Screening For Foetal Down Syndrome

The declaration of human rights clearly states that a person has the’ Right to Life, Liberty and Personal Security’ The process of prenatal screening is something that has been and continues to be a topic of debate amongst the world’s populous; from completely pro to completely anti, the ethical debate spectrum is almost boundless, this project hopes to evaluate both opinions and reach a conclusion on an ethical basis, supported by the scientific foundations.

This topic is up for debate due to the conflicting opinions behind it, Rachel Nolan, a member of the Queensland Parliament for 11 years and a state minister alongside being the state's parliamentary secretary for disability services between 2007 and 2009 explains in an article published by the Guardian why she chose not to use prenatal screening. As she is over 40 she understands that she has a significantly increased risk of carrying a Down syndrome pregnancy however she quotes that ‘Every one of us brings something unique to the world – surely we can see the value of difference as well as of conformity and we can extend our love and care to people with disabilities, both those among us now and those who hold at this stage just the potential for life ‘.

This could suggest that the anti-screening argument is based around individuality and the importance of differences. The volume of pro-screening resources is vastly limited compared to the anti and tends to be based around medical and scientific reasons rather than actually confronting and questioning the ethics, in terms of a preliminary judgement this could mean that perhaps it is not ethical if the weighting of argument is clearly imbalanced towards anti-screening.

There are five predominant sections which look at a Down syndrome life from the scan up until adulthood, it is important to recognise how for those who choose not to abort their pregnancy their life is impacted both positively and negatively. The research for this project is based mainly around secondary sources as the topic can present itself as controversial, meaning primary research is often unachievable. The research was carried out over a period beginning September 2017 up until March 2018 when sufficient means had been collected to write the report judiciously and effectively. The volume of academic reports, articles, case studies and books written regarding the topic was extremely important because it allowed for a non-biased judgement to be reached and also to secure the scientific foundations that are quintessential to understanding the topic in terms of ethics.

The Down syndrome association is also an important platform to understanding why this question is constantly up for debate and why parents should consider the continuation of pregnancies post-diagnosis. The opinion of those living with the condition or their families is invaluable because beyond the knowledge of experts they understand the day to day socioeconomic impacts.

Down syndrome is a word heard by expectant mothers every year in every area across the country and it would be fair to assume that in more cases than not this word is not received with jubilation. Every parent wants their child to have the best opportunities in life and upon hearing this diagnosis they may feel this is unachievable. But is it ethical to deny a person the right to life before it has even begun? In answering this question I will give evaluative points deriving from both opinions and views.

So why do women engage with prenatal screening? The most common reason given wants to prevent or ameliorate medical or disabling conditions that are based genetically, such as the focus of this report, Down syndrome. Once the screening has taken place the woman is left with essentially two options; the termination of the pregnancy via an abortion or the continuation of the pregnancy with prevention of family disruption through emotional, social and economic preparation, the main focus of this being to prepare the family for the consequences of the abnormalities their child will be born with. Research by (Alison Gee) shows that 90% of women who have a positive screening for Down syndrome chose to terminate the pregnancy although the nuchal fold thickness test is estimated at only 85-90% accurate, with 2.5% of children shown as having Down syndrome actually not having the condition at all.

Screening for foetal Down syndrome first became possible for UK women in the latter of the 1960’s when it was discovered that there was a correlation between the age of an expectant mother and the prevalence of Down syndrome at birth. At this time the nuchal fold thickness examination did not exist as it does today and the ‘screening’ process itself developed greatly throughout the subsequent decades.