The rapid clinical implementation of cell-free DNA (cfDNA) screening, a non-invasive method of prenatal genetic screening, has outpaced research on its social and ethical implications. This study is the first to compare the ethical and practical views of Spanish- and English-speaking pregnant women in the United States about cfDNA screening. Semi-structured interviews were conducted with diverse Spanish- and English-speaking women who had received prenatal care at a large academic medical center. Of the 24 interviewees, ten were Latinas who were interviewed in Spanish; English-language interviews were conducted with seven non-Hispanic Asian and seven non-Hispanic White women. Participants held positive opinions concerning the accuracy of cfDNA screening and often noted that it would enhance preparedness. Participants also expressed concerns about the possibility of inaccurate results and the potentially negative effects of cfDNA screening on the experience of pregnancy. Differences emerged between Spanish and English speakers in their portrayals of their relationships with prenatal health care providers, the extent to which they questioned providers’ advice, their ethical concerns, and their informational needs. We emphasize the importance of customizing prenatal test counseling to the needs of the individual patient, providing educationally appropriate counseling and literature, and mitigating potential language barriers.
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Funding support for this study was provided by NIH/NHGRI grants P50HG003389 and R00HG006452. The authors gratefully acknowledge institutional support from the Stanford University Center for Biomedical Ethics; the Institute for Health and Aging at the University of California, San Francisco; and the Biomedical Ethics Research Program at the Mayo Clinic.
Conflicts of Interest
Erin Floyd, Megan A. Allyse, and Marsha Michie declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.
No animal studies were carried out by the authors for this article.
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Floyd, E., Allyse, M.A. & Michie, M. Spanish- and English-Speaking Pregnant Women’s Views on cfDNA and Other Prenatal Screening: Practical and Ethical Reflections. J Genet Counsel 25, 965–977 (2016). https://doi.org/10.1007/s10897-015-9928-3
- cfDNA screening
- Prenatal screening