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Discrimination down to a science

The questionable ethics of prenatal genetic testing


Are we now in the age of the designer baby? Christians and ethicists have long been concerned that advances in genetics would lead to a future in which parents could choose the desired genetic makeup of their children. But eugenic practices in prenatal healthcare are not just a thing of the future—they are already routine. Eugenics, the practice of arranging human reproduction to occur with only the most desirable characteristics, has long been used as a tool to sterilize or even murder people considered to be “burdens” on society. It was adopted by the Nazis in Germany to condone its extermination of Jews, minorities, and the disabled. And today, a eugenicist-type practice is used in prenatal genetic testing to identify and eliminate the lives of unwanted children before they are born.

Prenatal genetic testing examines a small amount of the mother’s blood to learn the DNA of the unborn child to determine whether there are any genetic abnormalities. But genetic testing really tests the unborn child’s fitness for survival. It offers parents a false promise of peace by claiming to detect early fetal abnormalities. But these tests, which are not regulated by the U.S. Food and Drug Administration, are not subject to the quality control, clinical trial, or reporting requirements that government-regulated tests are. And new studies show they are not reliable.

The New York Times published on Saturday groundbreaking investigative research that some prenatal genetic testing yielded an 85 percent false positive rate at best, and a 95 percent false-positive rate at worst. That means for every 100 positive tests, usually conducted in the first trimester, 85 to 95 women receive a devastating diagnosis for their baby and are counseled on abortion—when their babies are actually perfectly healthy. This, despite test makers’ advertising that patients can have “total confidence in every result.” In many cases, even doctors are unaware of how unreliable these tests are, despite treating their results as definitive.

And while follow-up testing is recommended, it doesn’t always happen—or when it does, not in time. Devastatingly, the research recounts the story of a woman who had received a false positive for a rare genetic disorder, but follow-up testing proved her baby was healthy. By the time the results came in, the woman had already had an abortion. And a 2014 study shows that this response is not uncommon: 6 percent of patients abort their babies after receiving a positive genetic test result without doing the recommended follow-up testing to confirm.

The research affirms what many in the pro-life community already knew: Prenatal genetic testing leads to an increased number of abortions and is predicated on the logic that some lives are not worth living. Even if these tests were 100 percent accurate, they would still exist in tension with Christian teaching, which asserts every human life—born or unborn, with a disability or none—is inherently worthy, dignified, and created in the image of God.

Using prenatal testing to identify weakness and abort a pregnancy is not healthcare; it’s sterilized termination of life in a clinical setting.

The problem is not, as The New York Times suggests, the accuracy of the tests. The problem is that the logic undergirding much of the new prenatal healthcare (and arguably healthcare at large) is eugenicist and utilitarian. It assumes parents will not want a child with Down syndrome or any other genetic anomaly. It assumes a child’s life is more valuable insofar as the child is without any “problems.” And despite doctors offering their patients a so-called “choice,” there is no real choice—not when the entire medical system is designed to maximize profit and minimize risk—to end high-risk pregnancies rather than care for them. The deck is stacked against life. It’s easier and more efficient to abort a pregnancy than it is to care for one that’s high risk.

That’s not the logic of Christianity. Even when diagnoses are terminal, the Christian believes there is goodness and purpose in a life, no matter how short. And though pain and suffering and heartache may ensue, the Christian must always maintain hope—if not in earthly healing, then in the resurrection of the body.

Healthcare is not “the things that doctors do,” as our culture consciously or subconsciously defines it. True healthcare is the practice of restoring the body’s integrity and wholeness. Any action that is not geared toward the restoration of the body is not truly healthcare. Using prenatal testing to identify weakness and abort a pregnancy is not healthcare; it’s sterilized termination of life in a clinical setting.

While prenatal genetic testing could have the potential for doing good—to ensure the baby and mother are healthy, to assist in prenatal surgeries, to help parents prepare mentally and physically for illness, terminal or otherwise—the entirety of our modern medical system is weighted against this good, such that it becomes difficult even for Christians to participate in these routine practices without the temptation of falling prey to their deceptions. The billion-dollar genetic testing industry sows fear and reaps death. In the words of the 1997 film, Gattaca, which portrays the fictional outworking of prenatal eugenics, “We now have discrimination down to a science.”


Katelyn Walls Shelton

Katelyn Walls Shelton is a Bioethics Fellow at the Paul Ramsey Institute. She is a women’s health policy consultant who previously worked to promote the well-being of women and the unborn at the U.S. Department of Health and Human Services. She graduated from Yale Divinity School and Union University and lives in Washington, D.C., with her husband, John, and their three children.

@annakateshelt


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