Towards an ethically sensitive implementation of non invasive prenatal screening in the global context

摘要

Cell-free DNA (cfDNA) screening is an emerging prenatal technology available in 90 countries. Despite its rapid global diffusion, there is a gap in knowledge about its implementation outside of North America and Europe including low to middle income countries. To address this, we organized an international comparative workshop to explore the ethical and social implications of the global expansion of cfDNA screening. We describe 8 key insights that arose from discussions to illustrate how bioethical discussions and normative frameworks that originate and reflect North American and European ethical priorities can be enriched by attending to the importance of local context. The utility and ethical implications of cfDNA screening are highly variable and dependent upon local healthcare systems, cultural, economic, and socio-political contexts and needs. We call for a more subtle, dynamic and contextual understanding of the international spread of cfDNA screening, which will evoke diverse challenges across different contexts.