Prenatal screening: professional standards and the limits of parental choice

Article Abstract:

Prenatal diagnostic imaging techniques can provide information about the well-being of the unborn fetus. As prenatal diagnosis becomes more sensitive, issues surrounding parental autonomy emerge. Techniques such as amniocentesis are restricted to older women or those with a family history of genetic diseases. Many question whether these diagnostic methods should be available to all couples, and not for a selected few. Reproductive medicine has always had a commitment to parental autonomy in reproductive decisions. It is unclear whether physicians are obligated to give prospective parents information regarding all diagnostic capabilities or limit them appropriately. Policies regarding reproductive diagnostic services, the right of parents to choose these procedures and the professional standard of practice for prenatal screening used for the purpose of selective abortion are presented. Physicians should disclose information when the test is accurate and counseling is available. Limitations are based on whether or not full disclosure is potentially harmful to the parents (procedure risk and harm from false results), society (cost to society) or children. Standards of practice are also based on the overall risks involved and cost-benefit analysis. An example is the prenatal diagnosis of Down's syndrome using amniocentesis. The test is currently offered to women over 35 years of age because the risk for Down's syndrome is substantially higher among women in the older age groups. Secondly, the procedural risk of amniocentesis is uncertain, proscribing general use. Lastly, the most cost-effective approach to offering diagnostic tests that are risky is to limit their use to high-risk groups. It is suggested that prenatal screening should be discussed with all prospective parents and decisions to offer testing should be made available regardless of risk or age. However, whether or not the physician will provide those services is based on their personal individual values. Parents should be advised as to what services the physician can and will provide. (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Ethical aspects, Prenatal care, Prenatal diagnosis, editorial

---

Early age at menopause among left-handed women

Article Abstract:

Handedness is associated with a variety of physiological and endocrine variables, including autoimmune disorders, breast cancer (a higher incidence before age 45 occurs in left-handed women), and exposure to hormones (diethylstilbestrol) in utero. Because the endocrine or immune physiology of left-handed women may differ from the physiology of right-handed women, the age at which menopause occurs may also differ. To test this hypothesis, two large databases were evaluated: the Hispanic Health and Nutrition Examination Survey (HHANES) and the National Health and Nutrition Examination Survey (NHANES-I), including white and black women. After ruling out women who had undergone hysterectomy (removal of the uterus) and women who did not meet study criteria for other reasons, six left-handed and two ambidextrous HHANES women, and four left-handed and two ambidextrous NHANES-I women, were left. The recalled ages at which menopause had occurred were compared among the groups. Results showed that HHANES left-handed women were younger when they underwent menopause (42.3 years) than right-handed (47.3) subjects: ambidextrous women were youngest of all (40.7). Analysis of women who had not yet passed through menopause showed that, while right-handers reported menstruation until 56, no left-hander or ambidextrous woman continued to menstruate past 51. Left-handed women from the NHANES-I study tended to undergo menopause earlier than right-handed women, but the differences were not statistically significant; ambidextrous NHANES-I women had their menopause late (55 years). The findings could be explained by inaccurate recall or sampling error. Larger studies concerning handedness and endocrine function are needed to establish a suitably large population of left-handers. Recent research reports have suggested that early menopause is associated with early death; if left-handedness is associated with early menopause, insight could be gained into relationships among important physiological mechanisms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Demographic aspects, Menopause, Left- and right-handedness, Handedness

---

Similar abstracts:

• Abstracts: Screening for gastrointestinal cancer: an epidemiological review. Stress effects on gastrointestinal transit in the rat
• Abstracts: Retirement: perceptions of a professional couple. Principles of ethics and code of professional conduct. The rusty years: sixteen over eighty
• Abstracts: Preferential expression of alpha-B-crystallin in astrocytic elements of neuroectodermal tumors. Repeated dearterialization of hepatic tumors with an implantable occluder
• Abstracts: Neonatal pneumonia. Respiratory rate and pneumonia in infancy. Olivopontocerebellar atrophy of neonatal onset and disialotransferrin developmental deficiency syndrome
• Abstracts: Trichinella infection in travelers. Serodiagnosis of invasive amebiasis using a recombinant Entamoeba histolytica protein

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.