Section of Ethics, Philosophy and the History of Medicine, Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, PO 9101, 6500 HB Nijmegen, The Netherlands.
Midwifery. 2012 Dec;28(6):e837-43. doi: 10.1016/j.midw.2011.09.006. Epub 2011 Nov 10.
in debates around prenatal screening, it is frequently argued that responsible parenthood implies the acquisition of all available medical information about the health of a fetus, and use of this information to benefit the future child.
to analyse whether an offer of a prenatal test leads women to believe that they are morally obliged to control the health of their fetus.
a substudy within a randomised controlled trial (RCT) aimed to assess the decision-making process of women when confronted with an offer of a prenatal screening test.
111 women participating in an RCT were retrospectively asked their views on the meaning of testing within their parental duties.
testing was described as a personal option that goes beyond the normal parental responsibilities. Participants did not believe that they ought to control the health of the fetus or to avoid disability. A duty to test was only reported when the birth of a disabled child would have a negative impact on family life.
women's accounts suggest that two main factors are involved in making testing morally obligatory: (1) the woman's views on her moral duties to her family; and (2) the expected burden of a disabled child on the well-being of the family. A family-centred approach would be more suitable to assess the moral imperative character of testing than women's ethical views about their moral duties towards their unborn child.
a test offer should not be limited to communication of the characteristics of screening and the meaning of the test results. In helping women to assess the meaning of testing within their parental duties, counselling should include the family situation in which women have to decide, the women's expectations about living with a child with Down's syndrome or any other disability, and the women's views on their commitments towards their family.
在产前筛查的辩论中，人们经常认为负责任的父母意味着要获得有关胎儿健康的所有可用医学信息，并利用这些信息使未来的孩子受益。
分析提供产前检查是否会使妇女认为自己有道德义务控制胎儿的健康。
一项旨在评估妇女在面临产前筛查测试时的决策过程的随机对照试验（RCT）的子研究。
111 名参加 RCT 的妇女被回顾性地询问了她们对测试在父母职责中的意义的看法。
测试被描述为一种超越正常父母责任的个人选择。参与者不认为他们有责任控制胎儿的健康或避免残疾。只有在残疾儿童的出生会对家庭生活产生负面影响时，才会报告有测试的义务。
妇女的说法表明，使测试在道德上具有强制性的两个主要因素是：（1）妇女对其家庭道德责任的看法；以及（2）残疾儿童对家庭幸福的预期负担。与女性对其未出生子女的道德义务的伦理观点相比，以家庭为中心的方法更适合评估测试的道德强制性特征。
测试的提供不应仅限于筛查的特征和测试结果的含义的沟通。在帮助妇女评估其在父母职责中的测试意义时，咨询应包括妇女必须做出决定的家庭情况、妇女对与唐氏综合征或任何其他残疾儿童生活的期望，以及妇女对其家庭承诺的看法。
