Prenatal screening, ethics and Down's syndrome: A literature review

This article reviews the literature on prenatal screening for Down's syndro me. To be evidence based, medicine and nursing have to take account of rese arch evidence and also of how this evidence is processed through the influe nce of prevailing social and moral attitudes. This review of the extensive literature examines how appropriate widely-held understandings of Down's sy ndrome are, and asks whether or not practitioners and prospective parents h ave access to the full range of moral arguments and social evidence on the matter. Highly valued ideals of justice, personal autonomy, parental choice , women's control over their reproduction and of avoiding harm can all tend towards negative rather than neutral approaches to Down's syndrome. This a rticle considers how ethics and prenatal screening policies and practice th at take greater account of social evidence of disability could use moral ar guments that inform rather than determine the choices of people who use pre natal services.