Noninvasive Prenatal Genetic Diagnosis and Eugenic Aims: A Bioethical Reflection.

Abstract

The use of techniques of analysis of fetal nucleic acid present in maternal peripheral blood for noninvasive prenatal genetic diagnosis (NIPD) is a reality in clinical practice in the case of certain diseases. In the coming years, it will become part of routine prenatal screening and diagnostic techniques for fetal diagnosis. A bioethical reflection on the possible difficulties and problems of the use of these techniques is necessary. On one hand, these techniques will result in reduced costs of screening, an increase in the number of disabled fetuses detected, and a decrease in the number of indirect abortions caused by invasive techniques. On the other hand, the widespread use of NIPD could decrease the autonomy of women in the decision-making process; health authorities could use NIPD as a means of eugenic prevention of genetic diseases, for example, in Down syndrome cases; and finally, NIPD could increase the image of the disabled person as an individual that has to be excluded from society. For this reason physicians play an important role in the process of pre-diagnosis and post-diagnosis genetic counseling. As a result, we conclude that the use of NIPD to diagnose the existence of genetic diseases in the fetus in order to decide-in the case of a positive result-whether or not to perform an abortion implies and includes in itself the conditions that characterize a negative moral assessment.