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Article
Non-Invasive Prenatal Testing and the Unveiling of an Impaired Translation Process
Journal of Obstetrics and Gynaecology Canada (2017)
  • Blake Murdoch, Health Law Institute, Faculty of Law, University of Alberta
  • Vardit Ravitsky, School of Public Health, University of Montreal
  • Ubaka Ogbogu, University of Alberta, Faculty of Law
  • Sarah Ali-Khan, McGill University, Centre for Intellectual Property Policy
  • Gabrielle Bertier, Centre for Genomics and Policy, McGill University
  • Stanislav Birko, University of Montreal, School of Public Health
  • Tania Bubela, University of Alberta, School of Public Health
  • Jeremy de Beer
  • Charles Dupras, University of Montreal, School of Public Health
  • Meika Ellis, University of Ottawa
  • Palmira Granados Moreno
  • Yann Joly, McGill University Faculty of Medicine
  • Kaliina Kamenova, Trent University
  • Zubin Master
  • Alessandro Marcon, University of Alberta, Health Law Institute
  • Mike Paulden, University of Alberta Faculty of Medicine and Dentistry
  • François Rousseau, Université de Laval, Department of Molecular Biology
  • Timothy Caulfield, University of Alberta
Abstract
Non-invasive prenatal testing (NIPT) is an exciting technology with the potential to provide a variety of clinical benefits, including a reduction in miscarriages, via a decline in invasive testing. However, there is also concern that the economic and near-future clinical benefits of NIPT have been overstated and the potential limitations and harms underplayed. NIPT, therefore, presents an opportunity to explore the ways in which a range of social pressures and policies can influence the translation, implementation, and use of a health care innovation. NIPT is often framed as a potential first tier screen that should be offered to all pregnant women, despite concerns over cost-effectiveness. Multiple forces have contributed to a problematic translational environment in Canada, creating pressure towards first tier implementation. Governments have contributed to commercialization pressure by framing the publicly funded research sector as a potential engine of economic growth. Members of industry have an incentive to frame clinical value as beneficial to the broadest possible cohort in order to maximize market size. Many studies of NIPT were directly funded and performed by private industry in laboratories lacking strong independent oversight. Physicians’ fear of potential liability for failing to recommend NIPT may further drive widespread uptake. Broad social endorsement, when combined with these translation pressures, could result in the “routinization” of NIPT, thereby adversely affecting women’s reproductive autonomy. Policymakers should demand robust independent evidence of clinical and public health utility relevant to their respective jurisdictions before making decisions regarding public funding for NIPT.
Keywords
  • Commercialization,
  • obstetrics,
  • prenatal screening,
  • gynaecology,
  • ethics
Publication Date
2017
DOI
https://doi.org/10.1016/j.jogc.2016.09.004
Citation Information
Blake Murdoch, Vardit Ravitsky, Ubaka Ogbogu, Sarah Ali-Khan, et al.. "Non-Invasive Prenatal Testing and the Unveiling of an Impaired Translation Process" Journal of Obstetrics and Gynaecology Canada Vol. 39 Iss. 1 (2017) p. 10
Available at: http://works.bepress.com/jeremydebeer/79/