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NIPTs Pose Moral Quandaries

As non-invasive prenatal genetic testing advances more broadly into the marketplace and as tests for more and more disorders, conditions — and eventually, traits — become widely available to pregnant women and couples, some difficult ethical questions are bound to arise, Amanda Schaffer writes at Technology Review.

Many prospective parents who have been unable to find out about fetal status for disorders such as Down syndrome and similar large-scale genetic defects due to the possible risks of amniocentesis are likely to opt for NIPTs, now that they are becoming more widely available through companies like Sequenom, Illumina's Verinata Health, Ariosa Diagnostics, and Natera.

Before long, Stanford University bioethicist Hank Greely says, "We could see 50, 60, 70, 80 percent of American pregnancies getting genetic testing."

Those tests may seem like a blessing to concerned parents, but as they expand into a wider range of disorders, "the moral quandaries are sure to intensify as well," Schaffer writes.

The number of abortions will probably rise, which will lead people who are opposed to abortion in general to take a stand against the tests, Schaffer says. But as tests for less severe disorders, like Kleinfelter's syndrome, trickle into the market, even people who firmly support abortion rights are likely to grow uneasy, she says.

Greely imagines a situation in which two parents who have achondroplasia, an inherited form of dwarfism, want to have a child who looks like them: "Would it be wrong for them to terminate a normal-sized fetus?"

"These are hard questions," he says.

And what of tests for height, intelligence, hair color?

Schaffer says we should have "a healthy fear" of such using tests for such nonmedical traits, particularly in light of the "disastrous history of eugenics" and the Holocaust.

She adds that these questions are not entirely purely theoretical, as parents in India, China, and South Korea have already been selecting boy children over girls after ultrasounds.

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