Experiential knowledge of disability, impairment and illness: The reproductive decisions of families genetically at risk

Health (London). 2014 Sep;18(5):476-92. doi: 10.1177/1363459313507588. Epub 2013 Nov 6.

Abstract

As the capacities of Reproductive Genetic Technologies expand, would-be parents face an increasing number of reproductive decisions regarding testing and screening for different conditions. Several studies have acknowledged the role that 'experiential knowledge of disability' plays in arriving at decisions around the use of these technologies; however, there is a lack of clarity within this literature as to what constitutes 'experiential knowledge of disability' and an over-reliance on medical diagnoses as a shorthand to describe different types of experience. Drawing on both social model of disability theory and the literature on chronic illness, this article presents an analysis of data from an in-depth qualitative interview study with 64 people with an inheritable condition in their family, Spinal Muscular Atrophy, and reports their views around reproduction and Reproductive Genetic Technologies. An experiential typology is presented which demonstrates the way in which experiences of 'disability', 'embodied experiences of impairment' or 'embodied experiences of illness, death and bereavement' are strategically privileged in accounts of reproductive decisions, in order to validate reproductive decisions taken, and, specifically, justify use (or non-use) of Reproductive Genetic Technologies. By highlighting the experiential categories within which participants embedded their reproductive decisions, this article draws attention to the porous and collapsible nature of diagnostic categories in the context of reproductive decision-making and genetic risk, and suggests new ways of researching 'experiential knowledge of disability' within these contexts which are able to account for the various contours of the embodied lived reality of life with 'disability'.

Keywords: bioethics; chronic illness and disability; experiential knowledge; genetics; spinal muscular atrophy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Decision Making*
  • Female
  • Genetic Predisposition to Disease*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • Male
  • Muscular Atrophy, Spinal / genetics*
  • Reproductive Behavior / psychology*
  • Risk Factors
  • United Kingdom