Vanstone Meredith, King Carol, de Vrijer Barbra, Nisker Jeff
Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton ON.
Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London ON.
J Obstet Gynaecol Can. 2014 Jun;36(6):515-526. doi: 10.1016/S1701-2163(15)30568-5.
New technologies analyzing fetal DNA in maternal blood have led to the wide commercial availability of non-invasive prenatal testing (NIPT). We present here for clinicians the ethical and policy issues related to an emerging practice option. Although NIPT presents opportunities for pregnant women, particularly women who are at increased risk of having a baby with an abnormality or who are otherwise likely to access invasive prenatal testing, NIPT brings significant ethics and policy challenges. The ethical issues include multiple aspects of informed decision-making, such as access to counselling about the possible results of the test in advance of making a decision about participation in NIPT. Policy considerations include issues related to offering and promoting a privately available medical strategy in publicly funded institutions. Ethics and policy considerations merge in NIPT with regard to sex selection and support for persons living with disabilities.
分析母血中胎儿DNA的新技术已使非侵入性产前检测（NIPT）广泛商业化。在此，我们向临床医生介绍与这一新兴实践选项相关的伦理和政策问题。尽管NIPT为孕妇带来了机会，尤其是那些生育异常婴儿风险增加或可能接受侵入性产前检测的女性，但NIPT也带来了重大的伦理和政策挑战。伦理问题包括知情决策的多个方面，例如在决定是否参与NIPT之前，能否提前获得有关检测可能结果的咨询。政策考量包括在公共资助机构中提供和推广私人可用医疗策略的相关问题。在NIPT中，关于性别选择和对残疾人士的支持，伦理和政策考量相互交织。
