Will new tests promote abortion of an ‘undesired sex’ baby?

Art Caplan, MD, is a physician and bioethicist, who is prochoice, but shares the significant reservations I have about a new blood test that helps a couple know early in a pregnancy whether they have a male or female baby. I’ve predicted this will result in more abortions and that physicians should rarely offer this test. Now, my colleague, who is prochoice, agrees. See what you think in this transcript of a video of his from MedScape:

This is Art Caplan at the Center for Bioethics at the University of Pennsylvania. Today I want to talk to you about a very interesting new technological breakthrough in genetic testing.

There was a report not too long ago in the Journal of the American Medical Association that showed that it is possible to get cells from a fetus out of the mother’s blood. That means that if you get a blood sample from the mother, there are cells circulating from the fetus at least as early as 7 weeks, and they can be isolated from the blood. Therefore, you can now test for genetic traits of the fetus without having to perform the older type of testing.

That older test was amniocentesis. We had to put a needle right into the mom’s belly and try to get fluid out of the amniotic sac. We can’t do that until about 14 or 15 weeks gestation, and the results come back at 18 weeks. A sonogram might give you some information, but it’s obviously not genetic information and it is not very reliable until much later. Now we have a test that you can use early in pregnancy, and the Journal of the American Medical Association paper reported that it accurately determines the gender of the fetus.

The report was saying that this is good news, because now we are going to be able to find diseases that are linked to gender. Hemophilia would be an example, as well as some forms of muscular dystrophy. Additionally, people could make the decision to end the pregnancy depending on whether the test was positive.

The paper stopped there and the authors didn’t say much else. I think that is optimistic thinking, because when you can do gender selection (ie, test whether that baby is a boy or a girl) as early as 7 weeks, you are opening up Pandora’s Box. All around the world, there are millions of abortions performed in places like China and India just because somebody wants a boy. The preference is always for boys, and many people get prenatal testing using amniocentesis and have abortions because they want to pick the sex of their baby. I think that is not a good reason to do the testing and I think that is not a good reason to have an abortion.

I am pro-choice. I believe in a woman’s right to decide what to do about a pregnancy, but I also believe that there are better and worse reasons for having an abortion. If we have gender testing that is easy to perform relatively early in pregnancy, I think we are going to see a lot of people who use this test not for diseases, but because they want to pick the sex of their baby. Not as much in the United States, but there is a lot of potential for that to be the purpose of testing overseas.

When you look at this test, you have to ask yourself a question. What makes having an abortion ethically right or wrong? It is true that we can do things legally, but when technology opens up the opportunity to test for something like gender, which I don’t think is a disease, at least the last time I looked, I think doctors have a right to say, “I don’t want to test for that.” I think they also have to counsel people and say, “Sex selection, gender preference, and sexism are not good ethical reasons to end a pregnancy.

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