Citation

Bowman-Smart H, Gyngell C, Mand C, Amor DJ, Delatycki MB, Savulescu J. Am. J. Bioeth. 2023; 23(3): 3-20.

Copyright

(Copyright © 2023, MIT Press)

DOI

10.1080/15265161.2021.1996659

PMID

34846986

Abstract

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including "non-medical" traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as "non-medical"; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework.

Language: en

Keywords

abortion; Anticipatory Governance of Noninvasive Prenatal Testing for “Non-Medical” Traits: Lessons from Regulation of Medically Assisted Reproduction; Bioethicists Are Not so Divided on Reproductive Testing for Non-Medical Traits: Emerging Perspectives on Polygenic Scores; biotechnology; Considering the Collective in Ethical Decision-Making Concerning Non-Medical Uses of Noninvasive Prenatal Testing; Consistency of What? Appropriately Contextualizing Ethical Analysis of Non-Invasive Prenatal Testing; Expanding Our Thoughts about Autonomy in Relation to Whether We Should Offer Genetic Testing for Nonmedical Traits; genetics (clinical); Genomic Uncertainty as a Burden for Reproductive Choice? The Problem of Probabilistic Causation in Non-Invasive Prenatal Testing; Going Back to Basics: What is the Target of Prenatal Screening?; Including Non-Medical Traits in the NIPT: What Can We Learn from an Ethics of Care Approach?; Noninvasive Testing for “Non-Medical” Traits: A Misplaced Expressive Concern, Tough Policy Choices; Nurtured Genetics: Prenatal Testing and the Anchoring of Genetic Expectancies; Prenatal Testing: Responsibility and Reality; Reproductive technologies; Role of Vulnerability and Control in Prenatal Testing Ethical Decision-Making; Security and Sharing of NIPT Data Are the Basis of Ethical Decision-Making Related to Non-Medical Traits; Terminology and Consistency; The Need for Diverse Empirical Data to Inform the Use of Polygenic Risk Scores in Prenatal Screening; The Potential Role of Nudging in Expanded Noninvasive Prenatal Testing; The Slippery Slope of Prenatal Testing for Social Traits