BMJ 2002;324:110 ( 12 January )

Letters

Screening for Down's syndrome

    Antenatal screening has human costs
    Costings are crucial to model
    Conclusions do not reflect reality
    Modelling does not predict reality accurately
    Authors' reply
    Ratio of femoral length to tibial length needs to be evaluated extensively
    Nuchal translucency screening may help detect congenital heart disease

Antenatal screening has human costs

The first 150 words of the full text of this article appear below.

EDITOR---In their study Gilbert et al made no provision for the cost of counselling.1 I still hear from women who go for antenatal care and are screened without consent or counselling. 1 2 Some of these women regret entering a conveyor belt process that ends up with an invasive procedure that causes a high rate of fetal loss. Gilbert et al, by highlighting the economic implications of screening, remind us that mothers and their unborn babies continue to be used in what is primarily a cost saving procedure.

Doubt has already been cast upon the public health benefits of screening and the ethical component of such programmes.3 No pregnancy is replaceable. The cost of screening in human terms has not been evaluated. By excluding the costs of counselling and disregarding mothers' rights and the worth and value to society of children with Down's syndrome, the study by Gilbert et al . . . [Full text of this article]
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