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On Parenting
Posted at 07:00 AM ET, 02/22/2012

Rick Santorum on prenatal tests: Can the future of pregnancy health care be stopped?

First contraception, then professional aspirations. Now prenatal testing has become the political topic du jour as GOP presidential hopeful Rick Santorum continues his slash and burn march through women’s issues.

This past weekend in a CBS interview, Santorum criticized the President Obama-backed health-care program for requiring insurance coverage of certain prenatal tests because they “encourage abortions.”

The video of the that interview is below:

Prenatal tests have long been a private dilemma for families in higher-risk pregnancy categories because of the risk involved for the baby, and the question about what to do once hearing the results. No more. Not just because of Santorum, but also because these tests are becoming more and more common.

The landscape on prenatal testing, or genetic testing, is quickly changing. “Historically, genetic testing has been something to use selectively because of the risks,” Arthur Caplan, director of The Center for Bioethics at The University of Pennsylvania, told me when I called him to discuss the Santorum comments.

It used to be that relatively few pregnant women endured the invasive procedure known as amniocentesis. Because of that, the abortion rates for fetal anomaly were way down on the list for the reasons pregnant women decided to abort.

Now, the tests are becoming much easier and less risky to the fetus. Some are simple blood tests. Increasingly, in the first weeks of pregnancy, a woman can have the tests administered and get the resutls, as opposed to the first generations of tests where a pregnant woman might not get the results until the third trimester.

At the same time, a woman’s choice to terminate a pregnancy is quickly facing fewer obstacles. As medical advancements continue, a pregnant woman may learn that the fetus she is carrying is likely to have a severe disability soon after she discovers she’s pregnant. If she chooses to abort, she might be able to do so buy getting a prescription. She would never have to visit a doctor. The decision could be entirely private.

This is a key point.

Abortion foes, until now, have focused their ire on abortion providers and the clinics where they work. Medical technology had been an arrow in their quiver because sonograms and heart rate monitors made pregnancies more tangible. Just this month, the Virginia state senate approved a measure, with support from social conservatives, that would require clinics to show a patient ultrasound images of the fetus before aborting.

But the medical advancements are galloping ahead of this tact.

“[Abortion opponents] are finding themselves nose to nose with a different ethical argument,” Caplan said. “They are going to have [to] convince women individually not to take a pill.”

The advancements — tests, say for certain traits and propensities — will also increasingly raise other ethical questions, even among the pro-choice, about what constitutes a valid reason to terminate a pregnancy.

Caplan said there is a place for public policy in all this, perhaps in demanding that there be mandates to help regulate the industry or for coverage of genetic counseling services. He said there’s also a place for debate about making our society more tolerant of disability.

But to attack the tests themselves is “ludicrous,” he said. Doctors will feel the need to provide them and women have the right to know as much information about their pregnancies as possible.

In other words, the public focus might be more useful not on the tests themselves, but on the conditions they discover and on the people who will most be affected.

What do you think of prenatal tests and the future of genetic testing during pregnancy?

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Tags:  Disability, Down Syndrome, Ethics, Politics, Pregnancy

 
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