The Two Clocks: Diagnosis, Prognosis, Relational Time, and Crip Time Following a Prenatal Diagnosis of Trisomy 18
Abstract
Bruce H. Knox
Prenatal diagnosis of Trisomy 18 is commonly accompanied by clinical counselling focused on fetal loss, neonatal mortality, congenital anomalies, and anticipated disability. Such information is necessary for informed decision-making. However, families who continue pregnancies affected by Trisomy 18 often describe a second narrative in which time is understood not only through prognosis but through attachment, belonging, care, memory-making, and love. This reflective medical humanities paper examines these two temporal frameworks: the clinical clock and the relational clock. Drawing on parental-experience literature, perinatal palliative care, disability studies, and the concept of “crip time,” it argues that ethical prenatal counselling requires integrating prognostic realism with recognition of relational meaning. Medicine measures duration and risk; families also experience presence, identity, and enduring bonds. Both forms of time should be present in compassionate prenatal counselling.