de Wert G M W R, Dondorp W J
Universiteit Maastricht, Faculty of Health, Medicine and Life Sciences, afd. Metamedica, onderzoeksscholen CAPHRI en GROW, Maastricht.
Ned Tijdschr Geneeskd. 2016;160:D307.
Prenatal screening for Down syndrome has to date focused on facilitating the informed choice to continue or not with a pregnancy. The non-invasive prenatal test (NIPT) for Down syndrome does potentially offer the option to apply foetal neurocognitive therapy for Down syndrome (FTDS). Current research in animal models looks promising and therefore a proactive ethical reflection in relation to clinical trials is urgently needed. This discussion includes an exploration of the ethical aspects of FTDS. There seem to be no convincing a priori objections on the basis of the social model of disability. Arguments in terms of (respect for) autonomy, wellbeing and justice seem to in principle support such therapy. Still, both the conditions for sound clinical trials and the implications of possible effective therapy for current prenatal screening need further scrutiny.
迄今为止,唐氏综合征的产前筛查主要集中在帮助孕妇做出是否继续妊娠的明智选择。唐氏综合征的无创产前检测(NIPT)确实有可能为唐氏综合征胎儿神经认知治疗(FTDS)提供应用选项。目前在动物模型上的研究看起来很有前景,因此迫切需要对临床试验进行积极的伦理思考。此次讨论包括对FTDS伦理方面的探讨。基于残疾的社会模式,似乎没有令人信服的先验反对意见。从(尊重)自主性、福祉和正义的角度来看,这些论点原则上似乎支持这种治疗方法。尽管如此,完善的临床试验条件以及可能有效的治疗方法对当前产前筛查的影响仍需进一步审查。