The American Congress of Obstetricians and Gynecologists defines prenatal genetic testing as the optional practice by which would-be parents learn if the developing zygote, embryo, or fetus has a genetic disorder [1]. In “Hurtling Towards Eugenics … Again”, Dr. Mitchell, an associate professor at Trinity International University, argues that such screening tests promote the selection of beneficial traits emblematic of the eugenics movement’s aim to create “better humans through breeding” [2]. However, Mitchell’s reasoning is flawed because it employs a hyperbolic slippery-slope argument, fails to recognize the intent and autonomy of parents, and assumes personhood in the cells tested.
Mitchell does not offer a concrete link between the availability of screening methods and the eugenics that he alleges will undoubtedly follow. Instead, he assumes a direct connection and employs a hyperbolic argument asserting that “eliminating individuals” creates a mindset that justifies “human selection” [2]. Since any event can be traced to another and cited to be because of a snowball effect, the slippery-slope logical fallacy should be analyzed with caution in discussion concerning biomedical ethics. Avoiding the slippery-slope argument allows for a more nuanced look at the issue because it leaves behind untenable assumptions and rushed conclusions. In the legal world, the test of proximate causation exists to combat the slippery-slope in that it asks of the jury whether or not the consequences are reasonably foreseeable from the defendant’s actions. With 16 years passing from the publication of Mitchell’s article, society has yet to stray from the “truly human” path [2]. The practice of eugenics is not reasonably foreseeable from the fact that genetic screenings occur because the tests exist solely to inform expectant parents and have no inherently moral or immoral value.
In arguing against the use of prenatal genetic screening techniques, Mitchell does not adequately weigh the intent of parents in opting to carry out such screenings. He concedes, as an afterthought, that parents may find the information “important” as they prepare for a child who may have a disability [2]. However, this informative function of screening is the most valuable since it is the goal of the test itself. In some cases, issues found in the screening results can be rectified even before birth. For example, some types of spina bifida, a condition in which the spinal cord fails to develop properly, can be surgically corrected before birth [3]. Knowing if the growing fetus has or is predisposed to certain disorders enables parents to make fully- informed choices. It can allow for parents to adequately prepare themselves for caring for a disabled child or, in cases of reduced quality of life outlook, to choose if they need to terminate the pregnancy. Beauchamp and Childress, authors of one of the most widely cited medical ethics texts in the field, acknowledge that to “respect” autonomous agents is to acknowledge their right to “hold views, to make choices, and to take actions based on their values and beliefs” (106). The mother is an autonomous agent and the fetus is a part of her body, and thus she is entitled to information about her condition and to make choices as a result.
Underlying Mitchell’s argument is the idea that certain types of screening methods undermine the personhood of the fetus. However, genetic screening tests are often completed in the early stages of pregnancy and are non-invasive. To Mitchell, the clearest form of “human selection” is seen in preimplantation genetic diagnostic tests [2]. These procedures are used only in cases of in-vitro fertilization in which cells that are developing abnormally are separated from those that are developing normally. This is done because the number of embryos produced through in-vitro fertilization exceeds the number of embryos that can be implanted with the health of the mother in mind. At this stage, embryos are comprised of no more than eight cells. It can be safely assumed that such cells have no markers of personhood. Beauchamp and Childress assert that whatever the degree of moral status is possessed by a being with potentially “status-conferring properties”, the individual’s rights still may be “justifiably overridden” by the rights of others in certain circumstances [4].
Although Mitchell’s reservations about the possible uses of genetic screening should be considered, the concerns are hyperbolic. Prenatal genetic screening is a beneficial medical practice that should be defended because mothers are autonomous agents who are entitled to the information they seek about their own bodies. The informed choices they can make, whether to pursue treatment, prepare for a child, or to terminate pregnancy in some cases, are made possible by the availability of such genetic tests.
References
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 7th ed., Oxford University Press, 2009.
Mitchell, Ben C. “Hurtling Towards Eugenics ... Again.” The Center for Bioethics & Human Dignity, Trinity International University, 6 March 2002, cbhd.org/content/hurtling-towards-eugenics-again
Sanghavi, Darshak. “A Womb Without a View,” Slate, October 2011. http://www.slate.com/articles/health_and_science/medical_examiner/2011/10/prenatal_testing_birth_defects_often_come_as_a_surprise_.html
“Prenatal Genetic Screening Tests.” Women's Health Care Physicians, American Congress of Obstetricians and Gynecologists, July 2017, www.acog.org/Patients/FAQs/Prenatal-Genetic-Screening-Tests.