title: The genetics of prenatal diagnosis, c.1950-1990: the case of Malcolm Ferguson-Smith
Creators: name: Blair, Paula
Publisher: name: University of Glasgow
Year: 2020
Subjects: subject: history of medicine, prenatal testing, Malcolm Ferguson-Smith

description: In the present day, the fetus is a well-studied entity, with both physical appearance and genetic constitution able to be determined prior to birth. However, this is a relatively new phenomenon, that has been made possible due to developments which have occurred in the field of prenatal testing in the last fifty or so years. Prior to the implementation of antenatal testing technologies, the fetus was surrounded by mystery, accessed through information passed on by the pregnant woman. This thesis examines the developments that have occurred in the prenatal testing field within the time period 1950 to 1990, which have made it possible to characterise the physical and genetic structure of the fetus prior to birth. An analysis is made of the development of relevant prenatal testing technologies, including amniocentesis, chorionic villus sampling, and ultrasound, with a consideration of their role in making the fetus an accessible entity during pregnancy. To examine how these technologies have been implemented into clinical care, this thesis focuses on the development of prenatal testing and screening programmes in the West of Scotland. Within this region, the city of Glasgow presents an interesting case study for analysis. Work in this city was led by Malcolm Ferguson-Smith, who is widely regarded as one of the most eminent British medical geneticists of recent decades. This thesis studies the role which Ferguson-Smith and his colleagues played in the development and implementation of prenatal testing and screening programmes in the West of Scotland, particularly for chromosome disorders and neural tube defects. It will be shown that the group played a central role in bringing prenatal testing to residents of Glasgow, with the majority of screening programmes proving to be popular with pregnant women in the region. Whilst prenatal testing became technically feasible due to advances in technology and science, the field presents a particularly interesting area for analysis, due to the ethical questions which prenatal diagnosis raises. There are no medical treatments available for the majority of conditions which can be detected, and after a positive prenatal diagnosis, many women choose to terminate their pregnancies. The importance of the development of permissive abortion legislation is therefore important to consider within the context of this thesis. With prenatal testing being linked to termination of pregnancy, it can be seen that it has the potential to cause conflict between those who manage and participate in the prenatal testing programmes, and those who oppose abortion, such as certain religious groups. This thesis examines how the two largest religious organisations that were present in Glasgow during the time period of this study, the Church of Scotland and the Roman Catholic Church, responded to permissive abortion legislation in the form of the Abortion Act 1967. The views of both the Church of Scotland and the Roman Catholic Church on abortion following prenatal diagnosis will also be considered, and it will be argued that remarkably few discussions were taking place on this subject. This has created a complex situation whereby the expected conflict between prenatal testing and religion did not seem to be overly prominent during the time period of this study; this is reflected in a lack of direct correlation between prenatal decision making and religious affiliation. Glasgow presents a particularly interesting area for examining the interplay of the technical and social aspects of prenatal diagnosis. In the city there was a focus on prenatal testing amongst the group led by Ferguson-Smith, whilst concurrently the Roman Catholic population in the region were openly voicing their opposition to abortion. This thesis provides a detailed picture of the interaction of the technical and social influences in this geographical region. To achieve this, a wide variety of sources have been examined, including archival material, published scientific papers, and newspapers and magazines. A number of oral history interviews have also been carried out. As a result of the analysis of these sources, what emerges is an in-depth account of the development of prenatal testing in the West of Scotland.