Prenatal Tests: Oversold and Misunderstood | Bioethics Research Library

Lincoln Samuel tested positive for Edwards syndrome, but was born perfectly healthy

On Sunday of this week, the Boston Globe published an article that I’ve been waiting to see for months. It’s Beth Daley’s investigative report on noninvasive prenatal testing, and I’m hoping it will both create a larger public conversation, and shift the terms of the conversation so far.

As many of you know, NIPT is a new technology that promises to detect Down syndrome and other chromosomal conditions based on a maternal blood draw alone. These tests are sold as “99% accurate” – something I believed for a long time, and that some health professionals seem to believe – but as genetic counselor Katie Stoll has written, the actual test performance is nowhere near as good. NIPT is not diagnostic; it is a screening test, and a “positive” result only means that a diagnostic procedure, like amniocentesis or CVS, will be required to confirm fetal status.

I believe that it is not enough to consider reproductive technologies in the abstract. They cannot be contemplated only in a statistical or bioethical vacuum: we need fact-based stories to perceive human consequences on the ground. Beth’s article accomplishes this by focusing on the cost of false positives and false negatives in real people. She also delves into the facts about LDTs, or laboratory-developed tests, which are currently unregulated by the FDA. Because her article has already sparked pieces at The New York Times, NBC News, and elsewhere, I have hopes that a new conversation is beginning.