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

Published in Journal of medical ethics. 2014, vol. 40, no. 5, p. 310-314
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-makingAutonomyNondirectivenessDown syndrome screening
PMID: 23543803
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Research group Le Secret médical (676)
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
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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 https://archive-ouverte.unige.ch/unige:38858

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Deposited on : 2014-07-22

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