Patient Autonomy in Prenatal Testing Practices

Of Beauchamp and Childress’ four principles of medical ethics—autonomy, beneficence, non-maleficence, and justice—autonomy is often given the most priority. However, when it comes to receiving prenatal care, women face a number of external forces that compromise their ability to make autonomous decisions. These forces include: medical professional bias regarding disability and the routinization of prenatal screening tests; insufficient information provided to patients; a wide range of sociocultural circumstances, particularly familial and community pressure regarding pregnancy termination and economical considerations; and collective societal prejudice against disability. If autonomy is to be given primacy in medical ethics, expectant women need to be empowered to make fully autonomous decisions. Physicians and genetic counselors must understand the impact of factors on women’s decision-making, and not allow their biases to sway patients’ decisions. Furthermore, steps must be taken to ensure that pregnant women receive social and financial support regardless of their decision. With better information and less influence from biased external forces, women will be better equipped to make autonomous decisions regarding prenatal care.