Prenatal screening, reproductive choice, and public health

Bioethics. 2015 Jan;29(1):26-35. doi: 10.1111/bioe.12121.


One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues.

Keywords: autonomy; consent; eugenics; prenatal; public health; reproduction; screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Eugenic / ethics*
  • Choice Behavior / ethics*
  • Comprehension
  • Congenital Abnormalities / diagnosis*
  • Congenital Abnormalities / genetics
  • Cultural Diversity
  • Decision Making / ethics
  • Disabled Persons*
  • Dissent and Disputes
  • Down Syndrome / diagnosis
  • Eugenics
  • Female
  • Genetic Testing / ethics
  • Humans
  • Information Seeking Behavior
  • Informed Consent / ethics*
  • Morals
  • National Health Programs / ethics
  • Personal Autonomy*
  • Pregnancy
  • Pregnant Women* / psychology
  • Prenatal Diagnosis / ethics*
  • Public Health / ethics*
  • Reproductive Behavior / ethics
  • Social Discrimination*
  • United Kingdom