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Tuesday, Oct. 30, 2012
Prenatal test raises ethical concerns
As part of their research, about a dozen medical institutions in Japan plan to start carrying out prenatal detection tests that can predict whether a fetus has Down syndrome or not with an accuracy of more than 99 percent. The method, developed in the United States, consists of testing a blood sample drawn from a woman who has been pregnant for 10 weeks or longer. It is less risky than current amniotic fluid tests, which involves a needle being inserted into the abdomen and raises the risk of a miscarriage.
There is a possibility that women who take the new prenatal test might panic if the result is positive and opt for abortion without giving the decision sufficient consideration. Some women who undergo an abortion in such a mental state may later be plagued by a sense of guilt and regret. It is understandable that the Japan Down Syndrome Society has expressed fear from a bioethics standpoint that as testing becomes widespread, positive results could lead to abortions being carried out as a matter of course.
As a short-term goal, procedures to provide counseling to women who undergo the new prenatal testing should be strengthened, as should be the case for other types of prenatal tests as well. Whether to undergo testing to detect Down syndrome is up to pregnant women and their partners, but they should be provided with accurate information about such matters as what is Down syndrome, how to accept and bring up a child with Down syndrome, what kinds of support measures are available for such children and their parents, and what kind of experiences, including hardship and joy, parents who raise children with Down syndrome typically have. Japan suffers from a shortage of obstetricians and gynecologists who are licensed as medical geneticists. As such doctors are well qualified to give expert advice to pregnant women who are considering undergoing the test, more should be trained.
The National Center of Child Health and Development — which hopes to prevent a widespread commercial exploitation of this test — and other medical institutions that can offer sufficient counseling service had planned to start carrying out testing for pregnant women age 35 or older for clinical research beginning in September. But the medical institutions postponed the start of the diagnosis to mid-November or later because the Japan Society of Obstetrics and Gynecology issued an emergency statement saying that the testing should not be carried out lightly. The society is expected to work out guidelines for the test.
There is strong interest in the test because of the some 1 million babies born in Japan annually, about a quarter are born to mothers age 35 or older. Roughly one out of every 380 babies born to these mothers suffer from chromosomal abnormalities, including Down syndrome, and many of these children will face serious issues in the future concerning their quality of life. Japan must make strenuous efforts to realize the creation of a society that provides extensive support to such children and their families so they can thrive and realize their full potential.