| Many commentators are concerned that physicians | | | | adjustment. If we are moral persons, Kantian ethics |
| have an agenda when they discuss results of | | | | requires us to respect all individuals. Our children are |
| prenatal testing with their patients. Often, physicians | | | | not means to our personal fulfillment, nor are they |
| have preconceived values regarding what should be | | | | trophies to be displayed in their precocity and |
| an exclusively patient-centered arena. For example, | | | | perfection. Children are ends in themselves, and if a |
| many physicians are predisposed to recommend | | | | child is disabled she is deserving of as much respect |
| abortion when prenatal testing reveals the presence | | | | as any other. |
| of genetic or structural anomalies that would result in | | | | But respect for persons does not require a potential |
| disability. | | | | mother to knowingly bring a seriously disabled child |
| Such predispositions and preconceptions may be | | | | into the world. For example, severe spinal bifida |
| distinguished from an objective approach in which the | | | | would entail a lifetime of supervision and medical care. |
| physician provides in-depth background on the | | | | Even mild spina bifida can be burdensome and cause |
| specific potential disability and presents possible | | | | serious problems later in life. Prenatal testing makes it |
| outcomes for the family, whether they choose to | | | | possible to avoid giving birth to a child so burdened. |
| abort or to continue the pregnancy. Using such an | | | | The key issue is the availability of an authentic choice. |
| open-ended approach would "promote genuine | | | | Prenatal counseling should be as rigorous as any |
| reproductive choice and help families and society to | | | | well-designed informed consent process. Physicians in |
| flourish".1 | | | | this field should have advanced training and expertise, |
| Of course, I agree that a just society must | | | | beyond the standard obstetrics curriculum. |
| appreciate and nurture the lives of all people. And of | | | | There is also the potential for financial abuse of the |
| course, many disabled persons live lives of great | | | | system, as with any advanced technology. Until |
| personal satisfaction and value. I do not agree, | | | | prenatal testing becomes commoditized, that is, |
| however, that prenatal testing is in itself morally | | | | financially available to all, the procedure should not be |
| troubling. | | | | "standardized". Not every 28-year-old needs prenatal |
| Certainly, physicians should present both sides of the | | | | testing. Obstetricians should not offer the procedure |
| question. Prospective parents need information, | | | | as a necessary part of being pregnant. |
| rather than a bulleted summary burdened with the | | | | For many, prenatal testing is appropriate. The results |
| specialist's prejudices. I conjecture some prospective | | | | should be presented objectively, informatively, and |
| parents might choose to continue with such a | | | | the parents empowered to make the choice that is |
| pregnancy if they were provided with a more | | | | right for them. |
| complete analysis and report. | | | | 1Asch A: Prenatal diagnosis and selective abortion. A |
| And certainly, society's attitudes need quite an | | | | challenge to practice and policy. |