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(Changes in prenatal ultrasound practices after the Perruche decision and Law no. 2002-303 dated 4 March 2002)
Léticée N., Moutard M.-L., Moutel G., Ville Y.
Presse médicale (Paris, France : 1983) 35, 10 Pt 1 (2006) 1467-74 - http://www.hal.inserm.fr/inserm-00120085
(17028535)
[Changes in prenatal ultrasound practices after the Perruche decision and Law no. 2002-303 dated 4 March 2002]
Nadia Léticée1, Marie-Laure Moutard2, Grégoire Moutel3, Yves Ville4
1 :  Centre de diagnostic prénatal et de médecine fœtale
Institut de Puériculture et de Périnatalogie
Paris
France
2 :  Service de neuropédiatrie
GHU Ouest
Hôpîtal Saint-Vincent de Paul 74-82, avenue Denfert-Rochereau 75674 Paris Cedex 14
France
3 :  LEM - Laboratoire d'éthique médicale et médecine légale
Université Paris V - Paris Descartes
Faculté de médecine, 45 rue des Saints-Pères, Paris 75006
France
4 :  Service de gynécologie et obstétrique [Poissy - Saint-Germain-en-Laye]]
http://www.chi-poissy-st-germain.fr/site/Accueil_de_gynecologie_obstetrique-55.html
CHI Poissy-Saint-Germain
CHI Poissy/Saint-Germain-en-Laye Service de Gynécologie -Obstétrique 10, rue du Champ Gaillard BP 3082 78303 Poissy Cedex
France
OBJECTIVE: The aim of this study was to evaluate the effects of French law (court rulings in the Perruche decision and its progeny as well as the statute enacted on March 4, 2002 to reverse or moderate this jurisprudence) on physicians' prenatal diagnosis and fetal medicine practices. METHODS: We sent questionnaires to 186 physician-ultrasonographers in two French districts, inquiring about changes in their daily practice and their provision of information to and communication with the future parents, as well as their opinions about the future of their specialization. RESULTS: We received 54 responses (29%): 40% of respondents found it more difficult to tell patients about fetal anomalies. Written and oral information, medical reports and explanations about the limitations of ultrasound have improved substantially in content for 64% and are better used for 42%. Some clinicians (24.1%) report that they take the future parents' emotions into account more often. Some try to be more distant (13%) or more neutral (9.3%). More than half (51.9%) request the opinion of a center for prenatal diagnosis and fetal medicine more often and 20.4% request karyotyping more often. In all, 7.4% believe that their counseling now leads more often towards abortions. CONCLUSION: Although practitioners had an extremely negative perception of the case law and some were also unhappy with the new statute, these did lead to the reorganization and formalization of their practices. We can see that judicial decisions taken in a specific, individual situation can change collective practices and influence--or even overturn--public health strategies. The respondents' intention to take parents' emotions into account suggests they will find a common language to communicate with them. It is nonetheless necessary to organize a nationwide debate about the objectives of fetal ultrasound.
Sciences du Vivant/Ethique
Sciences du Vivant/Médecine humaine et pathologie/Gynécologie et obstétrique
Français
0755-4982

Articles dans des revues avec comité de lecture
Presse médicale (Paris, France : 1983)
non spécifiée
10/2006
35
10 Pt 1
1467-74

Abnormalities – Multiple – Female – France – Humans – Legislation – Medical – Male – Physician's Practice Patterns – Physician-Patient Relations – Pregnancy – Questionnaires – Ultrasonography – Prenatal – Wrongful Life
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