title: Non-invasive prenatal testing: ethics and policy considerations.
abstract: New technologies analyzing fetal DNA in maternal blood have led to the wide commercial availability of non-invasive prenatal testing (NIPT). We present here for clinicians the ethical and policy issues related to an emerging practice option. Although NIPT presents opportunities for pregnant women, particularly women who are at increased risk of having a baby with an abnormality or who are otherwise likely to access invasive prenatal testing, NIPT brings significant ethics and policy challenges. The ethical issues include multiple aspects of informed decision-making, such as access to counselling about the possible results of the test in advance of making a decision about participation in NIPT. Policy considerations include issues related to offering and promoting a privately available medical strategy in publicly funded institutions. Ethics and policy considerations merge in NIPT with regard to sex selection and support for persons living with disabilities.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton ON.
authors.forename: Meredith
authors.initials: M
authors.lastname: Vanstone
authors.affiliation: Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London ON.
authors.forename: Carol
authors.initials: C
authors.lastname: King
authors.affiliation: Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London ON.
authors.forename: Barbra
authors.initials: B
authors.lastname: de Vrijer
authors.affiliation: Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London ON; Children's Health Research Institute, London ON.
authors.forename: Jeff
authors.initials: J
authors.lastname: Nisker
mesh_terms: D004247:DNA / Q000097:blood; D005260:Female; D006801:Humans; D062145:Maternal Serum Screening Tests / Q000941:ethics* / Q000379:methods / Q000592:standards*; D011247:Pregnancy
chemical_list: D004247:DNA
keywords: cell free fetal DNA; ethics; non-invasive prenatal testing; policy; prenatal diagnosis; prenatal screening