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Genomic futures of prenatal screening: ethical reflection
Author(s) -
Dondorp W.J.,
PageChristiaens G.C.M.L.,
Wert G.M.W.R
Publication year - 2016
Publication title -
clinical genetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.543
H-Index - 102
eISSN - 1399-0004
pISSN - 0009-9163
DOI - 10.1111/cge.12640
Subject(s) - scope (computer science) , autonomy , prenatal diagnosis , futures contract , stakeholder , prenatal screening , normative , medicine , biology , pregnancy , political science , genetics , computer science , public relations , business , fetus , finance , law , programming language
The practice of prenatal screening is undergoing important changes as a result of the introduction of genomic testing technologies at different stages of the screening trajectory. It is expected that eventually it will become possible to routinely obtain a comprehensive ‘genome scan’ of all fetuses. Although this will still take several years, there are clear continuities between present developments and this future scenario. As this review shows, behind the still limited scope of screening for common aneuploidies, a rapid widening of the range of conditions tested for is already taking shape at the invasive testing stage. But the continuities are not just technical; they are also ethical. If screening for Down's syndrome is a matter of providing autonomous reproductive choice, then why would providing the choice to have a full fetal genome scan be something entirely different? There is a clear need for a sustainable normative framework that will have to answer three challenges: the indeterminateness of the autonomy paradigm, the need to acknowledge the future child as an interested stakeholder, and the prospect of broad‐scope genomic prenatal screening with a double purpose: autonomy and prevention.