Over the past 50 years, our understanding of diseases and the genetic causes behind many of them has skyrocketed at an exponential rate. With this knowledge has come an increased ability to test for the presence of these disorders, and as parents grow more aware of all of the potential disorders or disabilities that their children may develop, they want to know as soon as possible if their children will be healthy or not. This has led to the incredibly controversial process of prenatal screening, which is tied to one of the most divisive issues in today’s world: abortion.
Prenatal screening has been around since the 1970s and varies significantly in degree. Screens can be as non-invasive as evaluating the family history of a disease before a potential parent begins trying to have kids or as invasive as extracting blood from the umbilical cord after 6 months of pregnancy to analyze the child’s genome. Many expectant parents will look at an ultrasound to determine the sex of the child or other basic health concerns such as potential cardiac or respiratory problems. For the vast majority of screens, the results are smiles all around and increased anticipation of a healthy child. However, it is when the screens reveal potential health issues that the can of worms is opened.
For example, one of the most common prenatal screens conducted in America today is a non-invasive screen for aneuploidy, the genetic disorder responsible for conditions such as Down’s syndrome and Edwards syndrome. Patients with Down’s syndrome suffer growth delays, distinguishing facial features, and mental disability. And here lies the question that no one hopes they will ever have to ask themselves: if my child is going to be born with Down’s syndrome, should I abort the pregnancy?
Obviously, this question cuts straight to the core of the abortion debate, raising issues such as the rights of an unborn child and whether or not fetuses are alive. It is a question with deep religious, philosophical, and personal ties. Beyond the abortion debate, though, this question forces parents to deal with their opinions about mental and physical disability and ask themselves whether or not they are capable of raising a child with such a disability. For some people, the answer may be clear, and could spare both the child and the parents a lifetime of misery. For others, though, the question could be agonizing, and if the opinions of the two parents differ, the issue could have severe consequences for their relationship.
As these processes get more refined and more disorders can be traced back to specific genes, the ethical debate over prenatal screening will only grow more complex and more divisive. For example, what if, as autism becomes more understood, parents could find out whether or not their children will have autism after just three weeks of pregnancy? And what if they can determine the severity of the disorder? Is there a cutoff point where counselors would recommend abortion or continuation? And what if the test is inaccurate or misinterpreted and a parent chooses not to abort a child that ends up having severe defects? These questions are not as far in the future as they may seem, and when they become a reality, the world will be split down the middle.
Personally, I believe that everyone has the right to as much information as they desire about their child, and they alone have the ability to choose what to do with that information. The path forward is not as simple as one 18-year-old’s opinion, though. Prenatal screening will require regulation, standards of application and procedure, and an infrastructure designed to get answers as fast possible without sacrificing accuracy. The road ahead will be twisted and unclear, but these issues are ones that must be dealt with, and soon, before we get too much farther down it.