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Prenatal Genetic Testing and the Ethical Controversies


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Prenatal Genetic Testing and The Ethical Controversies SBI3U

15 April 2015




Prenatal Genetic Testing and The Ethical Controversies Introduction
Every introduction should start with a shocking fact about the topic, generally to piqué the interest of the reader. The problem is, surrounding the topic of prenatal genetic testing, there isn’t anything that is particularly shocking or interesting anymore. Anything that has a potential to injure a
‘helpless’ fetus, the public has already been informed of and the information has already been extremely exaggerated. The myth of prenatal genetic testing being dangerous has been greatly over told, and is a rather old notion according to a great number of medical journals such as: United States
National Library (Gates, 2009), UConn (Pennington, 2011), and many others listed in the references page. Prenatal genetic testing is the process of testing for potential genetic disorders or defects. Doctors and geneticist can now test for over 4000 diseases that are caused or influenced by a fetus’ genetic makeup. The tests can be invasive or non­invasive, and the risks associated with both categories of tests have been greatly reduced since genetic testing was first introduced to modern medicine. Although the risks to the mother and the fetus, there are still many ethical controversies discussed among people who actually are informed about the subject. Despite the excessive amount of controversy and myths surrounding it, prenatal genetic has the possibility to be a constructive process under certain choice circumstances. Prenatal Genetic Counselling
Before a family even considers having their unborn child (fetus) tested for any genetic disorder, they must first meet with a genetic counsellor. The genetic counsellor can be any doctor they feel comfortable with, except many OB GYN’s recommend seeing an actual certified geneticist to be the family’s counsellor. This is meant to reduce the biased choices or information that is relayed. A genetic counsellor has many responsibilities to the family, one of which is keeping the mother safe, If the family were to see the mother’s OB GYN the doctor’s responsibility would be to keep both the child and the mother safe, which isn’t beneficial to anyone involved.



A genetic counsellor will meet with the family being tested before, after, and during the screening process. Some very dedicated counsellors may even be present during a test. A genetic counsellor will essentially translate the medical and confusing terms to the parents. The purpose is to enhance the decisions; the decision to actually be tested, or the decision of what to do after the family receives the results of a genetic anomaly. While assisting in the decision making process of whether or not to be tested, the counsellor will discuss many things with the family, such as if the pregnancy is high risk, or if the child is at risk, discuss what the family should be testing for, the testing procedures, and most importantly the consequences involved, socially and medically.
The genetic counsellor is the medium in which consent is given. When a mother is considering having her child tested for any genetic defects, informed consent is very important. Many people don’t understand the associated risks with prenatal testing, granted they know the common excessively dramatised consequences. During a session with a genetic counsellor they will explore the best option with the parents, make suggestions as to which path they should pursue. After choosing a path the counsellor will explain in­depth the procedure of the actual test, then following it up with the consequences and benefits of the test. After all parties are informed about the risks involved, the genetic counsellor will then gain consent from the parents and doctor. Methods
As mentioned earlier, there are several, invasive and noninvasive procedures that can obtain the fetus’s genetic information. There is essentially 4 main tests; ultrasounds, amniocentesis, chorionic villus sampling (CVS), and percutaneous umbilical cord sampling (PUBS). Each method has many benefits and drawbacks associated with them, as well as having varying degrees of accuracy.
Ultrasounds are not typically considered a prenatal genetic testing method, as the results are usually very inaccurate. Although the results are less that ideal, a lot can be determined by performing an ultrasound. During the ultrasound physical abnormalities can be detected, included ones that are indicators of a particular genetic disorder. The ultrasound can determine the gestational age, fetal



position, growth, development and other birth defects. This method is completely noninvasive and poses no true risk to the fetus or the mother. With a skilled operator, the results of the ultrasound can be upwards of 90% accurate.
Amniocentesis is one of the more common and well heard of prenatal genetic testing methods.
During this test a long needle is inserted into the uterus, and gathers a sample of the amniotic fluid.
Amniotic fluid contains cells from the fetus, so there is a great deal of genetic information that can be learned from it. The amniotic fluid, after being extracted is then cultured­ not in the sense of watching old movies­ and then analyzed for genetic abnormalities by checking the chromosomes.This method, despite the many alleged risks, this method is now being considered the most safe and accurate way to discover genetic defects.
Chorionic villus sampling (CVS) is one of the earliest possible genetic tests that can performed.
A CVS can be taken as early as 9 weeks into the pregnancy. During the test a catheter is put into the cervix and uterus, and takes a sample of chorionic villus that surrounds the sac that protects the baby.
The DNA that is collected is quickly analyzed within 24 hours of collection. The beneficial part of this is that any ‘bad’ news that may be discovered about the pregnancy is discovered early on in the pregnancy, and can make the decision of elective abortion easier on the family involved.
The last most common method is percutaneous umbilical cord sampling (PUBS). This is a process of inserting a long needle into the umbilical cord, and some fetal blood is sampled and is tested for abnormalities in the chromosomes. Detectable Genetic Abnormalities
As stated earlier, prenatal genetic tests can detect over 4000 diseases that are related to genetic defects. Some of the more common tests are related to Huntington's, and down syndrome. Doctor’s are recommending patients only test for severe disorders, types that will severely lower the fetus’s potential quality of life. Prenatal genetic testing has evolved to a point where testing for the fetus’s hair colour, eye colour, sports ability, and intelligence is very possible. Doctors are concerned by this fact as these



facts may come as a disappointment to the families, especially if the child isn’t all they hoped they would be. So when the family can only test for severe life altering or diminishing diseases, the possibility for superficial selective abortion is lessened.
The biggest concern when testing a fetus is the detection of Huntington’s. Huntington’s is a genetically transferred neurological disorder. The symptoms usually start presenting themselves in middle aged people, usually aged 30­50. The symptoms can include loss of motor control, depression, dementia, personality, and can generally result in death. Generally when a fetus has a positive diagnosis of Huntington’s, a family will opt for an abortion as the child’s quality of life would be severely lessened. Ethical Controversies
There are many controversies associated with prenatal genetic testing. Ranging from selective abortion, eugenics, and the side effects. Many people are in constant debate over these topics. The majority of ethical dilemmas is on the topic of selective abortion.
Selective abortion is a family choosing to abort the fetus based on a certain characteristic.
Many pro­life people oppose this practice, and for the sake of simplicity and sanity, this report will forgo their senseless argument and focus on the important stances. On the one hand, genetic testing can eradicate certain diseases and disabilities, and improve the quality of life for the next generation. By aborting a fetus with a certain disorder could potentially eradicate an entire disorder. The other side of the argument is that by aborting a certain type of disability is discrimination. This is called the expressivist argument. This is the belief that aborting a fetus based on the disability or disease is sending a message to people who are living with the disease or disability that their life is not worth living. Conclusion
Although the only rule of a report is to not include your opinion, why not? In my opinion



genetic testing is a valuable process. Testing for certain genetic disorders to prepare the parent’s for the disorder the child might have is also a very valuable tool. I do believe that prenatal genetic testing may be too extreme now. Genetic testing can now determine practically anything physical about the child.
Every amount of surprise left to having a child is gone, and parents can now pick and choose what they want, thanks to abortions. Although I do not believe for a second that there are people out there that are getting pregnant and getting the fetus tested for a certain trait, and aborting it if it doesn’t have the trait.
Pregnancy should not be like an etch­a­sketch. Some things should be ‘reset’, such as serious quality of life altering diseases or a painful disability. But less severe defects shouldn’t be tested for, and it shouldn’t matter. Prenatal genetic testing is dehumanizing the process of giving birth­ “Don’t get attached until the genetic results come back”.



Gates, E. (n.d.). Ethical considerations in prenatal diagnosis. Retrieved April 15, 2015, from Women's Healthcare Physicians. (2014, June 1). Retrieved April 15, 2015, from­And­Publications/Committee­Opinions/Committee­on­Ethics/ Ethical­Issues­in­Genetic­Testing McLean, S. (n.d.). Prenatal Diagnostic Tests and the Social, Legal, and Ethical Implications.
Retrieved April 15, 2015, from Pennington, C. (2011, November 7). New Prenatal Screening Test is Easier – But Raises
Ethical Issues. Retrieved April 15, 2015, from­prenatal­screening­test­is­easier­–­but­raises­ethical­i ssues/ McLean, M. (n.d.). Genetic Testing: Ethical Choices. Retrieved April 15, 2015, from The Council on Ethical and Judicial Affairs. (n.d.). Ethical Issues Related to Prenatal Genetic
Testing. Retrieved April 15, 2015, from Regulation/ethical_issues_related_prenatal_genetic_testing.pdf Major Issues: Disability. (n.d.). Retrieved April 15, 2015, from 3.shtml MacDonald Glenn, L. (2007, December 1). Genetic Testing to Predict Disease: Ethical, Legal, and Social Implications (ELSI). Retrieved April 15, 2015, from Halsey Lea, D., Williams, J., Donahue, P., & Midwifery, J. (2011, March 1). Medscape Log In.
Retrieved April 15, 2015, from Morin, S. (n.d.). Where Genetics Meets Controversy: Prenatal Genetic Screening and Ethics.
Retrieved April 16, 2015, from Macer, Darryl R. J. Ethics and Prenatal Diagnosis. Retrieved April 16, 2015, from

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