Get ready for the flood of fetal gene screening

STANFORD, Calif., January 19, 2011—Regulators, doctors and patients need to be braced for the ethical, legal and practical effects of being able to sequence fetal genomes from mothers’ blood, says Stanford Law Professor Hank Greely in a comment piece in this week’s Nature.

Last week, researchers showed that a blood test for mothers could detect Down’s syndrome, and last month, writes Greely, two research groups independently published proof that the fetal genotype for thousands of genes could be derived from samples of fetal DNA with just a 10-millilitre blood draw from a pregnant woman. Checking for hundreds or thousands of traits with one blood test, early in pregnancy, could move prenatal genetic testing from rare to routine within the next decade. “That possibility will challenge all societies to decide for which ends and by what means they want such tests to be used, raising hard questions about, among other things, abortion, disability rights, eugenics, and informed consent,” he notes.

Greely calls on professional organizations, in medicine and in genetics, to get involved, in training their members about these technologies and in considering guidelines for their use, especially with regard to informed consent. Regulators, companies and consumer advocates need to be talking about assuring safety, efficacy and quality. “In the United States, the Food and Drug Administration should start that process immediately. And it is time for ethics commissions, such as the US Presidential Commission for the Study of Bioethical Issues, to report on these issues,” he writes. “Whether we view NIPD gladly as a way to reduce human suffering, warily as a step towards a eugenic dystopia, or as a mix of both, we should agree that the better we prepare, the more likely we are to avoid the worst misuses of this potentially transformative technology.”