COMMENTARY

Will New Genetic Tests Lead to More and Earlier Abortions?

Arthur L. Caplan, PhD

Disclosures

October 29, 2013

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Hi. I am Art Caplan at the New York University Langone Medical Center Division of Medical Ethics. Today I want to discuss an interesting ethical challenge that is emerging from a technological innovation in the area of genetic screening.

Historically, a pregnant woman who was deemed at risk of having a child with a severe birth defect would have undergone genetic testing using a technique called amniocentesis. Many of you know that this involves putting a needle into the pregnant woman's belly and pulling amniotic fluid out so that you can get cells from the fetus and analyze their genetic composition, looking for abnormalities such as Down syndrome.

That test can only be performed when the fetus is large enough to be sloughing off cells. Inserting the needle into the womb poses some risk of harm to the fetus if the needle accidently nicks it, or rarely by causing an abortion. There are also dangers of infection for the mom. But for women over age 35, the potential of having a child with a severe congenital defect has been deemed large enough to justify taking those risks.

That technique is soon to be in the dustbin of history because we have a new technology just emerging that I think is going to push it away forever. That new technology involves the ability to draw cells from the pregnant mother's blood and find fetal cells circulating inside the mother's bloodstream.

If you can get those cells out and then copy them or clone them, you can perform the same type of genetic tests that you can do with amniocentesis, but with no risk to the fetus. There is no needle injected into the womb. You are just taking a blood sample and analyzing the fetal cells that way.

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