What are they considering when they face a fetus with birth defects? A qualitative study on ethical attitudes of health professionals in China.

Autor: Liu Y; Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.; School of Health Sciences, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland., Wang X; Center for Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.; Center of Medical Ethics, Central South University, Changsha, China., Fang J; Hunan Provincial Hospital of Maternal and Child Health Care, Changsha, Hunan, China., Zhou W; Research Center for Public Health and Social Security, School of Public Administration, Hunan University, Changsha, China., Luo D; Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China. luodan_csu_2011@126.com.
Jazyk: angličtina
Zdroj: Global health research and policy [Glob Health Res Policy] 2024 Jul 15; Vol. 9 (1), pp. 27. Date of Electronic Publication: 2024 Jul 15.
DOI: 10.1186/s41256-024-00370-1
Abstrakt: Background: Birth defects are the leading cause of mortality in newborn babies and children under five years old. In response, the Chinese government has implemented a three-tiered prevention strategy, which has brought ethical concerns about fetuses with birth defects. This study aims to explore the attitudes toward fetuses with birth defects among health professionals engaged in maternal and child health services.
Methods: A qualitative study was conducted among 13 health professionals engaged in maternal and child health services in Hunan Province, China. The questions were designed to elicit the participants' work experience and attitudes toward fetuses with birth defects. The data were collected through in-depth semi-structured interviews, and NVivo 12 was used for data coding and analysis. A thematic analysis approach was employed following the SRQR checklist.
Results: Five themes and 13 attributes were generated regarding health professionals' perspectives on fetuses with birth defects. The five themes included: (1) severity and curability of diseases (two attributes), (2) family relations (four attributes), (3) medical assessments (two attributes), (4) social situations (three attributes), (5) self-value orientations (three attributes). The findings showed that the majority of health professionals held the view that a fetus with a curable disease could be born, whereas a fetus with severe disability and teratogenesis should be terminated. Twelve out of the 13 health professionals believed that parents should be the decision-makers, while only one thought that the family should make a decision together.
Conclusions: Attitudes toward birth defects were influenced by various factors, indicating the complexity of real-world cases identified in this study. The findings highlight the dilemmas faced by both families and health professionals regarding birth defects. Adequate medical knowledge and support from society are crucial to inform decision-making among family members. Additionally, standardized norms and policies for birth defects are needed. Establishing an ethics committee for prenatal diagnosis is necessary to address current ethical issues in this field.
(© 2024. The Author(s).)
Databáze: MEDLINE
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