Non-invasive prenatal diagnostics (NIPD) in the system of medical care. Ethical and legal issues

The procedures of prenatal and preimplantation diagnostics are discussed critically again and again in our community. In addition to the permanently controversial issues of embryo protection and abortion, considerations that discrimination on the basis of disability could occur with problematic consequences also for already born people with disabilities and their relatives now play a central role.

The role of preimplantational diagnostics in comtemporary reproductive medicine - a survey

Background Preimplantational diagnostics is a relatively new technique for diagnosing genetic and other abnormalities in different stages of fetal development. It provokes serious research interest and objections due to its probable consequences - the possibilities for selective abortion based on a selective approach to people depending on their hereditary peculiarities. In this connection, we conducted the present survey on society’s attitude towards some aspects of preimplantation diagnostics. Methods 114 subjects (21 men and 93 women), aged between 18 and 60 years (mean 28.44±1.16), participated in an anonymous survey. Results 69.3% of respondents expressed their strong support for the application of preimplantational diagnostics. We report a dependance of approval on respondents’ educational degree – participants with a secondary education approve in the smallest degree of preimplantational diagnostics p=0.004 (χ2=15.40). When comparing the results by respondents’ age, it is worth noting that those older than 41 years approve in a greater degree of preimplantational diagnostics p=0.001 (χ2=28.03) – most commonly these are people with a Master’s degree. It is more common for men to think that preimplantational diagnostics should be used for determining physical traits (colour of the eyes, hair etc.) and sex p=0.05 (χ2=5.73). As an explanation to their positive answer some respondents give the existence of sex-related genetic diseases. Therefore, even when the smallest doubt is present the so-called sexing should be conducted. Conclusions The participants in the survey approve of the use of preimplantational diagnostics in strictly observed rules and conditions. With the present laws in force there are numerous unresolved aspects and issues. More than half of the participants (66.7%) think that contemporary reproductive technology (incl. preimplantational diagnostics) could influence positively the attempt to overcome the demographic crisis in Bulgaria. Key messages Preimplantational diagnostics is a relatively new technique for diagnosing genetic and other abnormalities in different stages of fetal development. We conducted the present survey on society’s attitude towards some aspects of preimplantation diagnostics.