The moral aspects of prenatal diagnosis

Eisenberg, V. H.; Schenker, Joseph

doi:10.1016/s0301-2115(96)02667-x

Cited by 4 publications

(3 citation statements)

References 43 publications

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“…El propósito de la RMF debe ser complementar la información obtenida con el ultrasonido, ya sea al confirmar los hallazgos o proporcionar información adicional; sin embargo, no debe usarse como la herramienta primaria de tamizaje prenatal 15,16 .…”

Section: Discussionunclassified

Papel de la resonancia magnética fetal en la valoración de las anomalías prenatales

García-Moreno¹,

Torres-Olivas²,

Barrera³

et al. 2021

ARM

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Objective: To evaluate the contribution of fetal magnetic resonance (FMR) as a complementary study in prenatal diagnosis of prenatal pathology. Material and methods: We compared the ultrasound (US) findings of 146 patients with the Fetal MRI findings. Patients were divided in two groups as follows: Patients with 18 to 27 weeks of gestation and patients with 28 to 36 weeks of gestation. FMR diagnostic contribution was considered when it: Confirmed de US diagnosis and added new information, when it changed the US diagnosis for a new one or when it ruled out the US findings and found no alterations. FMR non-contribution was considered when the FMR just confirmed the US findings without adding any new information. Results: FMR contributed with additional information in 56% of cases. In 44% of cases it just confirmed the ultrasonographic findings. There was no difference between the groups of 18-27 weeks and 28-36 weeks. Conclusion:The FMR is a valuable tool for the evaluation of prenatal pathology, contributing with additional information to that obtained by ultrasound in 56% of the cases.

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Section: Discussionunclassified

Papel de la resonancia magnética fetal en la valoración de las anomalías prenatales

García-Moreno¹,

Torres-Olivas²,

Barrera³

et al. 2021

ARM

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“…These tests involve a range of very specific ethical issues that have been discussed elsewhere. [17][18][19][20] The study is based on a large number of exploratory literature searches complemented by a systematic search for existing prioritization frameworks (Supplementary Appendix available on request).…”

Section: Concepts and Methodsmentioning

confidence: 99%

Criteria for fairly allocating scarce health-care resources to genetic tests: which matter most?

et al. 2013

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The use of genetic tests is expanding rapidly. Given limited health-care budgets throughout Europe and few national coverage decisions specifically for genetic tests, decisions about allocating scarce resources to genetic tests are frequently ad hoc and left to lower-level decision makers. This study assesses substantive ethical and economic criteria to prioritize genetic services in a reasonable and fair manner. Principles for allocating health-care resources can be classified into four categories: need-based allocation; maximizing total benefits; treating people equally; and promoting and rewarding social usefulness. In the face of scarcity, the degree of an individual's need for medical intervention is an important criterion. Also, different economic concepts of efficiency are of relevance in the theory and practice of prioritizing genetic tests. Equity concerns are most likely to be relevant in terms of avoiding undesirable inequities, which may also set boundaries to the use of efficiency as a prioritization criterion. The aim of promoting and rewarding social usefulness is unlikely to be relevant to the question of what priority a genetic test should have in clinical practice. Further work is needed to select an appropriate set of criteria; operationalize them; and assign weights before some kind of standardized priority information can be added to information sources for genetic services. Besides the substantive criteria, formal considerations like those pointed out in the framework of accountability for reasonableness need to be considered in decision making.

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“…It also assumes that the test results cannot be obtained by less costly means. Furthermore, it excludes prenatal and preconceptive tests as well as screening tests which involves specific issues in the evaluation which have been discussed elsewhere [23][24][25][26]. Furthermore, the study assumes that the test results cannot be obtained by less costly means.…”

Section: A Needs-based Framework For Allocating Health Care Resourcesmentioning

confidence: 99%

Using needs-based frameworks for evaluating new technologies: An application to genetic tests

Rogowski¹,

Schleidgen²

2015

Health Policy

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Given the multitude of newly available genetic tests in the face of limited healthcare budgets, the European Society of Human Genetics assessed how genetic services can be prioritized fairly. Using (health) benefit maximizing frameworks for this purpose has been criticized on the grounds that rather than maximization, fairness requires meeting claims (e.g. based on medical need) equitably. This study develops a prioritization score for genetic tests to facilitate equitable allocation based on need-based claims. It includes attributes representing health need associated with hereditary conditions (severity and progression), a genetic service's suitability to alleviate need (evidence of benefit and likelihood of positive result) and costs to meet the needs. A case study for measuring the attributes is provided and a suggestion is made how need-based claims can be quantified in a priority function. Attribute weights can be informed by data from discrete-choice experiments. Further work is needed to measure the attributes across the multitude of genetic tests and to determine appropriate weights. The priority score is most likely to be considered acceptable if developed within a decision process which meets criteria of procedural fairness and if the priority score is interpreted as "strength of recommendation" rather than a fixed cut-off value.

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The moral aspects of prenatal diagnosis

Cited by 4 publications

References 43 publications

Papel de la resonancia magnética fetal en la valoración de las anomalías prenatales

Papel de la resonancia magnética fetal en la valoración de las anomalías prenatales

Criteria for fairly allocating scarce health-care resources to genetic tests: which matter most?

Using needs-based frameworks for evaluating new technologies: An application to genetic tests

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