Rethinking autonomy in the context of prenatal screening decision-making.

OBJECTIVES: Answering the question: Does the offer of prenatal screening impede women in making autonomous choices? METHODS: Semi-structured interviews with 59 women to whom a prenatal screening test was offered and who were in the process of taking a decision. RESULTS: Women described the offer as confronting but expressed a positive attitude towards screening and considered the offer as an opportunity for making up their minds about testing. Participants stated that they took decisions freely to follow their individual perspectives. Nevertheless, they preferred to share the responsibility of taking decisions, and its consequences for other family members, with their partner and close persons. CONCLUSIONS: The active offer of an unsolicited prenatal test need not be considered as an impediment for making an autonomous choice. The moral significance of prenatal testing is inseparably bound with the social context in which it is practiced. Influence from other persons and emotional reactions due to the test offer can be interpreted as supportive for making a choice. In clinical practice, testing should be timely offered in order to give women the opportunity of discussing their views with significant others. Caregivers should care for the emotions experienced by women so as to help them decide according to their values