Expectations, emotions, and medical decision making: a case study on the use of amniocentesis

The medical decision-making literature has paid scant attention to how prior expectations of patients and clinicians can influence medical encounters and affect patients' choices whether to accept or reject medical testing or treatment. To illuminate the issue, we offer a reflexive analysis of the experiences of a Mexican-American couple offered amniocentesis based on the woman's age and prior pregnancy history. We examine the impact of three principal factors: incongruity between expectations and reality for both patient and clinicians; the actors' ethnic backgrounds; and the history and nature of relationship dynamics between the patient and her male partner. We conclude that unmet expectations on the part of both patient and clinicians evoked powerful emotions that altered the woman's previous intention to agree to amniocentesis.