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To date, studies assessing whether the information given to people about screening tests facilitates informed choices have focussed mainly on the UK, US and Australia. The extent to which written information given in other countries facilitates informed choices is not known. The aim of this study is to describe the presentation of choice and information about Down's syndrome in written information about prenatal screening given to pregnant women in five European and two Asian countries. Leaflets were obtained from clinicians in UK, Netherlands, Spain, Italy, Czech Republic, China and India. Two analyses were conducted. First, all relevant text relating to the choice about undergoing screening was extracted and described. Second, each separate piece of information or statement about the condition being screened for was extracted and then coded as either positive, negative or neutral. Only Down's syndrome was included in the analysis since there was relatively little information about other conditions. There was a strong emphasis on choice and the need for discussion about prenatal screening tests in the leaflets from the UK and Netherlands. The leaflet from the UK gave most information about Down's syndrome and the smallest proportion of negative information. By contrast, the Chinese leaflet did not mention choice and gave the most negative information about Down's syndrome. Leaflets from the other countries were more variable. This variation may reflect cultural differences in attitudes to informed choice or a failure to facilitate informed choice in practice. More detailed studies are needed to explore this further.

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Objective  Informed choice has become an integral part of healthcare provision. We investigated the extent to which informed choice in the context of prenatal testing is universally valued. Design  The value attached to parental choice in prenatal testing and the perceived importance of significant others’ views when making test decisions were assessed in a cross‐sectional, descriptive study. Sample and setting  Male and female participants from general population samples in six countries: the UK (n = 210), the Netherlands (n = 197), Italy (n = 200), Greece (n = 200), China (n = 200) and India (n = 199). Methods  The questionnaires assessed values attached to parental involvement and the perceived importance of the views of significant others when making prenatal test decisions. Main outcome measures  Attitudes towards parental choice and attitudes towards the importance of others’ views were analysed by age, gender and education using Chi‐squared tests, Analysis of Variances and multiple logistic regression. Results  The majority of respondents from Northern European countries believed that undergoing prenatal tests should reflect parental choice. Conversely, only a minority of respondents from Southern European and Asian countries advocated parental choice, with most expressing the belief that all pregnant women should have the procedure. The perceived importance of significant others’ views when making test decisions also varied across countries: those in favour of parental choice perceived others’ views as less important in the test decision. A preference for prenatal testing decisions to reflect an informed choice was predicted by (i) country and (ii) the perceived importance of significant others’ views. Education, age and gender did not predict decisions. Conclusion  The implications of these findings for policy and practice depend upon whether placing a low value on parental choice, but a high value on the others’ views regarding prenatal testing is considered an informed choice. Further research is needed to determine whether cultural variation in values remains significant in a multicultural society.

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