Prenatal genetic screening in Hong Kong as a site for activity analysis: re-establishing the importance of participant structure in intercultural encounters

Abstract

In this paper we draw on the notion of activity type and examine Prenatal Genetic Screening (PGS) in Hong Kong. Activity type is defined as ‘a fuzzy category whose focal members are goal-defined, socially constituted, bounded events with constraints on participants, settings, […and] the kind of allowable contributions’ (Levinson, 1992). While previous studies suggest that the structure and goals constitute prime components of activity type, we maintain that in intercultural encounters, participation structure takes precedence over other components and has a direct impact on how the activity is realized discursively. In our study of PGS clients come from diverse backgrounds. The structure of PGS activity varies accordingly: for example, Filipina clients, predominantly Catholic, often come with a ‘pre-made’ decision not to undergo genetic screening and maintain their pregnancy regardless of the genetic diagnosis. This makes the information-delivery redundant, and the healthcare providers manage these decisions in order to ensure that the clients understand their implications. The goals of PGS also vary depending on the clients‘ socioeconomic background. With migrant workers who attend PGS on their own and lack the immediate familial support in Hong Kong, healthcare providers often have to manage explicit advice-seeking to ensure that the decision reflects the clients‘ values. The complexity of participation structure presents challenges to the healthcare providers who balance meeting the institutional goals of PGS and the clients‘ concerns. Our analysis re-establishes the importance of participation structure in intercultural encounters and sheds lights on some of the challenges that participants of these encounters face.