[Ethical aspects of prenatal screening for Down's syndrome]

Trisomy 21, the chromosomal base of Down's syndrome, results in severe mental and physical handicap. Owing to the development of medical genetics reliable screening and diagnostic procedures for the detection of the disorder are available in Hungary. To achieve the goals of prenatal screening it is important to address the main ethical issues arising through the application of technical-professional skills. The core objective of prenatal screening for Down's syndrome is to give information about the genetic condition of the fetus in order to enhance the autonomy of the parents in family planning. Screening programs should respect the ethical requirements of the principles of "do no harm", beneficence and autonomy of the patients, which are the most important ethical norms of doctor-patient relationship. Regarding the social aspects of screening it is essential to claim that voluntary participation and nondirective genetic counselling can exclude eugenic purposes. Though introduction of prenatal tests does not imply the discrimination of the disabled, anxiety of handicapped people deserves more attention. Abortion of affected fetuses isn't among the objectives of prenatal genetic screening but patient's autonomy is supported in decisions concerning the future of the pregnancy. Social justice can be taken into consideration by providing the test to all women without respect to their social position, educational level or their age. An open debate about the issues of prenatal screening for Down's syndrome could promote the formation of a consensus between professionals and the public.