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Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope
The noninvasive prenatal test (NIPT) as the first trimester prenatal screening (FTS) for trisomies 21, 18, and 13 is offered to all pregnant women in the Netherlands. NIPT using genome sequencing allows for an expansion of the scope of FTS and the introduction of NIPT gives rise to ethical and socie...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041621/ https://www.ncbi.nlm.nih.gov/pubmed/31710169 http://dx.doi.org/10.1002/jgc4.1188 |
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author | Bakkeren, Iris M. Kater‐Kuipers, Adriana Bunnik, Eline M. Go, Attie T. J. I. Tibben, Aad de Beaufort, Inez D. Galjaard, Robert‐Jan H. Riedijk, Sam R. |
author_facet | Bakkeren, Iris M. Kater‐Kuipers, Adriana Bunnik, Eline M. Go, Attie T. J. I. Tibben, Aad de Beaufort, Inez D. Galjaard, Robert‐Jan H. Riedijk, Sam R. |
author_sort | Bakkeren, Iris M. |
collection | PubMed |
description | The noninvasive prenatal test (NIPT) as the first trimester prenatal screening (FTS) for trisomies 21, 18, and 13 is offered to all pregnant women in the Netherlands. NIPT using genome sequencing allows for an expansion of the scope of FTS and the introduction of NIPT gives rise to ethical and societal concerns about deliberated decision‐making, pressure to engage in screening, and possible lack of equal access due to the financial contribution (€175) to NIPT. We explored the opinions and experiences of pregnant women, who were offered FTS, about these concerns, and the possibility of a broadened scope. Nineteen pregnant women representing a diversity of backgrounds were interviewed using a semi‐structured interview guide. Eight women did not opt for prenatal screening while 11 did (NIPT = 4, combined test = 7). Women experienced a free choice to accept or decline prenatal screening, despite sometimes receiving advice from others. Prior to pretest counseling, some women had already deliberated about what an abnormal test result would mean to them. Others accepted or declined FTS without deliberation. The current Dutch policy of requiring a co‐payment was acceptable to some, who believed that it functioned as a threshold to think carefully about FTS. Others were concerned that a financial threshold would lead to unequal access to screening. Finally, pregnant women found it difficult to formulate opinions on the scope of FTS, because of lack of knowledge. Life expectancy, severity, and treatability were considered important criteria for the inclusion of a condition in NIPT. |
format | Online Article Text |
id | pubmed-7041621 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-70416212020-03-03 Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope Bakkeren, Iris M. Kater‐Kuipers, Adriana Bunnik, Eline M. Go, Attie T. J. I. Tibben, Aad de Beaufort, Inez D. Galjaard, Robert‐Jan H. Riedijk, Sam R. J Genet Couns Original Articles The noninvasive prenatal test (NIPT) as the first trimester prenatal screening (FTS) for trisomies 21, 18, and 13 is offered to all pregnant women in the Netherlands. NIPT using genome sequencing allows for an expansion of the scope of FTS and the introduction of NIPT gives rise to ethical and societal concerns about deliberated decision‐making, pressure to engage in screening, and possible lack of equal access due to the financial contribution (€175) to NIPT. We explored the opinions and experiences of pregnant women, who were offered FTS, about these concerns, and the possibility of a broadened scope. Nineteen pregnant women representing a diversity of backgrounds were interviewed using a semi‐structured interview guide. Eight women did not opt for prenatal screening while 11 did (NIPT = 4, combined test = 7). Women experienced a free choice to accept or decline prenatal screening, despite sometimes receiving advice from others. Prior to pretest counseling, some women had already deliberated about what an abnormal test result would mean to them. Others accepted or declined FTS without deliberation. The current Dutch policy of requiring a co‐payment was acceptable to some, who believed that it functioned as a threshold to think carefully about FTS. Others were concerned that a financial threshold would lead to unequal access to screening. Finally, pregnant women found it difficult to formulate opinions on the scope of FTS, because of lack of knowledge. Life expectancy, severity, and treatability were considered important criteria for the inclusion of a condition in NIPT. John Wiley and Sons Inc. 2019-11-11 2020-02 /pmc/articles/PMC7041621/ /pubmed/31710169 http://dx.doi.org/10.1002/jgc4.1188 Text en © 2019 The Authors. Journal of Genetic Counseling published by Wiley Periodicals, Inc. on behalf of National Society of Genetic Counselors. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Bakkeren, Iris M. Kater‐Kuipers, Adriana Bunnik, Eline M. Go, Attie T. J. I. Tibben, Aad de Beaufort, Inez D. Galjaard, Robert‐Jan H. Riedijk, Sam R. Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope |
title | Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope |
title_full | Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope |
title_fullStr | Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope |
title_full_unstemmed | Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope |
title_short | Implementing non‐invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope |
title_sort | implementing non‐invasive prenatal testing (nipt) in the netherlands: an interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041621/ https://www.ncbi.nlm.nih.gov/pubmed/31710169 http://dx.doi.org/10.1002/jgc4.1188 |
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