[Cost benefit analysis and ethics of prenatal diagnosis]

Cost-benefit analysis is a necessary part of the decision-making process concerning the introduction of DNA-analysis in antenatal diagnosis (and diagnosis of carrier status) of hereditary diseases. The problems involved which are of increasing significance given the rapid development in mapping of the human genome, are reviewed on the basis of the autosomal dominant polycystic kidney disease. Many problems exist, particularly of an ethical nature, when attempts are made to employ cost-benefit analysis in this field. This article describes some of these and suggests some solutions. The discussion is concentrated on the need to decide what should be done as regards the genetic diagnosis, why this should be done and how decisions should be made to do so. These questions are too important to be decided by only the medical profession. Many others, not only in the health sector, are involved both economically and ethically. The numerous new methods of analysis make it necessary to decide who is to assess the costs and benefits when the Danish health service allocares resources to this and to many other fields.