Tuesday, November 13, 2012

Singapore - Patients’ perception of risk: informed choice in prenatal testing for foetal aneuploidy

Choolani M, Biswas A
Correspondence: A/Prof Mahesh Choolani, mahesh_a_choolani@nuhs.edu.sg


Each of us perceives risk differently, and so do our patients. This perception of risk gets even more complex when multiple individuals and interactions are involved: the doctor, the patient-pregnant mother, the spouse-father and the foetus-unborn child. In this review, we address the relationship between different levels of information gathering, from clinical data to experiential knowledge – data, information, knowledge, perception, attitude, wisdom – and how these would impact the perception of risk and informed consent.

We discuss how patients might interpret the risks of the same event differently based upon past experiences, and suggest how risk data could be presented more meaningfully for patients and family to assimilate for informed decision making.

Finally, we demonstrate how patients’ expectations and risk management can impact scientific research and clinical progress by way of the most topical subject of risk screening in pregnancy – non-invasive prenatal testing using cell-free DNA in maternal plasma.

Keywords: cell-free foetal DNA, heuristics in medicine, informed consent, non-invasive prenatal testing, perception of risk

Singapore Med J 2012; 53(10): 633–637

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