JOGC

Physician Liability and Non-Invasive Prenatal Testing

      Abstract

      Although non-invasive prenatal testing (NIPT) marks a notable development in the field of prenatal genetic testing, there are some physician liability considerations raised by this technology. As NIPT is still emerging as the standard of care and is just starting to receive provincial funding, the question arises of whether physicians are obligated to disclose the availability of NIPT to eligible patients as part of the physician–patient discussion about prenatal screening and diagnosis. If NIPT is discussed with patients, it is important to disclose the limitations of this technology with respect to its accuracy and the number of disorders that it can detect when compared with invasive diagnostic options. A failure to sufficiently disclose these limitations could leave patients with false assurances about the health of their fetuses and could raise informed consent and liability issues, particularly if a child is born with a disability as a result.

      Résumé

      Bien que le dépistage prénatal non effractif (DPNE) constitue une innovation importante dans le domaine du dépistage génétique prénatal, la technologie qui la sous-tend soulève certains facteurs à prendre en considération en ce qui a trait à la responsabilité des médecins. Compte tenu que le DPNE cherche toujours à faire sa place à titre de norme de diligence et qu’il commence tout juste à bénéficier d’un financement provincial, nous faisons face à la question de savoir si les médecins ont l’obligation de divulguer la disponibilité du DPNE aux patientes admissibles dans le cadre des discussions médecin-patiente au sujet du dépistage/diagnostic prénatal. Lorsque l’on discute du DPNE avec les patientes, il est important d’en divulguer les limites en ce qui a trait à sa précision et au nombre des troubles dont il permet la détection, par comparaison avec les options diagnostiques effractives. Lorsque l’on ne déploie pas suffisamment d’efforts pour divulguer ces limites, les patientes pourraient se trouver faussement rassurées au sujet de la santé de leur fœtus; une telle situation pourrait également soulever des questions de consentement éclairé et de responsabilité, particulièrement dans les cas où la grossesse en question se solde par la naissance d’un enfant présentant une déficience.

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