title: Fetal therapy for Down syndrome: an ethical exploration.
abstract: BACKGROUND
  Parallel to recent advances in prenatal screening for Down syndrome (DS), therapies for different aspects of the condition have become available. As intellectual disability is a key aspect, this is an active area for research. Several groups have hypothesized that prenatal interventions will give better chances at improving cognitive functioning in persons with DS than postnatal treatment. Clinical trials are being developed.
  
  
  METHODS
  We first discuss the ethical pros and cons of trying to improve cognitive functioning in persons with DS to see if there are categorical objections to the general idea, and then move on to explore ethically relevant aspects of the prospect of developing fetal therapy for DS (FTDS).
  
  
  RESULTS
  Only on the basis of a one-dimensional emphasis on the social model of disability would (fetal) therapy aimed at cognitive improvement be inherently problematic.
  
  
  CONCLUSIONS
  Inviting pregnant women to participate in FTDS-research should be based on adequate pre-clinical trials, as well as information aimed at avoiding the so-called 'therapeutic misconception'. Should FTDS be proven to be effective and safe, women carrying a fetus with trisomy 21 who have decided to continue the pregnancy may have a moral obligation to make use of this option. © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Health, Ethics & Society, School for Oncology and Developmental Biology (GROW), School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
authors.forename: Guido
authors.initials: G
authors.lastname: de Wert
authors.affiliation: Department of Health, Ethics & Society, School for Oncology and Developmental Biology (GROW), School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
authors.forename: Wybo
authors.identifier: http://orcid.org/0000-0003-4052-7192
authors.initials: W
authors.lastname: Dondorp
authors.affiliation: Mother Infant Research Institute, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, US.
authors.forename: Diana W
authors.identifier: http://orcid.org/0000-0001-9270-5267
authors.initials: DW
authors.lastname: Bianchi
mesh_terms: D000818:Animals; D003071:Cognition / Q000502:physiology; D004195:Disease Models, Animal; D004314:Down Syndrome / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D046128:Fetal Therapies / Q000941:ethics* / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D051379:Mice; D011247:Pregnancy