TY - JOUR
T1 - Interpretations of autonomous decision-making in antenatal genetic screening among women in China, Hong Kong and Pakistan
AU - Ahmed, Shenaz
AU - Yi, Huso
AU - Dong, Dong
AU - Zhu, Jianfeng
AU - Jafri, Hussain
AU - Rashid, Yasmin
AU - Ngan, Olivia My
AU - Ahmed, Mushtaq
N1 - Funding Information:
Acknowledgements This research was funded by: the University of Leeds; The Chinese University of Hong Kong; Hong Kong Baptist University; and Central Park Medical College, Lahore.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - The concept of informed choice for antenatal screening consists of Western ideologies, encapsulating individualistic approaches, and may be valued differently by people from countries with more collectivist cultures. This study aimed to explore perceptions of informed choice in antenatal screening in women from China, Hong Kong and Pakistan. A Q-methodology study was conducted during June 2016 to February 2017, in China (Shanghai and Duyun), Hong Kong and Pakistan (Lahore). A total of 299 women rank ordered 41 statements. Following by-person factor analysis, five distinct viewpoints were identified: choice as a maternal responsibility entrusted to doctors; choice as a shared decision led by the mother; choice as a shared decision led by the partner; choice as a responsibility delegated to the partner and doctors; and choice within a religious discourse. The findings highlight ethical dilemmas for healthcare professionals in facilitating informed choice for antenatal screening where policy and practice guidelines adapt predominantly individualistic approaches. Women's preferences for decision-making with health professionals and/or their partner, with minimal emphasis on individual rights, suggest the need for clarification of the role of health professionals in supporting and facilitating decision-making to enhance women's autonomy. Policy and practice guidelines need to be (re)framed to facilitate decision-making processes for antenatal screening using relational approaches to autonomy.
AB - The concept of informed choice for antenatal screening consists of Western ideologies, encapsulating individualistic approaches, and may be valued differently by people from countries with more collectivist cultures. This study aimed to explore perceptions of informed choice in antenatal screening in women from China, Hong Kong and Pakistan. A Q-methodology study was conducted during June 2016 to February 2017, in China (Shanghai and Duyun), Hong Kong and Pakistan (Lahore). A total of 299 women rank ordered 41 statements. Following by-person factor analysis, five distinct viewpoints were identified: choice as a maternal responsibility entrusted to doctors; choice as a shared decision led by the mother; choice as a shared decision led by the partner; choice as a responsibility delegated to the partner and doctors; and choice within a religious discourse. The findings highlight ethical dilemmas for healthcare professionals in facilitating informed choice for antenatal screening where policy and practice guidelines adapt predominantly individualistic approaches. Women's preferences for decision-making with health professionals and/or their partner, with minimal emphasis on individual rights, suggest the need for clarification of the role of health professionals in supporting and facilitating decision-making to enhance women's autonomy. Policy and practice guidelines need to be (re)framed to facilitate decision-making processes for antenatal screening using relational approaches to autonomy.
UR - http://www.scopus.com/inward/record.url?scp=85041338324&partnerID=8YFLogxK
U2 - 10.1038/s41431-017-0091-1
DO - 10.1038/s41431-017-0091-1
M3 - Journal article
C2 - 29386663
AN - SCOPUS:85041338324
SN - 1018-4813
VL - 26
SP - 495
EP - 504
JO - European Journal of Human Genetics
JF - European Journal of Human Genetics
IS - 4
ER -
