'Ultrasound is an invaluable third eye, but it can't see everything' : a qualitative study with obstetricians in Australia

Background: Obstetric ultrasound has come to play a significant role in obstetrics since its introduction in clinical care. Today, most pregnant women in the developed world are exposed to obstetric ultrasound examinations, and there is no doubt that the advantages of obstetric ultrasound technique have led to improvements in pregnancy outcomes. However, at the same time, the increasing use has also raised many ethical challenges. This study aimed to explore obstetricians' experiences of the significance of obstetric ultrasound for clinical management of complicated pregnancy and their perceptions of expectant parents' experiences. Methods: A qualitative study was undertaken in November 2012 as part of the CROss-Country Ultrasound Study (CROCUS). Semi-structured individual interviews were held with 14 obstetricians working at two large hospitals in Victoria, Australia. Transcribed data underwent qualitative content analysis. Results: An overall theme emerged during the analyses, 'Obstetric ultrasound - a third eye', reflecting the significance and meaning of ultrasound in pregnancy, and the importance of the additional information that ultrasound offers clinicians managing the surveillance of a pregnant woman and her fetus. This theme was built on four categories: I:'Everyday-tool' for pregnancy surveillance, II: Significance for managing complicated pregnancy, III: Differing perspectives on obstetric ultrasound, and IV: Counselling as a balancing act. In summary, the obstetricians viewed obstetric ultrasound as an invaluable tool in their everyday practice. More importantly however, the findings emphasise some of the clinical dilemmas that occur due to its use: the obstetricians' and expectant parents' differing perspectives and expectations of obstetric ultrasound examinations, the challenges of uncertain ultrasound findings, and how this information was conveyed and balanced by obstetricians in counselling expectant parents. Conclusions: This study highlights a range of previously rarely acknowledged clinical dilemmas that obstetricians face in relation to the use of obstetric ultrasound. Despite being a tool of considerable significance in the surveillance of pregnancy, there are limitations and uncertainties that arise with its use that make counselling expectant parents challenging. Research is needed which further investigates the effects and experiences of the continuing worldwide rapid technical advances in surveillance of pregnancies.

Essentialism i religionsundervisningen : Ett religionsdidaktiskt problem

Essentialist concepts of religion are common in the teaching of religion in schools and to a certain extent also in the academic discipline of religious studies. In this article, a number of problems with essentialist perceptions of religion are discussed. In the first part of the article a thesis is maintained, according to which essentialist conceptions of religion or specific religions are too limited to be of value in the teaching of religion. This is done through examples of essentialist expressions about religion. The examples are grouped according to a typology of different kinds of essentialism. Two main categories, each with two sub-categories are identified. Thus, the category of essentialism regarding the substance of religion is divided into transcendental or theological essentialism (which presupposes the existence of a sacred power of some kind, the experience of which is the basis for religion), and core essentialism (where it is presupposed that certain ideas or concepts constitute religion as a general category or specific religions). Likewise, the category of essentialism regarding the function of religion has two sub-categories: positive and negative essentialism. These kinds of essentialism presuppose that religion or specific religions are inherently good or harmful respectively to human beings. Examples from each of these categories are given and discussed. In the second part of the article, Benson Saler’s open concept of religion is presented as an alternative to essentialist or bounded perceptions. It is based on Ludwig Wittgenstein’s idea of family resemblances and on prototype theory. In connection with this, it is argued that a certain kind of conscious ethnocentrism is needed as a point of departure in the study and teaching of religion. The metaphor of education as a journey from the familiar out into the unfamiliar and back again is suggested as a possible pattern for such teaching. Finally,some examples of non-essentialist ways to introduce religions are offered.