This may be motivated by an ethical (prevention of suffering) or a health economic (reducing societal costs) concern, www.selleckchem.com/products/c646.html or by both. Both versions of the prevention view fit in with the notion of preconception

care as a general means for promoting healthy pregnancy outcomes for mother and child. The dominant view with regard to reproductive counseling in clinical genetics, however, is that this practice serves the quite different end of enhancing opportunities for meaningful reproductive choice (‘autonomy view’) (De Wert and De Wachter 1990). The ethical argument for this position is that reproductive decisions are and should remain personal and that this is difficult to reconcile with treating them as means to achieving societal goals. This view holds that under the prevention perspective, there is a risk that prospective www.selleckchem.com/products/urmc-099.html parents will be expected Akt inhibitor to make the ‘right’ decisions and that it will become normal and logical to hold them accountable for the consequences if they do not. This is especially regarded as problematic where abortion decisions are concerned. The only way to avoid pressure on pregnant women and their partners to test for fetal abnormalities and to terminate affected pregnancies would be to clearly distinguish between enhancing reproductive autonomy as the aim of genetic counseling on the one hand and avoiding the birth of affected

children as a possible consequence on the other. Of course, this notion of enhancing reproductive autonomy must be qualified as focused on decision making with regard to (serious) health problems in prospective children (Health Council of the Netherlands 2001). Without this qualification, the question might arise why prenatal testing should not also be offered for sex selection, or even to enable deaf parents to abort a hearing child. Moral acceptability

of embryo-selection and abortion As genetic counseling may lead to Terminal deoxynucleotidyl transferase discarding embryos (after IVF/PGD) and to aborting foetuses (after PD), a central issue concerns the moral acceptability of these options. This debate turns on the ‘moral status’ of human embryos and foetuses (De Wert 1999; Knoppers et al. 2009). On one end of the range of possible positions, there is the view that they are to be regarded as persons with a corresponding near absolute right to protection—a view which is difficult to reconcile with societal acceptance of e.g. intra-uterine devices. On the other end, some argue that embryos and foetuses are just tissues and cells with no moral status whatsoever. In between these more extreme positions, most argue that human embryos and foetuses have a real, but relatively low moral status, which can be overridden by other morally relevant considerations, including the wish to avoid transmitting a (serious) genetic disorder to one’s children (Health Council of the Netherlands 2001; Knoppers et al. 2006).