Faculty of Health, Medicine & Life Sciences, Department of Health, Ethics & Society, and GROW, School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
Hum Reprod. 2011 Nov;26(11):2915-7. doi: 10.1093/humrep/der268. Epub 2011 Aug 12.
The great promise of the pending introduction of non-invasive prenatal diagnosis (NIPD) for trisomy 21 (18 and 13) is that it enables one-step, early and safe testing for these abnormalities. The ethical debate so far has been limited to possible drawbacks of routine access to this type of testing: normalization of testing and abortion and adverse effects on autonomous decision-making. We address the ethical implications of the fact that routine NIPD affects the scope and strategy of current prenatal screening cascades. A decision is needed whether complementary (invasive) testing remains in place in order to avoid a loss of information as compared with current practice. If so, the supposed advantages of NIPD may be less significant than generally assumed. Accumulation of tests challenges informed consent and proportionality. Therefore, an ethical evaluation of the implications of NIPD for the prenatal screening strategy as a whole is needed.
非侵入性产前诊断（NIPD）即将引入 21 三体（18 三体和 13 三体），这为其带来了巨大的前景，它使人们能够一步到位，安全地对这些异常情况进行早期检测。到目前为止，伦理辩论仅限于对常规获得这种类型检测的可能缺陷：将检测和流产正常化，以及对自主决策产生不利影响。我们将探讨常规 NIPD 影响当前产前筛查级联的范围和策略这一事实所带来的伦理影响。需要做出决定，是否保留补充（侵入性）检测，以避免与当前实践相比丢失信息。如果是这样，那么 NIPD 的所谓优势可能不如普遍认为的那么显著。测试的积累对知情同意和相称性构成挑战。因此，需要对 NIPD 对整个产前筛查策略的影响进行伦理评估。
