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That is the central question that I believe should be at the heart of the debate I would like to see as more accurate and less-invasive testing procedures become available.

It was also the central question of a research report published in the British Medical Journal’s Journal of Clinical Pathology in 2003 (free registration required). 

The research involved the members of 40 research ethics committees in the UK asked to complete a survey on the ethics of screening (with varying hypothetic levels of effectiveness) for four coinditions ranging from the embarrasing to those risking cardiac defects. The replies were graded on a scale of 1 to 5.

The results make for interesting reading. When Down’s syndrome was described as a serious condition 56% of the 77 research ethic committee members responding thought screening was ethical.

That number dropped to 44% when the clinicial features of Down’s syndrome were described.

When the risk of miscarriage of one unaffected fetus for every two affected fetuses was added to the hypothetical picture the figure dropped to 21% who thought screening was ethical when Down’s syndrome was described as a serious condition.

With the same risks just 14% thought screening was ethical when the clinicial features of Down’s syndrome were described.

Recent research has indicated that in detecting and preventing the birth of 660 Down’s babies, 400 healthy foetuses are lost.

The author of the research report is quick to point out that as it is a small survey or research ethics committee members issues of prejudice should be taken into account, but notes that “One could conclude that it is impossible for physicians, and by implication for a national screening committee made up of healthcare professionals, to make decisions on such a controversial matter on behalf of a population.”