Published 6 July 2009, doi:10.1136/bmj.b2690
Cite this as: BMJ 2009;339:b2690

Clinical Review

Commentary: No risk, no objections? Ethical pitfalls of cell-free fetal DNA and RNA testing

Dagmar Schmitz, postdoctoral researcher1, Wolfram Henn, head of the department for genetic counselling2, Christian Netzer, senior research associate and clinical geneticist3

1 Institute for History, Theory, and Ethics in Medicine, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany, 2 Institute of Human Genetics, University Hospital, Saarland University, 66421 Homburg/Saar, Germany, 3 Institute of Human Genetics, University Hospital of Cologne, 50931 Köln, Germany

Correspondence to: D Schmitz daschmitz@ukaachen.de

Clinical review, doi:10.1136/bmj.b2451

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

At first glance, the prospect of achieving a definite prenatal diagnosis with no obvious procedure related risks is compelling. Implementation of non-invasive prenatal diagnosis will save the lives of healthy fetuses that would have been lost as a rare "side effect" of established invasive procedures like amniocentesis. But, as Wright and Chitty are well aware, a closer look shows that this technique may have "side effects" of a different kind, most importantly problems with autonomy.

From an ethical point of view, the main justification for prenatal diagnosis is to support the reproductive autonomy of the pregnant woman or couple, because the typical goal of prenatal diagnosis is not treatment, but the option to terminate a pregnancy if the fetus is affected. This core value, however, has to be balanced against the rights of the unborn child, against concerns about possible misuse of prenatal diagnosis for non-medical purposes (such as sex . . . [Full text of this article]


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Relevant Article

Cell-free fetal DNA and RNA in maternal blood: implications for safer antenatal testing
Caroline F Wright and Lyn S Chitty
BMJ 2009 339: b2451. [Extract] [Full Text]

Rapid Responses:

Read all Rapid Responses

Authors misrepresent goals and pitfalls of NIPD
Zuzana Deans, et al.
bmj.com, 10 Jul 2009 [Full text]
Schmitz et al overplay the ethical pitfalls of NIPD
Jane Fisher
bmj.com, 16 Jul 2009 [Full text]
Authors' reply to Deans and Newson
Dagmar Schmitz, et al.
bmj.com, 17 Jul 2009 [Full text]
Let’s make things better: prenatal test requirements raised to the Senseo®-standard?
Antina de Jong
bmj.com, 1 Oct 2009 [Full text]
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