title: Information-sharing to promote informed choice in prenatal screening in the spirit of the SOGC clinical practice guideline: a proposal for an alternative model.
abstract: The 2011 SOGC clinical practice guideline "Prenatal Screening for Fetal Aneuploidy in Singleton Pregnancies" recommends that clinicians offer prenatal screening to all pregnant women and provide counselling in a non-directive manner. Non-directive counselling is intended to facilitate autonomous decision-making and remove the clinician's views regarding a particular course of action. However, recent research in genetic counselling raises concerns that non-directive counselling is neither possible nor desirable, and that it may not be the best way to facilitate informed choice. We propose an alternative model of information-sharing specific to prenatal screening that combines attributes of the models of informative decision-making and shared decision-making. Our proposed model is intended to provide clinicians with a strategy to communicate information about prenatal screening in a way that facilitates a shared deliberative process and autonomous decision-making. Our proposed model may better prepare a pregnant woman to make an informed choice about participating in prenatal screening on the basis of her consideration of the medical information provided by her clinician and her particular circumstances and values.
authors.affiliation: Faculty of Health Sciences, The University of Western Ontario, London ON; Department of Obstetrics and Gynaecology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London ON.
authors.forename: Meredith
authors.initials: M
authors.lastname: Vanstone
authors.affiliation: Faculty of Health Sciences, The University of Western Ontario, London ON.
authors.forename: Elizabeth Anne
authors.initials: EA
authors.lastname: Kinsella
authors.affiliation: Department of Obstetrics and Gynaecology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London ON.
authors.forename: Jeff
authors.initials: J
authors.lastname: Nisker
mesh_terms: D002170:Canada; D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling / Q000379:methods*; D006801:Humans; D033181:Information Dissemination; D008962:Models, Theoretical; D011247:Pregnancy; D011296:Prenatal Diagnosis