Danielius Serapinas
Abstract
This article outlines the main medical, ethical and legal aspects of prenatal diagnostics. It has become standart in prenatal care to performe tests for chromosome abnormalities and neural tube defects. First trimester tests from maternal serum (free β human chorionic gonadotropin and pregnancy associated plasma protein A) are performed from 11week to 13 +6 days. Second trimester tests( AFP, chorionic gonadotropin, unconjugated estriol) are performed from 14 to 22 week of gestation. Detection rate for chromosome abnormalities is 70 – 87 percent with 5- 20 percent false positive results. Prenatal diagnosis raises complex ethical issues not only in terms of individual decision making, but also in the development of clinical services and the formulation of public policy regarding access and funding. The motivation behind prenatal diagnosis is generally to provide the family with information regarding the pregnancy so that the outcome can be improved. The issue of maternal versus fetal rights is perhaps the single most controversial dilemma in prenatal diagnostics. Here, the basic ethical dilemma is the conflict between respecting maternal autonomy versus acting beneficently toward the fetus. This article describes the essential concept of the fetus as a patient, describing serious clinical cases and based on two core ethical principles: beneficence and respect. The article explores the implications of this concept from prenatal diagnostics to perinatal medicine.
doi:10.5200/sm-hs.2012.065
Keyword(s): prenatal diagnostics; embryo; bioethics
DOI: 10.5200/307
Full Text: PDF