Imposed medical authority: orienting the decision
In some cases, medical authority is imposed without being requested by
the woman/couple. This is often the case in France when women are
hesitating to have a sample taken. They are often dissuaded from doing
so if they are determined to keep the child they are carrying. For
example, the midwife explained to a couple carrying the drepanocytosis
gene: “We can make the diagnosis before birth, but we need to ask
what we’re going to do. If [the foetus] is affected, are we
going to terminate the pregnancy? ” Following the woman’s negative
response, she continued: “the only thing we can do is an
amniocentesis. But there’s a risk of miscarriage. That’s why, if you
wish to keep this child, it’s better not to do [the
amniocentesis]” (Midwife, France).
Finally, the practitioner’s attitude can be clearly directive when there
is a strong presumption of anomaly. In France, for example, the
consultant immediately told a 45-year-old woman: “As you have
unfavourable blood results, with a very high level of hormones, this
suggests a risk of chromosomal anomaly. It would be a good idea to
rapidly have an amniocentesis to reassure you.” When facing what is
considered to be a high risk, there is pressure to move fast.