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ZENIT, The world seen from Rome
News Agency
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Prenatal Testing: A Double-edged Sword
Perverting Information in the Pursuit of Perfection
By Denise J. Hunnell, MD
WASHINGTON, D.C., JULY 25, 2012 (Zenit.org).- Peering into the womb and
glimpsing the developing new life within is an exhilarating experience
made
possible through ultrasound technology. Yet the marvels of ultrasound
are meant
for more than allowing parents to lovingly gaze upon their unborn
child. This
is a powerful, non-invasive tool for diagnosing numerous medical
conditions,
some of which can be corrected prior to birth.
Maternal blood tests that look at the alphafetoprotein levels can
suggest the
presence of neural tube defects like spina bifida, a deformity of the
spinal
column, and anencephaly, an absence of all or part of the brain and
skull. This
test can also be a marker for Down syndrome. More invasive tests
include
amniocentesis and chorionic villi sampling. These allow the direct
examination
of fetal chromosomes in order to detect genetic abnormalities. These
tests are
more accurate, but they also carry more risk for the unborn child. The
decision
to undertake any form of prenatal testing must weigh the risks against
the
potential therapeutic benefits derived from the information provided by
such procedures.
While prenatal testing offers the opportunity to correct some
abnormalities or
to prepare to adjust to others, it is unfortunately often utilized to
screen
for diseases and abort unborn children who are deemed defective. In
2007, the
American College of Obstetrics and Gynecology (ACOG) changed their
recommendations for prenatal screening from offering tests to pregnant
women
over age 35 to offering them to all pregnant women. Their rationale was
that
while women over age 35 had the greatest risk for conceiving a child
with Down
syndrome, most children with Down syndrome were born to women under the
age of
35. The expanded screening would allow for these cases to be detected
prenatally.
Currently, 92% of all children with Down syndrome in the United States
are
aborted. A newly developed maternal blood test, the MaterniT21, can be
administered as early as 10 weeks gestation and has a nearly 100%
success rate
in detecting Down syndrome. The prospect of such a test has pushed
Denmark to
declare that they will eliminate Down syndrome in the Scandinavian
country by
2030 through increased screening and abortions. In the Affordable Care
Act,
also known as Obamacare, such screening will be offered to all pregnant
women
free of charge.
The quest for the flawless child has led mothers to abort their child
for
easily correctible abnormalities like cleft palate. With the
exponential growth
in the use of in vitro fertilization (IVF), the pursuit of perfection
has
intensified. The Church rejects the use of IVF because it separates the
procreative and unitive aspects of human sexuality. It dehumanizes the
embryos
and reduces them to manufactured products. This is most evident when
the
embryos created are then screened for genetic abnormalities in a
process called
preimplantation genetic diagnosis (PGD). Those embryos found defective
are
destroyed. Sometimes, the only defect is that the embryos are the wrong
gender.
They are discarded because it is feared they will somehow unbalance the
family.
Embryos have also been destroyed because they carry the genes for
breast cancer
or colon cancer. Such actions presume that it would be better to never
be born
than face the possibility of cancer in future decades. Think of
the people you have known whose lives have been cut short by cancer or
other
serious illness. Would it really be better if they had never existed?
Were
their lives really so meaningless?
In the April 2012 issue of The American Journal of Bioethics, authors
Janet
Malek and Judith Daar make the case for both a moral and legal
obligations for
parents to screen embryos for genetic abnormalities. They argue that a
moral
case exists based on three principles, the first being that genetic
screening
produces a child with increased well-being. They claim that any
positive
outcomes experienced by an individual with a serious genetic disease
cannot
make up for the decrease in well-being resulting from such a malady.
The second
principle is based on expanded self-determination: individuals with
serious
genetic diseases have fewer life choices with regards to careers,
hobbies and
relationships. Therefore, parents have a moral duty to produce a child
free of
such limitations if possible. Finally, the authors claim that a sense
of
justice requires parents to produce a child that will not be subjected
to the
inequalities inherent in living with a serious genetic disease. The
y argue that the answer to societal inequalities is to eliminate those
embryos
unable to compete due to genetic defects.
One flaw in each of these assertions is that the authors do not regard
each
embryo as a unique individual. It is true that the child without a
genetic
abnormality who is ultimately born will often have greater health,
expanded
life choices, and more equal opportunities to succeed in society than a
child
born with a serious genetic abnormality. But the screening does nothing
to
increase the well-being, life choices, and equal opportunity of the
children
found as embryos to have genetic defects. In fact, those human beings
suffer
greatly because they are destroyed as embryos and all chances for
well-being,
self-determination, and success are irreversibly eliminated.
Malek and Daar further declare that a legal duty exists to screen for
genetic
diseases. Their argument is based on the premise that once parents
initiate the
reproductive process, they have a duty to execute that process in a
manner that
produces the least harm to a resulting child. Again, their logic
suffers
because it denies the harm inflicted on the children found to have
genetic
abnormalities who are destroyed as embryos.
The advocacy for extensive prenatal genetic screening currently focuses
on
embryos conceived by IVF because the screening procedure adds little
burden or
risk to the IVF process. As of now, genetic screening of unborn
children in
utero requires amniocentesis or chorionic villi sampling, so routine
evaluation
of fetal chromosomes for genetic defects is impractical. This may
change with
the announcement that researchers at the University of Washington were
able to
sequence the entire genome of a fetus using maternal blood and saliva
from the
father. The fetal genome is then scanned for abnormalities. A mere one
month
after this announcement, Stanford University announced that its
research team
had sequenced the fetal genome with maternal blood alone. Neither of
these
tests is ready for clinical use. However, when they are, will the
arguments of
Malek and Daar apply? Once the burden and risk of detailed genetic
testing are
removed will every fetus be analyzed for potential genet
ic diseases with the expectation that they will be aborted if not
perfect?
Seeking to rid a population of genetic disease through controlling
reproduction
is not a new endeavor. On July 14, 1933, Germany enacted the Law for
the
Prevention of Genetically Diseased Offspring. Any man or woman who was
afflicted with feeblemindedness, schizophrenia, manic-depressive
disorder,
epilepsy, Huntington's chorea, genetic blindness, genetic deafness,
severe
physical deformity or chronic alcoholism were brought before hereditary
health
courts. The courts then mandated these individuals be sterilized. By
1935 the
law was amended so the patients had no avenue for appeal and there were
fines
for physicians who failed to report patients who met the criteria for
sterilization. This law was followed by the creation of Information
Centers for
Genetic and Racial Hygiene to identify potential targets for
sterilization. By
1945, 400,000 Germans had been forcibly sterilized. It was this
expanding quest
to create the master race that precipitated so many of the atrocities of
the Holocaust.
Clearly, prenatal testing in and of itself is not morally evil. The use
of
ultrasound images in crisis pregnancy centers has been highly effective
in
convincing women considering abortion to continue their pregnancies.
Advances
in prenatal medicine and surgery allow lifesaving interventions in many
conditions that are discovered through prenatal screening.
When the information gleaned from prenatal testing is perverted for the
pursuit
of some arbitrary standard of genetic purity or perfection, however, a
line is
crossed. We have seen the horrors that ensue when the strong seek to
weed out
the weak through racial and genetic cleansing. We cannot allow anyone
to stand
in judgment of the unborn and designate those who are fit for life and
those
who are inferior and should be aborted. Every human life, regardless of
his or
her genetic composition, is of inestimable worth because every human
life, from
the moment of conception is made in the image of God.
* * *
Denise Hunnell, MD, is a Fellow of HLI America, an educational
initiative
of Human Life International. She writes for HLI America’s
Truth and
Charity Forum.