Marsha Michie, PhD
I am an anthropologist and bioethicist.
I research ethical and social issues in biomedicine and the ways that genetics
and genomics intersect with disability and other aspects of our identity.
This study focuses on the case of prenatal cell-free DNA (cfDNA) screening, popularly known as non-invasive prenatal testing (NIPT). The long-term goal is to learn how and when to intervene with guidance, critique, and/or collaboration in order to help produce technologies that are ethically and socially valuable.
Recent advances in prenatal genetic testing have renewed concerns from some quarters that prenatal diagnoses serve primarily to enable elective terminations. Yet many women say they choose prenatal testing for a very different reason, one that is largely unexamined in clinical literature: ‘preparation’.
At the core of research on reproductive genomic interventions is a fundamental question: whether and how to involve pregnancy-capable people in clinical trials. This project is creating robust guidance for research in reprogenomics and a broadened consensus on these technologies among key professional bodies.
While genomics in reproductive medicine has traditionally focused on genetic screening and diagnostic testing, there is an increasing focus on developing interventions that will modify the human genome, epigenome, or microbiome. It is essential to consider how risks for the pregnant person may shift in the context of research involving genomic interventions.
In June 2022, the Supreme Court removed a federal right to abortion access, returning the legality of abortion to each of the 50 states. This decision will have a profound impact on the provision of prenatal care in general and prenatal genetic screening and testing.
Advancements in prenatal genomics research and medicine have brought renewed ethical worries about eugenics and its philosophy of producing “good stock” or “well born.” Today our concerns are not only the import of valuing the “well born,” but the many meanings and values implicit in being “born well.”