Chromosomal microarray analysis in prenatal diagnosis: ethical considerations of the Belgian approach

J Med Ethics. 2020 Feb;46(2):104-109. doi: 10.1136/medethics-2018-105186. Epub 2019 Sep 16.

Abstract

Detection of genetic aberrations in prenatal samples, obtained through amniocentesis or chorion villus biopsy, is increasingly performed using chromosomal microarray (CMA), a technique that can uncover both aneuploidies and copy number variants throughout the genome. Despite the obvious benefits of CMA, the decision on implementing the technology is complicated by ethical issues concerning variant interpretation and reporting. In Belgium, uniform guidelines were composed and a shared database for prenatal CMA findings was established. This Belgian approach sparks discussion: it is evidence-based, prevents inconsistencies and avoids parental anxiety, but can be considered paternalistic. Here, we reflect on the cultural and moral bases of the Belgian reporting system of prenatally detected variants.

Keywords: Ethics; Genethics; Genetic Counselling/Prenatal Diagnosis; Obstetrics and Gynaecology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aneuploidy
  • Anxiety
  • Belgium
  • Chromosome Disorders / diagnosis*
  • Chromosomes*
  • Culture
  • Cytogenetic Analysis / methods
  • DNA Copy Number Variations*
  • Databases, Nucleic Acid
  • Disclosure / ethics*
  • Ethics, Medical*
  • Female
  • Fetus
  • Genetic Counseling / ethics
  • Genetic Counseling / psychology
  • Humans
  • Microarray Analysis
  • Parents* / psychology
  • Paternalism
  • Phenotype
  • Pregnancy
  • Prenatal Diagnosis / ethics*
  • Prenatal Diagnosis / psychology
  • Research Report
  • Social Values
  • Specimen Handling