The moral life of professionals in newborn screening in the Netherlands: A qualitative study

Abstract

Newborn screening (NBS) involves a complex logistical process, which depends on the close cooperation of many professionals, such as midwives, laboratory technicians, general practitioners and pediatricians. These professionals may encounter moral problems in the process, which have not been systematically studied before. This study fills this gap. We conducted interviews with 36 professionals involved in NBS in the Netherlands and made an inventory of the moral problems they encounter, as well as of the ways in which they tend to respond to them. The moral problems professionals encounter stem from interpersonal conflicts (when a professional's values conflict with those of a colleague or the NBS protocol) and intrapersonal conflicts (when one professional fulfills different roles with conflicting moral commitments, or when a person's professional role and personal moral intuitions clash). Given the complexity of the work of NBS professionals, the study suggests that the moral problems that occur on the work floor cannot easily be solved by means of offering better or more stringent policy guidelines. Rather, it should be appreciated that professionals contribute significantly to shaping the morality of NBS with the help of their daily choices, and they should be supported in carrying out this task-for example with the help of a moral training or regular multidisciplinary moral deliberation, facilitated by an ethicist.