There has been considerable debate on issues such as this in the past few years and the general consensus is that children should not be tested for adult-onset conditions unless specific interventions are available that must be instituted before reaching age 18. This preserves respect for the child s future autonomy without in general introducing any additional medical risks. A couple is referred for genetic counseling who currently have four daughters. An unintended pregnancy has occurred. They request prenatal diagnosis for determination of fetal sex and plan to terminate the pregnancy depending upon the sex of the child.
Clinical geneticists are still somewhat divided in their views on sex selection.
Many refuse to perform prenatal diagnosis in a setting such as this. A couple who are both affected with achondroplasia, a dominant dwarfing condition caused by mutation in the gene for fibroblast growth factor receptor 3, come for genetic counseling indicating a wish to have a child who is, like themselves, affected with achondroplasia. They desire to terminate a pregnancy if the fetus is either homozygous normal or homozygous affected and continue the pregnancy if the fetus has heterozygous achondroplasia. This situation is challenging. A decision that deliberately worsens the clinical status of the offspring would seem to violate the principal benefit for the child.