Special issue of Bioethics: Ethical Implications of New and Future Technical Developments in Prenatal Testing and Screening

One of  my core research fields over the years has been reproductive ethics, especially the ethics of genetic and reproductive technology. In my postdoc period, I published a study on the moral roots of prenatal diagnosis, followed by a number of further explorations of the ethics of reproductive technology, genetic testing and medical screening programmes in general. The last two years, this process has come full circle, due to new revolutionary technical developments regarding prenatal testing and related genetic analysis, and the last year or two, I have been busy presenting and discussing issues related to this several times with Swedish medical professional and medical ethical organisations and actors. In the spring of 2013, I was invited to present my views on this topic at a specially convened international symposium at the Brocher Foundation in Geneva, Switzerland. Out of that event now comes a full special issue on the ethical implications of new and future technical developments in prenatal testing and screening of the journal Bioethics, edited by Wybo Dondorp and Jan van Lith, of Maastricht and Leiden universities, respectively:

The content, of course, features a developed version of my talk at the Brocher meeting – A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal – arguing that the technical advances of prenatal testing should herald the beginning of the end of of large societal prenatal screening programmes. But the issue also features a large number of other contributions from leading names in the field, e.g. Angus Clarke, Zuzana Deans, Ainsley Newson, Steve Wilkinson and Guido deWert, and the full table of content reads as follows:

EDITORIAL

1. Dynamics of Prenatal Screening: New Developments Challenging the Ethical Framework (pages ii–iv)Wybo Dondorp and Jan van Lith

PAPERS

1. 1. Prenatal Screening: Current Practice, New Developments, Ethical Challenges (pages 1–8)Antina de Jong, Idit Maya and Jan M.M. van Lith
      
      
   2. Psychological Aspects of Individualized Choice and Reproductive Autonomy in Prenatal Screening (pages 9–18)Jenny Hewison
   3. For Your Interest? The Ethical Acceptability of Using Non-Invasive Prenatal Testing to Test ‘Purely for Information’ (pages 19–25)Zuzana Deans, Angus J. Clarke and Ainsley J. Newson
   4. Prenatal Screening, Reproductive Choice, and Public Health (pages 26–35)Stephen Wilkinson
   5. A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal (pages 36–45)Christian Munthe
   6. Prenatal Screening: An Ethical Agenda for the Near Future (pages 46–55)Antina de Jong and Guido M.W.R. de Wert
      
      
      
      

First Ever Live Birth After Live-donor Uterus Transplantation in Gothenburg, and Six More Chances Awaiting

 So, perhaps some of you remember reporting and commenting somewhat a few years back (here and here) on the Gothenburg Live-donor Uterus Transplant Project at the Sahlgrenska University Hospital and Sahlgrenska Academy at my university, lead by Mats Brännström, and since then successful transplant-procedures have been reported (here and here), to be followed by attempts to establish pregnancies. Late yesterday night, the embargo was lifted on the Lancet article reporting the first live birth within this project, which is also the first such case ever. The child and the mother are reported to do well, albeit the article reports a few minor complications – in no way exceptional and dealt with in a routine manner. Six more pregnancies are reported to be under way in the project. Besides the article and general presentation video linked to above, here is a video telling the story of these recent events:

As Mats Brännström states in this documentation, the eventuality of uterus transplantation becoming a routine procedure for the small – though not insignificant – group of women for whom the procedure may be indicated lies far off into the future. The procedure is still highly experimental and requires outstanding skill and organisation (and has, in the Gothenburg case, been funded exclusively by research grants from private foundations). You may, of course, debate whether or not it should ever become more than that, if nothing else for reasons of priority, but this will depend on what the cost of a fully developed procedure would be, and, of course, how one values the outcome.

In the meantime, I want to condone Masts Brännström and his team, not least, for the example-setting openness and conscientiousness about the ethical ramifications of this project which has surrounded it from day one (this is one publication concentrating on this particular aspect). And, of course, I extend my congratulations for this success to the team and, not least, the patient.