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.
Key Words
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Article Info
Publication History
Accepted:
June 20,
2014
Received:
April 22,
2014
Footnotes
Competing Interests: None declared.
Identification
Copyright
© 2014 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.
