Ethical aspects arising from non-invasive fetal diagnosis

Abstract

Non-invasive prenatal diagnosis (NIPD) could significantly change the framework for testing and screening in pregnancy. This chapter reviews the ethical implications of this technology, including current issues in prenatal diagnosis, implications for informed consent, possible non-medical uses and options for regulation. The prospect of NIPD normalising screening and termination in pregnancy is raised as a concern. NIPD will also require monitoring to ensure women are making well-informed decisions, given that a risk to the pregnancy is absent. The question of whether NIPD will reduce anxiety needs to be established and the prospect that it will increase terminations on the grounds of disability should be recognised. The offer of NIPD external to any clinical oversight might give rise to wider social sex selection, paternity testing or testing ‘for information’. The value assumptions of these uses of NIPD need to be addressed. Keywords: Ethical issues; Genetic counselling; Informed consent; Mass screening; Prenatal diagnosis; Sex selection