Prenatal testing and reproductive autonomy: defending against disability discrimination concerns

Arguments have been forwarded that terminating a pregnancy affected by a congenital abnormality discriminates against those living with disabilities and makes negative judgements about their lives.For the clinical geneticist these arguments raise questions as to whether their practice is ethical. In this thesis I aim to consider these concerns primarily from the position of the clinical geneticist by addressing ethical arguments. I argue that the fetus does not have full moral status equivalent to a person and therefore terminating a disabled fetus is not comparable with ending the life of a disabled person, and so does not imply that the lives of disabled persons are not worth living. I further argue that the decision to carry out prenatal testing and abortion should not solely rely on disability and on the objective opinions of healthcare professionals. Central to this argument is that when considering whether or not prenatal testing and abortion are justifiable, it is important to take into account the specific and unique circumstances of the family, particularly the parents and pre-existing children. Parents’ reproductive autonomy therefore needs to be considered as well as the harm having a disabled child could cause; both to the future child to and those directly affected by their existence.I conclude that prenatal testing and abortion does not discriminate against those living with disabilities. Despite this, however, reproductive autonomy is not being respected in current approaches to prenatal testing as late termination of pregnancy can only be legally permitted where two healthcare professionals agree to it. Therefore, in order to enhance reproductive autonomy I have made recommendations whereby the supportive role of the clinical geneticist can be further developed by their acting as an advocate for prospective parents when justifications for late termination of pregnancy are being considered by healthcare professionals