Prenatal Genetic Testing Ethics
Prenatal genetic testing has become a fairly common practice offered to pregnant women in the United States. Testing can detect genetic abnormalities, such as Down Syndrome, Trisomy 18, and Trisomy 13. Trisomies occur when a fetus has an extra copy of a chromosome. Extra chromosome are usually not compatible with life, and the children die shortly after birth. Prenatal genetic testing informs women about any potential genetic issues, which allows them to make educated decisions about the future of their child. However, prenatal genetic testing is accompanied by several controversial ethical issues and moral concerns.
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Genetic Testing
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Prenatal genetic tests are invasive procedures. As opposed to prenatal genetic screening, which requires a simple blood test, genetic testing requires that a needle be inserted through the stomach into the uterus to obtain a direct sample of the amniotic fluid. Chronic Villi Sampling, or CVS, is an invasive prenatal genetic test that involves inserting a needle into the uterus and obtaining a sample of the placenta to test for any genetic diseases. CVS is offered about 12 weeks into the pregnancy. Amniocentesis is offered later in the pregnancy. It is similar to CVS, except that the amniotic fluid, rather than the placenta, is sampled. Therefore, genetic screening is usually offered first. Based on the probabilities of genetic diseases shown on the genetic screening, women decide whether or not they wish to pursue genetic testing.
The Abortion Issue
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Many oppose prenatal genetic testing because it prompts many women to opt for abortion if it is determined that their child has Down Syndrome or any other genetic disease. Opponents of genetic testing argue that these genetic tests simply promote abortion. However, many women choose not to terminate the pregnancy even if they find out their child has a disorder. Rather, this testing educates the mother on the state of her child and allows her to make proper decisions and preparations for the future to ensure that her child will be properly accommodated.
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Gender Selection
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Many believe that prenatal genetic testing will inevitably lead to designing babies. Some clinics have already offered parents the ability to select for the eye color and the gender of the baby. However, these procedures are extremely expensive and are offered at very few institutions. The purpose of prenatal genetic testing is to educate the mother on any genetic disease her baby may have so see can make informed decisions about the pregnancy and make any necessary accommodations after the baby is born. Prenatal genetic testing does not endorse gender selection.
Wrongful Death Lawsuits
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Prenatal genetic testing is not perfect. CVS and amniocentesis come with a chance of miscarriage. The chance of a miscarriage is about 1 in 300 for amniocentesis and 1 in 200 for CVS. Therefore, these invasive procedures are not recommended for patients unless prenatal genetic screening shows a need for the test. Screening involves a simple finger-prick blood test and gives a chance of a certain genetic disease based on the blood test, mother's age and an ultrasound. For instance, a screening result may state that the child has a 1 in 100 chance of having Down Syndrome. Thus, genetic testing is only offered if the chance of a genetic disease is greater than the chance of a miscarriage from the test or if the mother has a history of genetic diseases. The wrongful death lawsuits that ensue from a miscarriage caused by genetic testing are extremely rare. Physicians performing the procedures have years of experience and take every precaution to be safe. Many miscarriages result from the mother failing to heal properly after the test, rather than the incompetence or wrongdoing of the physician.
No Cure
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Many oppose prenatal genetic testing because there is usually no cure if a genetic disease is discovered. Therefore, there seems to be no need for testing other than to depress the mother or promote the abortion of sick babies. However, genetic testing allows parents to prepare for life with a sick child after birth. For instance, many parents who find that their unborn child is diagnosed with Down Syndrome make special accommodations to care for the child after birth. They find trained caretakers and make arrangements at nurseries for children with Down Syndrome. Furthermore, testing allows parents to come to terms with the situation and accept life with a child with a genetic disease prior to birth. Although many parents choose to abort the baby if it is found that it has a genetic disease, that is the mother's right according to the laws of many states.
Insurance Problems
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A major issue with genetic testing is that it may have ramifications on medical insurance. If it is found that a woman has a history of conceiving children with genetic disorders, she may be denied medical insurance or offered higher rates. Since genes are passed from parent to offspring, an individual's genetic blueprint may have an impact on the medical insurance of close relatives. Thus, many opt to skip genetic testing due to this fear.
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References
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