Netherlands: Non-invasive prenatal diagnosis for aneuploidy: toward an integral ethical assessment

From Human Reproduction. 

The authors argue that the great promise of the pending introduction of non-invasive prenatal diagnosis (NIPD) for trisomy 21 (18 and 13) is that it enables one-step, early and safe testing for these abnormalities. The ethical debate so far has been limited to possible drawbacks of routine access to this type of testing: normalisation of testing and abortion and adverse effects on autonomous decision-making.

The authors address the ethical implications of the fact that routine NIPD affects the scope and strategy of current prenatal screening cascades. A decision is needed whether complementary (invasive) testing remains in place in order to avoid a loss of information as compared with current practice. If so, the supposed advantages of NIPD may be less significant than generally assumed. Accumulation of tests challenges informed consent and proportionality. Therefore, an ethical evaluation of the implications of NIPD for the prenatal screening strategy as a whole is needed.

Faculty of Health, Medicine & Life Sciences, Department of Health, Ethics & Society, and GROW, School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands/Centre for Society and Genomics, Nijmegen, The Netherlands.

Non-invasive prenatal diagnosis for aneuploidy: toward an integral ethical assessment. de Jong A, Dondorp WJ, Frints SG, de Die-Smulders CE, de Wert GM. Human Reproduction. 2011 Nov;26(11):2915-7. Epub 2011 Aug 12.