Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Νικόλαος Σαλάκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Καλλιόπη Χριστακάκου - Φωτιάδη Καθηγήτρια, Νομική Σχολή, ΕΚΠΑ
Απόστολος Μαμόπουλος, Καθηγητής, Ιατρική Σχολή, ΑΠΘ
Μακάριος Ελευθεριάδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλέξανδρος Σωτηριάδης, Καθηγητής, Ιατρική Σχολή, ΑΠΘ
Παναγιώτης Αντσακλής, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αγγελική Σαρέλλα, Καθηγήτρια, Τμήμα Μαιευτικής, ΠΑΔΑ
Original Title:
Βιοηθικά διλήμματα κατά τον προγεννητικό έλεγχο
Translated title:
Bioethical dilemmas in prenatal screening
Summary:
Prenatal screening encompasses a broad range of examinations performed before or during pregnancy to safeguard the wellbeing of the expectant mother and the fetus. More particularly, in the course of the last two decades the evolution of prenatal diagnosis and intervention has been considerable and ample progress has been noted.
In contemporary Greece, prenatal testing often includes identifying and diagnosing significant fetal abnormalities and intervening with therapeutic procedures such as intrauterine or postpartum procedures according to research protocol. The aim of fetal intervention is to aid fetal health through interventions during the course of the pregnancy, prevent or curate identified anatomic or genetic abnormalities, and better long-term neonatal health outcomes.
Based on the current guidelines, prenatal screening is advisable for all couples, especially those belonging to groups of high genetic risk and have an increased chance of having a child with a certain genetic disorder. The management of such situations that arise during a pregnancy, often raises ethical issues regarding the mother's autonomy, her informed consent and decision-making, influencing the management strategies followed.
Bioethics as the intersection of many scientific disciplines focuses on ethical issues in the field of health care with the aim of respecting prospective parents' choices and providing information in ways that promote autonomy and informed consent in decision-making.
In the discipline of Obstetrics, the approaches of obstetric staff (Obstetricians / Gynecologists, Geneticists and Midwives) are crucial to decision-making during prenatal screening. Health professionals involved in prenatal screening often face morally difficult situations in routine clinical practice that will have to manage in order to provide the best possible treatment for both the fetus and the parents.
The principal responsibility of healthcare providers involved in prenatal screening is to, respecting and encouraging autonomous decision making concerning the management of significant issues that arise during pregnancy. It is of utmost importance that the fetal unit team provides services in accordance with the new scientific developments and has access to ongoing education, in adherence to the protocols of the global obstetric community.
Ethics committees serve as a critical resource as it has been proven to help couples, pregnant women and healthcare staff in resolving ethical issues that arise in their daily healthcare practices as well as in counseling sessions aiming towards informed decision making. It is worth noting that, at present, there is no satisfactory and available prenatal treatment, as a direct consequence abortion or the birth of a child with a pathological condition appear to be the only feasible options. Recourse to prenatal diagnosis indicates a tendency to recommend termination of pregnancy in cases where a genetic disorder is detected.
In our country, it has been established in situations where fetal pathology is identified through prenatal diagnosis, the majority of women choose not to proceed with the birth of the child when a genetic abnormality is detected. Furthermore, a significant proportion of pregnant women with fetuses appearing to display severe chromosomal abnormalities, whether structural or numerical, choose to terminate their pregnancy.
Additionally, it is worth highlighting the fact that expectant mothers exhibiting a higher level of education have the tendency to follow recommended prenatal tests proactively, resort to intrauterine interventions and/or treatments, have more trust in healthcare professionals who are responsible for their care, and are well-informed about potential risks or side effects. The provision of care has the healthcare professionals` knowledge of how to navigate such situations as a prerequisite, and simultaneously prioritizing risk assessment and respecting the autonomy and informed consent of pregnant women.
Main subject category:
Health Sciences
Keywords:
Bioethics, Prenatal screening, Bioethical dilemmas, Informed consent, Health professionals education
Number of references:
231
File:
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Glynou_Anna_PhD.pdf
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File access is restricted only to the intranet of UoA.
