Moving up the slippery slope: Mandated genetic screening on Cyprus

Abstract

Many social scientists and bioethicists have argued that genetic screening is a new form of eugenics. Examination of the development of the quasi-mandated screening program for beta-thalassemia in the Republic of Cyprus (1970-1984) demonstrates that there is nothing eugenic about modern genetic screening practices. The Cypriot screening program involves mandated premarital carrier screening, voluntary prenatal diagnosis (originally through fetoscopy, now through CVS), and voluntary termination of afflicted pregnancies-all at public expense. In the Republic of Cyprus, the mandating agency for genetic screening is the established church, so this examination also demonstrates that religious authorities with profound objections to abortion can balance that moral precept against others, such as the imperative to reduce suffering that sometimes conflict with it.

Carrier screening for Beta-thalassaemia: a review of international practice

“…3 Nevertheless, some countries including Iran, Saudi Arabia, Palestinian Territories and Cyprus have laws in place making premarital screening for haemoglobinopathies mandatory for all couples before they are given approval to get married. 9,[20][21][22][23][24][25][26] This raises ethical questions, as couples are unable to voluntarily decide for themselves whether they would like to undergo genetic screening. Thalassaemia carrier screening has been included as part of an existing mandatory premarital blood test in Iran since 1991.…”

“…20,22,24 A quasi-mandated premarital b-thalassaemia carrier screening programme began in Cyprus in the early 1980s. 26 Cyprus has one of the highest carrier rates in the world, with an estimated carrier rate of one in seven. 26 Among Greek Cypriots, premarital screening is mandated by the Cypriot Orthodox Church.…”

“…26 Cyprus has one of the highest carrier rates in the world, with an estimated carrier rate of one in seven. 26 Among Greek Cypriots, premarital screening is mandated by the Cypriot Orthodox Church. 26 Couples wanting to get married by the Church are required to be screened and counselled by the Thalassaemia Centre and be issued with a certificate.…”

“…26 Among Greek Cypriots, premarital screening is mandated by the Cypriot Orthodox Church. 26 Couples wanting to get married by the Church are required to be screened and counselled by the Thalassaemia Centre and be issued with a certificate. 26 In all these countries, mandatory screening is practised in a confidential manner, and even though premarital screening is mandatory, carrier couples still have the right to get married if they wish.…”

Prevention of sickle cell disease: observations on females with the sickle cell trait from the Manchester project, Jamaica

“…These limitations do not apply to population screening and premarital screening has successfully reduced births with beta thalassaemia in Cyprus (Angastiniotis and Hadjiminas 1981) and Sardinia (Cao et al 1996) and has led to mandatory premarital screening in Iran (Karimi et al 2007), Bahrain (Al Arrayed 2005b), Saudi Arabia (Al Hamdan et al 2007), the Palestinian territories (Tarazi et al 2007), and Cyprus (Cowan 2009) as reviewed by Giordano et al (2014). Although contrary to the WHO guidelines (WHO 1998) on compulsory genetic testing, these programmes seem to have been well accepted.…”