Prenatal screening: professional standards and the limits of parental choice

Medicine has a strong tradition of respect for parental autonomy in reproductive decisions. As prenatal diagnostic technology develops, the physician's obligation to the prospective parents with respect to prenatal screening must be determined, and standards for disclosure of diagnostic capabilities and results must be developed. This article explores potential justifications for limits on parental choice in prenatal screening. Information about screening capabilities can be limited appropriately when resources do not exist to ensure accurate testing and counseling. Other policy limits to parental information and choice based on risk levels, cost-benefit analyses, or harms to the parent-child relationship cannot be established without broad consensus on complex ethical issues. Limits to parental choice may be more appropriately applied through the moral values of individual physicians in their provision of diagnostic services.