"Simply providing information": Negotiating the ethical dilemmas of obstetric ultrasound, prenatal testing and selective termination of pregnancy

Obstetric ultrasound is key to opposing ways of valuing foetuses, that is, both to the ascription of foetal personhood and to foetal selection and termination of pregnancy. Whilst ultrasound images are increasingly common within the public sphere there has been relatively little public discussion of its role in identifying actual or potential foetal anomaly and the consequences of this. This paper examines how professionals working with obstetric ultrasound encounter, navigate and make sense of the different uses of this technology. Professionals commonly delineate their work (as providing information) from women’s autonomous choices. Emphasising “women’s choice” can obscure consideration of different collective ways of valuing foetuses with anomalies. It can also deflect consideration of the fundamentally ambiguous information that ultrasound can produce. Distinguishing information from choice is underpinned by a questionable fact–value distinction. We describe alternate professional practices which involve questioning these binaries and foregrounding clinicians’ responsibilities for women’s current and future experience. Public discussion of ultrasound’s different roles in valuing foetuses would be enriched if the discourses and practices shaping professionals’ attempts to facilitate ethical decision-making were included for collective consideration.