Bioethics and Informed Consent in Prenatal Diagnostics

Abstract

Innovative methods of prenatal diagnosis allow us to see the development of the fetus and to detect early disorders of fetal development, which may lead to an early diagnosis and possible treatment, or to a woman’s decision to terminate the pregnancy. Therefore, it is very important to accurately inform a woman about the risks and consequences of this life-related issue, even before deciding to perform prenatal tests; and after the results, when a misinterpreted diagnosis may lead a woman to terminate her pregnancy. The obligation of doctors to inform patients is inseparable from the requirement to receive informed consent. The two parts are mandatory for any medical procedure and intervention. The main requirements for the informed consent include rationality, sufficient and clear information, free will, and the form of consent conforming to the legal acts. However, informed consent is not an absolute requirement, as the patient has a right to remain uninformed. Additionally, under certain circumstances, it might be impossible to inform patients, or to receive consent from patients or their duly authorized representatives. Prenatal testing is an integral part of ante-natal care that aims to verify the proper development of the fetus, or to identify potential hereditary or chromosomal diseases at the earliest possible stage. Prenatal testing can be classified as non-invasive or invasive measures, according to the types of procedures In addition to this, according to the aim of the procedure, into diagnostic prenatal testing with the aim of prenatal therapy, and purely diagnostic prenatal testing. Purely diagnostic prenatal testing is closely connected with the problem of selective abortion. Part of this article covers the main problems of informed consent in prenatal diagnostics, by outlining two stages of the process: conveyance before prenatal testing, and interpretation of the results alongside presentation of the possible choices. The legal implications we consider are based on information from other European countries: we name the main questions analyzed by courts, including cases of “wrongful birth” and “wrongful life”; inappropriate information regarding possibilities of abortion; the right of a woman to use all available diagnostic methods; and the allocation of damages to the claimants.