Non-invasive prenatal testing: public and doctors should be consulted, says BMABMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k2916 (Published 03 July 2018) Cite this as: BMJ 2018;362:k2916
The BMA has the backing of doctors to lobby the government to undertake a consultation on the views of the public and medical profession on new non-invasive prenatal testing (NIPT) and whether limits should be set on its use.
Disability advocacy groups welcomed the passing of a motion at the BMA’s annual representative meeting in Brighton on 27 June which said that “the time is right” for a consultation on the matter.
The move increases the pressure on the government to undertake a proper consultation and ethical review of NIPT. Last year, an open letter1 signed by 900 people with Down’s syndrome and their families was delivered to the health secretary Jeremy Hunt demanding that the approval of the implementation of NIPT on the NHS be delayed until a full consultation and ethical review takes place. A motion signed by 34 cross party MPs was also tabled in support of the call.
Three other parts of the motion debated at the BMA meeting were lost. They all concerned keeping a register of conditions for which NIPT is used in the UK.
Non-invasive prenatal testing checks maternal blood for fetal DNA indicative of Down’s syndrome and has been available in private clinics in the UK for several years. The test also screens for the rarer genetic conditions Edward’s syndrome and Patau syndrome. Research has found high rates of acceptabilty among women offered the test.2
NIPT has been piloted as a second stage test in some NHS hospitals among women found to be at high risk of carrying a fetus with Down’s syndrome. Public Health England said that the test will be rolled out across England in the autumn, although the details of how it will be used are still to be decided.
NIPT has attracted controversy because there are concerns it could increase terminations among women found to be carrying a fetus affected by Down’s syndrome, which can identified with 99% before 12 weeks. But doctors have reported that this has not been observed in practice.3
Mark Pickering, a GP in Yorkshire, said the following in a speech in support of the motion, “We must ensure that the use of NIPT, with the possible increase in resulting abortions, doesn’t lead to more stigma against children born with genetic conditions, nor a reduction in the support and expertise offered to such children and their families, nor any stigma towards parents who choose knowingly to raise a child with significant genetic condition.”
Zoe Greaves, a GP trainee and member of the BMA’s Medical Ethics Committee, who proposed the motion said, “In considering new technologies and the great potential they offer, we must also sadly safeguard against the ways in which they can be abused.”
John Chisholm, a member of the BMA’s Medical Ethics Committee, said, “I think it’s right that there should be consultation and the views not just of the profession but vitally of the public are sought.”