Chapter 9. ‘You may know better than I do’: Negotiating advice-giving in Down Syndrome screening in a Hong Kong prenatal hospital

This paper explores patient-initiated advice during a screening program for Down Syndrome in a Hong Kong hospital. In managing these requests medical providers have to balance the opposing demands of ensuring patient autonomy in decision-making while at the same time responding to patients’ requests for advice. Using discourse analysis we demonstrate that medical providers take a more or less direct stance depending on whether these requests are framed as (i) explicit advice-seeking about what test to take, or (ii) information-seeking about the screening program. In order to capture the complexities of how advice-giving is managed interactionally, 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.