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It is also seen by proponents as a responsible, balanced and proactive measure to address the increased use of prenatal testing resulting from the ACOG guidelines. The intent of the PPDCA is to give prospective parents accurate information so that they can make informed decisions about raising children with certain genetic disorders and is largely viewed as an attempt to encourage the dissemination of information to parents undergoing prenatal testing and support of parents caring for children with a genetic condition. While the dictates of the PPDCA are aligned with long-standing principles of non-directive genetic counseling, in response to the PPDCA and innovations, such as NIPT, professional organizations and individual commentators have called for refinements in counseling guidelines regarding the provision of complete information to prospective parents regarding what disorders can be tested for and what results mean [ 68 ].

Hemophilia and Pregnancy

In the near future, professional guidelines may be required to guide professionals in practicing non-directive counseling designed to provide information about all available options within states that impose restrictions on both patient access to information derived from prenatal genetic testing and limitations on the availability of pregnancy termination services. Table 2 provides applicable legal citations regarding how legislatures in each of the 50 United States regulate access to abortion and the actions health care providers must undertake in the provision of pregnancy termination.

Table 2. State statutes regarding access to abortion. As discussed above, healthcare professionals and their lawyers are already struggling with how the law responds to these technologies. Such innovations will raise numerous ethical, legal and social questions. This includes somewhat mundane questions related to the regulation of the technologies used in the provision of these interventions.

More importantly, it includes challenges to existing legal constructs regarding the responsibilities of healthcare providers and the potential rights and responsibilities of expectant parents to ameliorate the effects of an identified genetic and developmental disorder. Clinicians will have to determine their responsibilities in counseling patients regarding interventions that, while designed to minimize or even eliminate the phenotypic effect of the known genetic disorder, may not completely ameliorate the disorder or may result in yet unknown deleterious changes to the genotype.

In the future, parents will likely have to confront a myriad of dilemmas far beyond what patients now must consider, to facing decisions about altering the potential development of their embryo or fetus. Undoubtedly, courts and legislatures will develop legal responses that purport to resolve some of the disputes and contradictions that surround the consequences of these technologies, while generating still more.

Deborah Pergament was involved in the review of all cases and statutes cited in the article, supervised the collection and analysis of the statutes and case law and preparation of the tables included herein, as well as writing of the manuscript. Katie Ilijic was involved in the collection and analysis of statutes and case law and preparation of the tables included herein, as well as writing the manuscript. All authors approved the final manuscript. Terms and Conditions Privacy Policy. We use cookies on our website to ensure you get the best experience.

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Medical Center of Delaware Inc. X Garrison v. Lloyd , So. X Kush v. X Etkind v. Suarez , S.

X Clark v. Seslar , N. X Cowe v. Forum Group, Inc. Napier , N. X Grubbs v. Barbourville Family Health Center, P.

Prenatal Surgery

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Magendantz , A. X Willis v. Wu , S. Smith v. Gore , S. Krusen , S. X Nelson v. X Wood v. University of Utah Medical Center , 67 P. Statute prohibiting was repealed by Laws , c. Burger , S. Parke-Davis, Inc. Vaughn , P. Caserta , S. X James G. X Slawek v. Stroh , N.

Wierdsma , P. X Beardsley v.

Steinbock & McClamrock, "When is Birth Unfair to the Child?"

Written Materials Given Ala. Horne , F. Written Materials Offered A. Written Materials Offered Ga. Code Ann. Hiedeman , F. Idaho Written Materials Given I.

Written Materials Given IC Written Materials Given K. Written Materials Given M. Lawson , F.