Human Genetics Commission report Increasing Options, Informing Choice published April 2011 claims that its aim is to increase individual reproductive choice and reproductive autonomy. Yet, within the first two pages it reveals some of the inconsistencies of its thought. A screening programme in Australia is hailed as a success on the grounds that it led to a more positive attitude to testing and more people taking testing up. This conflicts with the stated aim that success of any pre-conception screening and counselling should be measured by the number of people given information, not by the choices they make.
Genetic information poses a conundrum to a medical ethics that has always been premised on the rights of the individual, since it’s often of relevance to other family members. This report suggests that a moral obligation may fall on people to pass genetic information on, and also that professionals should ‘make explicit .. the importance of sharing test results with family members in order to facilitate the offer of cascade screening’; in other words, to persuade – or nag – people to share their genetic information. It’s really interesting how in a era where privacy rights in some arenas are being jealously guarded, medical information is subject to pressures in the reverse direction, with professionals now tasked with the role of moral prompts. It perhaps suggests that the vaunted ‘reproductive autonomy’ takes priority over an individual’s own moral autonomy.