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Permissibility or Priority? Testing or Screening? Essential Distinctions in the Ethics of Prenatal Testing

Artikel i vetenskaplig tidskrift
Författare Christian Munthe
Publicerad i American Journal of Bioethics
Volym 17
Nummer/häfte 1
Sidor 30-32
ISSN 1526-5161
Publiceringsår 2017
Publicerad vid Institutionen för filosofi, lingvistik och vetenskapsteori
Sidor 30-32
Språk en
Länkar dx.doi.org/10.1080/15265161.2016.12...
https://gup-server.ub.gu.se/v1/asse...
Ämnesord prenatal screening, prenatal diagnosis, prenatal testing, NIPT, Wide genome sequencing, Whole genome sequencing, bioethics, medical ethics healthcare ethics
Ämneskategorier Reproduktionsmedicin och gynekologi, Reproduktiv hälsa, Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi, Medicinsk etik, Praktisk filosofi, Etik

Sammanfattning

Chen and Wasserman’s (2017) suggestion for unlimited whole genome prenatal screening ignores central distinctions, as well as important contributions in the literature, and is backed up by inconsistent arguments. They fail to recognize that their suggestion is less novel than it is held out to be and has been addressed before in various settings, and they miss important reasons against their suggestion. They ignore the distinction between using prenatal testing in general and doing it in the organizational form of a screening program. The latter brings many special ethical challenges that are left unaddressed by Chen and Wasserman. One of these is to not only show that some technology is permissible to use for screening, other things being equal, but also demonstrate that it would be defensible use of health care resources. This challenge seems to weigh heavily against Chen’s and Wasserman’s suggestion when asking whether or not it should be given priority (in public-, charity-, and business- operated settings), supporting limitations of prenatal screening to target more severe conditions available for detection. Chen’s and Wasserman’s argument against that idea is found to rest on, first, confusion between the issues of permissibility and priority. Second, the suggestion that escaping a need to demarcate what to test for is a reason against limiting prenatal screening undermines their own proposal to limit prenatal screening based on probability thresholds.

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