scholarly journals The Pro-Life Paradox of Pregnancy Termination and Disability Exclusion

2020 ◽  
Keyword(s):  
Decision Making ◽  
Genetic Testing ◽  
Pregnancy Termination ◽  
Disabled Persons ◽  
Termination Of Pregnancy ◽  
Unborn Child ◽  
Fetal Anomalies ◽  
Expectant Mothers ◽  
Inform Decision Making ◽  
Pro Life

The debate over the use of genetic testing to inform expectant mothers regarding fetal anomalies, with the intention of enabling her to decide whether or not to terminate pregnancy based on testing outcomes, is arguably deemed by many physicians and scientists to be major medical advancement. Proponents of testing believe that this information prevents the potentiality of lifelong suffering for of the unborn child, as well as encourages a healthier population. There are, however, scientists, geneticists, theorists, and disability advocates, who disagree with this theory. Furthermore, pro-life allies appear to take very differing stances on this topic, from opposing any termination of pregnancy, even in cases of severe disability or a likelihood of infant or maternal mortality, while some may believe abortion is acceptable under these unique circumstances, even if they oppose others. It is difficult to understand how the criteria is evaluated, particularly in cases of the former, when support and resources for disabled persons are greatly lacking, which can lead to a more challenging life, and when the stigma of bearing and raising a defective child is widespread. Thus, it is a crucial topic in women’s studies to understand when there is a pro-life paradox of disability exclusion is and how it may inform decision-making and advocacy regarding selective termination of pregnancy

scholarly journals A retrospective analysis of mid trimester termination of pregnancies for fetal congenital malformations at tertiary care hospital

2021 ◽  
Vol 10 (11) ◽  
pp. 4254
Author(s):  
Geethalakshmi Suriyanarayanan ◽  
Vijayalakshmi Kandasamy ◽  
Anuradha Coimbatore Ramachandran
Keyword(s):  
Congenital Malformations ◽  
Tertiary Care Hospital ◽  
Pregnancy Termination ◽  
Care Center ◽  
Tertiary Care ◽  
Termination Of Pregnancy ◽  
Care Hospital ◽  
Fetal Anomalies ◽  
Hospital Records ◽  
Musculoskeletal Abnormalities

Background: This study was conducted to analyse the spectrum of fetal anomalies as a cause of pregnancy termination in a tertiary care hospital.Methods: This retrospective study includes antenatal women with fetal anomalies diagnosed by an ultrasound (USG) and admitted in Chettinad Hospital and Research Institute, Kelambakkam from January 2018 to January 2020 for termination of pregnancy. Data was collected from hospital records and analysed.Results: Gestational age of women with fetal congenital anomalies ranged from 13 to 21 weeks. Pregnancy termination, was performed between 17-19 weeks of gestation in 41% of patients, between 13-15 weeks and 19-21 weeks in 23% of women respectively. Congenital fetal anomalies resulting in termination of pregnancy were CNS, musculoskeletal, cardiovascular, renal and multiple anomalies. CNS abnormalities was a major cause of termination of pregnancy which includes meningomyelocele, spina bifida, acrania, anencephaly.Conclusions: In our study conducted at our tertiary care center, CNS abnormalities were the major cause of mid trimester termination of pregnancies, followed by musculoskeletal abnormalities being second most common cause.

scholarly journals Expert Knowledge Influences Decision-Making for Couples Receiving Positive Prenatal Chromosomal Microarray Testing Results

2018 ◽  
Author(s):  
Meagan Rubel
Keyword(s):  
Decision Making ◽  
Genetic Testing ◽  
Expert Knowledge ◽  
Pregnancy Termination ◽  
Chromosomal Microarray ◽  
Theory Approach ◽  
Psychosocial Needs ◽  
Prenatal Genetic Testing ◽  
Factors Affecting ◽  
Uncertain Significance

To assess how participants receiving abnormal prenatal genetic testing results seek information and understand the implications of results, 27 US female patients and 12 of their male partners receiving positive prenatal microarray testing results completed semi-structured phone interviews. These interviews documented participant experiences with chromosomal microarray testing, understanding of and emotional response to receiving results, factors affecting decision-making about testing and pregnancy termination, and psychosocial needs throughout the testing process. Interview data were analyzed using a modified grounded theory approach. In the absence of certainty about the implications of results, understanding of results is shaped by biomedical expert knowledge (BEK) and cultural expert knowledge (CEK). When there is a dearth of BEK, as in the case of receiving results of uncertain significance, participants rely on CEK, including religious/spiritual beliefs, “gut instinct,” embodied knowledge, and social network informants. CEK is a powerful platform to guide understanding of prenatal genetic testing results. The utility of culturally situated expert knowledge during testing uncertainty emphasizes that decision-making occurs within discourses beyond the biomedical domain. These forms of “knowing” may be integrated into clinical consideration of efficacious patient assessment and counseling.

Expectant mothers' prospective decision making about infant and childhood vaccinations

2013 ◽  
Author(s):  
Jo Ann Shoup ◽  
Mary Guy ◽  
Danielle Varda ◽  
Jessica Sowa ◽  
Jason Glanz
Keyword(s):  
Decision Making ◽  
Expectant Mothers

scholarly journals HESR innovation in analysis that supports decision making and action

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Barr
Keyword(s):  
Decision Making ◽  
Health Equity ◽  
Social Protection ◽  
Well Being ◽  
Status Report ◽  
Policy Performance ◽  
European Health ◽  
The Individual ◽  
Health And Well Being ◽  
Inform Decision Making

Abstract The European Health Equity Status Report makes innovative use of microdata, at the level of the individual, to decompose the relative contributions of five essential underlying conditions to inequities in health and well-being. These essential conditions comprise: (1) Health services (2) Income security and social protection (3) Living conditions (4) Social and human capital (5) Employment and working conditions. Combining microdata across over twenty sources, the work of HESRi has also produced disaggregated indicators in health, well-being, and each of the five essential conditions. In conjunction with indicators of policy performance and investment, the HESRi Health Equity Dataset of over 100 indicators is the first of its kind, as a resource for monitoring and analysing inequities across the essential conditions and policies to inform decision making and action to reduce gaps in health and well-being.

scholarly journals Personalized Decision Making on Genomic Testing in Early Breast Cancer: Expanding the MINDACT Trial with Decision-Analytic Modeling

2021 ◽  
pp. 0272989X2199117
Author(s):  
Ewout W. Steyerberg ◽  
Liesbeth C. de Wreede ◽  
David van Klaveren ◽  
Patrick M. M. Bossuyt
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Genetic Testing ◽  
Early Stage ◽  
Pragmatic Trial ◽  
Genomic Signature ◽  
Genomic Testing ◽  
Analytic Modeling ◽  
Clinical Risk ◽  
Genomic Test

Background Genomic tests may improve upon clinical risk estimation with traditional prognostic factors. We aimed to explore how evidence on the prognostic strength of a genomic signature (clinical validity) can contribute to individualized decision making on starting chemotherapy for women with breast cancer (clinical utility). Methods The MINDACT trial was a randomized trial that enrolled 6693 women with early-stage breast cancer. A 70-gene signature (Mammaprint) was used to estimate genomic risk, and clinical risk was estimated by a dichotomized version of the Adjuvant!Online risk calculator. Women with discordant risk results were randomized to the use of chemotherapy. We simulated the full risk distribution of these women and estimated individual benefit, assuming a constant relative effect of chemotherapy. Results The trial showed a prognostic effect of the genomic signature (adjusted hazard ratio 2.4). A decision-analytic modeling approach identified far fewer women as candidates for genetic testing (4% rather than 50%) and fewer benefiting from chemotherapy (3% rather than 27%) as compared with the MINDACT trial report. The selection of women benefitting from genetic testing and chemotherapy depended strongly on the required benefit from treatment and the assumed therapeutic effect of chemotherapy. Conclusions A high-quality pragmatic trial was insufficient to directly inform clinical practice on the utility of a genomic test for individual women. The indication for genomic testing may be far more limited than suggested by the MINDACT trial.

Impact of an information booklet on satisfaction and decision-making about BRCA genetic testing

2006 ◽  
Vol 42 (7) ◽  
pp. 871-881 ◽  
Author(s):  
Julien Mancini ◽  
Catherine Noguès ◽  
Claude Adenis ◽  
Pascaline Berthet ◽  
Valerie Bonadona ◽  
...  
Keyword(s):  
Decision Making ◽  
Genetic Testing ◽  
Information Booklet ◽  
Brca Genetic Testing
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