The medical decision-making literature has paid scant attention to how prior expectations of patients and clinicians can influence medical encounters and affect patients’ choices whether to accept or reject medical testing or treatment. To illuminate the issue, we offer a reflexive analysis of the experiences of a Mexican-American couple offered amniocentesis based on the woman’s age and prior pregnancy history. We examine the impact of three principal factors: incongruity between expectations and reality for both patient and clinicians; the actors’ ethnic backgrounds; and the history and nature of relationship dynamics between the patient and her male partner. We conclude that unmet expectations on the part of both patient and clinicians evoked powerful emotions that altered the woman’s previous intention to agree to amniocentesis.
American College of Obstetricians and Gynecologists . (1996). Maternal serum screening . International Journal Gynaecology and Obstetrics, 55, 299–308 .
2.
Averill, J. R. (1992). The structuralbases of emotional behavior: A metatheoretical analysis. In M. S. Clark (Ed.), Emotion – Review of personality and social psychology (pp. 1–24). Newbury Park, CA: Sage .
3.
Balzano, S. , Preloran, M. , & Browner, C. (2002). El protocolo médico como una forma de performance cultural: La neutralidad profesional y su efecto en la vida de los pacientes y sus familias . Revista de Investigaciones Folclóricas, 17, 145–155 .
4.
Barrett, R. J. (1996). The psychiatric team and the social definition of schizophrenia: An anthropological study of person and illness. Cambridge: Cambridge University Press .
5.
Behar, R. (1993). Translated woman: Crossing the border with Esperanza’s story. Boston: Beacon Press .
6.
Behar, R. , & Gordon, D. A. (1995). Women writing culture. Berkeley: University of California Press .
7.
Bernard, H. R. (2002). Research methods in anthropology: Qualitative and quantitative approaches (3rd ed.). Walnut Creek, CA: Alta Mira Press .
8.
Browner, C. H. , & Preloran, H. M. (1999). Male partners’ role in Latinas’ amniocentesis decisions . Journal of Genetic Counseling, 8(2), 85–107 .
9.
Browner, C. H. , Preloran, H. M. , & Cox, S. J. (1999). Ethnicity, bioethics and prenatal diagnosis: The amniocentesis decisions of Mexican-origin women and their partners . American Journal of Public Health, 89, 1658–1666 .
10.
Clark, C. (1990). Emotions and micropolitics in everyday life: Some patterns and paradoxes of ‘place’. In T. D. Kemper (Ed.), Research agendas in the sociology of emotions. SUNY series in the sociology of emotions (pp. 305–333). Albany: State University of New York Press .
11.
Coreil, J. , & Marshall, P. (1982). Locus of illness control: A cross-cultural study . Human Organization, 41(2), 131–138 .
12.
Crandall, B. F. , Robertson, R. D. , Lebherz, T. B. , King, W. , & Schroth, P. C. (1983). Maternal serum alpha feto protein screening for the detection of neural tube defects . Western Journal of Medicine, 138, 524–530 .
13.
Cunningham, G. (1998). Evaluation of California’s public/private maternal serum screening program . Paper presented at the 9th International Congress on Prenatal Diagnosis and Therapy, June 11, Los Angeles, CA.
14.
Damasio, A. R. (1994). Descartes’ error: Emotion, reason, and the human brain. New York: Grosset/Putnam Book .
15.
Denzin, N. K. , & Lincoln, Y. S. (1994). Handbook of qualitative research. Thousand Oaks, CA: Sage .
16.
Ettorre, E. (1999). Experts as ‘storytellers’ in reproductive genetics: Exploring key issues . Sociology of Health & Illness, 21, 539–559 .
17.
Ettorre, E. (2002). Reproductive genetics, gender and the body. London: Routledge .
18.
Flores, G. , Laws, B. , Mayo, S. , Zuckerman, B. , Abreu, M. , Medina, L. , & Hardt, E. J. (2003). Errors in medical interpretation and their potential clinical consequences in pediatric encounters . Pediatrics, 111(1), 6–14 .
19.
Freiden, R. B. , Goldman, L. , & Cecil, R. R. (1980). Patient–physician concordance in problem identification inthe primary care setting . Annals of Internal Medicine, 93, 490–493 .
20.
Glaser, B. G. , & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine .
21.
Green, J. M. (1990). Calming or harming? A critical review of psychological effects of fetal diagnosis on pregnant women. Galton Institute Occasional Papers, Second Series, No. 2.
22.
Grieshop, J. (1997). Transitional and transformational: Mixtec immigration and health beliefs . Human Organization, 56, 400–407 .
23.
Hochschild, A. R. (1990). Ideology and emotion management: A perspective path. In T. D. Kemper (Ed.), Research agendas in the sociology of emotions. SUNY series in the sociology of emotions (pp. 117–142). Albany: State University of New York Press .
24.
Lantz, P. M. , & Booth, K. M. (1998). The social construction of the breast cancer epidemic . Social Science & Medicine, 46, 907–918 .
25.
Lawler, E. J. , & Thye, S. R. (1999). Bringing emotions into social exchange theory . Annual Review of Sociology, 25(1), 217–244 .
26.
Lazarus, E. S. (1988). Theoretical considerations for the study of the doctor–patient relationship: Implications of a perinatal study . Medical Anthropology Quarterly, 2(1), 34–58 .
27.
Lerner, J. , & Keltner, D. (2000). Beyond valence: Toward a model of emotion: Specific influences on judgment and choice . Cognition and Emotion, 14, 473–493 .
28.
Lerner, J. , & Keltner, D. (2001). Fear, anger, and risk . Journal of Personality and Social Psychology, 81(1), 146–159 .
29.
Levy, R. I. , & Hollan, D. (1998). Person-centered interviewing and observation in anthropology. In H. R. Bernard (Ed.), Handbook of research methods in anthropology (pp. 333–364). Walnut Creek, CA: AltaMira Press .
30.
McGuigan, F. J. (1999). Encyclopedia of stress. Boston: Allyn & Bacon .
31.
Michie, S. , Marteau, T. , & Bobrow, M. (1997). Genetic counseling: The psychological impact of meeting patients’ expectations . Journal of Medical Genetics, 34, 237–241 .
32.
Nsiah-Jefferson, L. (1993). Access to reproductive genetic services for low-income women and women of color . Fetal Diagnosis and Therapy, 8 (Suppl. 1), 107–127 .
33.
Preloran, H. M. , Balzano, S. , & Browner, C. H. (2003). The role of trust and cross-cultural miscommunication in clinical decision-making . Californian Journal of Health Promotion, 1(2), 198–207 .
34.
Rao, J. K. , Weinberger, M. , & Kroenke, K. (2000). Visit-specific expectations and patient-centered outcomes: A literature review . Archives of Family Medicine, 9, 1148–1155 .
35.
Rapp, R. (1998). Refusing prenatal diagnosis: The meaning of bioscience in a multicultural world . Science, Technology & Human Values, 23, 45–70 .
36.
Rapp, R. (2000). Testing women, testing the fetus: The social impact of amniocentesis in America. New York: Routledge .
37.
Rhodes, L. A. (1991). Emptying beds: The work of an emergency psychiatric unit. Berkeley: University of California Press .
38.
Roter, D. , & Hall, J. (1992). Doctors talking with patients/patients talking with doctors. Westport, CT: Auburn House .
39.
Rothman, B. K. (1998a). Genetic maps and human imagination. New York:Norton .
40.
Rothman, B. K. (1998b). A sociological skeptic in the brave new world . Gender and Society, 12, 501–504 .
41.
Sanchez-Menegay, C. , & Stadler, H. (1994). Do physicians take into account patient expectations?Journal of General Internal Medicine, 9, 404–406 .
42.
Taylor, S. J. , & Bogdan, R. (1998). Introduction to qualitative research methods: A guidebook and resource (3rd ed.). New York: Wiley .
43.
Triandis, H. C. , Marín, G. , Lisansky, J. , & Betancourt, H. (1984). Simpatía as a cultural script of Hispanics . Journal of Personality and Social Psychology, 47, 1363–1375 .
44.
Wang, V. O. (1998). Introduction to special issue on multicultural genetic counseling . Journal of Genetic Counseling, 7(1), 3–13 .
