Printing Unrealistic Expectations: A Closer Look at Newspaper Representations of Noninvasive Prenatal Testing

Abstract

Background: Informed consent is one of the major ethical issues raised in conversations about prenatal genetic testing, and understanding of the risks and benefits is a key component of informed consent. Because newspapers help translate complex scientific developments into understandable, practical insights, they can influence understanding of prenatal genetic testing outside of the clinical encounter. We assess the extent to which newspaper articles address concerns about accurately portraying cell-free fetal DNA testing and discuss how they create what we consider to be unrealistic expectations about this methodology. Methods: LexisNexis Academic was searched for United States-based newspapers to identify articles including discussion about cell-free fetal DNA testing for Down syndrome. This broad search yielded 447 articles. Two independent coders reviewed these articles for adherence to a specific set of inclusion criteria, and discrepancies were reconciled through consensus. Articles meeting the inclusion criteria (n = 23) were analyzed in terms of how they portrayed noninvasive prenatal testing. Results: Newspaper articles more often described the benefits of testing than the harms, suggesting to the reader that the benefits outweigh the risks. Many articles poorly explained costs and financial implications of testing as well as numerical evidence about accuracy, Down syndrome birth prevalence, and termination rates following prenatal diagnosis. While most articles included discussion or quotes where scientists and clinicians serve as experts, they sometimes insufficiently disclosed these experts’ relevant conflicts of interest. None of the articles included parents of adults with Down syndrome or those who choose to terminate pregnancies following prenatal diagnosis as external sources. Conclusions: We contend that newspaper framing of noninvasive prenatal testing is problematic, especially for the average health care consumer who may consider its clinical application. Ultimately, these representations may leave consumers with unrealistic expectations about such emerging technologies. Because of media influence on public understanding about noninvasive prenatal testing, readers must be critical of the information that media present, and clinicians should assess patient understanding at decision-making points in prenatal care.