Recent breakthoughs in pre-natal diagnosis raise serious ethical questions, notes an article in the journal Nature Reviews Genetics by German doctors. It now seems possible to detect foetal problems with just a sample of the mother’s blood. Sequenom, an American company, plans to release its test later this year.

Women will probably be offered this test routinely in the first trimestre. Doctors will offer them the opportunity to abort the child if it has Down syndrome or other defects. But this might "reduce the reproductive autonomy of the woman". The authors foresee that women might not be able to make informed choices because they will be under intense emotional pressure to choose an abortion.

This creates a problem for this peculiar area of medicine. As the authors note, pre-natal diagnosis "differs from other diagnostic procedures in medicine insofar as most of the conditions tested cannot be cured or substantially alleviated. In these cases, the mother's only option is to decide whether to accept the child's impairment or to terminate the pregnancy."

In fact, they think it possible that the doctor’s "offer" effectively cannot be refused by a vulnerable woman. In one German survey, 25% of women stated that they opted for pre-natal diagnosis because their physician wanted it; 36% thought that PND is an almost mandatory part of routine maternal care; and 16% had not given consent to the performed PND or could not remember giving consent. Studies in many other countries have provided similar results. ~ Nature Reviews Genetics, August