Ethical challenges in providing noninvasive prenatal diagnosis
- 31 March 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Obstetrics and Gynecology
- Vol. 22 (2), 128-134
- https://doi.org/10.1097/GCO.0b013e3283372352
Abstract
Purpose of review Noninvasive prenatal diagnosis (NIPD) can potentially allow early detection of fetal genetic disorders, sex, other nonmedical traits, and paternity. We review ethical concerns associated with the imminent introduction of this testing. Recent findings There has been inadequate scientific and medical review of some NIPD tests under development or already available as direct-to-consumer products. Test introduction is largely unregulated and this has prompted calls for greater oversight. As a replacement for current prenatal screening and diagnosis, NIPD may not necessarily identify the same spectrum of disorders. Ethicists are also concerned how women can receive adequate pretest counseling and provide a truly informed consent. Widespread use of NIPD for minor disorders, predispositions, sex, normal human variation and paternity could result in a trivialization of pregnancy termination. Other concerns include the equitable access to testing by all population subgroups. NIPD has the potential to significantly reduce the prevalence of some genetic disorders and thereby change public attitudes about the handicapped and their families. Summary Striking the correct balance between providing only worthwhile testing and ensuring individual patients' reproductive choice will be a major challenge and it is important to begin to address the many ethical issues that NIPD raises.Keywords
This publication has 26 references indexed in Scilit:
- Non-invasive prenatal testing: ethical issues exploredEuropean Journal of Human Genetics, 2009
- Trends in Down's syndrome live births and antenatal diagnoses in England and Wales from 1989 to 2008: analysis of data from the National Down Syndrome Cytogenetic RegisterBMJ, 2009
- With new prenatal testing, will babies with Down syndrome slowly disappear?Archives of Disease in Childhood, 2009
- Noninvasive prenatal diagnosis of monogenic diseases by digital size selection and relative mutation dosage on DNA in maternal plasmaProceedings of the National Academy of Sciences of the United States of America, 2008
- Noninvasive diagnosis of fetal aneuploidy by shotgun sequencing DNA from maternal bloodProceedings of the National Academy of Sciences of the United States of America, 2008
- Ethical aspects arising from non-invasive fetal diagnosisSeminars in Fetal and Neonatal Medicine, 2008
- Detection of Aneuploidy with Digital Polymerase Chain ReactionAnalytical Chemistry, 2007
- Plasma placental RNA allelic ratio permits noninvasive prenatal chromosomal aneuploidy detectionNature Medicine, 2007
- Down syndrome births in the United States from 1989 to 2001American Journal of Obstetrics and Gynecology, 2004
- Quantitative Analysis of Fetal DNA in Maternal Plasma and Serum: Implications for Noninvasive Prenatal DiagnosisAmerican Journal of Human Genetics, 1998