205Activity 9: Rational Decision-Making (Small Group Discussion)
Using one of the following patient scenarios, first go through the Danish and
D’Augelli (1983) decision-making steps, and then discuss how to minimize con-
straining factors.
The patient is coming for genetic counseling because of a family history of indi-
viduals with intellectual deficits. Her maternal uncle and some other maternally
related males are affected. She is terrified of having a baby who is similarly affected
and is adamant that she does not want to be in that situation. She definitely wants
every possible test done on her pregnancy.
OR
A 15-year-old female is 12 1/2 weeks into her first pregnancy (g1P0) and has just
been told that her fetus has gastroschisis. No other anomalies were found on ultra-
sound. The father of the pregnancy is not involved. Her mother has accompanied her
to the clinic. The mother is adamant that the pregnancy must be terminated.
OR
A 32-year-old woman has two sons; both have fragile X syndrome (one mildly
affected, one more severely affected). She wants another child. Her husband is sup-
portive and involved but doesn’t want any more children.
Process
If there is more than one small group, each group can present its decision model to
the other groups. Then the whole group discusses any questions/difficulties they are
having with the model.
Estimated time: 75 min.
Activity 10: Communicating Risk Information (Triads or Small Group
Role-Plays)
Role-play presenting risk information to:
- A 24-year-old prenatal patient with neurofibromatosis who has limited cognitive
skills. She is concerned about her baby. - A 39-year-old prenatal patient with a family history of CF who says, “I don’t
want to hear anything about risks because it scares me. Just tell me what to do.” - A Muslim refugee from Africa in a consanguineous relationship who states that,
“How children turn out is God’s will, and there is no way to predict or prevent
birth defects.” - A 25-year-old woman with a positive family history of breast cancer. Her mother
and maternal grandmother both had breast cancer, diagnosed in their 30s; both