Specific topic

Genetic diagnosis before and during pregnancy
(PND and PGD)

The term prenatal diagnosis (PND) covers a variety of different techniques of diagnosis prior to the birth of a baby. The aim of prenatal diagnosis is to identify high-risk pregnancies and births at an early stage and to ward off dangers to the life and health of both mother and child.

The techniques of prenatal diagnosis include not only imaging processes such as ultrasound but also methods that allow genetic examination of the unborn child by taking and propagating foetal tissue (e.g. chorionic villus sampling [CVS] or amniocentesis). Some 70 000 prenatal genetic examinations a year are currently performed in the Federal Republic of Germany.

If the prenatal diagnosis reveals the existence of genetic or chromosomal defects, the law at present in force allows the pregnancy to be terminated without a time limit and without the requirement of counselling if that is deemed to be medically indicated. It is a condition of such a medical indication that in the view of the doctor the continuation of the pregnancy would carry the risk of serious harm to the physical or mental state of the mother and that this risk cannot be eliminated in any other way that is likely to be acceptable to her.

Particular importance attaches to the practice of pregnancy counselling before and after prenatal diagnosis with regard to the ethical and social problems raised by PND, including that of society's attitude to disability.

In preimplantation genetic diagnosis (PGD), an embryo a few days old produced by artificial fertilization in the laboratory is examined for chromosomal or specific genetic defects. Embryos that lack the relevant chromosomal or genetic defects are selected for implantation into the woman's uterus.

PGD is not undertaken in the Federal Republic of Germany. It is a matter of controversy whether preimplantation genetic diagnosis is prohibited or is consistent with the Embryo Protection Law.

The ethical and legal issues arising in connection with PGD concern not only the moral and constitutional status of the embryo but also the rights of couples interested in having PGD and the possible contradiction in values between the attitude to the termination of pregnancy after PND and the ban on PGD.

The Opinion can be accessed online at: http://www.ethikrat.org/_english/publications/Stn_PID_engl.pdf

(back to the top)