Rethinking the Burden of Traditional Informed Consent Prior to Prenatal Genetic Screening.

Area of Science:

• Medical Ethics
• Genetics
• Reproductive Health

Background:

• Current guidelines recommend extensive pre-screening consent discussions for prenatal cell-free DNA (cfDNA) screening.
• Patients often avoid in-depth deliberation during consent, especially for average-risk pregnancies.
• Information-heavy consent is impractical in resource-limited settings and often insufficient for patient needs.

Purpose of the Study:

• To propose a shift from traditional extensive consent to a "just-in-time consent" model for prenatal cfDNA screening.
• To align informed consent processes with patient values and actual decision-making needs.
• To improve ethical support for patients receiving screen-positive results.

Main Methods:

• Conceptual framework development for a new consent model.
• Analysis of current practices and ethical considerations in prenatal screening consent.
• Proposal of relocating detailed deliberation and support to the post-screening phase, particularly for positive results.

Main Results:

• The traditional extensive consent model is often ineffective and impractical.
• Screen-positive results frequently lead to distress due to inadequate post-screening support.
• A "just-in-time consent" approach can optimize information delivery and support.

Conclusions:

• A "just-in-time consent" model prioritizes essential pre-screening information and post-result support.
• This approach enhances ethical care by providing resources when families need them most.
• It addresses the limitations of information-heavy consent and improves outcomes for patients undergoing prenatal genetic screening.