Issues of public policy in the USA raised by amniocentesis.

Amniocentesis, a procedure which can detect during pregnancy whether or not the fetus will develop into a mongol or one affected by other serious chromosomal defects, if given to all pregnant women aged 40 and over, would save both human suffering and economic loss to the community. The procedure is not at present widely used for various reasons, not all of them medical, and, if the test result is positive abortion is the remedy. The author describes an important clinical trial being conducted in the USA at the present time but suggests that an educational programme should be undertaken to inform the public of the existence of this procedure and its applications even before the results of the American large-scale trial can be known and evaluated. Amniocentesis and its use, Professor Etzioni concludes, is not the only genetic tool which should be reviewed in a manner which would give an overall picture. He compares those who are concerned with these matters to the citizens of Britain when they saw the first steam engine. They did not perceive the social changes--the industrial revolution--that would follow. In our time a 'genetic revolution' may not be long delayed.