Examining prenatal genetic screening and diagnosis in Switzerland: an integrative review

Abstract

Prenatal genetic tests are routinely offered to patients within Switzerland. As these technologies are continuing to advance, it is important to understand the ethical and societal values that shape their implementation. We conducted an integrative literature review, examining the medical and ethics literature, relevant laws, and websites of patient support organizations for a comprehensive understanding of Swiss clinical, legal, and ethical perspectives. The discussions of the ethical issues of prenatal genetic tests are primarily informed by the legal framework. Literature stressed the centrality of patient autonomy to the offer of such tests and how it is best supported through informed consent and non-directive genetic counseling. Nevertheless, some restrictions on patient autonomy are legally supported to protect the human dignity of the fetus. Both empiric studies and public-facing sources reflected concerns on how prenatal tests may reinforce patient and societal perceptions of disability. Our review of empiric studies suggests there should be additional research to assess the harmonization of the stated values in the legal framework and clinical practice for the continued ethical provision of prenatal genetic testing in Switzerland.