Globalization and the increasing mobility of the workforce have led to an increasingly multicultural professional landscape worldwide. In this talk I outline my research in two multicultural professional settings in Hong Kong, healthcare and business, and highlight some critical themes that my research has addressed in the last few years. I then examine one specific healthcare context, prenatal screening, that is an information-giving service about testing for fetal abnormalities provided to all pregnant women in Hong Kong and in most countries worldwide. I focus on the critical theme of decision-making which in prenatal context refers to choosing whether to pursue the testing or whether to opt out of it, and explore the impact of participants’ diverse cultural backgrounds on the decision-making trajectories in these encounters.
While a small body of previous sociological research in other healthcare settings suggests that healthcare professionals may contribute to decision-making in different ways depending on the backgrounds of their clients, this research has primarily employed ethnographic methods, and focused on the outcomes of healthcare encounters. The observations of these studies, however, are of particular interest in the context of prenatal screening in light of the nondirective approach that has been advocated for the professional practice that calls for empowering the women to make their own decisions and withholding professional imposition. In my research I draw on the extensive corpus of more than 120 video-recorded prenatal screening consultations involving professionals and clients of diverse backgrounds; and using discourse analytic methods examine the actual decision-making processes.
Findings suggest that both professionals and clients may be directive in decision-making (Zayts et al., 2012; Zayts 2013) and bring sociocultural factors as a rationale for withholding/ refusing or promoting/ accepting testing. Once these factors have been raised, the extent to which they impact decision-making trajectories differs (Pilnick & Zayts, 2011; 2012). Through my analysis I show that in order to capture the complexities of how decision-making is managed interactionally in prenatal screening, it is crucial to understand the specific constraints and ideologies that characterize the institutional and the socio-cultural context in which these interactions take place. I conclude by discussing the social and ethical implications of my research for professional practice.
Pilnick, A. & Zayts, O. (2012) “Let’s have it tested first”: Choice and circumstances in decision-
making following positive antenatal screening in Hong Kong. Sociology of Health and Illness, 34 (2): 266-282. [also published in N. Armstrong & H. Eborall (eds.) (2012) The Sociology of Medical Screening: Critical Perspectives, New Directions. 1st edition. Blackwell Publishing Ltd., pp. 105-120.]
Zayts, O. (2013) Genetic counseling in multilingual and multicultural contexts. In H. Hamilton & W.-Y. Chou (eds.). Handbook on Language and Health Communication. Routledge.
Zayts, O., Wake, V.Y. & Schnurr, S. (2012) Chinese prenatal genetic counseling discourse in
Hong Kong: Health care providers’ (non)directive stance, or who is making the decision. In Y. Pan & D. Gazdar (eds.) Chinese Discourse and Interaction: Theory and Practice. London: Equinox, pp. 228-247.