetric.com
Read the full text or download the PDF:
Other content recommended for you
- Implementation and staff understanding of shared decision-making in the context of recovery-oriented care across US Veterans Health Administration (VHA) inpatient mental healthcare units: a mixed-methods evaluation
- Autonomy-based criticisms of the patient preference predictor
- What are the decision-making preferences of patients in vascular surgery? A mixed-methods study
- What do patients value in their hospital care? An empirical perspective on autonomy centred bioethics
- Clarifying substituted judgement: the endorsed life approach
- Consent for anaesthesia
- Conscientious refusals to refer: findings from a national physician survey
- A case study from the perspective of medical ethics: refusal of treatment in an ambulance
- Do not attempt cardiopulmonary resuscitation decision-making process: scoping review
- Routine antenatal HIV testing and informed consent: an unworkable marriage? i