The Impact of Area Conservatism on Deviation from Best Practice: Women Choosing to Undergo Selective Reduction

By David W. Britt, Shelby Van Voris, Sanaa Jamil, Juliana Gebb, Mara Rosner and Mark I. Evans.

Published by The International Journal of Health, Wellness and Society

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Article: Print $US10.00
Article: Electronic $US5.00

We argue that politically and religiously conservative areas tend to lead to distortion of the flow of risk information in ways that appear to reduce the apparent need for reductions from a medical-risk point of view. They also minimize the credibility of non-medical risks experienced by patients. Understanding that this type of investigation is fraught with difficulties of definition and analysis, we bring to bear two different sources of data to engage this dialog. First, we examine in some detail medico-legal testimony in settled cases, to flesh out the ways in which processes of distortion may take place with respect to risk and options for dealing with it. Second, we use qualitative comparative analysis to examine a set of selective reduction cases from diversely conservative environments around the world in the period from December, 2014 through April, 2015 for which the main issue has been the advisability of reducing from two or three fetuses to one. We conclude that external conservative cultural forces may undermine the treatment of patients seeking selective reduction in several ways. From these analyses, we make recommendations for intervention.

Keywords: Medical Encounter Breakdowns, Distortion of Risk

The International Journal of Health, Wellness and Society, Volume 7, Issue 2, June 2017, pp.115-140. Article: Print (Spiral Bound). Article: Electronic (PDF File; 906.946KB).

Dr. David W. Britt

Director, Clinical Research, Fetal Medicine Foundation of America, New York, New York, USA

Shelby Van Voris

Director,, Tampa, Florida, USA

Sanaa Jamil

Resident, Karolinska Institute, Stockholm, Sweden

Juliana Gebb

Assistant Professor, Montefiore Medical Center, Albert Einstein College Medicine, New York, New York, USA

Mara Rosner

Associate Professor, Department of Obstetrics & Gynecology, Division of Maternal and Fetal Medicine, New York University, New York, New York, USA

Dr. Mark I. Evans

Director and Professor, Fetal Medicine Foundation of America & Mount Sinai School Medicine, New York, New York, USA