Transcript sociology of reproduction Wk_20 - C

Prenatal testing and
genetics
Week 20
Sociology of Human Reproduction
Recap
• Considered the family as a social
construction
• Considered the concept of ‘good
motherhood’ and stigma associated with
teenage pregnancy
• Considered pregnancy and breastfeeding
Outline
• Look at the issue of prenatal screening
during pregnancy
• Consider the interrelationship between
medical technologies and social
understandings
• Considered disability rights critique
Introduction to Testing
• Many forms of testing around reproduction
– Tests prior to conception (genetic counselling)
– Tests on developing embryos (PGD)
– Tests during pregnancy (antenatal care)
Tests prior to pregnancy
• Genetic Carrier Testing looks at inherited
conditions
– Cystic Fibrosis
• Linked to a faulty gene, if both parents carriers
¼ chance of baby with CF
– Huntington's Disease
• Linked to a faulty gene, each child has a 50/50
chance of inheriting the fatal gene. Everyone who
carries the gene will develop the disease.
– Breast cancer
• ‘Cancer’ genes give a predisposition
Tests prior to pregnancy
• If parents are identified as carriers, they
can use Preimplantation Genetic
Diagnosis
• Following IVF, an embryo is grown until it
consists of eight cells. Cell(s)
removed/tested and only ‘healthy’ embryos
replaced
Tests during pregnancy
• Antenatal Screening
• Bblood serum testing, scans
• Only gives a predictor of risk
• Prenatal Diagnostic Testing
• amniocentesis, chorionic villus sampling
• Gives a definitive answer
• Carries risk of miscarriage
• What do you think about prenatal
screening and genetic testing?
• Is it a benign or problematic process?
Routinisation
• Testing during pregnancy can be said to
be routinised
• ‘Optional’ tests become everyday practice
• Screening interrelated with
social meaning of scanning
Feminist debates over testing
• Some feminists argue that increased
testing furthers women’s reproductive
rights
• Women are given more
control over their pregnancies
• Women can ‘choose’ to know and make
decisions based on the outcome
Feminist debates over testing
• Others argue that women experience tests as
disempowering
• Furthers the medicalisation of pregnancy
• Pregnancy becomes ‘tentative’
• Social pressures to undergo testing and
selective abortion?
Abortion law
• 1967 Abortion Act Amended in 1990,
permits abortion up to 24 weeks
• Exception ‘substantial risk’ of ‘physical or
mental abnormalities’ which would mean
‘serious handicapped’
• No definition on what constitutes a ‘serious
handicap’
• Do you think that prenatal testing could put
pressure on women to choose abortion?
Disability Rights Responses
• Testing is part of the process of
discrimination against disabled people
• Testing to for the right of selective abortion
– Whose lives are valued
• Selective termination of
disabled foetuses is eugenic
Disability Rights Responses
• Practices of testing and selective abortion
informed by medical model of disability
• This focuses exclusively on impairment
and not on the way in which society
creates disability
• To terminate on basis of impairment is to
suggest that it s the only thing worth considering
Disability Rights Responses
• “Disabled people are under threat for their
existence in modern technological societies.
Medical science feels able to flex its muscles
and power to abolish all life where the unborn
foetus may be imperfect or impaired”
– (Rock, 1996: 112)
• “The message at the heart of widespread
selective abortion…is the greatest insult: some
of us are “too flawed” in our very DNA to exist,
we are unworthy of being born”
– (Saxton, 1997: 391)
Disability Rights Response
• Other disability activities challenge the eugenic
position
– Argue that it is overly simplistic
• Wishing to prevent impairment is not necessarily
an expression of prejudiced attitudes towards
disability
• Ignores the social context in which
decisions are made
• Do you think that prenatal testing is a form
of discrimination against people with
disabilities?
Whose choice?
• Contrasting cases:
– Whittaker case (UK)
• Parents wanted to use PGD to screen for an
embryo to be a suitable match for a ill sibling
• Permission was refused (outside legal remit)
• Widespread public condemnation of the decision
– Duchesneau & McCullough case (US)
• Deaf parents used screening to ‘choose’ a deaf
child
• Widespread public condemnation
Pro-choice/ anti-discrimination?
• Many who question prenatal testing are
not anti-abortion
• Do not want to restrict abortion, but to look
at how these issues are considered
• Question if current social structures ‘force’
women into a particular choice
Summary
• Genetic and screening technologies are
often seen as ‘scientific progress’
• The development of technologies linked to
societal values and social context
• ‘Choice’ is rarely a neutral issue