Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential “paradigm shift” in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire (...) fetal genome. The benefits of this screening tool are generally framed, by both providers and commercial laboratories, as enhancing reproductive autonomy and choice by providing an earlier, simpler, and more accurate screening while potentially reducing the need for invasive follow-up testing. The majority of the literature has explored these issues empirically or conceptually from a European or North American vantage point, one that assumes normative priorities such as individual reproductive autonomy and the clinical availability of maternal health care or prenatal screening programs within which cell-free DNA screening is offered. While its implementation has raised both challenges and opportunities, very little is known about real-world experiences and the implications of the rapid introduction of cell-free DNA screening outside of North America and Europe, especially in low- and middle-income countries. To begin addressing this gap in knowledge, we organized a four-day international workshop to explore the ethical, legal, social, economic, clinical, and practical implications of the global expansion of cell-free DNA screening. We describe eight key insights that arose from the workshop. (shrink)

This article explores the reasons women of diverse class, racial ethnic, national, and religious backgrounds give for their decisions not to accept an amniocentesis or, having accepted one, not to pursue an abortion after diagnosis of serious fetal disability. The narratives of refusers reveal conflicts and tensions between the universalizing rationality of biomedical interventions into pregnancy and the wider heterogeneous social frame work to which women respond in their decision-making processes.

Although conventionally tracked in the "overdeveloped world" , assistive reproductive technologies are now available in many parts of the globe. This review essay reports on qualitative social science research on techniques such as In Vitro Fertilization, egg purchase, gestational surrogacy, and sex selection across national boundaries. It highlights the disruptions and recuperations of gender and generational relations; religious and legislative regulation; and the opportunities as well as oppressions that the commercialization of the reproductive body entail.

Over the last three decades, an escalating portion of U.S. school children has been classified for special education; those with diagnoses entitled to services now number 15 percent of all public school pupils. At the same time, American scientists have focused increasingly on juvenile brains, studying what one psychiatric epidemiologist labeled ‘‘social incapacities.’’ This article reports on the laboratory labors of two scientific groups: neuroscientists who scan children’s brains in search of resting state differences according to diagnosis and psychiatric epidemiologists (...) who look to epigenetics to distinguish differential diagnostic populations. The article focuses on the medicalization of childhood differences and the harmonies and discordances between what researchers and parents understand to be at the root of children’s learning and social capacities. (shrink)