There is little doubt that potential parents have always been concerned about the well-being of the foetus, their invisible baby-to-be. In the past reassurance, if it came, came only with birth. Prenatal testing techniques and genetic knowledge now provide the means to see the foetus and to test it for genetic disorders. It has been argued that 'the availability of foetal surveillance techniques has transformed the pregnancy experience from a developmental process and a miracle of nature to a risk-dominated and technology-guided event'(Raines 1996). Rather than a transformation, however, it seems that awe continues to co-exist with varying degrees of agonizing in relation to calculated risk.
A variety of prenatal tests are available in this country. A blood test is offered (AFP test, the Triple test, the Triple Plus test, the Bart's test or the Biomark test) at about 16 weeks to test initially for genetic disorders, such as Down's syndrome. Several substances, or markers, in the blood are measured. The result and the woman's age is then programmed into a computer and the risk calculated. High risk is generally interpreted as less than one in 250 and low risk is calculated as more than 250 (Barnes & Bryan 1996). An early pregnancy scan or ultrasound, at the end of the first trimester can date the pregnancy, diagnose multiple pregnancy, and indicate the risk of chromosomal abnormality. If the odds are considered high, as with the blood test, other tests are offered, for example chorionic villus sampling and amniocentesis. The risk of miscarriage with the latter two tests is approximately 2% and 1% respectively. Other risks of these tests include bacterial infection and foetal injury (Minnuti 1996).
Prenatal testing for genetic disorders generates a number of challenging questions. What, for example, is a genetic disorder? For which genetic disorders and/or predisposi tions should prenatal testing be available? Which theory might best throw light on ethical questions which arise. In negotiating the dilemmas, how might the virtues guide the professional and the patient/pregnant? Finally, what guidance might we glean from virtue theory as we tentatively tread into the next millennium?
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