Ethics at the Beginning of Life: Prenatal Genetic Testing
Linda Field Despain
Submitted to Dr. Mark Jumper in partial fulfillment of
HCE430, Health Care Ethics
October 13, 2012
Prenatal Genetic Testing
Prenatal testing and genetic testing developed hand in hand. Many genes, the basic unit of heredity, are now known through the human genome project (Pence, 2011, pp. 273-274). Genetic testing can identify the existence of genes that carry potentially life impacting and threatening conditions. However, prenatal genetic testing can determine much more than simply the abnormalities or negative factors. It can indicate sex, hair and eye color, temperament, strength, and other tendencies within the womb. The knowledge of these predispositions can be used to select embryos with certain characteristics. At worst prenatal genetic testing can be used to apply discriminatory selective tactics or a process known as eugenics. Because of this, prenatal genetic testing should be limited to testing for diseases, birth defects, chromosomal abnormalities, or genetic diseases and should be regulated to not allow abuse of screening for non-disease conditions, such as selection for sex and for eugenic purposes. Comprehensive Description
Every parent-to-be anticipates a healthy baby, but it can be hard not to worry about the unknown. Genetics, “the study of… the way traits are passed down from one generation to another” (CDC, 2003, pp.1-8), is one way we try to assuage this fear. Fortunately, the application of diagnostic technologies in the form of prenatal genetic tests can help reassure and provide information throughout pregnancy. For the purpose of this paper, prenatal genetic testing is any investigation for a genetic disease or condition in an embryo, fetus, or baby before it is born, regardless of aim. The intention may be to detect birth defects, chromosomal abnormalities, or genetic diseases; to identify possibilities of adult-onset disease; to determine or select sex; or to identify desirable characteristics such eye color, temperament, intelligence, or strength.
Genetic testing came into wide use with the development of prenatal testing. Genetic testing can extend prenatal testing by focusing on diseases associated with specific genes which are inherited disorders. “Genetic diseases are inherited disorders” (Pence, 2011, pp.273-274). Traits can also be inherited, and non-disease or non-clinical attributes such as sex, hair color, and height can be screened for. Patients request tests for a variety of reasons, some simply want to know, others need to relieve anxieties, some select certain traits, and others just want to be prepared for any type of post-delivery issues. While this might seem benign, prior to modern day prenatal genetic testing, Social Darwinism and eugenics attempted to actually weed out traits from population. The selection of these traits was made by mindsets that would currently be viewed as racist or discriminatory. This discrimination or not treating all patients with justice manifests itself today. For example, some cultures such as China and India use sonograms to detect female fetuses that are then aborted, (Pence, 2011, p.106) this negative bias toward girls is evident in China, through current population numbers, where 119 boys are born for every 100 girls (BBC, 2010, p.8). Relevance of Issue to Current Health Care
Asking the question, “What level of genetic testing for abnormalities is beneficial to the patient, and what level of trait selection is ethical?” is relevant to preserving a patient’s autonomy. In answering this question we lead health care providers to develop their unique skill set which allows them to play a role of information provider about prenatal testing in a more helpful and understanding format to patients. This extends autonomy to patients promoting an informed decision...
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