Controversies in applying the Abortion Act to Down syndrome

2019 ◽  
Vol 14 (2) ◽  
pp. 57-62
Author(s):  
Marwan Habiba
Keyword(s):  
Down Syndrome ◽  
Published Data ◽  
Functional Abilities ◽  
Moral Uncertainty ◽  
Convincing Argument ◽  
Clinical Presentations ◽  
Substantial Risk ◽  
Late Abortion ◽  
The Uk

Recently published data from the UK pointed out that the number of abortions performed under Ground E of the Abortion Act 1967, which allows abortion for foetal abnormalities, was far lower compared to the number of pregnancy terminations where foetuses had Down syndrome. This prompted calls for the matter to be rectified. This article explores the issues raised and argues that rather than being a concern; the discrepancy is consistent with moral uncertainty or a non-judgmental approach. This is, perhaps fortuitously, in tune with recognized conceptualizations of functioning ability. Debate about what constitutes substantial risk may be resolved in those conditions where a diagnosis can be confirmed. But clinical presentations of those affected can vary and there is no necessary link between functional abilities and suffering. Despite the ambiguities, some practitioners have resolved in favour of late abortion in pregnancies with Down syndrome. It is tempting to develop inferences from these cases, but advancing a convincing argument that may encompass all affected cases requires agreement on underpinning assumptions. Given the polarized debate in this area, it is perhaps best to acknowledge the reality of diverse ethical viewpoints.

scholarly journals Medical vulnerability of individuals with Down syndrome to severe COVID-19–data from the Trisomy 21 Research Society and the UK ISARIC4C survey

2021 ◽  
Vol 33 ◽  
pp. 100769 ◽  
Author(s):  
Anke Hüls ◽  
Alberto C.S. Costa ◽  
Mara Dierssen ◽  
R. Asaad Baksh ◽  
Stefania Bargagna ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Trisomy 21 ◽  
Research Society ◽  
The Uk

Practice Tips for Measuring the Nuchal Translucency

Ultrasound ◽  
2008 ◽  
Vol 16 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Debbie Nisbet
Keyword(s):  
Down Syndrome ◽  
Nasal Bone ◽  
Nuchal Translucency ◽  
Operator Technique ◽  
Increased Risk ◽  
Fetal Nasal Bone ◽  
Form Part ◽  
The Uk ◽  
Bone Assessment ◽  
Down Syndrome Screening

In some countries, measurement of nuchal translucency (NT) is incorporated into national antenatal screening programmes to help detect pregnancies at increased risk of Down syndrome. Accurate measurement of the NT requires a specific technique. This article is an illustrated practical guide outlining the steps required for measuring the NT; it provides useful tips for improving operator technique and advises how to avoid common pitfalls. Although fetal nasal bone assessment does not currently form part of official Down syndrome screening programmes (in Australia or the UK), it is included here as debate about its usefulness continues.

Analysis of the Factors Contributing to the High Rates of Care in Wales: Briefing Paper (Revised)

2019 ◽  
Author(s):  
Helen Hodges ◽  
Dan Bristow
Keyword(s):  
Data Analysis ◽  
Significant Variation ◽  
Published Data ◽  
Local Authorities ◽  
Briefing Paper ◽  
The Uk

On 31st March 2018, there were 6,405 children looked after in Wales, almost 1,900 more children than were looked after in 2006. Over that time Wales has consistently had more children looked after per 10,000 of the population than the rest of the UK, and that gap has widened. Within Wales, while most Local Authorities have seen a rise in both the number and rate of children looked after, there is significant variation; and some have seen the rate of children looked after fall since 2014. Using published data, this report explores what we can say about the factors that are driving these trends. The following infographics drawing on our data analysis show the kinds of placements children in Wales are in and where they’re placed.

HIV: travel

2019 ◽  
pp. 659-662
Keyword(s):  
Developing Countries ◽  
Water Consumption ◽  
Developed Countries ◽  
People Living With Hiv ◽  
Sources Of Information ◽  
Substantial Risk ◽  
Traveller’S Diarrhoea ◽  
The Uk ◽  
Living With Hiv ◽  
Entry Restrictions

The main aim of this chapter is to provide clinicians with the information they need to know about giving advice and managing people living with HIV, who are intending to travel outside the UK. This information is also relevant to other developed countries. Travel to some developing countries poses substantial risk of infections, especially to those with immunodeficiency. Some countries have entry restrictions to people living with HIV. The chapter gives sources of information on these matters. The chapter explains the importance of planning travel well in advance, so that patients receive and complete the necessary vaccinations. The chapter also provides advice on food and water consumption, and traveller’s diarrhoea, as well as actions required by the traveller according to their CD4 count.

The influence of women's cognitive status on their understanding of Down syndrome screening

2020 ◽  
Vol 28 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Sophie John ◽  
Maggie Kirk ◽  
Emma Tonkin ◽  
Ian Stuart-Hamilton
Keyword(s):  
Down Syndrome ◽  
Mixed Methods ◽  
Need For Cognition ◽  
Cognitive Status ◽  
Informed Decision ◽  
Abstract Reasoning ◽  
Mixed Methods Design ◽  
Midwifery Education ◽  
The Uk ◽  
Down Syndrome Screening

Aim To establish whether women's cognitive status influenced their understanding of Down syndrome screening information, and to determine whether midwives offer the same oral explanation of Down syndrome screening to all women or if information was tailored to each woman based on their cognitive status. Methods Midwives (n=16) and women (n=100) were recruited from a regional NHS unit in the UK. A mixed-methods design encompassed two components; audio-recorded antenatal consultations and quantitative surveys to assess women's cognitive status and their understanding of Down syndrome screening information. Findings While women with abstract reasoning skills and high need for cognition (NfC) could understand information sufficiently, women with more concrete skills and low NfC require further explanation from the midwife to reach an informed decision. Conclusion Midwives did not tailor their communication based on women's cognitive status. This has implications for midwifery education programmes to train midwives to communicate Down syndrome screening information effectively.

Assessment of the returning traveller

2018 ◽  
Vol 11 (3) ◽  
pp. 148-154
Author(s):  
Ewan Clark ◽  
Michael Diamond ◽  
William Donovan
Keyword(s):  
Developing Countries ◽  
Full Spectrum ◽  
Tropical Regions ◽  
Potential Exposure ◽  
Clinical Presentations ◽  
Returning Travellers ◽  
The Uk ◽  
Global Travel ◽  
Gastrointestinal Upset

The extent of global travel is ever increasing, and this is reflected in the number of travellers attending GP surgeries on their return to the UK. Presenting issues more commonly dealt with by GPs, particularly among returning travellers who have visited developing countries and tropical regions, include gastrointestinal upset, feverish illnesses, potential exposure to schistosomiasis and the finding of eosinophilia. The full spectrum of travel-related illness is too extensive to be covered in detail, but an overview of the assessment and management of these clinical presentations is given.

scholarly journals Are there socio-economic inequalities in the uptake of Down syndrome screening in the UK?

2012 ◽  
Vol 32 (3) ◽  
pp. 293-295 ◽  
Author(s):  
Shamini Prathapan ◽  
Jean Adams ◽  
Mary Bythell ◽  
Judith Rankin
Keyword(s):  
Down Syndrome ◽  
The Uk ◽  
Down Syndrome Screening ◽  
Economic Inequalities

Screening for Down syndrome in the first trimester

1995 ◽  
Vol 7 (6) ◽  
pp. 1413 ◽  
Author(s):  
KJ Powell ◽  
JG Grudzinskas
Keyword(s):  
Down Syndrome ◽  
First Trimester ◽  
Maternal Blood ◽  
Maternal Serum ◽  
Published Data ◽  
Maternal Serum Screening ◽  
Ultrasound Findings ◽  
Serum Screening ◽  
Associated Proteins ◽  
Trimester Screening

Second-trimester maternal serum screening for Down syndrome is now well established, and permits detection of up to 70% of cases. The disadvantage of this sort of screening is that the timing of maternal blood sampling is relatively late (after 15 weeks). There is an accumulating body of evidence to suggest that in the first trimester concentrations of a number of pregnancy-associated proteins and hormones differ in chromosomally normal and abnormal pregnancies. A first-trimester maternal serum screening test for Down syndrome may therefore be possible. In addition, new methods of screening have recently been described based on ultrasound findings at 11 to 13 weeks of gestation. This review article presents a discussion of published data on the feasibility of first-trimester screening for Down syndrome.

scholarly journals Risk of death among people with rare autoimmune diseases compared to the general population in England during the 2020 COVID-19 pandemic

Rheumatology ◽  
2020 ◽  
Author(s):  
Emily Peach ◽  
Megan Rutter ◽  
Peter Lanyon ◽  
Matthew J Grainge ◽  
Richard Hubbard ◽  
...  
Keyword(s):  
General Population ◽  
Healthcare Services ◽  
Mortality Rates ◽  
Published Data ◽  
Risk Of Death ◽  
Increased Risk ◽  
Specific Mortality ◽  
Population Mortality ◽  
The Uk ◽  
Recorded Diagnosis

Abstract Objectives To quantify the risk of death among people with rare autoimmune rheumatic diseases (RAIRD) during the UK 2020 COVID-19 pandemic compared with the general population, and compared with their pre-COVID risk. Methods We conducted a cohort study in Hospital Episode Statistics for England 2003 onwards, and linked data from the NHS Personal Demographics Service. We used ONS published data for general population mortality rates. Results We included 168 691 people with a recorded diagnosis of RAIRD alive on 01/03/2020. Their median age was 61.7 (IQR 41.5–75.4) years, and 118 379 (70.2%) were female. Our case ascertainment methods had a positive predictive value of 85%. 1,815 (1.1%) participants died during March and April 2020. The age-standardised mortality rate (ASMR) among people with RAIRD (3669.3, 95% CI 3500.4–3838.1 per 100 000 person-years) was 1.44 (95% CI 1.42–1.45) times higher than the average ASMR during the same months of the previous 5 years, whereas in the general population of England it was 1.38 times higher. Age-specific mortality rates in people with RAIRD compared with the pre-COVID rates were higher from the age of 35 upwards, whereas in the general population the increased risk began from age 55 upwards. Women had a greater increase in mortality rates during COVID-19 compared with men. Conclusion The risk of all-cause death is more prominently raised during COVID-19 among people with RAIRD than among the general population. We urgently need to quantify how much risk is due to COVID-19 infection and how much is due to disruption to healthcare services.

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