Non-invasive prenatal testing (NIPT) on fetal DNA circulating in the mother’s bloodstream has just been added to the list of screening tests for Down’s syndrome during pregnancy, by a decree published on May 7th in the Official Journal in France. The Paris Public Hospital Network has already announced it will incorporate this screening test throughout its sites for at-risk pregnancies.
Until now, this test was still being evaluated, and was not yet even legalized in France. Screening for Down’s syndrome currently involves several steps: first a sonogram to measure “nuchal translucency”, then by comparing this result with other serial markers to evaluate the risk factors. The final diagnosis is then confirmed by amniocentesis, which consists in withdrawing amniotic liquid, a so-called invasive procedure, inconvenient for the mother, but risky for the fetus as well, since 1% of the amniocentesis techniques performed, provoke a miscarriage. Although the NIPT is promoted as a means of both screening and diagnosing via a simple maternal blood sample, thus decreasing the need for amniocentesis, it cannot however confirm any false negatives.
On May 2, 2017, the Paris Public Hospital Network announced this screening technique would be part of their standard operating practice even though the French National Health Authority has not yet rendered its decision concerning the test’s ethical aspects. The NIPT is not reimbursed by the government’s health care insurance. Nevertheless the Parisian hospitals are proposing these tests free of cost, as they are being “financed by the Health Ministry”. In France the usual fee charged by the Cerba or Biomnis laboratories is 390 €.
Already in 2013, the French National Consultative Ethics Committee emphasized that “even though they might be less numerous, there is still an ethical issue to be addressed concerning the way society accompanies those infants who are born handicapped.”
Caroline Roux, Alliance VITA’s Listening Service Coordinator:
« The pressure from doctors and the government to screen for Down’s syndrome is only exacerbated by this simple maternal blood test. We’ve become increasing aware that any diagnostic technique during pregnancy which is not accompanied by therapeutic or healthcare propositions tends to make future parents anxious. Parents receive a formal notification and are forced to « make a decision » even though the life of their child is at stake. Currently, 96% of fetuses diagnosed with Down’s syndrome are aborted. We are shocked by the Parisian hospital network’s decision to implement NIPT, financed at the last minute by the Health Ministry, just before the new president takes office. Inevitably, targeting children affected with Down’s syndrome only marks the beginning of the chase for aborting other infants with genetic diseases. Prenatal screening to detect and abort babies with disabilities instead of doing research for their therapy or accompanying their families is an unprecedented injustice and constitutes a serious set-back from scientific, social and human viewpoints.
