Reproductive Genetics: Canadian and European Perspectives

Abstract

Unlike medically assisted conception, the issue of the impact on women of reproductive genetic testing has been characterized by the emergence of a more ‘relativist’ position. This relativist position is grounded in the understanding of the universality of problems arising from human genetics. An analysis of the major reports emanating from different European countries will demonstrate that the discussion regarding the impact of medically assisted conception and reproductive genetic testing on women is often incidental and secondary. There are similarities and differences in the issues raised in the evaluation of both these technologies. Similarities, in their experimental character, the concomitant social pressure, the myth of the perfect child and the increased medicalization. Differences, in the inherent responsibility or guilt accompanying genetic testing, the timing of choices, the possibility of sex selection, the use and control of genetic information, the sense of intergenerational responsibility and the current qualification of such genetic testing as medical and diagnostic as opposed to a technology of ‘convenience’ as was often the case with the treatment of infertility. In contrast to the European reports, the work of the Canadian Royal Commission on New Reproductive Technologies has as its primary focus the impact of both these technologies on women, children and society.

Maternal Decisions Regarding Prenatal Diagnosis: Rational Choices or Sensible Decisions?

“…43,44 Conversely, a pregnant woman who either does not comply with a referral for testing or decides to continue to carry a fetus in which a disability has been detected is viewed by others as irresponsible, irrational, and selfish. 45 In this way, the birth of a disabled child has been transformed from an unfortunate event into a regrettable event that the mother could have (and perhaps should have) prevented. 44 Thus, the perception that the birth of a child with a disability could have been avoided through PT use creates the potential for the development of a social norm endorsing selective abortion, to the extent that society (a) places the blame for disabled children on women who do not make "proper" use of PT and (b) condones social punishment against these women.…”

Decision-making process about prenatal genetic screening: how deeply do moms-to-be want to know from Non-Invasive Prenatal Testing?

“…Some researchers argued that a woman who makes use of NIPT is seen as a responsible pregnant woman [ 64 ] who is acting in the best interests of the fetus, her family, and her community [ 65 ]. Conversely, a pregnant woman who either does not comply with a referral for testing or decides to continue to carry a fetus in which a disability has been detected is viewed by others as irresponsible, irrational, and selfish [ 66 ]. These debates illustrate the importance of closely monitoring the prevailing social norms governing NIPT use, in terms of both societal opinion and the actual allocation of social resources as the technology advances.…”

Decision-Making Process about Prenatal Genetic Screening: How deeply do Moms-to-Be Want to Know from Non-Invasive Prenatal Testing?

“…Some researchers argued that a woman who makes use of NIPT is seen as a responsible mother-to-be [62] who is acting in the best interests of the fetus, her family, and her community [63]. Conversely, a mother-to-be who either does not comply with a referral for testing or decides to continue to carry a fetus in which a disability has been detected is viewed by others as irresponsible, irrational, and sel sh [64]. These debates illustrate the importance of closely monitoring the prevailing social norms governing NIPT use, in terms of both societal opinion and the actual allocation of social resources as the technology advances.…”