Abstract:
Non-invasive prenatal diagnosis (NIPD) is a promising prenatal diagnostic technology that is currently being developed. The premise behind it is that fetal DNA can be detected in maternal blood plasma and potentially enable women to pursue reliable and timely prenatal diagnosis, while eliminating the risk of miscarriage associated with current methods. The goal of this study was to determine how genetic counselors believe the integration of NIPD would impact the field of genetic counseling. We recruited prenatal genetic counselors from the National Society of Genetic Counselors listserv for participation in an anonymous, online survey. A total of 206 counselors completed the survey, which consisted of 25 multiple-choice and 4 open-ended response questions. The questions were designed to ascertain the counselors’ opinions regarding NIPD, as well as elucidate how the technology might affect patient decision-making, the role of genetic counselors, and other aspects of prenatal genetic counseling services. Our results showed that 87.4% of counselors believed NIPD would be an important asset to prenatal care. The majority of counselors foresaw NIPD being clinically available within five years, and anticipated that it would be offered to all women in addition to the current prenatal tests. Only a very small percentage (6.8%) predicted NIPD would become a replacement diagnostic technology. Although the majority of counselors anticipated that their time spent counseling and educating patients would not change, they acknowledged that introducing NIPD would have ethical implications, including challenging the process of obtaining proper informed consent. Because of this concern, respondents recommended that all women be offered genetic counseling services before any prenatal testing. Our findings suggest that the introduction of NIPD will require increased attention to patient understanding, as well as the development of educational tools to help prepare patients and providers for the clinical, ethical, and logistical issues that will inevitably arise.
