‘I don’t want to see
my children suffer after birth’: The ‘risk of knowing’ talk and decision-making
in prenatal screening for Down’s syndrome in Hong Kong. In Health, Risk, and Society.
Alice Yau & Olga Zayts / The University of Hong
Kong
Abstract In this paper, we
examine the ‘risk of knowing’ talk (Sarangi et al. 2003, p.155) in
prenatal screening for Down’s syndrome in Hong Kong. The ‘risk of knowing’ talk
refers to the consequences of learning about a health condition, such as the
psychosocial and interpersonal implications of testing, and the subsequent
management of the condition. The stigma of eugenics and that the termination of
pregnancy is the only available ‘medical intervention’ imply that the risk talk
and decision-making in prenatal screening carry serious ethical, moral and
social implications (Pilnick and Zayts 2012). This issue has not attracted much
attention in the previous literature. This study is part of a larger project on
prenatal screening conducted in one Prenatal Diagnostics and Counselling
Department of a Hong Kong hospital in 2006–2013. It draws on 20 video-recorded
consultations with pregnant women who had received a ‘positive’ (high risk)
screening result and were invited to consider further diagnostic testing. Using
theme-oriented discourse analysis (Roberts and Sarangi 2005), we show that in
these consultations, the ‘risk of knowing’ talk was not initiated by the health
care professionals. It might, however, be evoked by the women. We examine the
impact of the ‘risk of knowing’ on decision-making, and discuss specific
discourse (linguistic and rhetorical) devices that the participants employed to
negotiate three competing agendas: the health care professionals’ preference of
diagnostic testing, clients’ concerns of having a baby with Down’s syndrome and
the overarching professional goal of these encounters of facilitating the
clients’ informed choice regarding further testing.
Alice YAU is a PhD candidate at the Centre for the Humanities and Medicine, the University of Hong Kong. Her dissertation focuses on risk and responsibility in the context of telegenetic counselling. The paper that this presentation is based on is a co-authored publication forthcoming in Health, Risk and Society (Co-authored with Dr. Olga Zayts). Miss Alice Yau is the recipient of the Fawzia Braine Memorial Award for the Best Journal Article Published by a Novice Scholar (2013/2014).
Alice YAU is a PhD candidate at the Centre for the Humanities and Medicine, the University of Hong Kong. Her dissertation focuses on risk and responsibility in the context of telegenetic counselling. The paper that this presentation is based on is a co-authored publication forthcoming in Health, Risk and Society (Co-authored with Dr. Olga Zayts). Miss Alice Yau is the recipient of the Fawzia Braine Memorial Award for the Best Journal Article Published by a Novice Scholar (2013/2014).
