Prenatal Genetic Screening: The Enigma of Selective Abortion

In the survival of favoured individuals and races, during the constantly-recurring Struggle for Existence, we see a powerful and ever-acting form of Selection ... Thus, from the war of nature, from famine and death, the most exalted object which we are capable of conceiving, namely the production of the higher animals, directly follows. And I think that our braver and better youth, besides their other honors and rewards, might have great facilities of intercourse with women given them; their bravery will be a reason, and such fathers ought to have as many sons as possible. Plato, THE REPUBLIC, Book V, 460b I. INTRODUCTION As we near a new millennium, technology changes the world at an astonishing rate. Almost no aspect of our world is as it was only a few years ago. Included within this change is the advent of new reproductive technologies which influence the choices available to prospective parents. Among these new technologies is the ability for science to accurately predict the genetic make-up of a fetus.(2) Available methods obtain samples of pre-natal cells and perform a battery of genetic testing.(3) Advances in molecular biology and genetics will soon produce a "genetic map"(4) which prospective parents can use to assess a full complement of the genetic traits of a potential child.(5) The advent of these technologies also brings questions of whether this "science" is ethically and legally acceptable.(6) This paper examines the issue of pre-natal genetic testing and its ethical and legal concerns. Part II details the scientific techniques involved in pre-natal genetic testing. Part III discusses the Human Genome Project and its influence on the choices available to prospective parents. Part IV analyzes the moral and ethical issues raised by pre-natal genetic screening. Part V presents the legal issues raised by pre-natal genetic screening. Finally, Part VI concludes and offers a prospective on the future of these technologies. II. SCIENTIFIC TECHNIQUES A. Amniocentesis Amniocentesis allows doctors to withdraw fluid from the amniotic sac and harvest the fetal cells contained therein.(7) This is accomplished by piercing the abdomen of a pregnant woman to gain access to the amniotic sac. A portion of the amniotic fluid is withdrawn and incubated to increase the concentration of the fetal cells found in the amniotic fluid.(8) One of the major drawbacks of amniocentesis is that it cannot be performed before the fifteenth or sixteenth week of pregnancy. Adding the time for incubation of the cells, the earliest an expectant mother can learn the results is around nineteen or twenty weeks. Additionally, amniocentesis has resulted in approximately a 0.5 percent pregnancy loss in the United States.(9) B. Chorionic Villi Sampling (CVS) CVS extracts fetal cells through biopsy of the chorionic villi.(10) The chorionic villi are hair-like projections that surround the embryo in the early stages of pregnancy. CVS can be performed by a physician using ultrasound to guide a thin catheter through the cervix. Once in the uterus, a small plug of tissue is removed. This plug contains chorionic villi from which fetal cells can be harvested.(11) The major advantage to CVS is that the procedure can be performed within the first three months of pregnancy. Because the chorionic villi will disappear in later stages, this procedure must be performed before the tenth week of pregnancy. CVS has the additional advantage of needing no time for incubation of the fetal cells. Thus CVS provides patients quicker results than amniocentesis.(12) However, the incidence of pregnancy loss as a result of CVS is slightly higher than that associated with amniocentesis.(13) C. In Vitro Fertilization In in vitro fertilization, sperm and egg samples are artificially conceived outside of the womb. …