Ethnicity, bioethics, and prenatal diagnosis: The amniocentesis decisions of Mexican-origin women and their partners
Ethnicity, bioethics, and prenatal diagnosis: The amniocentesis decisions of Mexican-origin women and their partners
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DOI：
10.2105/ajph.89.11.1658
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发表时间：
1999-11-01
影响因子：
12.7
通讯作者：
Cox, SJ
中科院分区：
文献类型：
--
作者：
Browner, CH;Preloran, HM;Cox, SJ
在美国，规范产前诊断的生物伦理标准和咨询技术是在胎儿检测的主要支持者是一群自我选择的白人、消息灵通的中产阶级妇女的时候发展起来的。自20世纪80年代中期以来，甲胎蛋白（AFP）检测的常规使用已经普及，为产前诊断引入了新的选区。这些新选区包括少数民族妇女，除了某些亚洲群体的妇女外，她们拒绝羊膜穿刺术的比例明显高于其他群体。本研究考察了一组AFP筛查呈阳性的墨西哥裔妇女在决定是否进行羊膜穿刺术时所考虑的因素。我们回顾了379张图表，采访了147名妇女和120名伴侣，以测试一些可能解释为什么有些妇女接受羊膜穿刺术而有些拒绝的因素。研究发现，妇女对医生、药物和产前护理的态度以及她对手术相关风险和不确定性的评估是最重要的。案例总结证明了决策过程的不确定性。我们的结论是，现有的生物伦理原则和咨询技术需要对少数民族客户做出羊膜穿刺术选择的方式更加敏感。
Bioethical standards and counseling techniques that regulate prenatal diagnosis in the United States were developed at a time when the principal constituency for fetal testing was a self-selected group of White, well-informed middle-class women. The routine use of alpha-fetoprotein (AFP) testing, which has become widespread since the mid-1980s. introduced new constituencies to prenatal diagnosis. These new constituencies include ethnic minority women, who, with the exception of women from certain Asian groups, refuse amniocentesis at significantly higher rates than others. This study examines the considerations taken into account by a group of Mexican-origin women who had screened positive for AFP and were deciding whether to undergo amniocentesis. We reviewed 379 charts and interviewed 147 women and 120 partners to test a number of factors that might explain why some women accept amniocentesis and some refuse. A woman's attitudes toward doctors, medicine, and prenatal care and her assessment of the risk and uncertainty associated with the procedure were found to be most significant. Case summaries demonstrate the indeterminacy of the decision-making process. We concluded that established bioethical principles and counseling techniques need to be more sensitive to the way ethnic minority clients make their amniocentesis choices.