Imaginaries as infrastructures? The emergence of non-invasive prenatal testing in Austria

Abstract

Non-invasive prenatal testing (NIPT) is a new technology used in prenatal testing (PT) that capitalizes on genomic platforms to transform DNA fragments in the blood of pregnant women into information about the genome of a foetus. Since its market introduction in 2011, it has travelled around the globe with remarkable speed. This article engages with the emergence of NIPT in and around Vienna, the capital city of Austria, to explore why and how this technology could travel so quickly in practice. Based on a qualitative analysis of interviews, documents, and field notes, it argues, first, that NIPT could travel so quickly because it travelled as 'adaptable boxes' that added on to different 'local worlds of prenatal testing (PT)', without disrupting them. Second, in so doing, NIPT could travel on a moral and material ground, or an 'imaginary of PT', built in the past. Third, the article argues that elements of this imaginary were also mobilized by commercial pioneers of NIPT, who 'infrastructurized' extant values, practices, and networks among biomedical professionals. Thus, various actors converged in mobilizing moral and material elements of an imaginary, transforming them into an infrastructure that facilitated the travels of NIPT, while also shaping its use.

How the governance of and through digital contact tracing technologies shapes geographies of power

“…We based our research on the framework of 'coproduction' (Jasanoff, 2004), which points to situations or 'moments' in which technologies emerge as particularly suggestive to explore the mutual shaping of solid technologies and liquid values and norms (Hurlbut et al, 2020;Jasanoff, 2004;2011;Jasanoff and Metzler, 2020;Metzler, 2020). In such moments, pioneers of technologies entangle technical devices into 'visions', foregrounding normative dimensions that make the use of technologies desirable and legitimate (Hilgartner, 2015).…”

Non-invasive prenatal testing: A diagnostic innovation shaped by commercial interests and the regulation conundrum

“…Offered at a somewhat higher price than "basic" NIPT, this "extended" or "complete" NIPT was marketed, like the more basic versions, as a means of preparing parents for the birth of a "special needs" child . Presented as a non-problematic improvement of the existing test, it was criticized nevertheless by some obstetricians, who pointed out to uncertainties produced by the "complete" NIPT (Allyse and Chandrasekhran, 2015;Hashiloni-Dolev et al, 2019;Metzler, 2020).…”

“…By contrast, testing for conditions such as sex chromosome anomalies and deletions was rejected because these tests are perceived to be less reliable, leading to a risk of undesirable outcomes and posing difficult ethical dilemmas. While a fall in the cost of NIPT may therefore make it more acceptable as a first screen, it is less likely to lead to the adoption of "extended NIPT" Metzler, 2020).…”