Opening Pandora's box? Ethical issues in prenatal whole genome and exome sequencing

Objective The development of genomic approaches to prenatal testing such as whole genome and exome sequencing offers the potential for a better understanding of prenatal structural anomalies in the fetus and ultimately for improved patient care and more informed reproductive decision making. In addition to the scientific and clinical challenges of achieving this, the introduction of new reproductive technologies also presents a number of ethical problems. The successful and appropriate development and introduction of prenatal genomics into clinical practice requires these problems to be identified, understood and carefully analysed in the development of models of good ethical practice. Method We conducted a critical review of the existing literature on ethical issues in prenatal genomics. Results We identified and discussed five areas of particular concern: valid consent, management and feed-back of information, responsibilities of health professionals, priority setting and resources, and duties towards the future child. Conclusion There is a need for further discussion of the issues we have outlined here and we hope that this brief summary of ethical arguments in the literature encourages researchers, clinicians, patients and scientists to engage in further discussion of these and other important issues raised by prenatal genomics