Prenatal genetic screening has its challenges – and hopes

Prenatal Genetic Screening (PGS) has become routine and is the source of many concerning stories and statistics. While PGS is fraught with potential for ethical dilemmas, temptations, and immoral actions, there are reasons for hope and resources to share that can be sources of life for many.

The practice of PGS has been shaped by technology, policy standards, and cultural changes. PGS technology developed soon after the structure of DNA was discovered in 1953 and Jerome Lejeune discovered the cause of Down syndrome in 1958. Eventually invasive methods (amniocentesis and chorionic villi sampling) and noninvasive methods (high-resolution ultrasound) of obtaining genetic and development information about unborn children were deployed. In 2011, an accurate non-invasive tool for PGS based on genetic analysis of a simple blood sample became available.
Use of PGS technology was encouraged by the American College of Obstetricians and Gynecologists (ACOG). In 1983, this notoriously pro-abortion organization advised OB-GYN physicians to offer PGS routinely to all pregnant women 35 and over. In 2007, ACOG advised that PGS should be offered to all pregnant women. This advice was significantly shaped by the goal of helping physicians to avoid liability from the newly recognized tort of “wrongful birth”— the harm to a woman or couple resulting from loss of opportunity to abort a less-than-perfect child.
These technologies and standards were abetted by an advancing culture of death. In many Western nations, the abortion rate following a Down syndrome diagnosis is over 90 percent. In Iceland, it is almost 100 percent.
Clearly there is much to condemn and to be concerned about. The first principle of the moral life is to avoid morally evil actions. Using PGS to target a developing baby for destruction is morally evil. However, the moral life also requires promoting moral goods. Some individuals and organizations have responded to the challenges posed by PGS with sound analysis, education, and therapies.
For example, Dr. Brian Skotko, director of the Down Syndrome Program at Massachusetts General Hospital, has been a leader in challenging abuses of PGS and in improving the ability of physicians and parents to care for children with Down syndrome. As a medical student in the early 2000s, Skotko published articles in major medical journals showing how poorly women were presented with PGS test results. Many were told abruptly, sometimes in voicemails. Too few were presented facts about the diagnosis, and fewer still were offered resources to help them keep and care for their children. In 2015, Skotko co-authored an important article showing that approximately 30 percent of unborn children with Down syndrome in the U.S. were being selectively aborted. This is not as draconian a rate as in other countries, but still too high.
Skotko has created educational programs to teach people how to deliver PGS test results with sensitivity and supportive resources (brightertomorrows.org) and to provide better medical care of children with Down syndrome (https://www.dsc2u.org). Moreover, PGS can be used responsibly. Physicians and scientists are developing a range of amazing interventions, including drug and gene therapies and surgeries, that can be provided in utero to help to heal a child before birth.
We should be aware of the ethical challenges of PGS as well as ethical resources. Our sisters, wives, and children routinely will be presented with a choice to undergo PGS at some time. We should prepare them to resist the secular anti-life pressures they likely will encounter and to find the support they need. Indeed, despite the real challenges posed by PGS, there are sources of healing, life, and hope. We should learn about them and support them to help build a culture of life.

JOHN F. BREHANY, PH.D., S.T.L., is executive vice president of the National Catholic Bioethics Center and past executive director of the Catholic Medical Association.