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Clinical Review

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

BMJ 2009; 339 doi: (Published 06 July 2009) Cite this as: BMJ 2009;339:b2690
  1. Dagmar Schmitz, postdoctoral researcher1,
  2. Wolfram Henn, head of the department for genetic counselling2,
  3. Christian Netzer, senior research associate and clinical geneticist3
  1. 1Institute for History, Theory, and Ethics in Medicine, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
  2. 2Institute of Human Genetics, University Hospital, Saarland University, 66421 Homburg/Saar, Germany
  3. 3Institute of Human Genetics, University Hospital of Cologne, 50931 Köln, Germany
  1. Correspondence to: D Schmitz daschmitz{at}

    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 …

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