„Selektive“ Fortpflanzung durch pränatale Diagnostik?

Objective: The broad introduction of noninvasive prenatal tests (NIPT) in recent years as well as its potential to include testing targets beyond trisomies ask for a reflection about the purpose of prenatal diagnosis (PND) as an emergent social practice. One prominent proposal in bioethical literature is to subsume PND to “selective” reproductive practices. In this paper, the accuracy and the moral presuppositions of this characterization are examined. Method: Moral analysis of the argumentative strategy in Stephen Wilkinson’s seminal publications on “selective reproduction”; explication of the assumptions connected to the characterization of prenatal diagnosis as a selective act; discussion of PND with social practice theory. Results: “Selection” misrepresents the decision after prenatal diagnosis. It also involves a problematic abstraction and distancing: it contains the assumption that the women and the couple either plan potentially several pregnancies from which they would choose one to bring to term, or that the women and the couple should understand themselves as executives of a selective strategy on the population level. By restricting the bioethical discussion on the issue of selection it ignores two relevant fields of moral concern that characterize moral perception in the situation of prenatal diagnosis: the ongoing pregnancy as a personal relationship and the ending of fetal life. Conclusion: On the grounds of this implicit normativity, selective reproduction is rejected as a meaningful description of the purposes of prenatal diagnosis.