Centre for Ethics in Medicine, Department of Community Based Medicine, University of Bristol, Cotham Hill, Bristol, UK.
Health Care Anal. 2011 Jun;19(2):122-32. doi: 10.1007/s10728-010-0146-8.
Empirical evidence suggests that some health professionals believe consent procedures for the emerging technology of non-invasive prenatal diagnosis (NIPD) should become less rigorous than those currently used for invasive prenatal testing. In this paper, we consider the importance of informed consent and informed choice procedures for protecting autonomy in those prenatal tests which will give rise to a definitive result. We consider whether there is anything special about NIPD that could sanction a change to consent procedures for prenatal diagnosis or otherwise render informed decision-making less important. We accept the claim that the absence of risk of miscarriage to some extent lessens the gravity of the decision to test compared with invasive methods of testing. However, we also claim that the definitive nature of the information received, and the fact that the information can lead to decisions of great significance, makes NIPD an important choice. This choice should only be made by means of a rigorous and appropriately supported decision-making process (assuming that this is what the pregnant woman wants). We conclude that, on balance, consent procedures for NIPD should mirror those for invasive testing, albeit without the need to emphasise procedure-related risk.
经验证据表明，一些医疗专业人员认为，新兴的非侵入性产前诊断 (NIPD) 技术的同意程序应该比目前用于侵入性产前检测的程序不那么严格。在本文中，我们考虑了知情同意和知情选择程序对于保护那些将产生明确结果的产前检测中的自主性的重要性。我们考虑是否有任何特殊之处 NIPD 可以批准修改产前诊断的同意程序，或者使知情决策变得不那么重要。我们接受这样一种说法，即与侵入性测试方法相比，对某些人来说，流产风险的不存在在某种程度上减轻了测试的重要性。然而，我们也声称，所收到的信息的确定性，以及信息可以导致具有重大意义的决策，使 NIPD 成为一个重要的选择。只有通过严格和适当支持的决策过程（假设这是孕妇想要的）才能做出这个选择。我们的结论是，总的来说，NIPD 的同意程序应该与侵入性测试的程序相匹配，尽管不需要强调程序相关的风险。
