LAVC Health & Medical Ethical Issues in Prenatal Genetic Testing Case Study

You have watched a presentation regarding the scenario ( attached below in pdf) . Write a paper on the scenario.

Discuss the main points of the debate on prenatal testing.

what stance do you take, support that stance

Why do you feel the way you do about the issue presented?

Of the four responses offered in the scenario, which do you think is the most ethical and why? (attached is a conversation between the two doctors and the last page has the responses you choose your opinion and paper on)

Which ethical theory would you use to support your stance? ( of the approved ones only– Kant; Act Utilitarianism; Rule Utilitarianism; Care Ethics; Virtue Ethics; and Social Contract, natural law theory, deontology) Why does this theory work?

discuss the opposing argument

Which ethical theory would you use to oppose your stance? ( of the approved ones only– Kant; Act Utilitarianism; Rule Utilitarianism; Care Ethics; Virtue Ethics; and Social Contract, natural law theory, deontology) Why does this theory work?

4.       Support your conclusions with evidence and specific examples, including a minimum of one theory of ethics to defend your stance.

Debating prenatal testing
Moderator:
Good morning, everyone, thank you so much for coming today. Concerns have been raised
recently that the strides that specialists are making in prenatal genetic testing are leading us
down the path of eugenics.
Eugenics, of course, is the theory and practice of human improvement by way of
genetic manipulation to produce desired traits in a child. If history is any indicator, there is
cause for alarm where ethics issues and eugenics are concerned.
Eugenics played a clear role in the Nazi genetic test “master race” project and the
extermination of millions of people who did not meet Nazi criteria. Can the mistakes of the past
be avoided? Doctors and legislators need to be open-minded and willing to hear all opinions on
this topic.
Today we are talking specifically about a blood test used to screen for Down syndrome during
the first trimester of pregnancy.
DR. WILLIAMS
The genetic test in question gives us the
ability to identify Down syndrome in the
womb without causing any harm to the fetus
using a simple blood test.
Down syndrome can bring with it a lifetime
of pain and frustration which, in addition to
the potential for physical abnormalities, can
include a loss of cognitive ability, respiratory
problems, heart defects, and more.
This test is extremely low risk and almost
100% accurate; there is no reason to view
this as ethically questionable.
Giving parents this information in advance
means parents have more options in
general, and an opportunity to raise a
healthier child.
DR. WILLIAMS
We are not telling parents what to do with
the
information we give them. We are simply
identifying a potential health hazard. This
test is a medical advance, plain and simple.
DR. GARCIA
Obviously there’s more to it than that,
Catherine. For starters, many children with
Down syndrome develop into healthy adults
who do not suffer from the health conditions
you mentioned. And many of those potential
conditions can develop independent of the
syndrome, in the general population. As
there is no cure for Down syndrome, the
“opportunity to raise a healthier child” you
refer to implies aborting a child after a
positive blood test. By promoting this test,
aren’t we stepping into a grey area where we
are engineering human improvement based
on a subjective evaluation of what is a
“better” human being?
Question for dr Garcia :
I know there’s no cure but how long do
people with Down syndrome typically live,
and what is their quality of life?
DR. GARCIA
Previous tests for Down syndrome were not
as accurate, and required withdrawing
amniotic fluid, which came with substantial
risks. This is a basic blood test. We are
identifying a clear health risk. It’s noncompulsory, and the benefits are strictly for
greater health.
MODERATOR
We have a question from the audience for
Dr. Williams: How rare is Down syndrome?
Dr. Williams?
R. WILLIAMS
the CDC estimated the frequency of Down
syndrome in the United States as 1 in 691
live births in 2011, up fam 1 in 1,087 in
990.
Advances in medicine have improved life
dramatically for those with Down syndrome.
True, most still live shorter lives on average
than those without the disorder, but many
now live to be 60 or older. In the United
States, many people with Down syndrome
complete high school, and some go on to
college. People with Down syndrome can
work, volunteer, and vote. And they are able
to give and receive love like everyone else.
DR. GARCIA
Perhaps not “strictly”. The test will inevitably
lead some parents to abort a child whose
test is positive for Down syndrome, but who
would not have developed any of the health
problems potentially associated with the
disorder.
healthy life would have been prevented in
favor of another life with more culturally
accepted aesthetics, and little more. Making
this test available is also making decisions
about which lives we value as a society, and
with that we are stepping beyond the realm
of health care. This is the reason that some
of us fear that these tests are leading us as
a culture toward eugenics. The blood test for
Down syndrome is a medical advance, but
that does not mean it is an ethical advance.
MODERATOR
OK, we have a question from the audience-What is the pregnancy termination rate after
a diagnosis of Down syndrome?
Dr. Garcia?
DR. GARCIA
Statistics vary widely, but following a
prenatal
diagnosis of Down syndrome, 60-90% of
expectant parents choose to terminate the
pregnancy.
Responses to choose from which do you agree with?
A. Dr. Williams is correct. A mandate to either keep a child or to abort it after a diagnosis would
be an entirely different discussion, but this is merely a blood test, and it is optional. We are
simply providing the expecting parents with more information about their unborn child. As
Down syndrome can cause significant impairment and increased health risks, we are acting
ethically as health care providers in making the test available to all.
B. This issue is deeper than it might at first appear to be. Down syndrome can cause health
issues, but the disorder itself is not unhealthy. It is just a condition that comes with a greater
risk for some health problems. Since eugenics, in any form, is often rightly associated with Nazi
Germany, let’s look at it in that light. What if a similar test were available in Germany in the
1940s? The Nazis would have aborted the children and might have deemed the parents no
longer fit to bear children and sterilized them. And for what? A condition that people can live
long, healthy lives with.
C. They are both right. It is a simple blood test, and it is ethical in and of itself, but we do need
to consider the ramifications of making such a test universally available. We also need to
consider the message it sends about Down syndrome. Perhaps the path to take here is to make
the test available as part of a battery of tests, and to provide information about Down
syndrome that lets parents know what to expect if they decide to keep a child shown to have
the disorder.
D. We should not be looking for Down syndrome at all. It is not, in and of itself, a health issue.
There are health risks associated with being an Ashkenazi Jew, such as the potential for TaySachs Disease, which are horrible and lethal. These are clear health concerns, and yet we would
never say it’s wrong to be an Ashkenazi Jew unless we truly learned nothing from World War I1.
This should not even be on the table for discussion.