title: Non-invasive prenatal diagnosis for aneuploidy: toward an integral ethical assessment.
abstract: The great promise of the pending introduction of non-invasive prenatal diagnosis (NIPD) for trisomy 21 (18 and 13) is that it enables one-step, early and safe testing for these abnormalities. The ethical debate so far has been limited to possible drawbacks of routine access to this type of testing: normalization of testing and abortion and adverse effects on autonomous decision-making. We address the ethical implications of the fact that routine NIPD affects the scope and strategy of current prenatal screening cascades. A decision is needed whether complementary (invasive) testing remains in place in order to avoid a loss of information as compared with current practice. If so, the supposed advantages of NIPD may be less significant than generally assumed. Accumulation of tests challenges informed consent and proportionality. Therefore, an ethical evaluation of the implications of NIPD for the prenatal screening strategy as a whole is needed.
authors.affiliation: Faculty of Health, Medicine & Life Sciences, Department of Health, Ethics & Society, and GROW, School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. at.dejong@maastrichtuniversity.nl
authors.forename: Antina
authors.initials: A
authors.lastname: de Jong
authors.forename: Wybo J
authors.initials: WJ
authors.lastname: Dondorp
authors.forename: Suzanna G M
authors.initials: SG
authors.lastname: Frints
authors.forename: Christine E M
authors.initials: CE
authors.lastname: de Die-Smulders
authors.forename: Guido M W R
authors.initials: GM
authors.lastname: de Wert
mesh_terms: D000782:Aneuploidy; D002882:Chromosomes, Human, Pair 13 / Q000235:genetics; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics; D004247:DNA / Q000378:metabolism; D003657:Decision Making; D004314:Down Syndrome / Q000175:diagnosis*; D004992:Ethics, Medical; D005260:Female; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*
chemical_list: D004247:DNA