Will the introduction of non-invasive prenatal diagnostic testing erode informed choices? An experimental study of health care professionals.

Objective: Informed choice is a fundamental concept within prenatal care. The present study assessed the extent to which the introduction of non-invasive prenatal diagnosis (NIPD) of Down's syndrome may undermine the process of making informed choices to undergo prenatal testing or screening for Down's syndrome by altering the quality and quantity of pre-test counselling.

Methods: 231 obstetricians and midwives were randomly allocated one of three vignettes, each describing a different type of test: (a) invasive prenatal diagnosis (IPD), (b) non-invasive prenatal diagnosis (NIPD) or (c) Down's syndrome screening (DSS).

Informed choice in prenatal testing: a survey among obstetricians and gynaecologists in Europe and Asia.

Purpose: To ascertain the extent to which the value obstetricians and gynaecologists attach to informed choice in the context of prenatal testing varies across countries.

Method: The values attached to informed choice and the perceived importance of test decisions reflecting the views of others considered significant to pregnant women were assessed and compared across obstetricians and gynaecologists in six countries: UK (n = 176), Netherlands (n = 331), Italy (n = 254), Greece (n = 116), China (n = 116) and India (n = 123).

Results: While respondents from the United Kingdom and the Netherlands almost unanimously believed prenatal testing should reflect a parental choice (94%), substantial minorities in Greece, India, and China and to a lesser extent Italy, believed testing should either reflect a family choice or no choice (11-41%).

Informed choice to undergo prenatal screening for thalassemia: a description of written information given to pregnant women in Europe and beyond.

Purpose: To investigate whether prenatal screening for thalassemia is presented as a choice, and how the condition is described in written information given to pregnant women in different countries.

Method: One leaflet from each of seven countries (UK, The Netherlands, Greece, Italy, Israel, India and China) was collected for evaluation. Statements relating to choice and those describing the condition were extracted for analysis.

Cultural variation in values attached to informed choice in the context of prenatal diagnosis.

One of the ethical implications of the widespread introduction of non-invasive prenatal diagnosis (NIPD) is that it might undermine the making of informed choices. There is an almost universal agreement among health professionals and policy makers that prenatal testing decisions should reflect informed choices. It is, however, unclear the extent to which this is a universally held value.