Philosophy Prenatal Testing Proposal Essay Example

diagnostic test, there are two options to choose from: amniocentesis or Chronic Villus Sampling (CVS). Amniocentesis is typically carried out between weeks 15 and 22 of pregnancy, whereas CVS can be performed earlier, between weeks 11 and 13.

Both amniocentesis and ultrasound have a small chance of causing miscarriage. Another ultrasound is done to identify open neural tube defects, while amniocentesis offers a more comprehensive examination. Regarding results, IPS typically shows that approximately 2-4% of 1000 women will test positive for Down syndrome, Trisomy 18, or an open neural tube defect.

Approximately 20-40 out of 1000 pregnant women have an increased chance of giving birth to a baby with Down syndrome, compared to the remaining 980-960 women. Of those who test positive, about 19-39 receive a false "screen positive" result, resulting in only one true positive outcome for every 1000 pregnant women.

If individuals desire prenatal diagnosis, these results typically come back negative, confirming the absence of any genetic abnormalities. To be eligible for this diagnostic testing, IPS results must be positive or the mother must be at least 35 years old.

It is important to note that there is always a slight increased risk of miscarriage during the diagnostic testing process. Amniocentesis negligibly raises this risk by 0.

A positive test result for Chorionic Villus Sampling (CVS) or Amniocentesis (2%) increases the risk of genetic conditions by 1%. Genetic counsellors can provide assistance to mothers who receive a positive test result in deciding whether to continue with the pregnancy or terminate it. One of the genetic conditions tested is Down syndrome, which affects both mental and physical abilities. In Canada, Trisomy 21, which accounts for 95% of all cases,

is the most common type. During conception, if either the sperm or egg fails to separate a pair of chromosomes 21, every cell in the developing embryo will replicate the extra chromosome.

While the exact cause of an additional chromosome 21 is not yet understood, it is commonly believed that the failure to separate chromosomes 21 is more likely to occur in the egg rather than the sperm. The chances of this happening during pregnancy increase as the mother's age advances, although women of any age can still be affected by Down syndrome. Trisomy 18, a condition similar to Down syndrome, also arises from chromosomal abnormalities.

The cause of Trisomy 18, a condition where babies have three 18 chromosomes instead of two 23 chromosomes at conception, remains unknown. However, researchers have discovered that the likelihood of a baby having Trisomy 18 increases as the mother's age increases. In comparison to those associated with Down syndrome, the developmental challenges related to Trisomy 18 are more severe. Sadly, less than 10% of children with this condition will survive their first year of life. Although the chances are low, the risk of a mother giving birth to a baby with Trisomy 18 does increase with age.

Open Neural Tube Defects (ONTD) is a genetic disorder characterized by an opening in the spinal cord or brain. The development of the spinal cord begins as a flat structure and then transforms into a tube around one month after conception, which is known as the neural tube. When there is a failure in the closure of the spinal cord, resulting in no formation of the tube, it leads to open neural tube defects.

This condition

can cause various conditions such as spina bifida, anencephaly, and encephalocele. These conditions involve the exposure of either the brain or spinal cord through a defect in either the skull or vertebrae.

To prevent this disorder, it is recommended to take folic acid supplements starting one month before conception and continuing for three months afterward. However, it should be noted that not all cases of open neural tube defects can be prevented similarly to Down syndrome and Trisomy 18.

History of Prenatal Testing

Over the past century, prenatal testing has undergone significant advancements, particularly in the last 50 years. Previously, expectant mothers had limited information about their unborn child's health and genetic disabilities. They either took a chance or avoided testing entirely. However, modern prenatal testing allows parents to gain insight into their child's development and explore new possibilities that were previously inaccessible. Since the 1950s, prenatal testing has involved analyzing samples of fetal DNA.

Originally, the main purpose of amniocentesis was to monitor the health of the baby before birth and detect signs of fetal distress. Later on, it was discovered that by identifying sex chromatin, doctors could determine if a male fetus had a higher chance of inheriting a genetic disorder from the mother. In the 1960s, Canada started introducing amniocentesis as a prenatal diagnostic test in certain hospitals, but there were limitations. The general public did not have enough information about this service, labs were not adequately equipped, and personnel didn't have proper training.

In Canada, by 1971, there were 13 prenatal testing centres. As the practice expanded globally and within the country, the testing capabilities also improved. However, because prenatal testing was relatively new, there were

debates about its limitations. Initially, volunteers who were interested in abortions for different reasons conducted the testing and were not concerned with the outcomes. The testing sometimes resulted in dry taps (no amniotic fluid retrieval), umbilical cord damage, infection, and miscarriage (though it was unclear whether it was due to the testing or natural causes).

Utilizing instruments such as ultrasound machines, needles, and microscopes allows for the achievement of scientific truth in prenatal testing. This involves extracting DNA samples from a pregnant woman and thoroughly analyzing them to determine the health status of the fetus.

The Integrated Prenatal Testing (IPS) uses ultrasound technology and blood samples to evaluate specific aspects of the fetus's health. Measurements are taken for nuchal translucency (the thickness of the skin at the back of the fetus's neck) and levels of PAPP protein between weeks 11 and 13 of pregnancy. A second blood test, conducted between weeks 15 and 20, assesses alpha-fetoprotein, estriol, and chorionic gonadotropin levels. Abnormal levels indicate an increased risk for conditions like open neural tube defect, Down syndrome/Trisomy 18, or Trisomy 18/Down syndrome. By considering all this information, conclusions can be drawn regarding the likelihood of these conditions [16].

If IPS results yield positive findings, there are two diagnostic options available.

Amniocentesis or CVS is utilized for suspected Down syndrome and Trisomy 18. Amniocentesis requires the insertion of a needle through the abdomen and into the amniotic sac with the assistance of an ultrasound, extracting a small amount of fluid (not exceeding 1 ounce) for testing purposes. In CVS, a tiny piece of placental tissue is extracted. Technicians can analyze the amniotic fluid and/or tissue to examine fetal culture cells concerning

particular genes and protein levels that might suggest a genetic abnormality [13].

Previously, individuals with disabilities were seen as frightening due to the lack of understanding about genetic disorders. As a result, these problems were perceived as both intimidating and mysterious. Film often depicted scary characters as having genetic exceptionalities, further perpetuating the belief that these individuals were similar to fictional characters in reality. This concept sparked scientists' curiosity, leading to research on the origins and causes of genetic disorders. Consequently, prenatal testing was developed, enabling scientists to detect these conditions during their formation.

The knowledge we have about genetic exceptionalities and prenatal conditions is constantly growing and shaping our perception of disabled individuals.

Technology

Is Prenatal Testing Considered as Technology? Prenatal testing is indeed considered technology because it applies scientific knowledge about fetal growth, birth defects, and human genetics. Currently, prenatal testing can be seen as an extensive technological tool that is not necessarily required during pregnancy. Some people see this technology as valuable and a logical addition to the "quasi-evolutionary process" of humanity. However, others view it as harmful because it can endanger the unborn child's life if problems are discovered or if the technology itself poses threats (depending on the type of prenatal testing).

Various technological artefacts are used for different steps of prenatal testing methods. These artefacts include ultrasound machines for producing sonographic images, tools like needles and syringes for obtaining samples from the mother, and digital machines for testing and analyzing the samples. These artefacts are essential for prenatal testing and are used by technicians as an extension of their bodies.

Technicians recognize the importance of consistently maintaining and improving technological artifacts to achieve optimal outcomes.

Prenatal screening methods differ and are conducted at various stages of pregnancy. Integrated Prenatal Screening (IPS) is a commonly used approach due to its safety and ability to detect Down syndrome, Trisomy 18, and open neural tube defects. While IPS is more accurate than other screening methods, it does not yield definitive results. The test consists of two parts: an ultrasound performed between 11 weeks and 13 weeks, 6 days of pregnancy to measure nuchal translucency (the thickness of the skin at the back of the baby's neck during development).

After undergoing an ultrasound, the mother is required to provide a blood sample. Another blood sample is taken during the 15th to 18th week of pregnancy, specifically on the sixth day. These blood samples, along with the nuchal translucency data, are used to assess the potential risk of the baby developing any of the mentioned issues. In case screening identifies an open neural tube defect, an additional ultrasound is performed for a detailed examination of the baby's back and head.

On the other hand, if the screening gives a positive result for Down syndrome or Trisomy 18, further prenatal diagnostic testing can be done such as amniocentesis or Chorionic Villus Sampling (CVS). These give extremely accurate results, but also carry the risk of causing miscarriages.

Ihde’s Analysis Applied to Prenatal Testing

The technological artefacts incorporated into prenatal testing can be further distinguished to possess some of the various intermediary roles proposed by Don Ihde. They are as follows:

• Ultrasound Machines: For the technicians who use this machine regularly in order to gather the information they need, they perceive this technology as an instrument panel (Ihde II). They operate the machine
  

to observe and gather information about what is happening inside the womb; the machine is part of the world they are observing and analyzing.

Technicians use syringes, needles, catheters, and other similar devices as if they are part of their own bodies. These tools are specifically designed to function smoothly and feel intuitive to handle. Consequently, technicians experience the Horizontal phenomena (Ihde VI) when using these artifacts. Conversely, patients' main concern is the extraction of samples from their bodies using these devices. They are aware of the methods employed for this purpose.

The patients are aware of the syringe utilized to collect their blood, but they do not give much consideration to the involved technology. Hence, there is a shared background connection between the technology and patients. The technicians employ digital machines for conducting tests and gathering data, subsequently analyzing and interpreting it for important information.

The technology of prenatal testing has a Hermeneutic relation (Ihde III), but patients undergoing this testing do not directly interact with or see the technology. Instead, they simply provide samples and wait for results, thus sharing a background relation (Ihde V) with the technology. The impact of prenatal testing on humanity is significant as throughout history, humans have relied on technology for survival and prosperity due to their lack of innate defenses against nature. Therefore, technology is considered a fundamental aspect of human existence. In the context of prenatal testing, this technology plays a crucial role in providing parents with

valuable information about their unborn baby's health before birth. This enables them to better prepare and address potential challenges, increasing the baby's chances of survival and a healthy life. However, it is important to acknowledge that the use of prenatal testing technology can also lead to inappropriate actions towards the baby, whether intentional or unintentional.

In the case of discovering a problem with the baby during early pregnancy, the pregnant mother might not feel the need to take extra precautions for the baby’s health. Unfortunately, this lack of action could lead to more issues for the baby upon birth. Additionally, there are individuals who prioritize having a "perfect baby" and may opt for abortion regardless of the accuracy of the diagnosis, driven by their hubris. The impact of IPS and diagnostic testing is felt both globally and locally in our society. On a global level, prenatal testing has implications for the international scientific community. Canada plays a significant role in this community as it provides funding for both prenatal genetic screening and testing.

Therefore, the Canadian government and economy are influenced by genetic testing as it relies on society's tax funds for the healthcare system. This testing also creates employment opportunities within the community through IPS, diagnostic testing, and the subsequent development of children with exceptionalities. Additionally, prenatal screening and testing directly impact the family unit and mother. The impact of IPS and diagnostic testing on society is significant, as it contributes to scientific research globally.

Genetic testing is a relatively new concept to society, but it provides scientists with the opportunity to explore and understand genetics. By analyzing genetics using IPS and diagnostic testing, there is potential

to discover cures for genetic disorders. These scientists utilize Ihde's typology of hermeneutic relations to navigate the technology utilized in prenatal testing, aiming to enhance the overall understanding of the field of genetics. Prenatal testing not only has an impact on the Canadian government and economy, but also influences societal perceptions and judgments regarding the government's perspective on this topic.

The provision of free prenatal screening by the Canadian government promotes the perception that female rights are being supported. This gives women greater control over their pregnancies as all expectant mothers are offered IPS or a form of prenatal screening. This allocation of funds towards such initiatives allows feminists and women to feel a sense of pride. The impact on the Canadian economy can either be positive or negative depending on the decision made after a positive test result. If the pregnancy is continued, the economy can benefit from the creation of more jobs to support individuals with exceptionalities. However, accommodating these individuals may require additional tax funding, which some argue could burden society.

IPS/diagnostic testing impacts the social and mental well-being of society. It instigates the labeling of individuals with disabilities and the potential for unjust prejudices when it comes to their inclusion in society. The testing encourages immoral considerations, as families are given the option to eliminate the "issue" when positive results are obtained. Allowing society to determine population inclusion (through pregnancy termination) based on genetics is unethical.

The effects and decision-making process of prenatal testing can have an impact on the family unit, particularly the mother. In Canada, the financial aspect is not a concern since the testing is provided free of charge, alleviating any

financial burden. In an interview with a local family physician, she expressed that in her experience, the choice to undergo genetic testing does not have a significant emotional impact on the patient or their family. It has become a standard procedure, and only a small number of patients contemplate whether the testing is suitable for them and their loved ones. This situation aligns with Ihde's typology of technology, as the technology of prenatal testing is not at the forefront of patients' minds, and they do not consider the scientific or emotional aspects of the process.

It is something that exists, so they choose to partake in it. Pregnant patients do not consider the negative or positive aspects of prenatal testing. As per the local doctor, 9 out of 10 pregnant patients will undergo screening because it does not have any physical impact on them or their unborn child. The decision-making process lacks logic. The potential consequences of a positive test result on the family are not taken into account. Nonetheless, there are instances where the testing has a beneficial effect on the family, enabling them to prepare for an unpredictable future.

On the other hand, there are women and families who face negative consequences from positive test results. The stress caused by the "burden of worry" and the "burden of bad news" can lead to poor decision-making such as termination of pregnancy or separation of the family unit.

Screening/Diagnostic Tests:

Are They Beneficial or Detrimental for the Overall Well-being? Screening/diagnostic tests may be seen as a challenging situation.

In the grand scheme of things, genetic testing can benefit humanity. Genetic tests enable scientists to explore the

enigma of genetics and discover and potentially treat 'abnormal' genetics. This highlights the positive impact that the scientific aspect of IPS/diagnostic testing can have on society. However, there are several reasons why testing adversely affects the greater good. It perpetuates the desire for perfection, leading to unjust judgment of others. Prenatal screening burdens the majority with worry and heightened stress levels, particularly when the mother undergoes the process alone. This additional stress is unnecessary, as our culture's mental health is already fragile.

Having the right to decide to terminate a pregnancy based on uncertainty is also a negative idea for society. The belief that "any child entering the world is a blessing" should be examined when applying Kant's theory to screening and diagnostic testing. It is necessary to consider if prenatal testing being universal is morally acceptable. If every pregnancy underwent IPS or diagnostic testing, chaos and irrational judgement would arise.

Not all countries have laws restricting abortion like Canada. If everyone has access to prenatal testing, the possibility of a dramatic increase in abortion rates arises because families tend to not desire an "abnormal" child. In countries with deficient education, many people lack the knowledge to interpret positive screening results accurately. Consequently, decisions to terminate pregnancies would be based solely on a screening that only shows the baby's likelihood of being diagnosed with one of three genetic problems. As the screening and testing promote enlightenment (allowing parents to make rational judgments about their test results), the consequence of selecting life for some and terminating for others could lead to disorder.

According to Kant's theory, prenatal testing is not universally morally acceptable. This is primarily because some

countries have limited knowledge about individuals with exceptionalities. With regards to the semantics of society, screening and diagnostic tests help society manage an uncertain future. Nonetheless, the perception of these tests by individuals seeking them can either increase or decrease future turmoil. Some individuals view the testing as a means of preparing for what lies ahead.

Therefore, prioritizing the baby's best interest is crucial for the family and their ability to handle what lies ahead. Families can navigate the uncertain future by embracing the concept of "Prevention of family disruption," which involves making adjustments to their home environment, acquiring specialized equipment, seeking social support, and connecting with other families facing similar circumstances. However, there are individuals who undergo prenatal testing with the expectation of having a flawless or "ideal" baby. This mindset will only lead to anxiety if a positive test result occurs, preventing the family from effectively preparing for their future and potentially resulting in the termination of a life or relationship.

Conclusion

Taking into account scientific truth/methods, technology, and society, we have established a foundation for understanding the significance of prenatal testing. However, there are still unanswered questions that require further exploration in order to fully grasp the impact that prenatal testing has on humanity.

Proposed Questions to be Answered in Society:

Will ‘perfecting’ the ideal baby lead to the perfection of society?

Will society experience improvement once all genetic disorders are cured?