Attitudes About NIPT Routinisation: A Report from a Qualitative Study of 20 UK Healthcare Professionals'.

Abstract

All healthcare professionals (HCPs) have responsibilities to provide information to patients according to the duties found within UK decision-making guidance and with regards to theory about the doctor-patient relationship. While routinisation can be understood in a number of different ways, this paper is concerned with how routines might negatively affect patients in the decision-making process. Therefore, in this manuscript, medical decision making is understood as problematically routine when a medical test or procedure is framed as a standard one and-given the way options are presented-it is implied that someone can decide to use that test or treatment without being given sufficient opportunities to think through their choices. Routinisation, when understood in this way, can affect the quality and amount of information provided to patients and the ways in which patients reflect upon their choices when making decisions. With the introduction of non-invasive prenatal testing (NIPT) into the UK healthcare system, bioethicists have questioned whether this new technology will be routinised and what the implications of routinisation on the decision-making process might be. While there have been numerous studies investigating the views and attitudes of pregnant women who use NIPT, there are fewer studies that look at the views and attitudes of healthcare professionals (HCPs). This study interviewed 20 UK-based HCPs who either offer NIPT or counselled pregnant women on the use of NIPT. One important finding was that many HCPs held the attitude that the NIPT decision-making process had become routine, however there was disagreement about whether routine NIPT was problematic or not. This study provides insights about the context that surrounds decision making for NIPT, and it raises important questions about how NIPT routinisation might be evaluated.