Medical purposes or “purely for information”? The potential applications of non-invasive prenatal testing.

A paper by Deans et al., (2015) offers an alternative viewpoint into ethics considerations surrounding non-invasive prenatal testing (NIPT). NIPT has been developed to detect cell-fetal free DNA in maternal blood. NIPT is more accurate than current screening methods and does not carry the risk of miscarriage associated with invasive diagnostic tests that are currently used within the NHS. Some couples may seek NIPT in order to make important decisions about the future of the pregnancy or to prepare for life with a child with a particular condition. Deans et al., (2015) considers the possibility of NIPT being used by parents “purely for information”, rather than for medical reasons.

NIPT has been used for fetal sex determination “purely for information” purposes and has already been used to sequence the whole genome of a fetus. The paper suggests that women may associate a lesser risk with NIPT since the risk of miscarriage is removed, although both NIPT and invasive tests detect the risk of abnormalities in the fetus. If choosing a test “purely for information” purposes women may deem NIPT as an “easier decision”. If only offered invasive testing women may think twice due to the risk to the pregnancy. In their desire for information about the baby parents may oversee the implications of NIPT, and may be unprepared for unexpected adverse results. It is important that healthcare professionals counsel women in the same way for NIPT as invasive testing as both tests carry the same diagnostic implications.

NIPT offers the opportunity for testing the presence of multiple disorders and will have the ability to reveal adult-onset conditions. Whilst parents may cite “preparation” for testing for both child and adult onset conditions, Deans et al., (2015) highlight that if parents are screening “purely for information”, with no intention to terminate the pregnancy, then they have to consider that the child may not want to know their susceptibility to a condition. Should it be the parent’s choice to decide whether a child knows the course of their future? A child is likely to feel anxiety knowing that they face a future with a particular condition. Not knowing and continuing their life without this weight on their shoulders may be preferable-ignorance is bliss.

The cost of introducing NIPT into the NHS has been widely discussed. Deans et al., (2015) note that if used “purely for information”, rather than for medical reasons, then NIPT would have great cost implications for the NHS.

Once technology is simplified, Deans et al., (2015) predict that the demand for NIPT will increase. These advancements will allow endless possibilities of choice for parents, it may be difficult to determine where to draw the line and could result in parents testing out of curiosity, rather than for medical reasons. The availability of such tests could provide the option to terminate pregnancy for minor conditions, thereby tampering with the course of nature.

 

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