Why object to improving prenatal tests?

The Daily Mail reports this week on a new blood test to detect
conditions such as Down syndrome or cystic fibrosis in fetuses. The
article raises concerns about ‘designer babies’. Yet given the recent
concern
about the risk of miscarrying normal fetuses with current
screening procedures for Down syndrome why isn’t the Daily Mail
welcoming these tests?

The tests reported in the Mail are not completely new. There have been reports about them in scientific articles and in the popular press for some time, though they are yet to enter routine use. They involve a blood test in the mother that is able to detect and analyse microscopic amounts of DNA material from the fetus (so-called “free fetal DNA”). One advantage of these tests is that certain conditions are able to detected much earlier during the pregnancy than they would otherwise. And this sort of ‘non-invasive prenatal test’ involves no risk whatsoever to the mother or fetus, unlike traditional forms of prenatal testing like amniocentesis or chorionic villus sampling. The conditions in the fetus that can be detected by non-invasive prenatal testing are exactly the same as those that can be detected using current methods. So what is the fuss about?

Will non-invasive prenatal tests lead to ‘designer babies’ as the Mail suggests? It is not clear exactly what this claim means. There is a general intuition that there is something wrong with the idea of ‘designing’ children. However these tests, whether performed invasively or non-invasively do not permit parents to alter or modify their fetuses. So they are not “designing” their babies in the way that an architect designs a house, they are not deliberately selecting and combining the characteristics of their future child. Instead prenatal testing allows parents to reject certain designs after the architect has drawn them and started the building of the house. If we think that there is something wrong with designing babies, our target should be genetic engineering, not prenatal testing.

Many people, whether they support or oppose abortion, think that there is something more morally serious about abortion that takes place later in pregnancy than earlier in pregnancy. So a change to prenatal tests that would allow mothers to terminate pregnancies earlier rather than later should be something that would be widely acceptable.

Yet the Daily Mail reports that pro-life organizations are opposed to non-invasive prenatal tests. One reason for their concern may be that providing easier and safer prenatal tests will encourage more mothers to undertake prenatal testing, and so lead to more terminations of pregnancy. This may be a genuine consequence of the change in prenatal tests, though if we think that it is legitimate for parents to test for conditions in the fetus and terminate their pregnancy, there is no reason to think that it would be a problem if more mothers did this. Secondly if, as some have claimed, non-invasive tests lead to the death of a large number of normal fetuses, the increase in terminations would be offset by a reduction in miscarriage. Given that many opponents of abortion believe that the embryo has moral significance from conception, they also should support a change to prenatal testing that would eliminate the risk of miscarriage that is associated with invasive prenatal tests.

Non-invasive prenatal tests should be supported for a number of reasons. If mothers are going to be permitted to terminate their pregnancies we should support medical advances that will give them better and safer ways to get the information that they need to make a choice. 

New blood test to spot Down’s syndrome at seven weeks leads to designer babies fear Daily Mail 24/9/08

Testing choices: weighing up risks of death and Down syndrome for fetuses Practical ethics News 15/9/08

 

New Down’s Syndrome test has lower miscarriage risk Daily Mail 1/2/07

Aust N Z J Obstet Gynaecol. 2003 Feb;43(1):10-5

3000 needless miscarriages Daily Mail 16/08/2007

Ethical aspects arising from non-invasive fetal diagnosis Seminars in Fetal and Neonatal Medicine 2008 Ainsley Newson

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