Tom Shakespeare

In August, it was announced that a new prenatal test has been approved for use in Switzerland, allowing highly accurate, non-invasive fetal testing for Down syndrome in the twelfth week of pregnancy. Should citizens be concerned? For now, I think not, for three reasons.

First, it’s nothing new: Swiss women are already testing their pregnancies for Down syndrome. Second, the PrenaTest is innovative because it works by sequencing DNA from fetal cells in the mother’s blood. That means there is no risk of miscarriage, unlike existing technologies. Third, the test comes earlier, so any termination of pregnancy is less traumatic than it would be at eighteen or twenty weeks.

I support disability rights, and I want disabled people to be welcomed in our society. But I also want women and men to have information and choices in pregnancy and I support abortion rights. That means supporting couples to have the test, or to refuse the test, and to have a termination or to continue the pregnancy. The danger comes if insurers start putting pressure on couples to test or terminate: that’s where it becomes eugenic. Parents should not face recriminations for their difficult moral choices, neither from neighbours, nor health providers nor insurers.

Choice also requires information: prospective parents need to understand not just about the test, but also about the conditions for which it is offered. They need to have balanced information about life with Down syndrome, and about parenting a child with Down syndrome: the difficulties, but also the joys.

Potentially, these fetal DNA tests could identify many different genetic traits, and I hope that the Swiss authorities will only license tests for serious diseases. Many people have the intuition that children should be a gift not a commodity. If in future prenatal testing is permitted for minor or trivial differences, it raises the spectre of “tentative pregnancy”, and “pick and choose” parenting.