Bioethical Challenges for the Rehabilitation Counselor

Bioethical Challenges - Current Advance Directives Physician Assisted Suicide Reproductive Technologies Prenatal Diagnosis and Selective Abortion

Prenatal Diagnosis and Genetic Counseling Ethical and Human Rights Concerns

Prenatal Testing Used to detect genetic disorders during early stages of pregnancy Common Procedures: Maternal serum screening Chorionic Villi sampling Amniocentesis Carries risk of procedure-related miscarriage and false pos & neg

Why is it important to detect genetic disorders? Reproductive Rights Prevention of Suffering/Quality of Life Child (wrongful life) Parent (wrongful birth) Society Gives family time to prepare

Why is it inappropriate to engage in prenatal testing? Who is qualified to define quality of life? Those without disabilities believe far greater suffering than those with disabilities Quality of life is related to more to societal response than to the disability itself Parents may feel coerced to do their part to “stamp out birth defects” (Moral responsibility to avoid preventable disease)

Why is it inappropriate to engage in prenatal testing? Everyone has the right to exist Child’s future right to autonomy is compromised by upholding parental right to autonomy Slippery Slope Discrimination vs. PWD Selective abortion based on other undesirable characteristics – “Made to order” children Perpetuates neg. attitudes toward disability Better not to be born than to have a disability

Why is it inappropriate to engage in prenatal testing? Belief that genetic counselors and physicians are biased toward selective abortion General lack of knowledge about disability Must make decision quickly before fully informed due to increased medical risk as pregnancy advances

Bioethical Challenges – Into the Future Genetic Engineering Cloning