Meanwhile, it had become clear that the test for neural tube defects could also be used to assess the risk for Down syndrome, namely by detecting low levels of alpha fetoprotein. A new round of governmental enquiry and requests for research began. see more In 1992, the Ethical Committee of the Department of Health advising on research applications (KEMO) was asked to consult on a project of the obstetricians in the northern and central regions of the Netherlands to offer screening for neural

tube defects and Down syndrome and study the ethical and psychological aspects of such screening. KEMO had no ethical objections to this type of research. However, it mentioned that this might actually not be seen as population screening in the sense of an offer without a prior medical condition. Since the women were pregnant they were already receiving

medical care. Furthermore, it was suggested that women might be informed about the test so they could make their own decision about it; thus reducing pressure to take the test (KEMO 1992). The same point of view was voiced by the parents’ organisation BOSK (BOSK 1992). The organisation wanted women of all ages to be informed about the test so they could decide for themselves. However, BOSK was concerned informed consent would not be guaranteed in case screening would be offered as part of a population screening programme; the free choice not to opt for abortion might be constrained through societal pressure.

As we will discuss below, this distinction between offering and informing would become important https://www.selleckchem.com/products/azd9291.html in the next decade. The Minister, however, decided not to implement serum screening for Down syndrome in the early 1990s. Testing for reproductive issues versus population screening The discussion on serum screening should be seen in the light of previous developments during the 1980s. As became clear in the Ureohydrolase discussions about the departmental report on the prevention of hereditary and congenital anomalies (Parliamentary documentation 1987–1988a), there was a strong consensus for government to keep its distance from prenatal genetic testing. In clinical genetic practice in the Netherlands, parental autonomy had been firmly established. It appeared that by then a ‘field of argumentation’ had developed regarding genetic testing for AR-13324 sensitive reproductive options. On the other hand, quite another field of argumentation had formed concerning population screening. There was consensus at the time that the instrument of population screening should be solely offered to improve public health if used for treatable disorders with an available early intervention. In short: no treatment, no screening. In this field of argumentation, the government should play an active role.