en
Scientific article
English

'Doctor, what would you do in my position?' Health professionals and the decision-making process in pregnancy monitoring

Published inJournal of medical ethics, vol. 40, no. 5, p. 310-314
Publication date2014
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.

Keywords
  • Decision-making
  • Autonomy
  • Nondirectiveness
  • Down syndrome screening
Funding
  • Swiss National Science Foundation - L'information et la gestion des risques dans le suivi de la grossesse : le contexte juridique et sociologique de la relation médecin-patiente
Citation (ISO format)
GOUILHERS, Solene et al. “Doctor, what would you do in my position?” Health professionals and the decision-making process in pregnancy monitoring. In: Journal of medical ethics, 2014, vol. 40, n° 5, p. 310–314. doi: 10.1136/medethics-2012-100887
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Article (Published version)
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Identifiers
ISSN of the journal0306-6800
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