title: Prenatal genetic testing kits sold at your local pharmacy: promoting autonomy or promoting confusion?
abstract: Research groups around the world are developing non-invasive methods of prenatal genetic diagnosis, in which foetal cells are obtained by maternal blood test. Meanwhile, an increasing number of genetic tests are sold directly to the public. I extrapolate from these developments to consider a scenario in which PNGD self-testing kits are sold directly to the public. Given the opposition to over-the-counter genetic tests and the continuing controversy surrounding PNGD, it is reasonable to expect objections to PNGD self-testing kits. I focus on one potential objection, that PNGD self-testing kits would undermine the autonomy of potential test subjects. More specifically, that 'direct to the public' PNGD would fail to ensure that consumers exercise authority in the following PNGD-related choices: Should I use PNGD? Based on the results of the PNGD test, should I continue or terminate my pregnancy? Under the current system, PNGD is provided by health care practitioners, who are required to counsel women both before and after the test. In contrast, 'direct to the public' PNGD would allow women to make their PNGD-related decisions outside the context of the health care system. I compare these two decision-making contexts, arguing that the health care system is not unequivocally better at promoting the autonomy of potential test subjects. Therefore the promotion of autonomy does not constitute a strong argument against such test kits. Other objections may be more persuasive, so I do not offer an overall assessment of the acceptability of 'direct to the public' PNGD.
authors.affiliation: 36 Gillard st, Burwood 3125, Melbourne, Australia. lucymodra@hotmail.com
authors.forename: Lucy
authors.initials: L
authors.lastname: Modra
mesh_terms: D000025:Abortion, Eugenic; D026686:Beneficence; D003068:Coercion; D032882:Comprehension; D003657:Decision Making / Q000941:ethics; D026689:Ethical Analysis; D005260:Female; D005817:Genetic Counseling / Q000592:standards; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000523:psychology; D008389:Marketing of Health Services / Q000941:ethics; D010353:Patient Education as Topic / Q000941:ethics; D026684:Personal Autonomy; D011247:Pregnancy; D037841:Pregnant People; D011296:Prenatal Diagnosis / Q000941:ethics* / Q000379:methods; D011933:Reagent Kits, Diagnostic / Q000600:supply & distribution*; D012935:Social Justice
chemical_list: D011933:Reagent Kits, Diagnostic