Prenatal genetic screening: democratic eugenics

Publié le : 7 May 2013
The new non-invasive prenatal genetic screening for Down syndrome continues to arouse controversy (Gènéthique press review of  04/22/2013). In an article published on, Jean-Yves Nau writes on the recent opinion of the CCNE (National Consultative Committee on Ethics) to announce "the arrival of a world like in ‘Gattaca‘," and to alert readers on "a risk of democratic eugenics." The new test on maternal blood, which if it is proposed to all pregnant women "would lead to diagnosing all the foetuses with Down syndrome, a total of 2,400" reports the daily Libération, would cost about €1 billion. This cost will come down very quickly when the test is widely proposed and reimbursed by national health service, Jean-Yves Nau points out. 
So the opinion of the CCNE is being used in sinister calculations to show that this new blood test will be more effective and more reliable in tracking down foetuses with Down syndrome. What this amounts to according to the Fondation Lejeune is a "validation of the modernisation of the eradication of trisomic people."   
In contrast, as Jean-Yves Nau accuses, the CCNE "seems to be refusing" the ethical analysis of the "shocking technical possibilities of screening and the eugenicist abuses associated with them." The CCNE has given in to a fait accompli, he explains. As "prenatal genetic selection tests" have been used for some years now, the question "is not so much to decide if their use is ethical or not: it is rather to specify, faced with the technical advances and the market pressure, which could be the least bad methods of using them."     
This opinion no. 120 of the CCNE marks an irreversible step which will allow almost systematic access in the short term to the foetal genome.    
And yet the CCNE worries about the possibility of accessing the complete sequencing of the foetal genome which will allow the detection of a large number of genetic disorders, or even simple predispositions to disease. But Jean-Marie Le Méné, president of the Fondation Lejeune, reacts: "Why worry about the future abuses involving certain pathologies rather than deciding today to advocate the halt of the screening for the Down syndrome?"
It should be remembered that the French health authorities have not yet "approved" the new non-invasive screening based on a test of foetal blood and that two official assessment commissions are working on this question in two hospitals, Necker and Antoine-Béclère in Clamart.

NB: Gènéthique informs its readers that, contrary to what was stated in the health section of Libération, in France the number of foetuses found to have Down syndrome is closer to 1,200 rather than 2,400 (the prevalence of Down syndrome is 1/700, and the number of pregnant women is 820,000 per year).

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