Biomedical Engineering Reference
In-Depth Information
undergoing treatment and there were risks for misdiagnosis. Was there a 'risk'
that different risks became normalised, in the sense of common and accepted
parts of everyday clinical practice, i.e. risks that professionals were aware of,
found undesirable and tried to make explicit to couples, but which still became a
'normal' part and parcel of the treatment? Whereas most interviewees told stories
of risks, only one interviewee commented on the low success-rate and he was
upset that so few people questioned the very use of the methods on this basis.
(What other methods would be allowed, this interviewee asked, in which only 20
per cent of the treatments were successful in the sense that a healthy, biological
child was born?)
17
Had risks become normal? Finally, it is worth noting that the
normality of wanting to have healthy children through the means of PGD was
seldom questioned or problematised.
18
Discussion and concluding comments
The results of the analysis of the empirical data presented in this chapter
point to some issues that need to be further analysed. Choice resulted as a
major thread in the narratives. What does choice in the fi eld of reproductive
genetics mean and what should characterise a desirable situation of choice in
genetic counselling? Elsewhere, I have argued that abilities and opportunities
(i) to refl ect on what really matters to the persons engaged in choice, with
regard to their reproduction, (ii) to come to a decision and (iii) to act upon
it are important
if
someone can be said to have an autonomous choice in this
particular fi eld. It is important to enhance both the abilities and possibilities
of such choice (Zeiler 2005, see also Meyers 1989).
19
However, it is also important to note that whereas choice and autonomous
choice have been much discussed in bioethics (Beauchamp and Childress
2001; Faden and Beauchamp 1986), this focus has also been questioned
(Dodds 2000). In what can be called a
twofold
empirical
criticism
in the
discussion of autonomy, it is sometimes argued, on an empirical basis, that
not everyone wants to choose (Schneider 1998)
20
and that those who want
to do so, do not always manage to do so. In my data, I take the presence of
hampering infl uences on conditions for choice and autonomous choice to
indicate that choice and autonomous choice within reproductive genetics
were not always present (see also Zeiler 2005; Corrigan 2003; Hildt 2002).
Furthermore, it has been argued that the rhetoric of reproductive choice
in fact prevents us from examining the context in which reproduction
becomes institutionalised (Raymond 1995). There are, to say the least, many
complexities of choice in medicine (Lupton 1997).
Choice in the PGD situation is also different from choice in many other
medical settings. A comparison between situations of choice in medicine in
general, with some exceptions, and situations of choice at the PGD clinic
can clarify this point. In the case of medicine in general, there is most often
one patient. Whereas this patient may choose to discuss her or his situation
with others who s/he wants to discuss it with such as family, friends, other
