title: Ethical and legal aspects of noninvasive prenatal genetic diagnosis.
abstract: The new technology that will allow genetic testing of a fetus within the first trimester of pregnancy by isolating cell-free fetal DNA (cffDNA) in the mother's blood raises a range of ethical and legal issues. Considered noninvasive, this test is safe and reliable, and may avoid alternative genetic testing by amniocentesis or chorionic villus sampling, which risks causing spontaneous abortion. Ethical and legal issues of cffDNA testing will become more acute if testing expands to fetal whole-genome sequencing. Critical issues include the state of the science or diagnostic art; the appropriateness of offering the test; the implications of denying the test when it is available and appropriate; disclosure and counseling following test results; and management of patients' choices on acquiring test results. A challenge will be providing patients with appropriate counseling based on up-to-date genetic knowledge, and accommodating informed patients' legal choices.
authors.affiliation: Faculty of Law, Faculty of Medicine, Joint Centre for Bioethics, University of Toronto, Toronto, Canada. Electronic address: bernard.dickens@utoronto.ca.
authors.forename: Bernard M
authors.initials: BM
authors.lastname: Dickens
mesh_terms: D002474:Cell-Free System; D004247:DNA / Q000097:blood; D004992:Ethics, Medical; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005817:Genetic Counseling; D030342:Genetic Diseases, Inborn / Q000175:diagnosis; D005820:Genetic Testing; D006297:Health Services Accessibility; D006801:Humans; D007603:Jurisprudence; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000941:ethics* / Q000379:methods; D014342:Truth Disclosure / Q000941:ethics
chemical_list: D004247:DNA
keywords: Cell-free fetal DNA testing; Ethics of fetal testing; Fetal genetic diagnosis; Genetic counseling; Noninvasive fetal testing; Termination of pregnancy; Whole-genome sequencing