Pre-Natal Screening: An Ethical Alalysis |

Introduction
It is useful to begin by citing the teaching found in the 1987 document issued by the Vatican’s Congregation for the Doctrine of the Faith, Donum Vitae (Instruction on the Respect Due to Human Life in Its Origin and on the Dignity of Procreation). This document addressed the morality of both pre-natal screening and the use of therapeutic procedures on human embryos. Regarding pre-natal diagnosis it affirmed: “pre-natal diagnosis makes it possible to know the condition of the embryo and of the fetus when still in the mother’s womb. It…makes it possible to anticipate earlier and more effectively certain therapeutic, medical or surgical procedures. Such diagnosis is permissible, with the consent of the parents after they have been adequately informed, if the methods employed safeguard the life and integrity of the embryo and the mother, without subjecting them to disproportionate risks. But this diagnosis is gravely opposed to the moral law when it is done with the thought of possibly inducing an abortion depending upon the results: a diagnosis which shows the existence of a malformation or a hereditary illness must not be the equivalent of a death-sentence.” Concerning therapeutic measures applied to the human embryo it taught: “[O]ne must uphold as licit procedures carried out on the human embryo which respect the life and integrity of the embryo and do not involve disproportionate risks for it but are directed towards its healing, the improvement of its condition of health, or its individual survival. Whatever the type of medical, surgical or other therapy, the free and informed consent of the parents is required…The application of this moral principle may call for delicate and particular precautions in the case of embryonic or fetal life.”

This shows that pre-natal screening and diagnosis is morally good when used to be of benefit to the unborn child but is morally wicked when used as a means to “hunt and destroy” “defective” unborn babies. It also provides the moral norm relevant to use of therapeutic procedures.

Screening as hunting for and destroying, if found, “defective” unborn children
When the U.S. Supreme Court in its 1973 ruling in Roe v Wade struck down as unconstitutional state laws proscribing abortion on the grounds that such laws violated the “right to privacy” granted to pregnant women and their doctors by the 14th amendment, the pressure for diagnosing unborn children grew and the legal penalty imposed on obstetricians for failing to warn or diagnose fetal anomalies became a driving force in obstetric care (on this see Maggie Datiles, “Better Off Dead: The Ethical Thicket of Wrongful Life, Wrongful Birth and Related Legal Issues ,” content/view/674/1/). Here it is important to note that in 1967 the Supreme Court of New Jersey, in Gleitman v. Cosgrove, soundly rejected a “wrongful birth” suit by the Gleitmans against their obstetrician Cosgrove on behalf of their son Jeffrey. It declared: “It is basic to the human condition to seek life and to hold onto it however heavily burdened….The right to life is inalienable in our society.” The wisdom of this Court—a wisdom shared as a basic truth in our society at that time—has been, of course, repudiated by the 1973 Roe v Wade decision.

This barbaric consequence of legalizing abortion was illustrated for me a few years ago on a visit to my daughter, Kathleen, in London. Her husband, James Boardman, a pro-life pediatric neurologist then finishing his residency, came home sickened one night because a newborn brought to him was blind in one eye. The needle used for an amniocentesis to determine whether he had Down Syndrome had pierced that part of the brain where the eye develops. James told us that invasive procedures which jeopardize the unborn child (e.g., amniocentesis) are medically unnecessary in medical practice in which neither the doctor nor the patient are not willing to abort, a judgment made also by the well-known champion of life Thomas W. Hilgers (see his essay,“Prenatal and Pre-Implantation Genetic Diagnosis: Duty or Eugenic Prelude?” in Human Genome, Human Person, and the Society of the Future, eds. Juan de Dios Vial Correa and Elio Sgreccia, Vatican City: Libreria Editrice Vaticana, 1999, p. 186).

Morally good uses of pre-natal screening
Prenatal diagnosis can be very valuable. It can, for example, discover, by use of sonograms and other modern diagnostic procedures, neural tube malformations. It is then frequently possible to employ a therapeutic action on the developing unborn child while still in its mother’s womb. A shunt can be inserted into the child’s brain and fluid causing pressure on the brain drained from it, thus providing great benefit to a child suffering from spina bifida. At a hearing at the US Senate some years ago sponsored by pro-life Senator Gordon Humphrey (unfortunately no longer in the Senate), I personally was present at testimony given by a couple and their physician, with the child—now born and resting on her mother’s lap—in which they described the wonderful surgery that had been done on the child while still in her mother’s womb, a therapeutic intervention indicated after prenatal diagnosis had shown that she suffered from a neural tube defect and that fluids were building up in her cranium, exerting pressure on her brain. This timely intervention was successful in minimizing the harm this child suffered.

Conclusion
Thus pre-natal screening can be used in a morally good was as well as in a morally bad way. It seems unfortunate that most medical hospitals who respect the sanctity of life and refuse to abort unborn children deemed “defective” because of the hunt and destroy use of pre-natal screening do not offer pre-natal diagnostic services. Because of this, couples most in need of support in obtaining truly therapeutic help that will beefit their unborn children are sent away. But that support must be to affirm the sanctity of human life. Prenatal diagnosis offers information to a woman, a couple; such information is good because it delineates reality.