Open Door Review III

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A0BC$*D0%EF)#<030%_!@>_!F0_!82Y0%C26$_!'>_!L$67#92**_!">_!H2B_!Q>_!"6$2*($6_!i>_!G!"C2Y2%26_!a>![+,,b^>! ;*(0%Y$0Z$*D!Z)90*!2*&!7)B1<06!2:(0%!1%0*2(2!;*!@>!A0BC$*D0%EF)#<030%_!'>E@>!'*D0<6! G!">!"6$2*($6!['&6>^_! 1-%&N@+>(&Q@?%&"!&'#%+@,@B&;)@L+"(,)?(C&/&2>#":%@+&6,>*A&`#)*L)+L&2,-)?(O&'(A?-"@+@BA()(O& @+*&Z%*)?)+% ![11>!-.-E+-b^>!A)*&)*?!I2%*27!F))M6>! A0BC$*D0%EF)#<030%_!@>![+,-P^>!"#0!@0&02!:2*(264?!=*!0Y$(23<0!3B%&0*!&B%$*D!1%0*2(2!;*!;>!@)06<0$*E"0$6$*D!G!L>!"#)96)*!Q2<)!['&6>^_! 1-%&Q%$@B%& `"*AC&.+()*%&@+*&4>,()*% ![11>!-+\E-.-^>!A)*&)*?!I2%*27!F))M6>! >-001(3! In the frame of a large EU wide study we developed a specific form of crisis interventions and studied their outcome: First a short summary of the complete study: Achievements in genetic research produce ethical and moral dilemmas which need to be the subject of reflection and debate in modern societies. Moral dilemmas are seen as situations in which a person has a strong moral obligation to choose each of two alternatives for action, but cannot fulfill both. Denial of ambivalences that moral dilemmas arouse constitutes a threat to societies as well as to individual persons. The EU wide study “Ethical Dilemmas Due to Prenatal and Genetic Diagnostics” (016716-EDIG), which was performed from 2005-2008, tried to investigate these dilemmas in detail in a field which seems particularly challenging: prenatal diagnostics (PND). The existence of PND confronts women and their partners with a variety of moral dilemmas: Should they make use of this technique at the risk of hurting the fetus by the technique itself or by being possibly confronted with the decision for or against the termination of pregnancy? Once they have undergone PND, data regarding abnormalities confront women and their partners with moral dilemmas regarding the decision on the life or death of the unborn child, the responsibility for the unborn child, for its well being even with abnormalities and its possible suffering and so on. An important aspect is the conflict of individual beliefs and obligations and those of society’s specific cultures. These dilemmas have not received full attention in our societies and often remain latent, creating a source of distress for women (and partners) and may be a burden on the relationships. Some couples show better coping capabilities, particularly if support by competent professionals is available. However, more research is needed to identify those with vulnerability to psychopathology as a consequence to abortion after PND results or to giving birth to severely handicapped children. Pathology sometimes appears not until years after the decision. Our study was a step in this direction. The study described existing care systems across participating centres in Germany, Greece, Israel, Italy, Sweden and the United Kingdom. Data was collected in 2 sub-studies. All results were integrated into a discourse on ethical dilemmas. Study (A) recruited two groups of couples (positive or negative PND, total n= 1687). Experiences with PND and connected dilemmas have been explored (questionnaires, interviews). Results have been discussed in interdisciplinary research groups. Study (B) interviewed psychoanalysts and their long-term patients who showed severe psychopathologies as reactions to the dilemmas mentioned. Results of the study help to discuss possible protective and risk factors for women/couples undergoing PND. The results and perspectives for training have been discussed with participating couples, experts, the general public, and politicians in order to develop culturally fair connected clinical practice in this field within the EU, taking into account cultural and religious differences.

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