Biomedical Engineering Reference
In-Depth Information
These fi ndings refl ect one of the tensions inherent in surveillance medicine
(Armstrong 1995). On the one hand, efforts are made to reduce risk (by
better and more effi cient methods to detect those at risk) and on the other
hand, the individual is given responsibility for her own health (by presenting
screening results and leaving the decisions to be taken to the individual).
While the health professionals can be assisted by new reproductive
technology, the information about normality and abnormality produced
by these technologies can, as we have seen in this chapter, take on quite
different meanings for the individual woman and confront her with
the moral responsibility for the consequences of the screening. These
discrepancies between the medical objectives and the women's expectations
and experiences need to be taken into consideration.
Finally, new reproductive technology not only raises questions about
the social 'costs' and 'benefi ts' of these technologies, but also 'opens up' to
debate issues which formerly belonged to the realm of biological 'givens'
(Williams 1997: 1045). As new reproductive technology is developed, and
more diagnostic tests are added to the routine surveillance of pregnant
women, further research is needed to understand not only the social impact
of the single technology, but also how the totality of the tests that women
will encounter through a pregnancy will infl uence notions of the normal
pregnancy and the biological 'givens' in reproduction.
Acknowledgements
Economic funding for this study has been gratefully received from the Swedish
Foundation for Health Care Sciences and Allergy Research (Vårdalstiftelsen),
the Centre for Health Care Sciences at the Karolinska Institute, and the
South General Hospital in Stockholm. The study has been approved by the
Regional Research and Ethical Committee at the Karolinska Institute.
Notes
1 The current aim of the routine ultrasound examination is to estimate the
gestational age, to localize the placenta, to screen for multiple pregnancy and to
detect structural malformations (Swedish National Board of Health and Welfare
1996).
2 In several countries, an ultrasound scan at 11-14 weeks is already being introduced
as a routine offer in addition to the traditional scan in mid-pregnancy.
3 Today, antenatal care, and particularly the ultrasound scan, involves both
parents-to-be (see for example Chapter 5 in this volume, and Draper's study
(2002) of fathers' experiences of the ultrasound scan). This chapter, however, is
based on an interview study with pregnant women.
4 In Sweden, the ultrasound examination is usually performed by a midwife with
special training in ultrasonography.
5 We see an embodied approach to reproductive technology as one important
avenue in the exploration of women's experiences, however it is not elaborated
