Studies in Research Ethics no. 7

The Moral Roots of Prenatal Diagnosis

Ethical Aspects of the Early Introduction and Presentation of Prenatal Diagnosis in Sweden

Written by Christian Munthe

88 pages in English. Centre for Research Ethics, Göteborg 1996.

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Abstract

Motives put forward by specialists on prenatal diagnosis in support of this procedure when it was introduced in Swedish health care during the 1970's are described and analysed. The motives are set in relation later criticism of prenatal diagnosis as well as general bioethical issues.
Three motives are described: 1) Prenatal diagnosis is a tool for improving genetic counselling, thereby promoting the autonomy and reducing the anxieties of pregnant women who fear having children with some disorder or disease. 2) The point of prenatal diagnosis is to effect medical prevention by reducing the number of children born with diseases or disorders. 3) Prenatal diagnosis has an economic advantage in that it may save society from some of the costs involved in the care for disabled or retarded people.
These motives are found to communicate an unclear and partly inconsistent body of ethical values. First, complex ethical issues in connection with abortion were not addressed. Secondly, it is highly unclear how considerations of autonomy was weighed against considerations of well-being and economic aims. This unclear picture of the support of the autonomy of patients is also relevant when the economic motive is set in relation to accusations that prenatal diagnosis springs from similar moral values as eugenic policies of the past. Three interpretations of this motive are distinguished of which only one may actually support eugenic policies. However, even if the economic motive is interpreted in a very defensive way, it still expresses a tolerance of policymakers setting aside the autonomy of individual patients in order to achieve economic aims. It is argued that the expression of such tolerance can only be blocked by a clear willingness to actively fight any threat against the autonomy of patients, and that the expression of such an attitude is incompatible with the use of the economic motive.

 Key words: bioethics, eugenics, genetic counselling, medical ethics, prenatal diagnosis, research ethics, selective abortion

Table of Contents

FOREWORD

 Chapter One
INTRODUCTION
 
 

Chapter Two
THE OFFICIAL VIEW: A TOOL FOR GENETIC COUNSELLING
 
  Chapter Three
THE PREVENTIVE AIM
 
  Chapter Four
THE ECONOMIC MOTIVE
 
  Chapter Five
Discussions of Ethical Aspects

 Chapter Six
CONCLUDING DISCUSSION

 REFERENCES

 INDEX


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