Non-Invasive Prenatal Testing for “Non-Medical” Traits: Ensuring Consistency in Ethical Decision-Making

Abstract

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework.

Keywords:

• Reproductive technologies
• biotechnology
• abortion
• genetics (clinical)

This article is referred to by:

The Slippery Slope of Prenatal Testing for Social Traits

Expanding Our Thoughts about Autonomy in Relation to Whether We Should Offer Genetic Testing for Nonmedical Traits

The Need for Diverse Empirical Data to Inform the Use of Polygenic Risk Scores in Prenatal Screening

Including Non-Medical Traits in the NIPT: What Can We Learn from an Ethics of Care Approach?

Role of Vulnerability and Control in Prenatal Testing Ethical Decision-Making

Genomic Uncertainty as a Burden for Reproductive Choice? The Problem of Probabilistic Causation in Non-Invasive Prenatal Testing

Security and Sharing of NIPT Data Are the Basis of Ethical Decision-Making Related to Non-Medical Traits

Considering the Collective in Ethical Decision-Making Concerning Non-Medical Uses of Noninvasive Prenatal Testing

Noninvasive Testing for “Non-Medical” Traits: A Misplaced Expressive Concern, Tough Policy Choices

The Potential Role of Nudging in Expanded Noninvasive Prenatal Testing

Terminology and Consistency

Consistency of What? Appropriately Contextualizing Ethical Analysis of Non-Invasive Prenatal Testing

Prenatal Testing: Responsibility and Reality

Bioethicists Are Not so Divided on Reproductive Testing for Non-Medical Traits: Emerging Perspectives on Polygenic Scores

Going Back to Basics: What is the Target of Prenatal Screening?

Nurtured Genetics: Prenatal Testing and the Anchoring of Genetic Expectancies

Anticipatory Governance of Noninvasive Prenatal Testing for “Non-Medical” Traits: Lessons from Regulation of Medically Assisted Reproduction

Additional information

Funding

Research conducted at the Murdoch Children’s Research Institute was supported by the Victorian Government’s Operational Infrastructure Support Program. This research was supported by an Australian Government Research Training Program (RTP) Scholarship. This research was funded in whole, or in part, by the Wellcome Trust [Grant number WT203132, WT104848]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This work was supported by the Australian Government through the Medical Research Future Fund, as part of the Genomics Health Futures Mission (Grant number 76749).