Inconsistent principles in public health screening frameworks for non-invasive prenatal testing
Ryan Friets1, National University Of Singapore 1National University Of Singapore
Abstract
Non-Invasive Prenatal Testing (NIPT) and Screening (NIPS) has become increasingly common in public healthcare screening programmes in recent years, with most testing focused on detecting chromosomal anomalies (such as foetal aneuploidies or inherited conditions). However, as the possibility of prenatal Whole Genome Sequencing materialises, current screening and testing frameworks may not adequately address new challenges as they arise.
As part of my ongoing PhD research, I examine the question of whether the State is ever justified in influencing individual reproductive decisions when adopting a pluralist approach in determining the boundaries of publicly funded reproductive screening programmes. Various conceptions of public health pluralism endorse different goals that public health programmes should aim towards, both at the individual and public level. However, these goals can sometimes be in tension. For example, the public health goal of building a genetic database that facilitates understanding of population health would be tempered by the individual goal of ensuring reproductive autonomy, as the former is achieved by encouraging screening but within limits set by an autonomy-focused approach.
This paper will examine how public health screenings (outside of reproductive screening) are regulated based on public health rationales, and subsequently compare those principles against the various apparent principles that underlie different jurisdictions’ NIPT/S provision frameworks. It will then highlight inconsistencies between the principles and, after attempting to justify these inconsistencies, make preliminary claims about the boundaries of State intervention and how regulation should be structured, while crystallising areas of inquiry for further empirical research in my thesis.
Biography
Ryan is a Postgraduate Researcher at the Centre for Biomedical Ethics. He holds a BA in Jurisprudence from the University of Oxford, and an MA in Medical Ethics and Law from Kings’ College London. His research interests include regulation of emerging medical technology and reproductive ethics.