Prenatal Screening, Reproductive Choice, and P ublic H ealth

One widely held view of prenatal screening ( PNS ) is that its foremost aim is, or should be, to enable reproductive choice; this is the P ure C hoice view. The article critiques this position by comparing it with an alternative: P ublic H ealth P luralism. It is argued that there are good reasons to prefer the latter, including the following. (1) P ublic H ealth P luralism does not, as is often supposed, render PNS more vulnerable to eugenics‐objections. (2) The P ure C hoice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of P ublic H ealth P luralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) P ublic H ealth P luralism is at least as well‐equipped as the P ure C hoice model to deal with autonomy and consent issues.