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Programme: accepted abstracts

Abstract ID: 1071

Part of General Paper Session (Other abstracts in this session)

The dynamics of family decision-making in intercultural prenatal screening

Authors: Zayts, Olga A. (1); Schnurr, Stephanie (2)
Submitted by: Zayts, Olga A. (The University of Hong Kong, Hong Kong S.A.R. (China))

In recent years there has been a proliferation of research in medical sociology, medical anthropology medical education, and genetic counseling literature examining the role of culture in genetic counseling (e.g. Clarke and Parsons 1997; Lewis 2002; Ota Wang 2001). This attention to culture may be attributed to the fact that genetic counseling encounters involving participants from diverse cultural and linguistic backgrounds are increasingly becoming the norm due to due to globalization of health care and an increasing migration of professional workforce and clients around the world. A common theme emerging from these studies is that culture has a significant impact on the decision-making and the outcomes of genetic counseling. However, most of these existing studies tend to view culture as a static concept and make “grand generalizations” about its impact while often over-looking how culture is actually oriented to by interlocutors on the micro-level of interaction.

In this paper, we employ theme-oriented discourse analysis (Roberts and Sarangi, 2005) to explore how participants’ cultural background may impact the dynamics of family decision-making processes in prenatal screening for Down syndrome. In particular, we examine 40 prenatal screening encounters where participants include Hong Kong Chinese healthcare providers and clients (pregnant women and their husbands/partners) who come from a variety of cultural backgrounds. The clients are referred for screening due to the women’s advanced maternal age (≥ 35 years old) and the associated risk of having a child with Down Syndrome. The screening encounters are organized as information-delivery sessions aimed at facilitating the clients’ decision whether to pursue genetic diagnosis or not.

In our data we observed the tendency that among Asian couples the husbands are often actively constructed as the main decision-makers by both pregnant women and husbands themselves, whereas in Western couples women and husbands seem to co-participate in the decision-making. However, rather than interpreting these observations as generalizations in terms of culturally motivated behaviors, we are primarily interested in examining the various  rhetorical and interactional means though which participants negotiate and construct their decisions. We thus look beyond culture and also explore other factors that may have an impact on the family decision-making processes displayed in our data, such as participants’ gender role expectations and their language proficiency.

References:

Clarke, A. and E. Parsons (eds) (1997) Culture, Kinship and Genes: Towards Cross-Cultural Genetics,

Basingstoke: Macmillan; New York: St. Martin's Press.

Lewis, L.J. (2002) ‘Models of genetic counseling and their effects on multicultural genetic counseling’, Journal of Genetic Counseling, 11 (3): 193-212.

Ota Wang, V. (2001) ‘Multicultural genetic counseling: then, now, and in the 21st century’, American Journal of Medical Genetics, 106: 208-215.

Roberts, C. and S. Sarangi (2005) ‘Theme-oriented discourse analysis of medical encounters’, Medical Education, 39(6): 632-640.