Prenatal Testing: Worthwhile or Wrong?
Neonatal Therapist Considers Ethical Pros and Cons
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ROME, DEC. 19, 2008 (Zenit.org).- Though prenatal testing is increasingly more routine, it does not get an ethical green light in all cases and circumstances, clarified a member of the Pontifical Academy for Life.
Carlo Bellieni, director of the department of intensive neonatal therapy at Le Scotte University Polyclinic of Siena, spoke recently with ZENIT about the ethical parameters in which prenatal testing is licit, and even recommended, and when it should be avoided.
He first clarified that prenatal testing can be broadly divided into genetic and non-genetic types.
Prenatal testing of the genetic variety often uses direct tests such as amniocentesis and chorionic villus sampling to study the child's chromosomal makeup, thereby enabling the diagnosis of such conditions as Down Syndrome. Genetic testing can also be indirect, with the use of structural sonograms or analysis of maternal blood.
Bellieni noted that genetic testing does not currently have the aim of curing the child. Testing for certain non-genetic conditions, meanwhile -- things such as growth delay, malformations, fetal suffering -- can lead to treatments and cures, either before birth or shortly afterward.
"Research in itself," Bellieni said, "is always something good." But he cautioned against routine testing that can create a mentality in which parents feel pressured to seek and verify that they are carrying a "perfect child."
Planning to abort
The professor offered some principles for families faced with the possibility of prenatal testing.
First, he affirmed, "Prenatal diagnosis should have a positive intention for the health of the child and the mother."
Statistics show that this "positive intention" is often lacking. As ZENIT reported in September, citing the Washington Post, some 90% of unborn children diagnosed with Down Syndrome are aborted.
In one of his monthly bioethics columns, Father Tadeusz Pacholczyk, director of education at the Philadelphia-based National Catholic Bioethics Center, clarified that prenatal testing is gravely immoral if done with the intention of aborting the child if the tests reveal abnormality.
And even if there is no intention to abort, Bellieni went on to note that the risks of prenatal tests for the child must be taken into account. He said that, for example, one in about every 100 or 200 amniocentesis tests results in the death of the child.
On the other hand, as Father Pacholczyk explained in his column, "Prenatal testing is permissible, indeed desirable, when done with the intention of providing early medical intervention to the child."
He cited the example of a disease known as Krabbe's leukodystrophy, saying it "can be successfully treated by a bone marrow transplant shortly after birth. If a diagnosis of the disease is made by prenatal testing, the family can initiate the search for a matched bone marrow sample even before the child is born. That way, valuable time can be saved, and the early intervention improves the likelihood of a good outcome."
The priest noted that other diseases, such as spina bifida, can be treated while the baby is in the womb.
"Prenatal testing which aims to provide diagnostic information to assist in the treatment of an in utero patient represents a morally praiseworthy use of this powerful technology," he concluded.
Another positive effect that prenatal testing could have, Bellieni noted, regards the psychological serenity of the parents. "In cases especially full of tension," he said, the tests could serve "to calm the couple in case of intense anxiety over their child's genetic health, but this should not be routine, so as not to create the mentality -- in the couple and in the population -- that the first position to have toward a child is to 'verify his normality.'"
Bellieni also had counsel for doctors and specialists who perform the tests. He urged the informed consent of the parents, saying they must be made aware of the objectives and the risks involved in testing.
"In case of diagnosis of pathology, the woman or couple must be directed to the specialist of the pathology in question, with which therapeutic possibilities will be further explored and the real nature of the problem determined," he added. "It might also be of use to involve officially recognized associations of relatives or patients of the pathology in question."