Women’s Decisions about Genetic Tests I: Values and Probabilities

Abstract

Women could only choose from the genetic screening/testing options, if any, which they had been offered, or, more unusually in our study population, had successfully requested. In the next two chapters, we will first describe the choices which women made; and then analyse their decision-making with reference to both quantitative associations and their own accounts of the reasoning which underlay their choices. This first chapter will discuss the survey findings about women’s choices, and then use evidence of associations between these choices and other variables to provide clues about the processes on which they were based. Previous survey-style research into parental decisions about genetic tests, reviewed by Shiloh (1996), has shown that they are influenced by utilitarian considerations, including: aversion to abortion (Wertz et al., 1992); assessment of the severity of Down’s syndrome and judgements about the uncertainty-reducing value of genetic tests (Sagi et al., 1992); the degree of risk and desire to have children (Frets et al., 1990). Our survey analysis will add two variables to the list of influencing factors, namely a woman’s level of risk consciousness, as indexed by her concern for her own health, and the genetic screening/testing choices which she sees as available to her. Identification of the latter influencing factor brings into consideration the organisational context which determines the menu of available choices.