2006). In this light, early PD by means of non-invasive testing in maternal blood may be seen as a morally important new development (De Jong et al. 2010). Moreover, many would find abortion even for ‘medical reasons’ only acceptable up to foetal viability or to some other limit related to the notion of increasing moral status (Boonin 2003). These lines may or may not correspond with legal abortion-limits as drawn in different jurisdictions. Responsible practice: informed decision making and the limits of non-directivity In the context of reproductive counseling, the option of genetic testing of the counselee(s) (and/or

close relatives) will often be proposed in order to obtain a more accurate view of the transmission risk. Such testing requires BAY 57-1293 the voluntary and informed consent of the person

to be tested (Knoppers et al. 2006). This requires professionals to provide adequate (balanced and sufficient) pre-test information about the aim and nature of BMS-777607 the test, the test procedure, and the meaning and implications of possible outcomes. Informed consent is not an end in itself, but a means to enable autonomous decision making. This is more strongly emphasized in the notion of ‘informed choice’: the person to whom testing is offered must be helped to make his or her own weighing of the pros and cons, also taking account of possible psychosocial implications, and making a fit with his or her personal values and beliefs (Marteau et al. 2001). This account of informed decision making is closely related to

the ideal of professional non-directivity (De Wert 1999). In the context of reproductive counseling, this requires professionals to create a climate in which those ‘at risk’ ZD1839 research buy can make their own decisions, not just about testing, but also with regard to choosing reproductive options. Directive counseling is generally regarded as problematic in this context, given that people may have very different views about what reproductive risks are acceptable (Wertz and Knoppers 2002). Still, there are situations where advising counselees to avoid reproductive risks may well be appropriate. One should think here of cases where both the chances of having an affected child and the level of suffering and harm for those having the disease are high. An example would be a couple with a child-wish where the woman is a known carrier of Duchenne muscular dystrophy (DMD). Given the X-linked inheritance pattern, this means that their risk of having a child with DMD is 25%: if the child is a boy, one in two will have this very serious disease that strikes already at an early age.