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Office of Technology Assessment at the German Bundestag Office of Technology Assessment at the German Bundestag

Information on the project

Current status and developments of prenatal and preimplantation diagnosis

Thematic area: Biomedical technologies
Analytical approach: Monitoring
Topic initiative: Committee on Education, Research and Technology Assessment
Status: ongoing
Current project phase: Reports completed. Approval by the Committee on Education, Research and Technology Assessment pending
Duration: 2016 till 2017

Background and central aspects of the topic

Prenatal (genetic) diagnosis is characterised by the progress of the scientific and technological possibilities and the qualitative and quantitative expansion of their application, but also by the continuity of the related ethical, psychosocial and overall societal debates and challenges. For many years, the requirements and affordability of a comprehensive consultation prior to and subsequent to prenatal diagnosis and the influence on social attitudes towards people with (congenital) disabilities have been regarded as a problem.

In contrast to earlier prognoses, however, invasive chromosomal and also DNA diagnosis have still not become standard treatments in medical pregnancy support. One probable explanation is the enormous increase in the sensitivity and precision of ultrasound diagnosis.

Nonetheless, two developments of the past years could substantially alter the available options and the range of prenatal diagnosis (PND): On the one hand the non-invasive chromosomal testing approved and offered in Germany since August 2012 (mainly in the form of the »Praenatest« by Lifecodexx) and on the other the different versions of whole genome sequencing both prior to and subsequent to birth or for examination of the genetic constitutions of (future) parents prior to pregnancy. Over the past years, the German Ethics Council (Deutscher Ethikrat) and the Academies of Science Leopoldina, acatech and BBAW have addressed these developments and have compiled statements on the related perspectives and challenges. Also, several projects currently promoted by the Federal Ministry of Education and Research (BMBF) on the ethical, legal and social aspects of modern life sciences deal with aspects of prenatal diagnosis, in particular the non-invasive testing procedures (NIPT).

Concerning preimplantation diagnosis (PID), our attention should be focussed on the implementation of the law which came into force in December 2011 on the regulation of preimplantation diagnosis. The Federal Government submitted an initial report on experiences made with preimplantation diagnosis in October 2015 (German Bundestag Printed paper 18/7020).

Objectives and approach

In the TAB monitoring project, a focused overview on the status of the scientific and technological developments and the practice of application, the social scientific and societal debate and important future questions concerning prenatal and preimplantation diagnosis is to be prepared. In view of the tight budget and time framework, a comparative assessment of the available national and international TA and other interdisciplinary studies shall lay the basis for the report.

The following aspects will be addressed:

  • Methods and practice of PND (chromosomal, DNA- and other diagnosis, imaging techniques)
  • Purposes of PND in theory and practice
  • Data situation: Utilisation, determining factors and consequences
  • Research, foreseeable developments, protagonists, drivers
  • State of social science research on the theory and practice of consultation

During analysis of the situation regarding PID, the developments of the past years in Germany shall be investigated in particular as to what extent the expectations or the fears discussed prior to the statutory provisions have actually come to fruition. Here the basic (ethical) pro and contra debate on PID should not be depicted once again, but rather as systematic an analysis as possible of estimations or criticism of important stakeholders is to be conducted concerning the beginning and expected continued practice of PID.

The results of the analysis of the current status of prenatal and preimplantation diagnosis should then act as the basis for an interdisciplinary workshop by TAB in which existing gaps in knowledge, research desiderata and estimations of the consequences of the technology are to be discussed.