Sunday, November 20, 2005

testing, testing

A new prenatal test for Down's Syndrome detects the condition several weeks earlier in the pregnancy, sometimes as early as 11 weeks.

Early screening would give women carrying an affected embryo the option of having an abortion earlier in the pregnancy when the risks to the mother are lower, or allow them more time to prepare themselves should they carry the pregnancy to term.

An op-ed in the New York Times today raises some troubling questions about this test, and testing in general. First, there's the claim that 80 percent of women who get a positive test choose to have an abortion, which is chilling to those with Down's who are capable of understanding the issue. It's also chilling because high abortion rates associated with these tests will mean there are less people with these conditions, which will probably mean research money will go to testing and not to cures and therapy.

Then there's insurance. Will insurance companies continue to insure disabled children if their parents refused to get the test? Will insurance companies realize that abortion is less expensive than treating a disabled child? Will testing become so expensive that these kinds of disabilities occur primarily among the poor?

The most chilling statistic is the five percent of the new prenatal Down's tests that return false positives. Who would want to make a decision based on this test knowing that there is a five percent chance it's wrong?

The op-ed about the Down's test ends on a hopeful note:

Even as genetic tests appear to have lowered the number of Down syndrome births, he said, social conditions for people with the conditions have improved markedly.

"We're in the midst of a gentle social revolution," said Dr. Crocker, and, he believes, it may just outpace the scientific one.

That's a stretch. Has society ever been even one step ahead of science? Medical advances are moving much faster than the public discussion that keeps them under control. And that's before money and politics comes into play and perverts the discussion. Just wait until this issue works its way into the Roe v. Wade debate.
Then there's the yesterday's Times editorial about rapid AIDS testing. Pretty soon, we might be able to test at home for AIDS. Getting a positive back on this test would be pretty traumatic for someone to handle alone--it may be best delivered by a doctor or counselor. But the Times says that trauma is worth it--the alternative is people spreading AIDS because they don't know they have it.

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