“New prenatal genetic test gives parents more
answers”
The “unknown” is a scary concept.
For mothers-to-be, prenatal genetic tests help to alleviate some of this
uncertainty in having healthy and happy pregnancy. Current screening and diagnostic methods have their
limitations and often test for specific conditions.
In regards to prenatal microarray testing - is knowing more necessarily
better? What are some pros and
cons of delivering all of these results vs. more specific results from less
comprehensive test methods? Who
would benefit from microarray testing?
And who wouldn’t?
http://thechart.blogs.cnn.com/2012/12/06/new-genetic-test-gives-parents-more-answers/?iref=allsearch
Prenatal microarray testing comes with both positive and negative consequences. It is great that parents-to-be can learn more about their fetus, but it comes with serious consequences attached to that previously unknown knowledge. Hopefully, prenatal microarray testing would only be used for good, but there is also the ethical concern that this type of testing will lead people to take advantage of knowledge they can now find out about their fetus.
ReplyDeleteThe article states that people will now be able to use these new applications to identify potential intellectual disabilities, developmental delays, autism, congenital abnormalities, and reasons why a pregnancy failed. All of these things can be beneficial for parents-to-be to know so that they can be better prepared for when their baby arrives. I feel the most promising identifier is the reason why pregnancies fail and the testing that can be done on stillborn babies. These outcomes can be the most devastating to parents, especially when it happens on multiple occasions without answers as to why this is happening.
At the same time, these new tests could lead some people to be more selective about which pregnancies to keep. Currently there are tests for Down Syndrome and some congenital abnormalities, but the idea that people can now test for autism and other intellectual abilities may be taking it too far. More people may choose to have elective abortions when they find out that their fetus may have autism or another intellectual disability. There is no way to test how severe these intellectual disabilities will be in the fetus and many of these babies born with some sort of intellectual disability grow up to live very successful and meaningful lives.
I think prenatal microarray testing shows promise in further helping clinicians and parents-to-be in learning more about their unborn child. However, as Dr. Nancy Rose said, it will be important to look into any potential ethical issues before making this a routine test.
I don't think that knowing more is necessarily better. Researchers have opened up a whole new can of worms with the development of prenatal microarray testing. It's important for parents to know what risks their unborn children will be exposed to and how to prepare for any pregnancy abnormalities. However, these tests are being done earlier and earlier in pregnancy and I feel that they may lead to unnecessary abortions (for example if a child is "at risk" for a developmental disability) or to parents valuing their unborn children less. I'm pro-choice when it comes to abortion rights but I don't think that being at risk for autism, Down's syndrome, or other disorders should be grounds for pregnancy termination all the time, and I think that these tests are enabling those choices to be made.
ReplyDeleteOn the other hand, the information that these tests can provide could prove to be very useful in identifying risk factors for developmental/genetic disorders, and can be used to develop treatments, education campaigns, or possibly even cures. If this test is safe and not overly-invasive for the mother, I think that the data could be used by the government and other organizations for further research.
The ethics of this topic are tricky and relatively new - a larger discussion should take place that will provide a more clear answer (or at least perspectives) on the issue of prenatal and other pregnancy testing.
The pros to this kind of testing are being able to prepare for the needs of your child before they are born or for the parents of a stillborn, knowing what caused the stillbirth if they wish to try to have more children. In the case of knowing that a child will be born with, for example, Down Syndrome, the parents could prepare for therapies that are going to be needed and schools that would be appropriate, not to mention just mentally and emotionally preparing in order to be able to provide the best life for that child.
ReplyDeleteI think that there are dangers that come with knowing too many details about your fetus. For example, selective abortion could become common practice. We talked about this when I took medical ethics. Parents would have the ability to find out details of their growing fetus and if they don’t like what they see, abort it.
I think prenatal testing should be left to the more severe disorders. In the article it says, “researchers suggest using this test to identify potential intellectual disabilities, developmental delays, autism…” A child should not be treated differently because they have the “potential” to have a disorder. What if the gene is not expressed? It would cause unnecessary worry to the parents.
Knowing more isn’t necessarily better in all cases, I think it could take some of the adventure and mystery out of someone’s life.
After reading the article and comments above, I definitely see the potential benefits as well as the negative consequences that could come from prenatal microarray testing. On the one hand, it can give parents, especially new parents, the ability to prepare for what might come of the pregnancy. The early detection of disorders and abnormalities in a fetus can give parents the opportunity to seek genetic counseling and time to cope with possible stresses. On the other hand, these tests could lead to more parents having unnecessary abortions.
ReplyDeleteIn the most serious cases, this testing will allow parents to make well-informed decisions about their pregnancy. The test could identify conditions that a fetus will be born with and with this knowledge, parents can evaluate whether or not their child will live a valuable life. In these cases, this testing will prove to be beneficial and can be used for the good of the fetus. With this information, parents can plan parenting methods, schooling, and further resources that their child might need. In less serious cases such as those that identify a fetus to be at risk for a given condition, the test might lead parents to make inappropriate decisions based on what they believe the outcome will be for their child. Parents might take advantage of the test results and make unethical decisions if they do not want a child with a given condition, even though this child has the potential for a valuable life. Unfortunately, we cannot be certain of how these tests will be used by all parents, but I do believe that the testing will be used appropriately by parents for the preparation of the future of their children.
The topic of genetic testing is always controversial because everyone has their own opinion of whether they agree or not. The idea of knowing certain things about the infant before he or she is born can have advantages and disadvantages depending on a persons view on life and the world. A persons decision is always based on some intention. If the parents decide to use genetic testing because it was recommended to them based on previous unsuccessful pregnancies, a family history of genetic diseases, or simply for the health of their future child, then I think there can only be an advantage to knowing certain things. If the intention for genetic testing is for the purpose of knowing how to prepare and care for a child in the best way possible, then it can only be advantageous.
ReplyDeleteThe more controversial aspect of genetic testing is when we introduce the issue of abortion. Some parents may agree with the idea that they will always have the child, regardless of any genetic issue, and therefore there is no reason to knowing anything about him/her before he or she is born. Others, however may feel that if they find out that their infant has a certain genetic disease or mutation, they may not want to continue the pregnancy. My opinion on the issue of abortion only applies to me, and therefore there is no reason to share it in this type of forum. As a future health professional, I think it is important to be able to see the issue from all angles.
Clearly there is a lot of research being done on the different methods of prenatal genetic testing (microarray, amniocentesis, chorionic villus sampling, etc.). Our guest speakers in lecture mentioned several reasons of why one might choose to do genetic testing, such as family history of disease. I think that it is crucial to look at these issues as determining factors, however I don't think genetic testing should be taken lightly. In my opinion, prenatal testing should only be used in a case where the is a strong possibility of mutation or disease. Otherwise, there is the possibility that it can be extremely invasive, painful (emotionally and physically), and unpleasant for no reason.
I’m not a big proponent of pre-natal screening. If a parent wants to know whether or not a child is going to have a birth defect I believe it important to screen after the point that it is no longer possible to terminate the pregnancy. The amount of people I know who’s mothers were told that they have a child with down syndrome during prenatal screening is ridiculous, only to be surprised by a non-down’s baby on delivery day. These mothers are true heroes, and chose to continue with pregnancy even when being tempted with abortion. We are giving power to parents and doctors that is not theirs to have. The decision of life or death because of faulty pre-natal screening processes is no way to determine whether or not a pregnancy should be terminated.
ReplyDeleteHowever, screening to prep the mother and father of the baby’s current health, as used as an educational tool to prepare the parents how to raise their child effectively is important. It seems this micro-array testing is more accurate and seems to be more correct than previous testing methods; however I don’t think it should be the end-all be-all. I think it should be used as a tool and another thing to prep the family for potential health outcomes.
Now again, although I’m not a big supporter for pre-natal screening for the purpose of aborting what a family doesn’t want, there are some benefits to this micro-array testing. And it’s for these benefits that I think this technology is amazing. First off because this test is more expansive than other tests, it allows for more knowledge to be attained about the health of the fetus, which can help prepare parents better, so in this case more is better. Second is that the testing can be used after a pregnancy on dead skin. It can benefit mothers who had still borne pregnancies, and help tell them why, and help them prevent what had happened for the next pregnancy. It can also supposedly determine why a baby has birth defects, and be used to educate the parents to help avoid defects in the future if possible. For these reasons I see this micro-array testing as hugely important.
Obviously more research is needed. But for the above benefits I see micro-array testing as beneficial. But this testing should be taken with a grain of salt, things change, and making a decision to terminate a pregnancy because of what could be, shouldn’t be the reason for getting pre-natal screening. Pre-natal screening should be used to educate and prepare the parents for the birth of their child.
I strongly agree with the point about screening once the termination window has passed. I believe that this will help alleviate ethical issues such as termination on grounds of having a "less than perfect child.' Determining why a baby has birth defects is important for researchers yes, but as I said I think it leaves a lot of room for the parents to feel guilty.
DeleteMicroarray tests reveal many genes at once. However, when it comes to finding out about the genetics of children, boundaries can easily be crossed. When tests can reveal whether a child will have mental retardation or congenital abnormalities this may discourage women from having the child in the first place. Even though this can also give answers as to why a pregnancy failed, this testing may lead to more unborn children resulting from the fears of not being able to care for a special needs child. Microarray tests can cause many genetic abnormalities that were never considered in the first place to become problems for the parents. This is true especially if the pregnancy is terminated after such a discovery.
ReplyDeleteOf course the needs of the child need to be held in the highest regard. If a parent doesn’t believe they can take care of a child with special needs, then it might be in the best interest of the child and the parent to selectively abort the child. I think it takes a special kind of person to raise a child with special needs or congenital abnormalities. All parents want to have a successful perfect child.
I think what comes into question is how much is too much? To what extent should doctors interfere in order to improve the outcome of the child? Even if changing the course and progression of the pregnancy will make the child avert congenital abnormalities or not be special needs, is that ethically right? I think this would make the special needs community feel discriminated against. They would probably question what would be the “improvement” in the first place. To change the course of the pregnancy would arguably be “playing God”. This may also cause issues with religious communities who voice strong opinions on the subject. Despite being beneficial to geneticists and researchers who can see how and what genes affect people and what therapies can result, the ethics still needs to be considered.
When it comes to abnormalities such as stillbirths or ghost pregnancies I think this technology can really be beneficial. Finding out what parents can do differently or what went wrong can offer hope to families who do want children in the long run. I think more research needs to be done and the benefits need to outweigh the costs before anything is permanently implemented. I do think that as we advance in medicine we will be able to overcome anything, however the question of what is right and what is fair will always come into play.
http://articles.chicagotribune.com/2012-06-11/news/ct-met-prenatal-genetic-testing-20120611_1_prenatal-genetic-testing-genetic-makeup-technology
With new microarray technology, prenatal testing becomes easier and more broad. It is used to identify potential disabilities, developmental delays, autism, and congenital abnormalities. The potential harms and benefits that accompany prenatal microarray testing make it such a controversial new technology.
ReplyDeleteWhen used for good, it could allow parents to better prepare for the arrival of a baby with a disability, it could alleviate worry of any possible prenatal abnormalities, and it can determine the reason for previous miscarriages. However, this type of testing could also be used in a less ideal way. In some cases, knowledge is not better. This test could potentially cause unnecessary worry (conditions vary in severity), unnecessary abortion, stigma, and ethical issues. Many conditions vary in severity, which these tests cannot detect. This means that an otherwise perfectly healthy baby with mild leaning disabilities could end up being aborted, because the parents were imagining the condition to be more severe. For this reason, it is vital that parents be properly counseled on the results. If they don't opt for abortion, this test could also cause parents to unknowingly stigmatize the child from birth. He or she might be viewed as being weak and needing help right from birth. When it comes to prenatal testing for learning disabilities or autism, boundaries can be easily crossed.
Although prenatal microarray testing comes with many risks, the people that need it deserve to have the benefits. Women who have had previous miscarriages can identify the reasons why the pregnancy failed and hopefully move forward with a successful pregnancy. This test would also benefit older mothers, because they are at risk for a variety of age-related conditions (not only inherited conditions). Hopefully this new and exciting technology can continue to be put to good use and benefit those who need it.
This is an article featuring a woman who found out her baby would have intellectual disabilities after going through prenatal testing: http://www.nytimes.com/2007/05/13/weekinreview/13harm.html?_r=0
As with many things, more is not always better. While it is true that in the realms of science and medicine more knowledge can mean more progress, this does not necessarily equate to "right" or "good". A potential harm that could come out of the greater knowledge that parents could gain from discovering early that their child will have a developmental problem is that some would elect not to have the child. There are many cases in which we can look to that show mentally or physically handicapped people can still lead rich and healthy lives. The degree of mental illness determines the capacity in which the individual can function and I don't believe this can be measured extremely accurately from a fetal standpoint. That being said, this knowledge could be invaluable to a family that maybe does not have the resources to support the extra needs that a handicapped child would have. This issue brings up a multitude of moral dilemmas that are subject to an individual basis, not a general rule.
ReplyDeleteSeen here is a news report that polls the reactions of different people to similar types of screenings. http://www.youtube.com/watch?v=-AEm1POQL1A
Microarray testing could be very beneficial in the sense that it can provide a broader picture of what to expect in an unborn child, rather than the specificity of some less comprehensive tests that can be misleading. I think that the people who could benefit most from this type of testing would be families who are at a genetic risk of having a child with Downs or other genetic disease. Knowing the results of this could help them make a more comprehensive decision if confronted with test results that confirmed an abnormailty. Microarray testing wouldn't seem to benefit families that would be committed to having a child despite complications, this source of commitment could be moral, religious, etc...Whatever the case, the way in which we progress with this type of testing will serve to simplify some lives and complicate others, rarely is there a case of black and white in this profession.
Knowing more isnt necessarily better in my opinion. It opens the door for various ethical concerns to arise. However, another red flag is that microarray testing requires an amniocenteses which is an invasive procedure, usually recommended for expecting mothers with advanced age, and also carries the potential for spontaneous miscarriage. This is a serious risk that, quite frankly, Im not sure is a risk worth taking.
ReplyDeleteAlso, lets not forget the nature vs. nurture argument. I believe a child in an unhealthy and/or under stimulating home environment is also at risk for improper intellectual development, but it would be unethical to prohibit neglectful parents from having children. This runs along the same thread as terminating a pregnancy due to a genetic (rather than an environmental) abnormality. Also, who is to say that this "abnormality," could not be overcome with things in their environment such as early intervention or special needs services? Microarray testing cannot accurately foresee the course of that child's life as that is a collaboration of numerous factors.
Like many others have said, this test could serve only to cause unnecessary stress on the mother, which in turn could exacerbate the "abnormality," in addition to putting a serious damper on what is supposed to be a happy event. It sounds to me like researchers are overly gluttonous for information and are masking this by promoting the benefits of microarray testing. I, however, dont really see that many. In my opinion, a child with a developmental disability is a dynamic situation to be taken day by day, knowing nine months in advance isnt going to change that. I suppose knowing why a pregnancy failed would be some consolation but could really just cause self-loathing and guilt, depending on the reason of course. So, the benefits remain to be seen in that case as well.
Also, the cost of this testing is unknown as well as if it will be included in insurance plans, which is doubtful since it seems to fall under the category of elective. Basically, I think expectant mothers should gather pertinent information about their unborn child, as in serious abnormalities/problems.
New tests have been discovered by geneticists to facilitate the ability to find a cause of death or cause of abnormality in infants and still borns. Chromosomal microarray uses the newly invented technology to observe tiny amounts of genetic material to ultimately detect developmental delays, congenital abnormalities and even why a pregnancy failed. Aside from the ability of chromosomal microarray to dig deeper in the intricacy of its testing, it also allows geneticists to perfom this test on dead skin cells as opposed to previous testing which required the cells studied to be living. The article spoke of the need for psychiatrists in this study to help parents understand diagnosed bad results or revisit the pain of losing a still born infant. Overall the continuation of this study would be morally upsetting for the parents involved, but it would be supremely beneficial for the future of human development, and therefore worth it. More specific results would help a parent understand exactly what happened instead of leaving so many questions open ended. I strongly believe that knowing more is absolutely better because the parents can prepare for any struggle that could come with the possibility of a birth defect. The National Institute of Health reported that 1 out of every 160 births in the united States are a still birth. This is a substantial amount of deaths that could be studied and avoided by the continuation of this testing. Although it may not benefit the individuals involved, it would substantially benefit the birth of the future.
ReplyDeleteBased on some of the comments that I have read, people seem torn about the ethics concerning pre-natal genetic screening. I can already imagine the reaction of many religious, political, and handicapped/disability groups must have about the new technology. Religious groups may fear that this sort of screening is too empowering - that it may be tampering with the works of God or nature. Disability advocacy groups may argue that this technology may lead to even further stigmatism for those with genetic disabilities.
ReplyDeleteBut at the same time, one can argue about the benefits of pre-natal testing, particularly with regards to more choices and better planning. There are many legitimate reasons why women would terminate pregnancy. For one, the costs of raising certain genetically disabled child is so astronomically high and with the economy in such a bad shape, some parents may not be economically prepared to take care of the child. In addition, some parents may not be emotionally prepared to deal with the stigmatism and discrimination that their children will most certainly face. It would be a disservice to the child to be brought into a family environment not equipped to handle the educational, economical, and emotional needs of the child.
I fear that this sort of testing will put pressure on families to produce only perfect children; that any sort of “imperfect” gene found in the cell of the fetus will be grounds for termination. While I do not believe that is ethical, I know that I do not have any right to dictate the choices that women and families make. I think that how society responds to and uses this technology will really define who we are as a society and who we think other people should be. The new technology will definitely benefit families, but at the same time, it may lead to the further stigmatization of those who are handicapped and place pressures on families to have genetically “superior” children. I think that the ethics of pre-natal genetic testing needs to be more thoroughly explored before it is official.
As many people have already stated before me, I don’t think that knowing more is always better. In a way I do agree that microarray testing can be useful when it comes to finding out why a pregnancy failed in relation to stillborn babies. The article talks about a second study which addresses the issue of 1 out of every 160 births in the US being a stillbirth. It says that microarray testing can be done on tissue that is not alive, which is different than previous tests which require live tissue. This could help parents understand the reason why their baby didn't survive and provide them with information to have a successful pregnancy, instead of blaming themselves or giving up.
ReplyDeleteOn the other hand, as other people have also mentioned, the process of microarray analysis is dangerous. The genetic material is taken through amniocentesis or CVS which are invasive procedures which could be harmful for the fetus. Knowing that a baby could have an intellectual disability, developmental delays, autism, or cognitive abnormalities could force the parents to automatically think that they cannot care for it and want to abort their fetus. That could give parents the impression that they can just pick and choose which of their fetus’ they want to keep or get rid of because of how easy it is. The American College of OBGYNs already have a listed number of tests that they, as professionals, believe are necessary based on the mother’s age, medical history, ethnic, or family background. Microarray testing is not part of this necessity so it would be causing more unnecessary harm to the fetus rather than benefit.
If anyone, mothers who have other children with developmental disabilities, autism, or cognitive abnormalities, or mothers who have had stillborn babies may be the best candidates for microarray analysis. I don’t think it should be used on all mothers just because it is probably more expensive than other traditional procedures and not necessary. The idea of abortion is already very controversial, and allowing microarray analysis for all mothers could lead to more ethical dilemmas, further complicating this issue.
Becoming a parent is nerves racking and many people think about all of the different things that can go both right and wrong in the life of their child. New parents worry enough about how much time they will be able to spend with their child and how they will provide for them, knowing they have a genetic disorder that this microarry testing can show is not necessary. Stress causes adverse health affects when not complicated by pregnancy. A mother knowing she will give birth to a child with a disorder such as autism will cause more stress than necessary.
ReplyDeleteKnowing is not necessary, these expecting parents have enough to worry about without counseling about genetic disorders their child will have. This also brings the issue of termination of pregnancy to the table. The article stated that it was done in the first trimester when termination is still legal as according to Roe v. Wade. Although this is not something that I agree with being prepared for such diagnoses is not a bad thing, these parents seek resources even before birth and they will know what needs to be done in home life to cope with such diagnoses, but what if they do not want to follow through with the pregnancy due to this diagnosis? Common testing that is already done determines if a child will be born with down syndrome and a few other diseases, is done in the same time frame but only tests for very specific diseases that parents needs to be prepared for. These tests all raise ethical issues but the other testing is something that has been commonly accepted.
Parents will both benefit and suffer from microarray testing, they will be prepared for the diagnosis when it comes and have different opportunities to seek resources in their area but they will suffer in the fact that they will know there is an diagnosis coming and stress about the situation for much longer than necessary. This can also cause suffering for the fetus as some parents might choose to terminate the pregnancy and if they do not make this choice the mother can also be put under such stress due to the knowledge that she will miscarry. This will benefit health care professionals in a positive financial way.
According to the guardian in 2006, 1800 pregnancies are terminated a year due to abnormalities, is there a reason to add to this number? These numbers were collected before the option of microarray testing and could be greatly affected due to this new form of testing.
http://www.guardian.co.uk/lifeandstyle/2006/jan/26/healthandwellbeing.health
In regards to prenatal microarray testing, I do not necessarily believe that knowing more is better. There are various pros to prenatal screening such as: knowing if your child will be born with a defect. This allows for the parents to properly prepare and align the necessary therapies for early intervention to provide the best life possible for the child. Another pro is determining why a mother gave birth to a still born. It is hopeful that the information can bring peace to the family and also lead to a successful pregnancy in the future.
ReplyDeleteThough prenatal screening can bring good, I think it also brings forth many ethical issues (as stated by many of the other students). If parents find out that their child will be born with a defect, they may no longer want to continue with the pregnancy. It may scare them from having a child, and cause them to abort the child. I think as Anthony previously commented, pre natal screening should only be done after the abortion window closes. Another con of screening is that it involves an invasive procedure (amniocenteses) which can lead to a miscarriage. A last con is the cost of testing. Are procedures covered by insurance and how much do the procedures cost? Also if parents find out that their child will have a disability the cost of caring for the child may cause them to terminate the pregnancy.
I think parents who currently have a child with a disability would benefit more from microarray testing rather than parents who are bearing a first child. If there is a risk of having another child with a disability it will be good for the family to prepare once again to care for the child. If there is a family history of certain conditions, I think those parents will also benefit. If parents just want to test just for testing and then base termination upon results, I do not agree with that.
I think one of the only advantages to this technology is the opportunity for early intervention. However, I think the disadvantages outweigh this benefit. This type of technology brings up several ethical issues. It could change the way the child is treated, for example if the parents know of birth defects or developmental delays before it is even born. Parents could have their biases to these issues and may not treat or view the child the same as if it had been born without these aspects. In addition, parents could choose they do not want the child anymore, which is a major ethical issue.
ReplyDeleteThe woman's pregnancy overall could be greatly altered as well. If the mother is really disappointed with the findings about her child, her emotional well-being would negatively be affected, and this could carry over to her child which could potentially cause more issues. While I think early intervention is very important, this type of technology could lead to a slippery slope.
I think that the more in depth prenatal testing becomes, the closer to eugenics we get. Of course, testing a fetus for a chromosomal disorder is different than choosing your future child's exact genotype, but are they really that different if the parents decide to terminate a pregnancy based on the outcome of a chromosomal test? Although I believe everyone deserves a chance to have happy, healthy children, I think the motivation behind having a child should not be to have a "perfect" child.
ReplyDeleteI think that situations where this testing is appropriate include those where predisposing genetic factors are at hand. For example, if there is sufficient family history of a certain genetic disease, a parent may want to know the likelihood of their child having it. Especially if this disease is debilitating or will greatly impact the child's quality of life. In these cases, I think genetic counseling is very important, in order to guide the parents through the decision making process and to make sure they are aware of the possible implications and all of their options. Still, I can't help but think that in the decision to have children, parents should be in a mindset that they are bringing a child into the world to love and care for, and they should do so unconditionally.
Microarray testing is a genetic test that analyzes the chromosomes of the fetus and allows us to identify potential developmental delays, intellectual disabilities, autism and other congenital abnormalities. This new type of test can detect genetic material and identify abnormalities that karyotyping cannot, through traditional amniocentesis or CVS. As Wapner says, through discovering developmental issues “we are better able to counsel parents about that they would mean for the child”. There is also the possibility of changing the course and outcome for the child. Overall, this new test could help us to identify developmental issues early on so that the parents of the child can be prepared to take care of the child or to make an informed decision about whether or not to continue with the pregnancy. This test can also help researchers to find the specific genes that may potentially turn into developmental issues so that we could possibly alter the track of these genes in the future and prevent abnormalities or develop a treatment. The results from this test can also be used to understand the reasons for the death of a fetus and can help parents to understand and cope with the situation.
ReplyDeleteHowever, there may be a negative aspect of this new test that need to be evaluated. It could lead down a slippery slope to a similar situation we face presently with IVF and PGD. The ethical issues that arise from knowing whether or not a developmental issue or congenital anomaly exists also need to be considered. Parents would have the choice to terminate or continue with the pregnancy if a developmental issue were present. This can result in what we consider ‘good’ characteristics to be selected for instead of the results of natural development. This would result in a large number of pregnancies being terminated because of abnormalities. With the prenatal tests that already exist, parents are already faced with the decision of whether or not to terminate if an issue exists. This test will help to identify more abnormalities earlier on in pregnancy but parents will still be faced with the tough decision of what to do. This test could result in an increase and pregnancy terminations. These negative aspects need to be considered and weighed with the benefits of this test. The price of this test also needs to be taken into consideration. If it is not covered by insurance that it will be difficult for everyone to utilize this test and will therefore create another health barrier for those that are not wealthy. I believe that parents have the right to know whether or not their child will have a developmental or congenital abnormality and they do have the right to decide whether or not to continue with the pregnancy.
I think that there are definitely some advantages and disadvantages when it comes to microarray testing. The biggest benefit in doing microarray testing is to detect any genetic abnormalities early on in the pregnancy and counsel the parents. They can be better prepared as to what to expect when their baby is delivered and they can also be given options. This would prevent any sudden "surprises" after giving birth and being unprepared for any type of genetic diseases. Parents can seek out resources and proper treatment (if applicable) and this can help them into a much smoother transition.
ReplyDeleteThere are disadvantages, however, and many of them include whether it is ethically right to find out about any genetic abnormalities earlier on in the pregnancy. As mentioned by the other students, it can lead to parents automatically aborting the fetus, and even having a negative emotional response by the mother. Amniocentesis is also an invasive procedure and is not 100% safe, which can put the baby's life at risk.
While there are many pros and cons, I think that overall it is very helpful in determining whether the baby will have a genetic abnormality, especially to parents that are carriers of a certain trait. Any family that has history of a certain disease or trait, should definitely get prenatal screening done. Just like stem cell research, IVF, and cloning, prenatal screening has some advantages and ethical disadvantages.
The development of prenatal microarray testing is definitely a monumental step. Although I don’t necessarily agree with this kind of testing, it gives parents the choice to find out if their unborn child will be affected by a number of different diseases and/or disabilities. I would say that families who have either lost a child to a genetic disease or who already have a child that is affected by a specific disease would benefit from prenatal microarray testing in order to find out if another child will also be affected. This kind of testing will help parents prepare for having a child with a genetic disease or a disability such as Down Syndrome or PKU, if they choose to keep the baby after these results are given.
ReplyDeleteThere is also a negative side to prenatal microarray testing. Abortion rates will most likely increase as well as the use of selective abortion. Unless it is an extreme case, I don’t think that it is ethical to terminate a pregnancy based on the results of these tests. I agree with the idea about screening once the termination period has passed. I don’t think that knowing more is better. Just because a test comes out positive for a specific disease or mutation, does not mean that the child will be significantly affected. Because the severity of genetic conditions cannot be tested for, parents might become discouraged when faced with positive test results.
This development brings up a lot of ethical, political, and religious concerns that may cause issues. I think that the risks and cons such as invasive testing procedures, emotional stress, guilt, and anxiety that come with this testing and results might outweigh the benefits of knowing if a child will or will not be affected by a certain disease or disorder.
This is an interesting article. In the fifth paragraph Dr. Ronald Wapner, says "with microarray, doctors don't look at chromosomes and are able to evaluate smaller pieces of DNA". That is good but it shows that the test focus is not to replace the other exams, it is to expand open them to offer more information to parents and more specifically parents that have had still births. I feel that this exam is important for giving closure to families as well as potentially opening up knowledge about family histories and getting families to talk about genetics in their families. If a couple has a stillbirth and they find that the reason is linked to genetics that has persisted throughout the family they may be able to make better family planning decisions and be aware of the risks of child birth. I do not agree that the development of this test may increase the rates of selective abortion. I feel the test is mostly to be used for still births and while it would be able to give parents foresight into what their children's' condition may be like i do not believe that a vast amount of parents would take a their child's life based off a test result.
ReplyDeleteKnowing more isn’t necessarily better. In some instances, knowing that your child may have a certain condition may cause you to stress about it and not really enjoy your pregnancy because instead your thinking about the child’s condition and what you want to do about it. At the same time, to some people knowing ahead of time may be considered an advantage because then they will be able to prepare themselves to care for their child. Its also very complex because if they find out that their child tests positive then they might have the option to terminate their pregnancy and if they never found out then maybe they would have been able to accommodate to their child’s situation and care for them.
ReplyDeleteI think that it really depends on the couple and so, those that opt for the testing may really want to know so what they can be prepared in which case everything will be great because it might alleviate them to know that their child is healthy or in other cases it will just give them a heads up that their child is not. I think that parents who have a positive family history for certain conditions will benefit from this kind of testing so that they will know if their child is also positive for that condition (or others). I think that with like most things in life, it has both positives and negatives, but I think that ultimately its up to the child’s parents to weight out the good and the bad and make the decision.
The advancements in technology surrounding prenatal genetic testing are raising ethical questions about extensivity and necessity.
ReplyDeleteThe second study mentioned in the article, focused on the use of microarray testing to analyze stillborn babies. This new development in particular was one of the major advantages I took away from the reading. I sympathize with families who’ve experienced stillborn births and fully support and appreciate what microarray testing can achieve in terms of closure, education and support. The access that microarray testing grants to both parents and doctors is a significant educational opportunity that will undoubtedly act as a healing method. In turn, the knowledge acquired will offer new information and support for an eventual successful pregnancy. The unique benefits that microarray testing presents for stillborn research represents an important niche that prior prenatal screenings have ignored.
In other regards, it seems that I am in agreement with my fellow classmates. I have my concerns that this more distinguished brand of prenatal screening may lead to hasty decisions (including unnecessary abortions) when undesirable results are revealed to families. Further, I feel that the existing prenatal tests should be sufficient until more studies have been conducted and proven conclusive.
A solution that might suppress my worry is if microarray testing were only offered in circumstances of stillborn analysis. This way the test would be catered to a controlled population and guaranteed to inspire constructive behaviors as opposed to destructive ones.
Prenatal testing is a polarizing topic that I am divided over because of the ethical questions that it raises. As the article states, microarray testing can identify disabilities and disorders early in the pregnancy and also can help parents understand what went wrong in stillborn cases. An obvious advantage of having this test done is that parents can start coping with and preparing for special needs their child may have. However, the problem with prenatal testing is that people have different intentions and how the knowledge the test provides is used will depend on the hands it falls into. Our hope is that people will use prenatal testing solely for the benefit of their child, but the issue moves into a morally grey area if some parents use testing for the purpose of terminating their pregnancy should the baby have traits that are undesirable to them. If selective abortion is dangerous and immoral, what degree of control over the traits of our offspring is acceptable? What is and isn't appropriate use is too messy and subjective for the law to determine. Though we can say what microarray testing should be used for, we probably can't legally prohibit people from using it for purposes that are viewed as immoral to others.
ReplyDeleteThe controversy over this issue stems from the fact that people weigh the costs of testing against the benefits of it differently and draw the line in different places. Looking at this from the viewpoint of a parent who already has a child with a disability, I am not against microarray testing. However, before it becomes common practice across the country, I think we need to accept the potential negative consequences that present a us with a trade-off. Knowledge is not always used for good.
As with most advances in science and medicine, it is easy to jump at the option of “knowing more”. However is knowing more necessarily better? The ethical concerns that stem from these tests are endless. In particular there appears to be a debate stemming amongst my classmates about when this testing should be administered. Should this testing be done prior or post the termination window? Abortion is a tricky debate to argue one way or another, but now one must factor in these tests as well. If a parent has knowledge of mental retardation or congenital defects would this sway them to terminate the pregnancy? If so, would this even be considered wrong?
ReplyDeleteWhat exactly are the intentions of testing? Surely it would be beneficial to be aware of a major congenital defect in your child. That way, you could seek counseling early on and begin to formulate a plan to benefit your child. However, what if you were in a position that seeking these resources was just not feasible and you were not in a position where you could properly raise a child with such a defect? As Alex Vastano mentioned previously, not everyone is in a position to raise a child with special needs and perhaps it would be in the best interest of the child that the pregnancy be terminated.
There is also the case of babies being born with incurable diseases or defects that would cause early death. For example, a couple I know gave birth to an encephalic baby and raised it for a little over a month before the baby passed. The baby had not higher brain function and basically just carried out physiological processes. As heart breaking as it was already, imagine if this couple went throughout their pregnancy knowing that their baby would die just a month or so after birth. This knowledge would be extremely disheartening to the mother and father and cause undue and unhealthy levels of stress to the mother.
This is not to say that genetic testing should not be utilized at all. I just think that a lot of thought needs to be put into the timing that tests will be administered as well as the extent to which they test. Screening for diseases where treatment works best in early stages can mean the difference between life and death. However, we must be careful and follow the guidelines of what to screen for and be aware if the costs (both medically and financially) will outweigh the benefits.
Prenatal microarray testing would provide the most service to parents looking to conceive following a failed pregnancy. Because 1 of every 160 births in the United States is a stillbirth there is a large percentage of the population that would benefit from learning if there was a genetic causation for the loss. Miscarriages and still births are extremely traumatic, as such understanding their cause through testing would provide answers to parents looking to conceive. In this arena knowledge is ideal in that it could provide answers and stop parents from continued potentially futile attempts.
ReplyDeleteRegarding postnatal diagnostic purposes, it would be advantageous for parents to have answers preceding the birth. It would be particularly effective for parents who know that their child is more likely to have an autism spectrum disorder or developmental delay. This would include parents who already have a child with one of these disorders. However for the standard parent I don’t believe that there would be an enormous difference between the answers provided by amniocentesis and prenatal microarray testing. The downside would be the increased risk of miscarriage and the cost.
http://www.medscape.com/viewarticle/775687
The use of microarray analysis in prenatal testing is a controversial issue. Microarray analysis will allow more genetic abnormalities to be detected through its small-scale examination of the DNA. Knowing more can be both a blessing and a curse, depending on each individual situation. In the case of identifying a condition that, with early intervention, can be improved, knowing more is typically a good thing. However, some parents may not want to know ahead of time about a birth defect, especially if it is caused by genetics, because they may feel at fault and helpless. There are both benefits and fallbacks from every type of prenatal testing. Delivering less specific results but using a more comprehensive testing method could be harmful if children had, for example, a mild intellectual disability that went undetected from the test and therefore wasn't diagnosed until later in life when intervention wasn't as beneficial. However, delivering less specific results could be beneficial because the tests are more comprehensive, so something that might not have been tested for otherwise could be detected. In the case of microarray testing, children with a chromosomal disorder would not be benefitted, because the doctors would evaluate smaller pieces of DNA instead of the chromosomes themselves. Also, some conditions were not able to be tested by any of the other methods including microarray, and it is thought that genetic sequencing could help. Families who would benefit from microarray testing would be the families who could use early intervention to assist in their child's development, such as if the child was found to have Autism or an intellectual disability. Overall, the effectiveness and ethical barriers of microarray testing needs to be strongly evaluated.
ReplyDeleteJamie Shaw
ReplyDeleteI feel that this is a very touchy and divided topic among everyone who chooses to discuss it. Obviously this is a marvelous scientific achievement and I think it's extremely helpful for parents who experience a miscarriage or stillbirth, and it would provide a lot of information and education for these parents to help them with their coping and closure. I also support this category of testing because for parents who learn they have a child with a severe disability (such as Down's Syndrome or PKU, or perhaps if the child were severely mentally challenged) they do have the option to decide to terminate the child. I understand that this receives a lot of backlash in that people believe if you are ready to have a child you should be ready for anything. While this has validity, there are simple facts that sometimes people are not in a position to raise a child with a severe problem, and testing would allow them to prepare themselves for either abortion or adoption, both of which will raise seriously mental trauma to the parents.
I also support the decision to test prenatally for parents who have a known genetic abnormality or are carriers for one, or parents who are facing a risky pregnancy. Perhaps this is due to advanced age, or some ingestion of teratogens (somehow), or for parents who really are worried about having a child with a severe disability (as I discussed earlier). I do not necessarily support prenatal testing for the general public, however. I, along with the majority of my peers, also do not feel that more knowledge is better. I feel that society has developed a need to label everyone and there are plenty of circumstances where a child is born with a mild condition, such as Autism or ADHD and through simply living, and their parents support and teaching, has outgrown it naturally - and never gained a label. I think to label everyone with a disorder seems problematic and I don't believe in that style of psychiatrics.
I think this is a very obviously polar debate, and would ultimately come down to the parents decision of if they want to learn about possible abnormalities and are ready to accept the necessary interventions if the child is diagnosed with anything or not. I think that such extensive prenatal testing will be welcomed by some, and waved on by others.
When discussing the topic of pre-natal microarray testing, there is always a part that is amazed and wants to push research even farther. There is also another part that worries about ethics and if it is right to interfere with what nature has designed.
ReplyDeleteI personally believe that the more you know about an unborn child the better. For example, if you find out, via amniocentesis, that your child has downs syndrome, you can mentally and physically prepare for a child with impairment much earlier on. If you find out upon birth, it could be emotionally devastating. Even finding out the sex of your child is helpful when planning the child’s room colour, clothes and even planning out his or her life. Although that is a smaller issue, it’s significance varies for parent to parent. I think that microarray testing is another option that will vary by each set of parents; some will not want to know more while other will want to know everything. However, I think having the option to know the specifics is important.
In the case of parents who birth a stillborn, this can be extremely tragic and knowing more could be very helpful both emotionally and for future planning. If you understand why the fetus died, you can better plan for the next one. Also, on a psychological standpoint, the mother would not blame herself for the death whereas she might should she not know the biological grounds.
Of course, the flip side of this scientific knowledge is that, parents may decide to terminate a pregnancy if they know their child will be born with an undesirable condition. This is where ethics comes into play and varying opinions about abortion clash with one another. Another major issue is that, as science progresses, this type of technology/procedure will only become more sophisticated. When is it time to stop? There is already talk of gene manipulation in unborn infants where parents can literally select for certain traits. Is this ethical? When is enough, enough?
Knowing more may or may not be better, based on the situation and the type of illness. If it is an illness that may present itself later in life like Alzheimer’s, I would much rather not want to find out about it. Otherwise, it may change my perception of my child and the way I would treat him/her. There will be this continuous dread and I feel like it would take away their opportunity to live life to the fullest. Knowing about other conditions like PKU, as mentioned in class, would be much more beneficial since it provides the opportunity of possibly saving the child’s life. It would help by giving an idea of the condition in order to prepare the parent for the most efficient and crucial interventions. As for microarray testing, I think people who are known to be carriers for certain genetic disorders would benefit more than those who do not, since there is a higher risk for children to be affected.
ReplyDeleteThe pros of delivering these results is that it gives time for the parents to prepare themselves mentally, emotionally and physically in raising their child. It can give the parents time to educate themselves of the possible conditions their child might have. It will also give them a hint on risks that can be involved with the child’s health for future pregnancies. A con with prenatal testing would be that it gives parents the chance to terminate a pregnancy, as others have mentioned. It would only add to the abortion issue and by allowing parents to avoid dealing with a child’s condition by simply not having the child, it gets rid of the chance to spread education about certain diseases. It can result in people just ignoring it.
When I first read this article, I thought that knowing more is definitely better. If I knew that my child was going to have a birth defect that would severely impair his or her development, I would definitely consider terminating the pregnancy rather than risk giving birth to a child knowing that he or she would be predisposed to a very difficult life. However, what defines a defect that significantly impairs a child’s development? Obviously everyone wants to have a perfect child, and knowing that a child will have a birth defect that may not be significant enough for anyone else to notice still changes the expectations of the parents. That child’s parents could go through his or her childhood constantly using that small defect as an excuse for negative events that occur in the child’s life. Additionally, there are many parents who would do anything to help their child, and knowing that their child will be born with a birth defect and that there is absolutely nothing that they can do about it could be somewhat discouraging during the pregnancy and may result in the parents behaving in risky ways, providing an even greater risk to the unborn child. I think mothers without the resources to help their children overcome adverse birth defects would benefit from microarray testing. If a mother knows that raising a child with some type of birth defect will require a lot of treatment and therapy that she cannot afford, then perhaps she will reconsider having the child. Parents with significant history of disease would also benefit from this kind of testing, because if they know that their child will be born with a disease they can put preventative measures in place that will slow down the progression of the disease or even prevent it from occurring altogether if that is possible. Expecting mothers who do not know who the father of their baby is and plan to raise the baby alone would also benefit from these test results. If the child will have significant birth defects, and the mother was already hesitant about being able to fulfill all of the responsibilities of being a single mother, these test results may help her make her decision. These tests do raise a lot of ethical concerns, especially if they are done with enough time for the pregnancy to be terminated.
ReplyDeleteThis comment has been removed by a blog administrator.
ReplyDeleteAlexandra Kramer
ReplyDeleteI am always torn about topics such as this one because although it is great that we are learning more about our DNA and genes and being able to predict problems earlier and earlier, there is the ethical issue that we also have to consider.
This type of testing could be very beneficial, like the article stated, when learning about life threatening diseases. To prevent an infant from suffering only to die a few months later is something I think most people would agree is a positive aspect of this testing. However, at what point do we say it is okay to let a child live? This is where the line gets very fine; would we take each parents' situation and let them decide what they want to do?
On that note, there is the issue of telling a parent that their child will have a learning disability. I don't necessarily think it is ethical to be able to tweak or fix genes so much that we are basically deciding what kind of child we would like. That is a slight exaggeration, but I feel that if we continue on this path, it will eventually get to that point. We have come a long way in history in appreciating diversity and understanding different ways of looking, acting, and learning. In my opinion, this would be back tracking in a way, being able to eliminate "unappealing" aspects of people that yes, may not lead to a conventional upbringing, but are actually wonderful and interesting in their own way.
This is a very interesting topic that I am curious about continuing to learn about. It is great that we are discovering so much and are able to try and help and better society, however it is also such an ethical issue that we need to be really careful about.
When it comes to prenatal testing, knowing more is only better when intervention is possible. As with other forms of prenatal testing, microarray can be valuable to parents because it allows them to prepare for the child that is to come. Families who are at risk for a serious genetic disorder would benefit greatly from this form of testing because they would have more time to prepare and/or make decisions regarding the pregnancy. However, when microarray testing detects a disease or defect that is inevitable and untreatable, it may not be worthwhile to receive the results. If the notion of terminating the pregnancy is out of the question, having this information would only cause stress to the pregnant mother and potentially exacerbate the condition of the fetus. I feel that microarray should only test for preventable diseases and up to a certain point during gestation.
ReplyDeleteMicroarray is important particularly for those parents who have had stillborn babies and want to know the reasons behind it. They can use this information in order to make more informed decisions about trying again to have a successful pregnancy. Microarray testing is unique in this way because it can be done on tissue that is not living, whereas other forms of testing cannot.
I am very excited by the new technology utilized in microarray testing and hope that ethical issues do not cloud the potential for great benefit. Utilizing the technology to detect congenital abnormalities is an inherently controversial process, however I believe that information is empowerment. The more information a family can have, the better. I know that some may abuse this power in a way which many would deem “ethically immoral,” however I do not have the right to pass judgment on other people’s medical decisions. I also recognize a woman’s right to physical autonomy and would not want to infringe on her rights in any way. While it would be hard to witness this misuse of this technology, I believe we must trust that people will use the information for positive means and assist families through the process. Not only could families use this information to prepare themselves for any hardships ahead in child-rearing, but they can also decide to which extent they wish to intervene in utero to curb future suffering. Not only does this information empower those tested, but the entire scientific community would benefit from the detailed information gathered through testing.
ReplyDeleteI believe that the most exciting aspect of this new technology is the ability to extract critical information from non-living tissue, a feature that is new to microarray testing. As the article states 1 out of every 160 births are stillborn and for many cases the cause of fetal death remains unknown. I believe that this technology could have very positive implications for the prevention of late-term fetal death through the retrospective microarray analysis of stillborn babies. Overall, I believe that this is an exciting new development and hope to explore the potential further!
I really find this article to be interesting. I automatically tend to be on the optimistic side by assuming that people will always only want to know this genetic information so that they could prepare early. However, that is certainly not the case and this does raise some ethical questions as my fellow classmates have already said. To begin with, CVS carries with it a risk of miscarriage that is approximately 1 in 100. If this were to somehow become a highly recommended thing for women, the risk of spontaneous abortion would have to be a lot lower than that. There is the possibility of a fetus being perfectly healthy but dying because you tried to conduct genetic testing. Then also the very obvious issue would be the parents wanting to know about potential diseases in the fetus so that they can abort the baby early on. If I were given the option of testing my child, I would. I would like to know what I can do to make sure that my child has the best upbringing that I and my husband could provide. However, for other people knowing more is not necessarily better. Knowing more for other people could mean that instead of enjoying the pregnancy that they would be stressed and worried for the child's possible outcomes in life until the child is born. Such constant stress would affect the mother’s body which in turn would have an effect on the baby. The parents could also become fixated on the possibility of mental disability even if the child might just have the chance and not actually guaranteed to develop the disability.
ReplyDeleteFor the sake of being prepared, this prenatal testing is good for parents who no matter the outcome of the test are going to do all they can to take care of the child.
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ReplyDeleteIn regards to prenatal microarray testing, knowing more isn't necessarily better. It would be better for some people, but definitely not everyone. Sometimes, knowing more will just uncover more problems for a family or more worries that shouldn't be dealt with at the moment or the family just can't deal with it at the time of a pregnancy. People have different opinions and views about things; some people might want to know if their unborn child might have some kind of mutation in preparation for it or if they know that they have some kind of genetic mutation in the family and some people might not want to know if there is something wrong because they might have religious views and from that culture, they might just hope for the best that their unborn child will be healthy.
ReplyDeletePrenatal microarray testing can bring positive and negative consequences as well. Positive consequences include identifying potential intellectual disabilities, developmental delays, autism, and determining why a pregnancy failed. I think this prenatal testing is especially beneficial to those who have had failed pregnancies; this would be way to help them in finding out what is the problem for their failed pregnancies.
Negative consequences though, include parents being more selective about their pregnancies which would lead to an ethical issue. Allowing people to know if their unborn child might have a mutation or disability might cause people to choose abortions instead of going through with the pregnancy. Also, another negative consequence of prenatal microarray testing, in particular for chorionic villus sampling (CVS) is that this procedure comes with the risk of miscarriage. And that ultimately can harm both the fetus and mother. So maybe this testing really isn't worth it if it risks the lives of both the mother and fetus. It would only be worth it if a mother really needed to know whether their unborn child has a genetic mutation or not. Otherwise, pregnant women shouldn't do this prenatal microarray testing just to know if their child is mutation-free or not.
Overall, prenatal microarray testing is a great application that allows those who want to know if their unborn child might have a genetic mutation to know, be it that they have a genetic mutation in the family, or they're worried, or they've had failed pregnancies in the past. But as stated in the article, "It's a great promising new technology, but the clinical application really needs some careful evaluation because of any potential ethical issues."
In terms of prenatal microarray testing, it is absolutely something that should only be performed when the child is at risk and some kind of preventative measured can be taken. However, people often have a tendency to take all uncertainty of having a child away by having testing done. Ethically, I don't believe testing ti be acceptable as it may lead to questions of whether a pregnancy should be aborted or not. It is a very different circumstance when the child is known to be at risk for some possible disease, and just simply performing prenatal microarray testing without having any reason in particular for it.
ReplyDeleteIn addition, as stated in the article, there could still be a "specific genetic condition that was not detected prenatally by karyotyping." This just proves that testing is not one hundred percent accurate and absolutely can miss things. I can understand a parent wanting the best for their child, but this prenatal testing is nothing to rely as the child may develop complications after birth as well. The "genetic abnormalities" that this testing can pick up on should be those that the parent has the ability to prevent/act on. Simply worrying about some abnormality a child may, or may not have as the testing is not 100% accurate, serves no purpose. It is at this point that I believe the testing to become an ethical issue as each birth is equally significant and should never be diminished or skewed due to the results of prenatal microarray testing. The upsides of being able to both physically and emotionally prepare for certain circumstances in any birth do lend themselves to people wanting the tests performed.
I am consitently amazed at the manner in which science is progressing. In terms of Microarray testing, I believe it can be both helpful and hurtful. When my mother was pregnant with me, she had an amniocentesis which concluded that I was going to be born this down syndrome. My dad and mom decided prior to getting pregnant that they would keep their child regardless of any pregnancy complications. After my moms test, my parents spent a lot of time and money preparing for me to be born with a disability. Raising a child with a disability presents many challenges and they did all they could to be ready for my arrival. A few weeks before I was born, the doctors realized that I was actually perfectly healthy. Though this happened 21 years ago, false positives will always be present in medical testing.
ReplyDeleteI believe the question of whether knowing more is better differs for each family. I do not believe that all women should have Microarray testing, as this would be a great financial cost and be totally uneeded. However, older women and those at risk should definitely have the testing done. I personally believe Microarray testing could be beneficial when identifying potential developmental delays, autism and congenital abnormalities. For me, the more information a family can have, the better. The article notes that one study also found this type of prenatal testing to surpass the standard testing when detecting genetic abnormalities, thus it may prove to be a better alternative. Though there is the possability that Microarray testing would increase the rate of abortions, I am not here to judge others medical decisions, and only see this type of testing as the most accurate and helpful way for families to be informed about the health of their future child. I have always been a big planner, so knowing that my child was at risk would allow me to be the best parent I could. According to the article 1 in 160 births is a still born. Microarray testing could help determinine why exactly a pregnancy failed, and provide answers to parents looking to conceive.
It is clear that a con of Microarray testing would be the increase in stress and strain from the procedures and results. Another con to this type of testing is the ethical dilemmas present. Microarray testing eventually could lead to a change in the course of a pregnancy. Who is to say what is normal and abnormal? Is it ethically right to rid of a childs congenital abnormalities or take away their special needs. What about the financial aspect to testing? Will all those with developmental and cognitive abnormalities be the children of parents who did not have the financing for testing?
Financially the health care industry will always gain from discoverys such as Microarray testing. Researchers would benefit as this type of testing allows them to learn what genes cause certain problems. Eventually, this could lead to development of potential cures and treatments. It is clear that this is a hot topic and I am interested to see how Microarray testing fits into the future of health care.
Prenatal genetic testing is a great scientific achievement, one which can greatly benefit society in various ways. However, with the introduction and application of genetic testings comes great responsibility due to the ethical issues that are carried with it. As many have stated, it is of concern that people will abuse this knowledge in order to terminate a fetus for superficial reasons, such as terminating a fetus due to it being autistic. SItuations such as this one are complicated because it is not know how severe the condition will be and even then, many people with various conditions once thought severely debilitating end up living very successful and enriching lives. I'm in favor by the idea proposed by Anthony where there should be a window of time when the testing can take place.
ReplyDeleteOn the other hand, it pleases me that prenatal genetic testing can be used to give parents of stillborn babies possible answers as to why it occurred. Losing the life of a loved one is always tough, but not knowing the reason makes it that much tougher. With this testing, some form of peace and resolution can be met, while also providing the parents with information as to how to have a successful pregnancy for the future.
All in all, there seems to be many benefits as well as complications with the introduction of prenatal genetic testing. However, despite the worries that may come with the testing, I believe that the benefits outweigh the potential downfalls and if this testing is handled and administered in an effective ethical way, then the testing would have the potential of serving great use to society.
I think that prenatal genetic testing can be beneficial but is also a place for a great deal of ethical concern. Knowing more information about an unborn fetus can be a good thing if the fetus presents a problematic medical problem that has a solution. If doctors find some kind of abnormality that can be fixed by changing their environment or another feasible solution, I think it would be beneficial to have genetic testing. However, in conditions that have no known solution, I think that invasive genetic testing procedures are unnecessarily stressful. There is also high risk of pregnancy complications or miscarriage associated with amniocentesis and CVS.
ReplyDeleteMicroarray testing could be beneficial for women with high risk pregnancies. This includes women who are older than traditional childbearing age or have an older child with a disability. I also think this test could be incredibly useful for women who have had a failed pregnancy, as this technology could be used to provide a lot of information without being invasive because it can be taken from nonliving tissues.
Ethically, I don’t know how I feel about these types of tests. Personally, I do not agree that knowing this information is a reason to terminate a pregnancy. Developmental disabilities appear in children in a wide spectrum and often these children are very high functioning and appear “normal.” Sometimes these tests (like all medical tests) produce false negatives. Sometimes, having too much testing done and knowing too much information is not a good thing. It is important that this information continues to be used for ethical purposes only.
New micro array testing has been a momentous achievement in medicine; but with this achievement much support as well as opposition exists. The revolutionary thing about this test is that now unborn children can be screened for a multitude of conditions such as, "intellectual abnormalities, developmental delays, autism and congenital abnormalities".
ReplyDeleteThe supporters of this new test believe that with the information obtained t can be "used to facilitate a better outcome for the child", what this means is if there are abnormalities in the fetus doctors take early actions (such as counseling the parents on what the abnormalities mean for the child) for the betterment of the child's health. From a research perspective, there is now a way to study genes and see what genes cause certain problems. The ultimate goal of this would be to find a treatment for these diseases and abnormalities.
With every action there is good and evil, and micro array testing is no different. Even though there is a multitude of good things that are a product of this testing there are also bad things that come along with it. The biggest one being the early termination of pregnancy. Because prospective parents may get news from this test that their soon to be child may have some sort of disease the worry that many people have is that the parents will terminate the pregnancy because they do not want/ cannot handle the burden of having a child with these types of problems.
Many people are affected by this micro array, genealogists, obstetricians, the parents and even the fetus all have a part in this test. From the information on this subject I believe that the good outweighs the evil in this scenario and that the micro array may change the face of medicine, but ultimately it is up to the parents to decide what is best for them, their child and their family
I would agree that, although there are certainly negative consequences of micro array testing, the potential benefits of prenatal genetic testing could help improve the lives of infants and their families. By testing the fetus in utero for life threatening disorders, researcher and physicians are able to gain insight into future health outcome the child may face. I believe that parents have a right to this information early on in the pregnancy. If parents are made aware of potential developmental disorders early on, they will have time to prepare before the child arrives.
ReplyDeleteI would argue in support of the prenatal testing because in actuality it carries the same benefits as genetic testing of parents before they conceive. For parents who did undergo genetic evaluation prior to having a child, this could be an opportunity learn more about the health of their unborn child.
Although I understand the importance of prenatal genetic testing in some situations, I do not think its necessarily something that should become normalized prenatal care. I agree with previous comments that these advances get to a point where ethical concerns outweigh some of the benefits. As our guest speakers mentioned, some individuals could have superficial motives like only wanting to keep the baby if its a certain gender, which in my opinion completely unethical. I do understand the need for certain families with known or an increased risk of genetic disorders to undergo testing because they do not want to pass on a disease.
ReplyDeleteI see a huge difference with these scenarios, where the parents are making a decision about the future child’s quality of life and family’s capability both emotionally and financially to provide for that child if he or she inherited the disease or disorder, and not superficial traits. When my mother got pregnant after advanced maternal age with my little sister, she was 41, she was continuously pressured to undergo genetic testing because of the known increased risks of getting pregnant after 35. There is no history of genetic disease in our family, so for this reason and the risks of the actual tests she declined, and my sister is perfectly healthy.
Obviously there is not always such a positive outcome, but I think the need extent of testing should be limited, as it is a slippery slope for what people might want to test for in the future as it becomes easier and more telling. There comes a point where it is a matter of retaining individuality.
I think that when determining if knowing more is truly better is truly situational. Each family is different in terms of how necessary a test might be in determining a long term genetic outcome for the child. Time, money and emotions are all factors to consider when weighing whether or not more information is better. Personally, I would want to know more rather than less if my time and resources allowed it but others may not necessarily feel this way.
ReplyDeleteAs mentioned in the article, one benefit of the microarray test is that it can be effective in determining the cause of pregnancy loss. This could give families the information that they need to heal properly and could also provide them with the tools to promote a successful pregnancy in the future. The microarray test has also been shown to benefit those with birth defects. The genetic changes can be detected earlier and more accurately to allow families the time to make decisions and preparations. Additionally, parents who may have undergone genetic testing and discovered a possibly dangerous mutation may choose to have the more comprehensive microarray test done.
Though there are many benefits to knowing more, the microarray test may not benefit everyone. The test is not fool proof. It is not 100% comprehensive and does not detect every possible condition prenatally.
The new prenatal genetic test discussed in the article can provide a wide range of information that can help parents in certain decision, however brings up many valuable ethical concerns. One of the most valid points and reasons behind the test is to help parents who have experiences still born pregancy's understand why and help them in future pregnancy's. What makes this test so innovative is the fact that it can test on dead tissue where old tests only can test on live samples. This test will benefit parents who have a history of problematic pregnancy's.
ReplyDeleteOn the other side, the test brings up some concrete ethical concerns. One of the most striking statements in the article was “adequate counseling for parents is needed in case tough decisions need to be made regarding the pregnancy, given the testing outcome...”. Meaning, that if the test comes back and detects a certain spectrum disorder, or other genetic disorder with your baby parents may make the decision to have an abortion. Even though many genetic tests are very accurate, before putting parents in a situation where they may not necessarily benefit from the test , more information needs to be uncovered. According to the Wilson and Jugner criteria for ethical genetic testing one of the points is that there should be treatment for the disease. In one case, if a parent has no history of stillborn pregnancy's, genetic disorders, or any other children that have had an disorder and their test comes back positive for their baby having a specific condition, their first thought may be to discard the pregnancy., There are many occasions when predictions made by genetic testing has been incorrect Family's who are also low income may feel more pressured to discard the pregnancy. Before the test is used I a wide range more research definitely needs to be done.
ReplyDeleteI think this article really tied in to everything we have learned about in class in relation to different forms of DNA testing. Knowing more I think is definitely better because you can prepare yourself for the future. Even if the results given to the parents contained bad news, I think most people would want to know if their child was going to have a defect so they can plan accordingly. As the saying goes: Knowledge is power. But it is up to he parents to decide what they want to do with this knowledge in regards to their unborn child.
Some pros to microarray testing are you are able to understand if your child will have a genetic defect. If a specific disease or condition runs in your family, then many parents would want to find out if the child will be affected. Diseases like Down syndrome, Turner’s, Fragile X can all be determined by genetic testing in early stages. If you have a relative that suffered from a genetic condition then you may not want the same life for your child. Also, many fetuses that have genetic conditions do not survive the first trimester so it may give parents closure if there is a sudden miscarriage. The con to this testing is that there is a risk the mother can lose the baby. The article mainly points out the pros of microarray testing but fails to mention possible miscarriage associated with amniocentesis and CVS.
As stated earlier, those that would benefit from this testing would be those that are possible carriers for a certain type of gene that can result in a disease or syndrome. I do not think it would be a good idea for parents that have healthy family background to get genetic testing because they risks would outweigh the reward of knowing your child is disease-free.
I do agree with Devon that this article is extremely related to class material. I probably would not be able to understand most of what was going on if I was not enrolled in genomics.
DeleteHowever, I do not believe parents should have too much information about their unborn child. Though you could be more prepared for whatever the outcome may be, it may cause some parents to make unethical decisions. There is much controversy about termination of pregnancy already and this can definitely add to that argument.
Another thing to add is that there is minimal to no mention of any risks of possible genetic testing. As with many prenatal test/surgeries, there is always a change of miscarriage.
Ultimately, the choice should be left to the parents. Providers should inform their patients about the risk and benefits of the test, but leave the decision making to the caregivers.
The article describes the use of genetic testing during a pregnancy to determine the health of a couple’s unborn child. In my opinion knowing more in this situation is not necessarily better. Personally I would not choose to undergo this type of testing because in most scenarios with this test even if something is found there is little the parents can do at that time. In the case of a possible disability or a high chance of miscarriage there is not much if anything that can be done and for me this information would only make the situation more stressful. However, I feel that this issue is definitely a matter of opinion. Some individuals are better able to handle stressful situations if they know something may happen. The extra time to prepare and reach out to friends family and other couples in similar situations may be extremely helpful for some individuals. This time could also be used to look into the best resources for supporting a child with special needs if that is a situation a family finds themselves in.
ReplyDeleteIn the case of doing these tests to analyze a failed pregnancy I think that the information could be incredibly useful. Couples who are experiencing trouble having children would definitely benefit from better understanding why miscarriages and stillbirths have occurred and what if anything can be done to prevent them in the future.
Like many of my classmates have stated there are certainly some ethical implications to think about when looking at these tests. It is possible a couple who has found out their child may have a disability would choose to end the pregnancy. If the parents feel they are unable to provide a full life to a child with a disability due to economic means, location, time etc. this is an option. However, choosing to end a pregnancy is a very difficult and emotional decision and because the test does not attest for the severity of certain disabilities, is not 100 percent accurate in its predictions and has risks associated with it in itself this can be extremely tricky.
I think the tests have positive and negative aspects. I feel that making the tests routine would be taking it too far but as an elective procedure it may benefit parents who already present risks in their own genetics or family history, feel that they would benefit from more prep time for certain conditions or are having significant problems in having a child.
I agree that this article does encompass much of what we have learned this far, but I feel that there should be a time limit on when parents can find out to ensure that the fetus isn't aborted based on a test result. It is important to be prepared though, so if implemented the earlier the better.
ReplyDeleteAs seen in the article "When Genetic Testing Can Be Dangerous to Your Health
Read more: http://www.oprah.com/health/Genetic-Testing-Dangers-DNA-Research-Breakthroughs#ixzz2LlS4ZaVV", DNA testing isn't always the answer. Based on information that we receive we will act on it, whether it is a passive or active approach. However, this information may not be completely accurate especially if the person analyzing the data is not highly trained in the field of genetics, which is many times the case. Many people, based on test results, will opt for preventative surgeries or other invasive procedures that were never actually needed. In all, I think it is important to have DNA testing, but even more important to make sure we have the most accurate information possible.
It is important to know about your family history, but as seen in the movie shown in class, this knowledge can be very burdensome. Early testing for some diseases is like knowing there is a ticking time bomb waiting inside your body. Some people have a better quality of life as far as stress and worry not knowing. Despite all pros and cons I think it is up to the persons values and what is important to them.
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ReplyDeleteA family friend in her early 30s is expecting her first child. I know that she was really nervous in the beginning, thinking about how to best get through her pregnancy safely. Many of us around her have realized that the nervousness is in part due to the hype around certain tests, methods, and findings of what to do (and not do) during the pregnancy to ensure a happy, healthy child. It kind of relates to this article in the way that knowledge can sometimes be really overwhelming. I can imagine that tests providing a lot of results can be very overwhelming for parents who had no reason to suspect any disorders or conditions in the first place.
ReplyDeleteI think it is a good idea to limit the use of more specific tests to instances where there is due reason to suspect a certain disorder or condition (perhaps after considering family history, or another less extensive/more basic test has been performed). In this way, such tests are good because they can help parents understand and prepare for their child’s needs. (That assumes that the parents choose to have the child, however. It is possible that some parents may feel that they do not want to keep the pregnancy after certain findings are made.) Tests can also be good to use when findings can be used for further research on potential treatment options.
The three latest studies involving DNA microarray technology have shown promise in the detection of genetic mutations in an unborn child during pregnancy. With technology advancing in all areas of science and the implementation for clinical use usually taking a few years, I think it is great that microarray testing is beginning to strive toward clinics. But before this is put into practice, we must make sure it is completely reliable and valid. I think giving parents the answers about their child's genetic code is and important information if this technology is refined and ready for practice. I would even say that it would be ethically wrong to not use this technology in routine care because in the favor of the family and the child. Of course a set of standards and rules will have to be strictly regulated when making decisions about what the parents want for the child.
ReplyDeleteOn the other hand, I think we should also take into consideration the cost of these tests because if the price of testing is not decreasing over time then alternative options should be considered. I think part of this genetic testing is a person's responsibility to unravel their own family history and track diseases that have been common in family members, this can help determine if you want to have a child. In the end it is a personal decision to have any of these tests done.
After reading the article, I can see that there are many pros to microarray testing. Some pros include finding more genetic material than traditional testing, it's helpful to researchers, and can be performed on tissue that is not alive to inform parents why they had a stillborn. Personally, I would not like to get microarray testing because I know I would have to face many ethical considerations. Even if I were to find out that my child was going to be born with a disease, I would choose to keep it.
ReplyDeleteThe concern I have with microarray testing is that it is still a fairly new procedure, and it can be quite dangerous. In this type of testing, the genetic information is obtained through amniocentesis. Amniocentesis can put some women are at risk for miscarriages. In an article published in JAMC, it states that for now, this testing should only be used for fetuses that are at high risk for chromosomal abnormalities, since they would benefit more. In addition, there are several ethical dilemmas that can arise because there are no treatments for many of the genetic problems they will find. The most common solution to not have a disabled child will be termination. Some proponents of microarray testing may even argue that since more children with disabilities will be terminated, this will in turn make health care costs decrease.
There are also barriers to having mircorarray testing. For example, it is expensive, and some health insurance companies may not want to reimburse the services performed.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659835/
I think like most genetic testing, the preferences come down to individual cases and the desires of the families to know about unborn children or in this case, what caused a stillborn. This technology should be utilized for families to determine possible learning disabilities or abnormalities that could cause a financial or emotional burden on the family. I believe this will greater prepare families and ease that burden. In a sense that it could make it easier to cope with a stillborn. I think this microarray technology should be recommended further by doctors, but only after further testing and research further validates the recent development of the technology. Especially when the technology is not only being used on the baby but the mother as well.
ReplyDeleteI would argue that knowing more is not necessarily better, when it comes to prenatal microarray testing. There may be some benefits, such as learning the reasons for a still birth. This benefit is purely scientific but could aid in protecting against certain avoidable causes for stillbirth. However, this information won't necessarily ease the pain of having had a stillborn baby. This also raises many ethical questions. Considering a disease like autism, where there is a spectrum of symptoms and severity, even knowing a diagnosis beforehand would not necessarily benefit the parents. In thinking about screening tests, a key factor is whether this information will be helpful, or can be addressed successfully; in this case, it doesn't always seem that it can.
ReplyDeleteFurthermore, if we think about the BRCA1 and BRCA2 test, it isn't recommended for anyone and everyone. Family history and race/ethnicity is taken into account, before a genetic test is considered. Perhaps, if this testing does become part of available testing, it should only be available on a limited basis- to those who have a family history of certain diseases. One would also need to consider the personal, moral and ethical questions that apply to each family, just as one does now when testing, for example, for Down Syndrome.
In regards to microarray testing, I would say that knowing more is better if that knowledge is used to achieve good. The benefit of this type of test is that it can detect genetic defects that a karyotype cannot. It also benefits individuals who believe that they have a higher risk of genetic defects if it runs within the family, or for older couples. This allows such families to have access to earlier information so that they and their providers can develop a plan to meet their potential needs. The test also helps families with failed pregnancies, as it can give them the information they need as to why their pregnancy failed and will help them with future pregnancies.
ReplyDeleteHowever, some problems that may arise with microarray testing is the risk of miscarriage from the amniocentesis(between 1 in 200 and 1 in 400) or chorionic villus sampling(1 in 100) as some couples have had the unfortunate incidence of occurring. Another problem may be an ethical one, where some couples may use the information to abort an unwanted child. Whether or not this can be done will be a debatable topic, but I believe that the benefits of this type of test far outweighs the downfalls of it because the test would only be used by those most at risk, since usual pregnancies would not require amniocentesis or CVS.
http://americanpregnancy.org/prenataltesting/amniocentesis.html
http://americanpregnancy.org/prenataltesting/cvs.html
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After reading this article, I believe prenatal microarray testing would be a good test for mothers who are older, have genetic predispositions to certain diseases and disabilities, and for stillborn deaths. Knowing why a baby didn't survive would help the mother and doctor gain a better understanding of what may have gone wrong during the pregnancy and what can be done to minimize the risk of it occurring again. The older the mother the more likely the fetus is too develop disabilities and diseases, so getting this more comprehensive test done allows the parents to prepare to raise a child who needs more care than other babies.
ReplyDeleteDepending on what diseases or disabilities a fetus has, parents can choose the best course of action, which may be to terminate the pregnancy. The responsibility and burden a special needs child can be on a family can be seen as too stressful and difficult for some new parents, so they would choose to terminate the pregnancy while others would not because of religious beliefs or they are ready to raise a child who needs 24 hour care.
I don't think the prenatal microarray testing should be used for young mothers (under 30) because most of the babies will be in good health and an amniocentesis can be performed if parents choose to have testing done. Knowing every disease or disability a baby could get would put more stress on parents. Sometimes tests are done and they end up being false positives. What would happen if a mother had decided to terminate the pregnancy based on the test results that were wrong? What if the disease or disability is not severe and the child could live a normal life with it?
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ReplyDeleteLike many of the comments above, I do believe that prenatal microarray testing would definitely be beneficial in certain ways. For mothers older than 35, for families with a history, etc. It may be more beneficial to provide background information on the situation so that mothers and families can make decisions regarding the pregnancies that would work best for themselves.
ReplyDeleteBut, again, as others pointed out.. I don't think it's a very good idea to use this test for much else other than detecting a stillborn death. Even with that category, the process I imagine would be unbearably difficult to go through, but maybe in some cases the knowledge using the test as to why it happened could be beneficial for the mother in helping her cope with the situation. Other than the stillborn scenario, I think it's bad because many diseases and problems are definitive. Like autism, there is a huge spectrum underneath that title, and I think people in these situations would tend to always assume the worst case scenario, which would be wrong to do. So in fact, maybe in some situations having more information and knowledge by using this test would just result in being more misinformed in another way.
I'm glad that it exists regardless because I believe that everyone should have the choice and have it be available if that is what they want to do. I just warn them to be careful about the information given to them, and how they choose to react to it.
Prenatal microarray testing is an excellent way for parents to know more about the genetics of their unborn child. But is knowing more necessarily better? I believe that this question cannot be necessarily answered with a simple yes or no. It depends on the case in which the soon-to-be parents are in. Microarray testing can help the parents know if their child will have a disability. This can either help the parents with getting counseling to learn more how to deal with their soon-to-be child’s disability. At the same time it can lead to the parents making the decision to terminate the pregnancy because they believe that they will not be able to raise a child with a disability.
ReplyDeleteMicroarray testing mostly benefits the parents of the unborn child since they are the ones who receive the information and are the ones who in the end decide to carry through or terminate the pregnancy. It is possible that child can benefit from this if the pregnancy is carried out to term, since its parents will already be aware of the possible disability. This gives the child a possibility of a better outcome since by the time it is born the parents will have received counseling on how to deal with their child’s disability. Yet in some cases the fetus is who does not benefits from the microarray testing because if something is found that can lead to a disability the parents may choose to terminate the pregnancy.
ReplyDeleteMany medical advances are being made today in the area of prenatal genetic testing. The goal of prenatal genetic testing is to obtain information on a baby's health before they are born. I believe that this new technology will definitely improve the quality of human life. I strongly think that if we have the resources to obtain information on on such important things like unborn fetuses, we should utilize them. It will aid in diminishing diseases through new advances, and with further clinical experimentation it could potentially save lives. Children will be less at risk to have major health problems in their lives adding positively to their life experiences. With any innovation, there is the fear over usage and abuse of the technology, but I think in this case people would have to be educated about the goals and actual applications of this type of technology.
The only issue I have with this type of technology is the potential for genetically altering fetuses. This will create a slipper slope to eugenics, which is simply unethical. There is no doubt that it could be extremely useful for preventing diseases before we are even born, however it comes with the ability to modify humans which will create a discriminative societal burden.
Microarray testing has many benefits that I think with further testing will be able to help a lot of families. It catches more genetic material that traditional testing and its helpful to researchers. One of the things that stood out to me in this article is that it will truly benefit the families who need to deal with a stillborn child. Everyone believes different things and I, for one, think that knowing more is usually the better route. If disorders or developmental issues can be detected prior to birth, families will be able to properly prepare and educate themselves in a way that will be beneficial to them and their future child. I definitely think that this should be an option for families who are willing to enhance their knowledge on conditions their children might have to face.
I think that microarray testing like any medical technology can have its advantages and disadvantages. One of the advantages to having this test done is that parents who have had failed pregnancies. This test can give them answers as to why their baby did not survive and what they can do in the future to have a successful pregnancy. The information from a microarray test can assist them in making future decision about pregnancy. Another advantage to this test is that it can prepare parents and have some idea of what to expect if their child has some kind of developmental issue. Knowing that their child will have a developmental issue before the birth can allow the parents to learn more about their child’s condition, find appropriate doctors, therapist and other things that will enable the child to have the best life possible. Having this knowledge before the birth of their baby can put the parents more at ease. If they know what to expect and have the appropriate help they might be more less worried about their abilities to take care of a child with a disability. Like other students, one thing I would be concern with is parents wanted to end a pregnancy if they find out their child has a disability. They may not feel that they can handle raising a child with a disability but there are many other options for them other than end the pregnancy. The results of a test like this can be overwhelming and emotional and physical stress. I personally would want to have this test done if there was a disease that ran in my family or I was over the age of the 35 years old. It would be helpful to be prepared before the birth so that I could give my child the best life possible.
ReplyDeleteMicroarray testing would be beneficial to every prospective parent who is in a stable mental state with logical thinking. I think this developed form of testing a fetus for developmental delays, etc. is very useful. It can help give parents a glimpse into the health status of their unborn child, and ultimately provide them with time to consider how to care for such a child, if they will be able to care for the child at all. Having answers about your child's health status, etc. months before the child is born, provides a greater amount of time for the parents to research and plan how their lives will have to change and decide on what choices they will make in regards to life with the child. Parents are provided a better chance to have/create the life and family of their choosing, which means happier parents, and ultimately a possibly happier child. However, I feel as though such testing should really be paired with genetic counseling, so that parents are aware of which disabilities/abnormalities are truly severe/life altering, and which are simply minor difficulties in one's life. This would prevent parents from simply choosing abortion for every slight "imperfection" in their child. Overall, I feel as though the more information the better and the sooner the better.
ReplyDeleteThis CNN Health article was very interesting to read, considering we only briefly spoke about microarray testing in lecture. Chromosomal microarray analysis is a genetic test that finds small amounts of genetic material that traditional testing such as karyotyping cannot detect. The genetic material is obtained during a regular amniocentesis (where small amounts of amniotic fluid and cells are taken from the sac surrounding the fetus and tested during the second trimester of pregnancy) or another commonly used test called CVS, or chorionic villus sampling (where a small amount of cells is taken from the placenta during the first trimester). So far in our Sargent Health Science courses, we’ve only really learned about the dangers of these types of tests, but for this post I will try my best to look past any preconceived notions.
ReplyDeleteResearchers suggest using this test to identify potential intellectual disabilities, developmental delays, autism and congenital abnormalities as well as determining why a pregnancy failed. According to one study, this prenatal testing surpassed standard testing to detect more genetic abnormalities. The thoughts of prenatal testing that can discover and identify even more about the health of an unborn child is exciting. If potential development issues are found, "we are way better able to counsel parents about what they would mean for the child," Dr. Ronald Wapner says. "... We can modify the course and improve the outcome for the child." This all sounded great, until reading comments from my classmates about unnecessary abortions and parents not using prenatal testing appropriately. That is both a realistic and scary consequence.
Dr. Nancy Rose says as a reproductive geneticist, "It's a great promising new technology, but the clinical application really needs some careful evaluation" because of any potential ethical issues. As Kaeleigh Kennidy said, “Overall, the effectiveness and ethical barriers of microarray testing needs to be strongly evaluated.” I also agree with Jeremy Meltzer that “The ethics of this topic are tricky and relatively new - a larger discussion should take place that will provide a more clear answer (or at least perspectives) on the issue of prenatal and other pregnancy testing.”
With regards to who would and would not benefit from this microarray prenatal testing, I like a line in Lauren Arcidy’s post, “the people that need it deserve to have the benefits.” That being said, I cannot help but wonder if there would be a continuation of health disparities. Even if these newer prenatal tests were proven beneficial, would everyone still receive the same access to it? Doctors are supposed to recommend genetic counseling and testing when appropriate, but that does not mean they all are. Would they make this microarray testing available to all patients that could benefit?
While I appreciate the fact that microarray testing could identify the cause of stillborn deaths, I do not particularly agree with its use for determining potential abnormalities in fetuses. I understand why some parents would like to know about potential complications before the birth. However, I feel that in many cases, knowing more about the child before birth is not necessarily better. I fear that parents may choose abortion, for example, if they learn that their child has an increased chance of an intellectual disability—when I’m not even sure we can be so prideful as to say an intellectual disability will necessarily cause a decreased quality of life. Can we even define intelligence with such narrow measures? Knowing about a health outcome of an unborn child may allow parents to better prepare for the birth. However, I feel it would cause excessive anxiety for the parents. Also, who’s to say the result isn’t a false positive? For example, my mother was told after genetic counseling that my younger sister would be born with Down Syndrome, which did not happen.
ReplyDeleteThose who may benefit from microarray testing are parents looking for closure after a stillborn death. It may give them some relief to understand the medical cause of the death, for example. Also, mothers who are unable to take care of a child with certain health outcomes may also benefit from the testing by looking into adoption at an early stage. Those who wouldn’t necessarily benefit from testing include people of certain ages or races who are not targeted for genetic testing. For example, genetic counselors may screen more mothers over the age of 35 for children with Down Syndrome, while overlooking mothers under that age who may also have that outcome but are just at a lower documented risk for it.
In my opinion, the most appealing pro of delivering a wide array of results with the delivery of one test (through prenatal microarray testing) is minimal invasion and disruption of a pregnancy. In addition, the genetic prenatal testing "surpassed standard testing to detect more abnormalities" meaning that it is effective in detecting more abnormalities than any other tests currently being used. And finally, due to the test's ability to be performed on dead tissue the last pro is the application that this test has to determine the potential causes of stillbirths. As for cons, I agree that the test's ethical and medical risks may not be explicitly determined until the microarray testing is reviewed and approved by such reputable organizations as the American College of Obstetrics and Gynecologists. With that said I am under the impression that in regards to pregnancy and genetic testing, knowing more is better given that the information is used responsibly by parents to make informed decisions. I personally would like to have such information so that I might be able to make the appropriate preparations to welcome my child, with or without a disability, into the world. Such preparations may include developmental/physical support for my unborn child but also counseling support for myself, my spouse, and my children (if I have any). After reviewing the pros and cons I believe this test is appropriate for any mother that has an elevated risk of abnormal pregnancy (family history, advanced maternal age, adverse exposure during pregnancy, etc.).
ReplyDeleteThere are definitely some cases that would benefit more from microarray testing than others. For mothers that have difficulty in becoming pregnant or suffer from multiple miscarriages learning why there are problems is definitely a potential benefit of the microarray testing. Knowing that there could potentially be some serious medical issues for the mother, the baby, or both is also something that could be very useful in the medical community. Learning why babies are born stillborn is extremely interesting to learn since this occurs more often than people may think. However, knowing more is not always better. There is the possibility of abusing these tests for parents that are not concerned with medical conditions. This could turn parents now wanting to have a baby that looks a certain way. There are many medical conditions that can be determined through genetic testing that are not necessarily life threatening but some parents may not want to have to deal with in their children, such as mental disabilities for example. Microarray testing would absolutely bring many benefits to prenatal testing but rules should be put in place in order to not abuse the causes for the testing.
ReplyDeleteI can understand why many parents opt to have various testing on their unborn babies. In addition to other things, the parents' goal is to protect their children from the harms and dangers of the world, even if it is their own genetics. I agree with the student who said that this is a question that cannot be answered with a simple yes or no. On one hand, knowing too much information may result in completely altering and reprograming the child's personality and thus creating a flawless robot rather than a human. On the other hand, the guilt of knowing one could have prevented an awful disease or genetic condition that interfered with the child having a free and normal life may haunt the parents. I think what it comes down to is ethics. How far is too far? In my opinion, I think it is good for parents to have the microarray testing done in the case of a disability so that the parents are better equipped to raise the child. Of course one concern is that once the parents learn that their unborn child has the disability may opt for drastic options such as an abortion. This is certainly an area that is still fuzzy and would depend on the situation. I think use of microarray testing would be for stillbirths because not only would it help the parents of the stillborn baby but the results may help other future parents identify risk factors that may contribute to the baby's death.
ReplyDeleteIn general this whole idea of in depth genetic testing before the baby is even born makes me feel uneasy. I understand that it is a way for parents to begin to protect their child, but it is also like playing God or seeing into the future. It gives the parents an option rather than nature to make critical decisions before the baby is even born.
This new technology could provide answers for a lot of patients whose child died at birth. In the article it said that 1 out of every 160 births in the United States is stillborn. With this new technology doctors can now provide reasoning as to why their baby died. This could bring a sense of calmness and understanding to the parents who are having the child. The earlier and more accurate the diagnoses are, the more options it gives the parents. Uncertainty about your newborn child can cause a lot of stress and anxiety. Some parents may want to know exactly what sort of problems their child may have as early as possible. On the other hand, this could make for some very tough decisions on the parents behalf. If they know that their unborn child has a disease or mental disorder they might not think that they could give the child the best possible life. They could decide to abort the baby choose other options instead of giving birth.
ReplyDeleteAlso, this type of testing can help to researchers learn what genes cause certain problems and could lead to development of potential cures and treatments. If research can find out what genes code for a certain disease then preventative measures could be taken before the baby is ever born. Although the prenatal microarray testing could provide more answers for the doctors it also could cause some ethical implications. I agree with Victoria Hogan’s comment when she said that the ability to test for autism and some intellectual disabilities might be taking it a bit far. The parent may not know to what extent the disability is but still choose to abort the baby. If they had gone through with the birth the baby could have gone on to be a very smart and successful person.
With all the advancements in prenatal testing brings along a lot of ethical issues. Parents could get so particular with all these prenatal testing’s and want to produce a “perfect baby.” The advancements in our technology bring a lot of positives but at the same time could bring some negatives. I think that some things are better if they are left alone.
I believe that microarray testing will be extremely beneficial in allowing parents to get a "peak" in their unborn child's health situation. If used correctly I believe that this head start can do wonders for parents who are notified ahead of time that their child has some sort of health issue. This extra time can allow parents to do their research, go to counseling and get an idea of how their lives are going to be affected by this. However, I do not think that this type of screen testing is for all parents. As sad as it may be, there are surely parents out their that would terminate a birth after finding out that their child might be predisposed to have some sort of disease or condition such as autism and it is even tough to determine now how I, myself, would react if I was put in a similar situation.
ReplyDeleteDespite these potential cons I believe that for the most part microarray testing would be advantageous especially for couples who would be able to determine the cause of their "stillbirths" When making the decision to support this type of testing you must acknowledge the possibility of these abilities to potentially extend into the genetic modification realm which is a highly controversial medical ethics topic.
Prenatal diagnostic tests such as microarray testing have many benefits. As the article mentions, these tests help to detect genetic abnormalities of the fetus. It is pretty amazing that with just one test of a small sample, a doctor is able to analyze the expression of many genes. Knowing that your fetus will have a genetic defect will help the parents to prepare ahead of time such as finding early intervention programs, buying any equipment, contacting support groups, etc. If the abnormality is severe enough, the parents have time to contemplate terminating the pregnancy.
ReplyDeleteI feel compelled to question what our ethical responsibility is to consider the information that diagnostic tests do not give us. The human genome is very complex and there is still more to be studied. Prenatal diagnostic testing can tell parents whether or not their child will have adverse genetic mutations. However there are genetic mutations that might not be fully understood or detectable that would be helpful to know and possibly, to preserve. One example is natural resistance to HIV where the origin of which is not yet understood. If someone had a genetic adaptation that is beneficial to keep in the human genome, it might make parents reconsider terminating their pregnancy of a fetus that also has genetic mutations that are considered unfavorable. It seems rather one-sided to only consider the genetic mutations we might want to remove, what about the ones we want to be sure to keep and pass on? This is an example of where knowing more might not always be better. It is possible that we actually do not know enough.
This article sheds light on an incredible example of the possibilities that stem from modern technology. Only a few years ago prenatal screening was an unthinkable option but we now have access to not only one, but multiple, methods to determine the health possibilities of an unborn child.
ReplyDeleteIn terms of prenatal testing, I think that the decision to screen is up to each parent but the option should absolutely be available for them. With these new opportunities in front of us, we should take advantage of the option to be prepared for any and all possibilities for our children. People will have different opinions on whether or not they want to know (personally I would definitely want to know), but the decision should of course be up to each individual. This should also extend to the option of receiving all results or more specific results. There are different risks and options depending on which test method is used, so the decision should depend on the person (given that he/she is educated in all of the options and risks involved).
General results would be beneficial for couples who don't already have a child with a condition and only want to be prepared for the future, while more specific tests would be helpful to those who for example, already have a child with a disease or condition and want to know if having another child will put their second child at risk.
Those who believe they may be potential carriers for a certain disease or condition would benefit most from micro array testing. This would help determine the risks involved if they are to have a child. People from healthy families that have little to no evidence of carrying the gene for a specific disease probably should outweigh the pros and cons of micro array testing because it may not benefit them. And since the test may not detect every possible prenatal condition, the risks may not be worth taking the test.
Here's a link to a study done to determine whether screening for prenatal risks will lower the rate of infant diseases and illnesses. It's an interesting article, and it also shows the low risks of prenatal screening. http://www.ncbi.nlm.nih.gov/pubmed/23211699
The two procedures the article refers to in order to remove genetic material are regular amniocentesis and CVS. While there are risks for both procedures, it is through the procedures that go wrong that researchers learn how to make them better. Thus, it is unfortunate for those who take the risk of having a procedure done and it going wrong. However, these are the mistakes that will some day lead to a more perfect procedure.
ReplyDeleteThat being said, I think the advances researchers have made are amazing to have such studies to examine beyond chromosomes and evaluate smaller pieces of DNA. However, I don't think that finding these results in regards to prenatal microarray testing is necessarily a good thing. Like Wapner says in the article, "tough decisions need to be made regarding the pregnancy, given the testing outcome." On one hand, if testing goes well but issues are found, the actions that a parent does would determine how ethical getting the test done in the first place was. For example, if a parent were to want an abortion if they found out their baby may have a birth defect, I think that would be pretty selfish to not want to take care of a child with extra needs. However, it would be less terrible if a parent knew they financially, physically, or mentally couldn't take care of a child with birth defects. Moreover, the article talks about finding ways to improve the outcomes for such a child. This is a case where testing would be good for a parent who is hopeful for their child and tries to modify the course of their child. Therefore, testing could benefit any pregnant mother and researcher to learn the development and potential treatments for genetic abnormalities of a baby. However, I don't think testing may be the right thing for anyone, depending on how selfish their motives and reasons are.
To begin, I don't feel that there is necessarily one answer to the question "Is knowing more better?" I feel that the answer to that question is highly subjective and depends on the situation as well as the individuals involved. How much do the individuals really want to know? I think that there is a reason the saying "Ignorance is bliss" exists. Sometimes, knowing isn't always better and causes pain. On the other hand, sometimes knowing can prevent something bad from happening, like unnecessary preventable pain or suffering.
ReplyDeleteFrom reading this blog post, it does seem like there are many advantages to microarray testing. This type of prenatal testing has been found to surpass the standard testing methods used to detect more genetic abnormalities, making is possible to better counsel parents of the unborn children. Microarray testing is also beneficial to researchers and can potentially help them learn which genes cause certain problems and may lead to the development of potential treatments and cures to these developmental issues. As the blog states, 1 in 160 births in the United States is a stillborn. This type of testing can help both doctors and parents understand why the baby did not survive the pregnancy and can also provide information that can be used in the future to lead to a successful pregnancy because it does not require use of live tissue as other tests currently do. Microarray testing is also better to detect genetic changes in fetuses that have birth defects than tests currently available.
However, a few limitations of this testing was also mentioned. The first being that despite the advances this technology could lead to, not all genetic conditions are detectable. Additionally, this testing has been said to need careful evaluation it terms of its clinical application because of the potential for ethical issues.
My initial reaction to this form of testing is that it would be great for use in studies to help determine the causes of developmental delays, intellectual disabilities, congenital abnormalities, autism, and determining why a pregnancy failed. As was mentioned earlier, this could lead to huge advances in treatments and even cures for such illnesses and disabilities. However, I feel that there is a lot of room for abuse of the testing in a clinical setting and couples wanting perfect children as opposed to children with any detectable disabilities or illnesses. I do think that there could be many ethical issues with this type of testing, as there are with most new medical advances, that should be considered before this is introduced to the clinical setting. Lastly, I would be interested to know the risks involved with this type of testing as I have learned that amniocentesis and CVS are not the safest tests to run and could result in miscarriage in some circumstances. I think that this form of testing could result in huge medical advances, but I also feel that it could cause some major ethical issues as well. Before anything can be fully determined, it seems that more testing needs to be done before any major decisions can be made.
It is amazing to think that after the introduction of DNA microarray about 20 years ago, we have already made some major improvements to the technology. So improved that it has the potential to be the first test that is able to detect intellectual disabilities. After reading this article, I wanted to learn more about the potential benefits of DNA microarray. Interestingly, I found an article that discusses the effectiveness of chromosome microarray analysis (CMA) in high-risk pregnancies. The test detected DNA abnormalities in about 22% of the 75 patients. Although the procedure was said to be invasive, the decision to undergo testing is completely up to the mother, so if the mother weighs the risks more than the procedure then she should go through with it. I believe that more studies should be conducted to observe the benefits and drawbacks of microarray testing. Because even though one study shows it has the potential to detect 22% of certain abnormalities, I believe there needs to be more long term studies done to show how the CMA has affected the child’s future.
ReplyDeleteI think the ability to determine why a pregnancy failed would be helpful information for many people. It would bring up the question of whether this would be a good use of our resources, but I think the fact that such a test exists could bring answers to many couples desperately seeking those answers. Tests such as amniocentesis and chorionic villus sampling already exists, so the issues regarding the ethical decisions that people would make knowing more about their unborn child are not new. I think having more accurate and in depth tests would be good, because society has already embraced the other prenatal testing options. Given this, it would be good to be sure to have correct information, something this test could provide. While this test would not be perfect, it sounds like it could be more accurate than some of the other options currently out there. Those who have screened positive as carriers for genetic disorders or those with a family history of genetic disorders would rely on this more detailed testing to be prepared for the arrival of a child with certain needs or choose to make whatever decisions they felt was best for them and their child.
ReplyDeleteI do think that more knowledge is better. I feel that there are more pros than cons that come from microarray testing. For example, microarray testing can help to identify intellectual disabilities, developmental delays, autism, congenital abnormalities, and can help to determine why a pregnancy failed. In addition, this type of testing can mentally and emotionally prepare parents that find out they're going to have a child with some type of developmental abnormality, such as Autism. Knowing ahead of time can help parents set up therapies and things as the such that the child will need to have the best life possible. Another upside of microarray testing is finding out why a couple had a stillborn child. This can help tap into the genetics of the parents, which probably had not done before. Also, this can help the parents to decide if they want to or should try to have another child again or not.
ReplyDeleteA definite con of microarray testing is that selective abortion can become common practice. On a personal level, I do not see this as being a bad thing. Raising a child with developmental abnormalities is definitely not for everyone. It takes a lot of time, money, and patience. Having a child with such abnormalities takes a toll on the family mentally, emotionally, and sometimes physically. I know that if I found myself in the position of knowing that I was pregnant with a child with Down Syndrome for example, I would choose to have an abortion. First, because I would not want to bring a child into this world that would suffer and not be able to have a normal life, but also for the sake of myself and my husband. I would not want to dedicate the rest of my life taking care of someone else. This is the type of ethical debates that arise from making abortion legal. You can't prevent excess abortions as a result from microarray testing. Unless you regulate it and make the test only available after you cannot longer get an abortion, which I obviously disagree with. Another con of microarray testing is too much stress felt by the mother stemming from the results of the test. Too much stress could potentially end the pregnancy itself. You never know how you're going to react when you're told that your child will have Autism or anything else of that nature. So too much stress as a result from those test results cannot only harm the mother, but the baby.
Overall, I would support more research to make this type of testing as most accurate as possible, so mothers and fathers alike aren't given wrong or misleading test results, only to find out months later that their baby was fine and that feeling so much stress and anxiety was for nothing.
This article mentioned how "the clinical application really needs some careful evaluation" because of any potential ethical issues. After reading, I wondered how safe the procedure was. I went on to read this article: http://nyp.org/news/hospital/New-Prenatal-Test-2012.html which explains how subjecting to microarray testing is an invasive process which puts at risk fetal abnormalities, procedure-induced miscarriage, and having an affected child. It would be ideal to come up with a non-invasive test involving a blood sample from the mother, which researchers are working on. If microarray testing gets to a point where it can be done in a non-invasive procedure and all pregnant women are offered it, I believe it is ethical if there is informed consent. Mothers would benefit by having information on their baby and how to prepare for it. If the procedure is not invasive, I believe women who wish to get tested should have the right to because they will find out the results eventually when their baby is born so why not prepare for it? I believe microarray testing in relation to stillborn babies should be considered ethical and non-onvasive since it is only involving non-living tissue. If procedures were invasive to living tissues, fetuses would not benefit and in fact be at risk of being harmed.
ReplyDeleteAfter reading this blog post and a few of the responses, this situation has reminded me of a topic that was discussed during my medical ethics class.
ReplyDeleteThere are obvious benefits to knowing more about a future child's genes. I even think that it would be comforting to know that my child would definitively be healthy. The one area of controversy is if having this knowledge would lead some people to abort children with disabilities. Many people argue that children with disabilities suffer throughout their lifetime and it would be in their favor to keep them from ever having to live or suffer at all. However, this argument is not very logical. If you look at this from the perspective of the unborn child, there are two options, living a life that is less than ideal, or not living at all. Clearly it is more beneficial, from the child's perspective, to be born.
I also see this topic potentially becoming a slippery slope. If we start testing for things like down-syndrome, how long will it be until we start testing for less severe things like autism and asperger's syndrome.
I think that there are many situations where this kind of testing could be beneficial and helpful, but it would have to be regulated heavily, and I'm not confident that we could regulate out all of the potentially harmful and awful situations. I actually go back and forth in my head, with trying to prevent misuse of new technology, and settling with the idea that we can't control the people who will use beneficial technology in a harmful way.
I have come to meet many families with children with disabilities, and while their lives would definitely be easier had their child been born without disabilities, I don't think any one of them would take back their child's life.
I don't think it's necessarily better to know more, but I do think it can be beneficial in many cases. I think that
ReplyDeleteif there is a disease somewhere in the parents lineage that could present struggles for the fetus. If there are no potential health factors or diseases, I think it may be better to opt out of prenatal microarray testing. This test would give couples answers to questions presenting anxiety during their pregnancies. The test has many cons. These include preparing the parents for any hardships that may come with the pregnancies, mentally and emotionally preparing the parents for any decisions they may have to make for their fetus and coming up with a "game plan" if their future child does have some sort of disease or disability. With that being said, there are also some cons. These include the stress of parents feeling obligated to make a decision, preparing themselves to raise a baby who may potentially have a disability and the emotions that may come knowing you could bring a baby into the world with special needs and how you will adjust to take care of it. Those with diseases and disabilities already in the family would benefit from this sort of testing.
Overall, I think the testing is beneficial, and is also optional.It seems to be the most accurate choice and therefore more dependable. Then, genetic counselors can help the families through with their decisions.
Jonathan Greenbaum
ReplyDeleteIt is nice to see that there are so many new technological breakthroughs surrounding this microarray technology. This is a technology that certainly could prove to be extremely useful in screening for genetic diseases and allowing us the possibility to institute earlier prophylactic treatments when possible.
Although this testing allows us to learn important potentially life altering information, there are definitely many ethical issues that surround it. I believe the test is very important for mothers to be because it allows them to prepare for the lifestyle they may have to lead if their child is born with a genetic disorder as well as affords them the opportunity to decide whether to go through with the pregnancy. However, I do not believe these tests should screen for diseases that may occur later in life, such as Alzheimer’s or Cancer. Those types of tests should be reserved for adults who make a conscious decision to find out this type of information. It would be very unfair for a child to grow up knowing they will one day develop a genetic disease.
It is important to recognize that having this type of information would absolutely alter your perspective and outlook towards life and this is why knowing too much is not always a good thing. It is also important to point out that there is definitely a difference between testing because a child is known to be at an increased risk and testing for no specific reason. I understand that parents only want the best for their children but prenatal testing absolutely should not be exploited to make rash decisions about the child. I definitely support further research in this field to make this type of testing as accurate as possible so that parents don’t make decisions based on wrong information.
ReplyDeleteIt amazes me every time I read these articles that have a new discovery of leading man to understanding more about the human body, its genes, etc. and especially, the new advanced technology that we have.
“To each his own” is a phrase I firmly believe in. I think in regards to prenatal microarray testing of being necessarily better depends on the individual. For some people, knowing as much as they possible can about their baby is of utmost importance to them. For some, it is not. In the article, it states that, “According to one study, this prenatal testing surpassed standard testing to detect more genetic abnormalities.” This line makes me hesitant to acknowledge how accurate this prenatal testing actually is because of the fact that it is claim of one study.
To answer your second question, I believe that it is all up to the individual on what the pros and cons are of delivering all of these results vs. more specific results from less comprehensive test methods. I personally do not believe in finding out as much as I can about my baby besides its gender and whether or not the baby will be living by the time he/she is delivered. I think parents of the child who are generally worried about their family genetic history of serious illness would definitely benefit from microarray testing. I do not think that microarray testing is for everyone because there will be many people who are not as worried, who cannot afford this testing, who do not believe in finding about stuff about the child, etc. will not benefit from it.
Chromosomal microarray testing is a new form of testing that allows experts to be able to detect potential intellectual disabilities, developmental delays, autism and congenital abnormalities, and can determine why a pregnancy failed. This new form of testing has shown to be superior to its predecessors because it can be done with dead tissue and and can use smaller amounts of genetic materials to analyze. The new test can help doctors better determine why a baby is a stillborn baby, which the older tests cannot determine as well. This new technology is a great step in the field in my opinion. It's a step in the direction of preventative medicine which is important because it saves money in the future because healthcare expenditures that aren't necessary don't need to happen. I am a firm believer in preventative medicine and that is the direction that healthcare in America is headed in because of our absurdly high healthcare expenditures. This technology is also great for parents to better understand what their baby's life could potentially be like if they did actually have intellectual disabilities, developmental delays, autism and congenital abnormalities. Some people might not be fit to support a child that would suffer from any of these conditions and if that baby's life was going to be one of low quality, then the parents should have the choice to chose for their baby, whether or not they want them to live that life.
ReplyDeleteMicroarray testing on unborn testing is certainly an amazing breakthrough in technology. This type of testing opens up many possibilities in the realm of chromosomal characteristics. Researchers claim that these tests can be used to detect potential diseases, genetic abnormalities, or even reasons behind failed pregnancies. However, I completely agree with the statement, "'the clinical application really needs some careful evaluation' because of any potential ethical issues." This type of technology may be used with the best intentions; however, certain ethical issues arise with pre-birth genetic testing used to "customize" certain desired characteristics. For example, it may be harmful if people were given the choice of gender, or physical characteristics before birth. This could potentially create inequalities in societies where people cannot afford to test for, or choose certain genetic characteristics. This type of technology can potentially be used in malicious ways as well, and companies who are looking to increase profits may not have the highest regard for ethical considerations. None the less, I feel that this technology is great, but will be highly controversial in its use.
ReplyDeleteIt is great to see how far technology has come today, but I believe that knowing more is not necessarily better in regards to prenatal genetic testing and could result in being more harmful to parents than beneficial. Knowing more about the specific health does allow parents to better prepare themselves (by receiving counseling) for some possible conditions or diseases that the baby may have when it is born. It also does allow for researchers to gather information looking at smaller pieces of DNA and possibly come up with future cures or treatments regarding certain abnormalities. Although these two points show the positives of prenatal microarray testing, one aspect that I believe that this article fails to cover is the stresses and worries of the parents that come along with knowing that the baby will not be fully healthy upon being born. We discussed about the issue of stress earlier this semester and how it could be passed down to have an effect on further generations. This articles leaves out that the stress of knowing about specific abnormalities and dealing with this knowledge throughout the pregnancy could play a huge role in the future health of the unborn child.
ReplyDeleteThose that would benefit from microarray include couples who have a strong history of specific diseases and abnormalities that drastically impair the living quality of a human being. This testing could help these couples with a strong history of certain diseases have the option of choosing to keep the fetus or not. Another group that would benefit from microarray testing would be women who have given birth to still born babies. This prenatal genetic testing would benefit them because it would provide them with an answer on why the fetus did not survive the pregnancy and also it would provide them further information that would lead to a successful pregnancy in the future. A group that these prenatal tests would not help out would be those couples in the lower portion of the socioeconomic level because they would most likely not have the knowledge about this prenatal testing, nor the means to pay for it.
In regards to prenatal microarray testing, knowing more may not always be better. As other students have pointed out, there are both advantages and disadvantages to this type of testing. In the case of stillbirths and miscarriages, these tests could be very useful. If the tests reveal the reasons for the failed pregnancy, the parents and doctors might be able to make changes so that the next pregnancy is a success. However, there is also the concern that one of the procedures for microarray testing, amniocentesis, is an invasive procedure that could cause a miscarriage. Another pro for this type of testing would be that the tests could reveal a type of disability to the parents that better prepares them for caring for their child. Knowledge of a disability before the birth gives the parents time to become accustomed to the specific needs of their child. Unfortunately, the knowledge that their child has a disability could prompt the parents to abort the child. This raises many ethical issues, and there is a definite concern that the tests could be abused in such a way. Also, there is a level of uncertainty with many similar tests. These tests most likely won't be able to predict the severity of the disability, and a healthy child with a slight learning disability could be aborted because the parents feared that they would have a child with a severe disability that they would be incapable of caring for. The test could also produce a false positive.
ReplyDeleteI believe that the tests should be only given to older mothers or women with certain family histories. These women would be at the most risk and would benefit the most from prior knowledge about their children. Someone mentioned above that the tests should only be given after the abortion window has closed, but I disagree. Situations in which parents abort less than perfect children is definitely a major concern, but it would be unwise to completely close off the option due to unforeseen future circumstances where abortion may be the better option.
Finally, the cost of the tests could have a major effect. If the tests are not covered as a part of insurance, then only those with enough money would be able to pay for the tests. People with less money and/or no insurance would receive no benefit because they would be unable to take the tests in the first place. If these tests are going to offered to the public, they should be available to all pregnant women, and a lack of funds should not prevent a woman from prenatal microarray testing.
Most women give birth to healthy babies and common genetic testing methods such as CVS and amniocentesis have been proven helpful for women who decide to take advantage of these tests. Plenty of women don’t use these tests and still give birth to newborn babies. Considering that at the current moment, genetic testing is not the most affordable genetic test offered everyone should not use microarray testing. Women who present certain risk factors such as maternal age, being a carrier for a certain genetic trait or who may have given birth to a child afflicted with a genetic disorder may benefit more from the test. Moreover, it should completely be an expecting mother’s choice if she wants to undergo microarray testing even if she has some of these risk factors. I wish the article discussed more about the effectiveness of microarray testing as opposed to amniocentesis and CVS. On average, if microarray testing only picks up 1 in 1000 more genetic issues than these more common place tests it may not be that useful. However, if it picks up much more genetic issues that may have otherwise went undiagnosed then it would certainly be a useful tool. The article makes a great point discussing microarray testing and stillborn babies. This would provide a way for mothers to no longer be troubled by their child’s death and instead know why they gave birth to a stillborn child.
ReplyDeleteFor researchers, this is definitely a breakthrough. How exciting to have the opportunity to gain so much data that may lead to new preventive measures during pregnancy. There are many pros, but also many cons to this kind of information. But even these pros and cons are subjective. Clearly, this information may lead to better health outcomes for all children, but it may also lead more stress for mothers and maybe even fetus diagnoses that were mistakes or whose quality of life would have been less affected than predicted, but were terminated. In this case, both the family and the baby lose out.
ReplyDeleteWith that said, I had an interesting conversation with my mother recently. My mom was 40 when she had me and she is a special educator who absolutely loves everything about her job. She had told me before that she chose not to have me tested for Downs because from her experience, children with Down syndrome live happy lives. But, she continued on to tell me that if there would have been a test for severe autism, she doesn't know what she would have done because she thinks she would hurt to much to see me unable to communicate and upset by so many triggers.
On the other hand, one of my friends is studying severe special ed and specializes in children with autism. I've had this conversation with her, and she feels very different from my mom. For this reason, I believe that the pros and cons are so subjective that people will be upset with whatever happens or does not happen with this information.
But, in general, I think most people can agree that to an extent, many children and families could benefit from the long-term information that this comprehensive testing could generate in terms of prenatal care. But at what cost? That cost is different for everyone, based on personal experience.
Some of my classmates say that knowing is not necessarily better and if parents were to know, then they should not know until it is to the point where the pregnancy is not able to be terminated. I do not have a strong stance on either extreme sides, however when I read these posts, I can't help to think about the different situations such as families who would not have the resources to raise a child with a disability or severe disease. We are afraid that families can make unethical decisions when they find out the health status of their unborn child. However, it may even be unethical in the long run if health professionals do not notify families with who may not be able to give a good life for the child. For example, a family can already have 2 children with autism and it is already too hard to handle. They are expecting another child but would not be able to give the best life to all 3 children if they are all autism because it is overwhelming for the parents.
ReplyDeleteI am glad that there is new scientific development such as this pre-natal micro array test because more knowledge may lead to other discoveries. I believe that the best way to implement this new advanced method, is to only screen for severe diseases and give the option to the family if they would be able to keep the child or not. Knowing early can be beneficial because there could be preventative measures that the family can take. We should not screen for non-severe diseases because it may lead to more unethical decisions by the family compared to knowing about severe diseases. In other words, I think that families would be more careful in deciding on severe diseases than non-severe diseases.
Cons to the pre-natal micro array testing is the cost. For more screenings, it leads to more costs to either the insurance company or the patient. Of course, there is the con of unethical decisions of the family such as if they want to have testing just to see the gender of their baby or if the baby will not have the prettier eye color.
I think that the pre-natal micro array test is a good test for pregnant mothers to take. A lot of people think that it is best to remain ignorant of the potential disabilities of their unborn baby; however, I believe that the more you know, the better prepared you can become to care for your unborn child. This micro-array test would probably be best suited for mothers who have experienced still born babies in previous pregnancies, or already have children with disabilities, but I think it would be wise for every pregnant woman to take this test. Coming from a family who has had to care for a severely mentally disabled child, I understand how hard it is for a family, even a family with the actual means to take care of a child with a disability, to make sure that a child who is disabled has the best life possible. There are many families out there who are not mentally, or financially ready to take care of a severely disabled child, and I think it is important for those families to have the knowledge of the health of their child to either prepare themselves to take on the care of that child, or make a different decision.
ReplyDeleteSome of the cons associated with this test would be the cost of the micro-array test vs. the specific one. Since this test covers a wide variety of genetic disorders, it is probably more expensive than the specific test. Another con associated with this test is the ethical problems that can arise from the results of this test. Many people consider it unethical to abort a fetus just because it has a birth defect.
This new technology provides exciting opportunities for researchers in that we have the opportunity to delve further into the genome during development and to learn more about genetic factors that contribute to disease. We can look further into how genes from the parents impact genes of the fetus and can look further into processes involved in mutations and polymorphisms that contribute to developmental and other diseases.
ReplyDeleteThe way these new testing opportunities impact clinical opportunities is, however, something to be looked at more cautiously. Certainly, I agree with what the article states in that this more specific testing method can be beneficial to mothers who are older and are known to be carriers for certain inheritable diseases in that it can provide them with information regarding their babies early on, which is certainly helpful for taking preventative measures and for preparing for what's to come. However, I don't think it should be necessarily made available or recommended to all individuals expecting a new child. Reading this article reminded me of discussions from this and other classes regarding a possible new era of eugenics. While I think at this point, definitely this technology could be helpful in detecting disease and working to help the child, we need to consider the ethical implications of looking deeply into the child's genome and revealing certain information beyond known disease traits to parents. Additionally, the added benefits of using this microarray testing vs traditional chromosome analysis should be looked at very carefully, since the article revealed that one study found that this testing still missed certain conditions.
Gathering genetic information from stillborn babies may very well be generally beneficial in that gathering more data on the genetic factors at play in stillbirth can be shared in the science world and perhaps eventually with the general population if important indications develop, and in that informing parents who have experienced one or more stillbirths of any significant findings that may come from microarray testing can help them to make important life decisions or lifestyle changes.
Microarray testing is very exciting for researchers; now, certain diseases and pregnancy outcomes can be linked to different genes. However, the testing may not be as exciting for parents. Microarray testing, as stated in the article, can identify potential cases of autism, developmental delays, and intellectual disabilities, all of which have no cure. Although counseling can be done, nothing can change the outcome of the pregnancy and may result in increased rates of abortion. For certain religious communities, microarray testing may seem like another way to give parents a reason for undergoing an abortion. On the positive side, knowing this information can allow proper planning and identification of useful services. Parents can be made aware, before the birth, of the available services to provide for their child. Again, this may not be positive if services are not even available to parents and the results of the microarray test may make things seem hopeless.
ReplyDeleteThat being said, I think there is a place for microarray testing. Specifically for parents who have access to services, knowing if their child has a developmental delay ahead of time will aid their future struggles. For those with no access, knowing may not be better, especially if the mother is adamant about keeping the baby no matter the circumstances. In the end, microarray testing all falls on preference. I think all mothers should be aware of the costs and benefits of all available testing, and individually, they should decide what is best for them. Some may choose to remain in the dark, while others may be set on knowing every possibility, but either way, the option should be there for everyone.
As for providers, those giving the microarray testing should always be prepared to counsel their patients about their options. Not only should providers be able to administer the test, but they also must be able to discuss, evaluate, and guide their patients to appropriate resources. Just giving test results is not acceptable; all providers should be trained or be able to refer their patients to someone who can help them post-result. Without this important aspect, microarray testing is not beneficial to the consumer, just to researchers. In conclusion, microarray testing is beneficial for all mothers who wish to know about possible genetic diseases, as well as researchers.
All prenatal testing will have risks, the microarray testing is done through either an amniocentesis or a chorionic villus sampling, which both have many risks for the mother and fetus. I think the microarray testing is advantageous for the expecting parents. Like amniocentesis or CVS, microarray testing has the ability to diagnose a fetus with disorders before the child is delivered. This allows expecting parents to be able to prepare for the obstacles their child and family will face.
ReplyDeleteHowever, the ethical issues that accompany this information are always difficult. Although it is ultimately the parents’ decision, it is a slippery slope from aborting a pregnancy due to a potential disorder and aborting the fetus because they are the wrong gender, or genetic composition. There has been a lot of talk about designer babies and more advanced genetic testing and technologies keep being developed to help parents know more and more about their child before they are born. This technology is wonderful for all the doctors and researchers, allowing them to study the genetic causes of varying congenital diseases or disorders. Using this testing and procedures to change genetic components of a fetus is beneficial in the event that a parent is a known carrier for a serious disorder or disease. Controlling the gene that controls the expression of specific diseases can be great for science research and the quality of life of that family and their child. However, we have to be careful that this doesn’t lead to controlling genetic expression for less serious health problems. While everyone would like to lead a healthy life, making a lot of changes to our genetic make up could have potential risks that we have no idea about yet.
I think microarray’s biggest pro is that it allows families that experience miscarriages to know why their baby didn’t survive. If the miscarriage was caused by something the parents did or one of the parental factors, they can try to change that or at least account for it if they try to become pregnant again. I think this test will benefit expecting parents who had a miscarriage, an affected child, or know that a close family member is a carrier for a major disorder. They can find out whether their child has the potential to have this disorder and what their future would entail. There’s always the possibility to be incorrect and the result of the test only incorrectly scared potential parents. I think as further research is done with this testing and as it is fine-tuned some more, it can be extremely useful for expecting parents.
In regards to prenatal microarray testing knowing more is not necessarily better. One opinion of a person from the film In The Family was "Let it stay a mystery." A quote in response to her feelings on genetic testing of the BRCA gene. If a parent finds out that their child will have a certain disease later on in life, it's like having an imaginary time bomb on them, not knowing when it will blow. Having more specific results and less comprehensive test methods can lead to standardization of these tests. Some pros can include better public health for the population and even early interventions to minimize or even negate any future problems. Cons can include life insurance policies rejecting people due to test results or unemployment if an employer takes note of a disease from the tests which would require consistant sick days throughout the year.
ReplyDeleteThose who can benefit from microarray testing are families with a history of genetic ailments such as cancer, Alzheimers or other chronic diseases. These tests can help the family plan the future for their child as well as give them the option, if they absolutely must, to abort.The future child benefits most if the family plans accordingly. The child's life can be prolonged if a fatal disease is found and can be accommodated for if a disease is found where the child may have physical impairment. It can also be argued that the parents are also at a loss with these microarray tests. If test results return positive, then the family may have to change their entire lifestyle, which can potentially lead to a huge financial investment that may cripple the family in the short-run or even long-run.
I think the question of should we continue advancing genetic prenatal testing and its capabilities is an ethical question that will never have a definitive answer. Too many people have different opinions, varying slightly and greatly, and most are unwilling to compromise - and they shouldn't have to. If a parent-to-be wants to have genetic testing done then they should have the option, but I think it's important that those that don't want to know (because knowing isn't always better) shouldn't be forced to, or be surrounded by pressure to. The same dilemmas are presented to parents-to-be, however, as those brought to light by current genetic testing. The severity of the disease, disorder, or condition cannot be determined - an important fact that needs to be taken into account by the parents. As a result, knowing may not always be better.
ReplyDeleteSpecifically, microarray testing might benefit those that have a history of a particular disease or condition in their family that the more narrowed microarray testing could detect. Knowing if their child is affected or carries the disease might either help them prepare to raise that child with possible additional needs, or decide to follow another route. Either way, the microarray testing would be beneficial to them.
Being able to determine or shed light on why a pregnancy failed might also be beneficial to those trying to have children but are having difficultly for unknown reasons.
I think that it's great that the genetic material can be obtained through the use of current procedures, like amniocentesis or CVS, and that a whole other, more dangerous procedure does not have to be done to do this testing.
I think that prenatal testing is good for expectant parents to find out what problems or risks that the unborn child has or could face. however prenatal testing should be used as an educational tool and knowledge gaining experience but not as a cherry picker for children. Prenatal testing needs to take place after the point of termination in order to avoid and hopefully eliminate ethical issues that could arise if parents are not satisfied with the characteristics of their unborn child. I am adamant about these prenatal test not being the determining factor for whether a child lives or not. My mother could have aborted my younger brother after they told her that he was going to have down syndrome. However she chose not to and luckily because he was born not only without down syndrome but also with out any mental delays. These tests are not 100% accurate. The microarray testing is a great step in genetic testing and should be used wisely when informing patients.
ReplyDeleteI believe that pre-natal testing is good for expectant parents because it helps parents prepare for any problems that might arise with their child during or after the pregnancy. Many people have raised valid points about the ethical issues surrounding the results that the information from these pre-natal tests could have on the outcome of pregnancies; however, I believe that parents should have the right to terminate pregnancies based on the information that they learn from these tests. If these tests have the capability to detect certain genetic disorders or severe mental retardation, I think that it is perfectly acceptable for parents to consider abortion. I have a brother who is severely mentally disabled, and I could not imagine life without him; but, his quality of life has been far better than most other mentally disabled children because my parents have the means to provide 24/7 care for him. There are many families who would not be able to provide the proper education/care for a child with severe mental retardation; therefore, that child's life would be negatively impacted. If the pre-natal test can detect severe issues with fetus, I think that the family has a responsibility to seriously think about the choices that they will have to make for that child for the rest of that child's life.
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