Is it FASD? And does it matter? Swedish perspectives on diagnosing fetal alcohol spectrum disorders

Abstract

Fetal alcohol spectrum disorders (FASD) is an umbrella term covering a range of conditions related to prenatal alcohol exposure. In Sweden, only the most severe of these conditions, Fetal alcohol syndrome (FAS), is used as a medical diagnosis. The aim of this study was to analyze the Swedish discussion on whether or not FASD conditions (other than FAS) should be actively diagnosed/identified. The data consisted of a webpage material from a FASD interest organization and a report from a Swedish authority. The analysis was informed by Fairclough's critical discourse analysis and strived to pay attention to which discourses that were drawn upon, and how these discourses related to each other, and to a broader social context. The discussions on whether or not FASD should be actively diagnosed/ identified were structured by three main discourses. These were: a scientific discourse, a pragmatic discourse, and an ethical discourse, with the scientific discourse taking a special position, often being present also when other discourses were drawn upon. Taken together, there is not yet any consensus around what the status of the FASD conditions should be in Sweden, neither regarding the usefulness of diagnosing/identifying, nor regarding the causality between prenatal alcohol exposure and FASD.