Communicating about chromosomes: patients, providers, and cultural assumptions.

Field-based anthropological research on the social impact and cultural meaning of prenatal diagnosis suggests four factors that contribute to multicultural patient-provider miscommunication. These are: 1) the detection of fetal mental retardation, particularly Down syndrome, is not always an appropriate reason to test; 2) the statistical information on age-related risk rates for chromosome abnormality may appear small when compared to more pressing vulnerabilities faced by poor and/or immigrant pregnant women and their families; 3) variation in individual reproductive histories and social values strongly shape acceptance and rejection of the test; and 4) most controversially, not everyone accepts the burdens of individual choice.