Download - Lynn Murray
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The Right toThe Right to
Life andLife and
DisabilityDisability
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Down Syndrome & Antenatal
Screening
By Lynn Murray
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When the State (and therefore by extension National Health
Service) funds a screening programme that selects for fetalanomalies there is a risk that this may be viewed as
eugenics, or that the social acceptance of people with
disabilities is diminished leading to substandard health care
of affected children
Antenatal Screening
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Quote from: Antenatal Care Routine Care for the Healthy
Pregnant Woman Clinical Guideline CG062 (updated 2008)
Woman-centered care
Antenatal Information
Give information that:
is easily understood by all women, including women with additional needs
such as physical, sensory or learning disabilities, and women who do not
speak or read Englishenables women to make informed decisions
is clear, consistent, balanced and accurate, and based on the current
evidence
is supported by written information and may also be provided in different
formats.
Remember to:respect a womans decisions, even when her views are contrary to your own
provide an opportunity forher to discuss concerns and ask questions
make sure she understands the information
give her enough time to make decisions
explain details of antenatal tests and screening in a setting conducive to
discussions (group setting or one-to-one). This should happen before the
booking appointment.
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AnotherQuote from: Antenatal Care Routine Care for the
Healthy Pregnant Woman Clinical Guideline CG062
(updated 2008)
Recommendations on screening for fetal anomalies
The purpose of the scan is to identify fetal anomalies and allow:
reproductive choice (termination of pregnancy)
parents to prepare (for any treatment/disability/palliative care/termination of
pregnancy)
managed birth in a specialist centre
intrauterine therapy.
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Health TechnologyAssessment Report
Routine ultrasound scanning before 24 weeks ofpregnancy
produced by National Health Service Quality Improvement
Scotland (2004)
Ethical Issues
It has been hypothesised that when the State (and therefore by extension National
Health Service) funds a screening programme that selects for fetal anomalies there
is a risk that this may be viewed as eugenics, or that the social acceptance of
people with disabilities is diminished leading to substandard health care of affected
children. (Robins 2002).
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Health TechnologyAssessment Report
Routine ultrasound scanning before 24 weeks ofpregnancy
produced by National Health Service Quality Improvement
Scotland (2004)
Ethical Issues
..The HTA can only acknowledge this broader ethical issue.
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Study by the Clinical Chemistry Department,
Queens Hospital in Staffordshire, England (2003)
Down syndrome screening is unethical: views of todays research ethics
committee
CONCLUSIONS: Down's syndrome screening raises ethical concerns about
genetic testing in general that need to be dealt with before the introduction of
any prenatal screening test.
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Women in Scotland will be offered a new screening test for Down Syndrome.
The special ultrasound scan, known as a 'Nuchal Translucency scan' measures
the amount of fluid lying under the skin at the back of the baby's neck. This
measurement and the results from a blood test will be entered into a computer
programme along with the women's age, weight and any other relevant factors
to calculate the chance of the baby having Down's syndrome.
The future ?Improved Screening
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Antenatal Care will be based upon
more up-to-date medical information
about the lives of t
hose people w
ho
have conditions such as Down
Syndrome, Spina Bifida etc
The brighter alternative ?
Resources will be used to help
people with Down Syndrome, Spina
Bifida etc
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