ATTITUDES OF MEXICAN GENETICISTS TOWARDS PRENATAL-DIAGNOSIS AND SELECTIVE ABORTION

Prenatal diagnosis (PD) provides the physician information on whether the unborn fetus has a genetic or chromosomal disorder, and offers pat ients a new option: selective abortion. In the present study, we analy zed the answers Mexican geneticists provided to a few selected questio ns from a multinational survey designed by Wertz and Fletcher [1988: A m J Hum Genet 42:592-600]. The selected questions were related to the use of PD, the acceptance of selective abortion, and the self-reported directiveness of counselling following the diagnosis of a fetal anoma ly. Our results show that the great majority of Mexican geneticists pa rticipating in the study agree with PD when medically indicated, but n ot on free demand. Specific cases stimulated the group on thinking mor e than the general statements provided in the survey. Although the maj ority agreed that PD should be available to all women, when faced with cases of nonmorbid maternal anxiety, paternity testing, and sex selec tion, the proportion of geneticists willing to perform the test decrea sed substantially. When counselling patients on a fetal anomaly, the m inority would be as unbiased as possible, and this seems to be the ten dency in developing countries where counselling, as stated in the resp ondents' comments, reflects the belief that the goal of genetics is th e prevention of or opposition to abortion. Counselling was influenced by the severity of the disorder. The geneticists' personal attitude to ward abortion in the same situations was stronger than when counsellin g others. Analysis of directiveness in counselling for fetal anomaly s howed that older geneticists, with more years of experience in medical genetics, were more likely to be neutral. When counselling directivel y, the group showed an overall direction toward continuing affected pr egnancies. However, older geneticists and those with more than 10 year s of practice were more likely than their younger counterparts to coun sel towards terminating affected pregnancies. In personal situations o f fetal disorder, the general tendency was to abort; however, genetici sts seeing more than 5 patients per week, and those who believe that r eligion is important, were more likely to reject abortion. The sample is representative of Mexican geneticists and the main limitation of th is study is that the geneticists have very little experience in PD, an d that their responses were mostly based on theory. However, their opi nions may influence the demand and the availability of PD and abortion , as well as the possibility of legalization of abortion on the basis of a fetal defect. (C) 1998 Wiley-Liss, Inc.