Submission to National Screening Committee Consultation on cfDNA screening proposal – October 2015
The UK’s National Screening Committee (UKNSC) has brought forward a proposal to introduce cell-free DNA (cfDNA) testing, a form of Non-Invasive Prenatal Testing (NIPT) into the UK’s Fetal Anomaly Screening Programme (FASP). This proposal is justified based on an ‘expert review’ of two studies, a ground study performed by the Reliable Accurate Prenatal non-Invasive Diagnosis (RAPID) programme, and a systematic review (SR) of studies relating to cfDNA .
Stop Gendercide are concerned about the effect the introduction of cfDNA in detecting trisomies will have on the FASP’s ability to expand to detecting other groups. Normalising NIPT as part of the screening system would help enable such expansion. Most pertinently to the Stop Gendercide campaign, since cfDNA allows for a test of fetal sex (1), this could help to enable sex-selective abortions. Worryingly, the most recent report from UNESCO’s International Bioethics Committee anticipates this very occurrence:
“Another risk lies in the cultural prejudices of preferring a child of the male sex, the sex of the baby being one of the characteristics that can obviously be discovered by NIPT. As this test can be carried out at a very early stage of the pregnancy it would be difficult, even impossible for doctors to forbid the communicating of sex to the parents, and especially at a time when many countries have liberalised abortion. This could lead to a selection based on sex, which is against ethical values of equality and non-discrimination” (2) .
The concern of the Stop Gendercide campaign is that, in the absence of proper medical reforms and clarification that sex-selective abortion is illegal, the implementation of cfDNA could worsen the problem of sex-selective abortion in the UK by more readily enabling it. The prevention of such abuses is something the Government needs to address before allowing the implementation of this technology.
(1) As is presented in marketing material from existing cfDNA testing providers: http://www.ariosadx.com/expecting-parents/faqs/;
(2) ‘Report of the IBC on Updating Its Reflection on the Human Genome and Human Rights’, October 02nd 2015, section 91: http://unesdoc.unesco.org/images/0023/002332/233258e.pdf