Course:LIBR559A/Vassy2006

Citation

Vassy, C. (2006). From a genetic innovation to mass health programmes: the diffusion of Down's syndrome prenatal screening and diagnostic techniques in France. Social science & medicine, 63(8), 2041-2051.

Purpose of article

Argues that prenatal testing for Down’s syndrome has become routinized despite the risks and controversies involved due to the way that the information about this testing is presented by health professionals and politicians.

Main Argument(s) and supporting evidence

According to Vassy, testing foetuses for Down’s syndrome developed mainly due to two factors: 1. The encouragement of key players and 2. A constructed framework of shared knowledge which gave legitimacy to this practice, even though many scientists still find the testing controversial (2042).

Pregnant women were convinced that Down’s syndrome testing was useful because it was being advocated for by professionals who engendered trust: scientists and clinicians (2047). Much of the persuasion also took place during one-to-one meetings with pregnant patients during consultations which furthered trust. Their discourses about the test were full of rhetoric about “public needs”, saying that “the public wants these tests to be done,” (2047) which wasn’t entirely true; however, the language used stressed that all pregnant women were being asked to take them and so in a self-fulling prophecy, more women decided to have the tests done (2048).

When describing the framework of shared knowledge which legitimized the practice of testing foetuses for signs of Down’s syndrome, Vassy writes that new values were set for what a heathy foetus means. Based on the policies, foetuses with Down’s syndrome were given less value and opened possibilities to what women were entitled to do with the foetus. In the midst of powerful, world-wide controversy regarding the status of the foetus, as well as its rights, or lack thereof, it is amazing that testing for Down’s syndrome is so highly recommended by health care practitioners (in France – however similarities can be drawn with many other Western countries). This type of testing is ethically troubling to Vassy for two main reasons: one is that “the only solution medicine can offer [to foetuses showing signs of Down’s syndrome] is abortion” (2042) and the other is that the option of choosing whether to terminate a pregnancy based on the results of the testing may indicative of some form of eugenics.

Method(s) (e.g., case studies, interviews, thought piece, survey)

For the methodology, Vassy gathered data through literature reviews and interviews with key stakeholders (2044).

Theoretical frameworks followed by the author(s)

Although not ascribing to any socio-technical theory in particular, this article follows a “socio-historical approach” (2042) which captures the progression of routinizing testing foetuses for Down’s syndrome and the consequences that testing has had.

Potential Contribution to the scholarship of Social Studies of Library and Information and to the practice of Librarianship

Health advice and recommendation is not always neutral; libraries can help by informing patrons about the social and political motivations in health technology in order to facilitate informed decision making when it comes to health.

Page author: Caroline Mniszak