Ethical considerations in first-trimester Down syndrome risk assessment

@article{Chervenak2010EthicalCI,
  title={Ethical considerations in first-trimester Down syndrome risk assessment},
  author={Frank Chervenak and Laurence B. Mccullough},
  journal={Current Opinion in Obstetrics and Gynecology},
  year={2010},
  volume={22},
  pages={135–138}
}
Purpose of review First-trimester risk assessment has now become sophisticated and of increasing relevance and applicability to decision-making by pregnant woman about invasive diagnosis. Ethics is an essential dimension of understanding this relevance and applicability. This paper addresses the ethical dimensions of first-trimester risk assessment for trisomy 21. Recent findings It is now well established in the ethics and law of the informed consent process that physicians are obligated to… 
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    Informing on prenatal screening for Down syndrome prior to conception. An empirical and ethical perspective
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    The administration of prenatal testing continues to only provide one part of the information recommended by medical guidelines: the testing itself, and patients are not receiving the recommended pre- and post-test counseling and educational materials, nor are these being covered to the same extent as the cost of the NIPS test itself.
    Prenatal screening for Down syndrome and for structural congenital anomalies in the Netherlands: Information provision, informed decision-making and participation
    TLDR
    The goal of the active, routine offer of information about prenatal screening for Down syndrome and structural congenital anomalies, is to enable prospective parents to make an autonomous informed decision about whether or not to participate in the prenatal screening program.
    The Swedish Maternal Health Care Register : Internal Validity, User Perspectives and Register Outcomes; and Experiences by Midwives in Antenatal Care
    TLDR
    This work presents a meta-analysis of data from the Swedish Maternal Health Care Register (MHCR) that shows clear trends in care provided to pregnant women and their offspring between 1999 and 2013 and in the years up to and including pregnancy.
    Contributo para a melhoria da acuidade do diagnóstico pré-natal: análise crítica da correlação entre o diagnóstico pré-natal e o diagnóstico post-mortem

    References

    SHOWING 1-10 OF 29 REFERENCES
    Implementation of first-trimester risk assessment for trisomy 21: ethical considerations.
    TLDR
    It is concluded that ethics is an essential dimension of implementation of first-trimester risk assessment for trisomy 21.
    Clinical implications of the ethics of informed consent for first-trimester risk assessment for trisomy 21.
    TLDR
    The clinical implications of the ethics of informed consent for risk assessment for trisomy 21 are identified and it is found that routinely offering first-trimester risk assessment in centers qualified to provide it is ethically obligatory and routinely withholding the results are ethically unjustified.
    Enhancing patient autonomy with risk assessment and invasive diagnosis: an ethical solution to a clinical challenge.
    TLDR
    A clinically based, ethically justified informed consent process for risk assessment and invasive genetic diagnosis that enhances patient autonomy is described and clinical strategies are identified for the implementation of the varied responses of pregnant women to the offer of RA and ID.
    Evidence-based obstetric ethics and informed decision-making by pregnant women about invasive diagnosis after first-trimester assessment of risk for trisomy 21.
    TLDR
    Pregnant women are able to use sophisticated screening information to make scientifically and ethically rational decisions about invasive testing for trisomy 21, and empiric data compliment the arguments of normative ethics to create evidence-based ethical standards for informed consent regarding invasive testing.
    Patient preference regarding first-trimester aneuploidy risk assessment.
    TLDR
    Older patients and those patients with a better understanding of screening tests preferred immediate disclosure of first-trimester risk assessment results; these women were more likely to prefer to terminate an affected pregnancy.
    Ethics in obstetrics and gynecology.
    • K. Ryan
    • Medicine
      American journal of obstetrics and gynecology
    • 1985
    We are now in an era when everything done in medicine is judged in ethical terms, and this is certainly the case for obstetrics and gynecology, which has had more than its share of morally troubling…
    Prenatal informed consent for sonogram: the time for first‐trimester nuchal translucency has come.
    TLDR
    The argument that prenatal informed consent for sonogram be accepted as an indication for the prudent use of obstetric ultrasonography performed by qualified personnel is extended to first-trimester ultrasonographic screening for aneuploidy using nuchal translucency determination.
    Women's opinions and the implications of first‐ versus second‐trimester screening for fetal Down's syndrome
    TLDR
    Two groups of pregnant women were questioned regarding their opinions on serum screening for Down's syndrome in the first trimester of pregnancy, and many women currently deciding to undergo chorionic villus sampling (CVS) would allow a first‐trimester screening test to influence their decision.
    Prenatal informed consent for sonogram: an indication for obstetric ultrasonography.
    TLDR
    It is argued that the standard of care demands that prenatal informed consent for sonogram be accepted as an indication for the prudent use of obstetric ultrasonography performed by qualified personnel.
    Assessment of the value of reporting partial screening results in prenatal screening for Down syndrome
    TLDR
    It is found that the value of providing partial results when using the Combined Test or Integrated Test to identify women with a high enough risk of having an affected pregnancy based on NT and maternal age alone such that there would be little advantage in combining this information with data on the serum markers.
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