Social Aspects of First Trimester Diagnosis

  • B. Modell


By necessity, the approach in this paper is the pragmatic one of the practising clinician aiming to bring out some of the social and ethical problems of fetal diagnosis as they present themselves to the patient and the doctor. The topic falls naturally into five parts. Firstly, a summary is presented of the relative frequency of the different types of serious congenital disorders, the time in life at which people acquire a risk of passing on a congenital disorder to their children, the nature of the risk, and the possible choices open to people at risk. Secondly, the evidence available about the choices that people actually make and the reasons why is briefly reviewed. Thirdly, the special features of the clinical relationship to the couple (or mother) at risk is contrasted with the general pattern of medical consultations, and its implications in terms of the distribution of responsibilities between the doctor and the couple is described. Fourthly, the way in which earlier fetal diagnosis alters the existing balance of choice and responsibility, extends the global scope of fetal diagnosis, and raises new questions is discussed. The final section touches on the issue of ultimate, realistic objectives of fetal diagnosis.


Genetic Diagnosis Trimester Abortion Selective Abortion Fetal Diagnosis Marriage Behaviour 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Carter CO (1973) Current status of genetic counselling and its assessment. In: Motulsky AG, Lenz W (eds) Birth defects. Exerpta Medica, AmsterdamGoogle Scholar
  2. 2.
    Fletcher JC (1983a) Ethics and public policy: should sex choice be discouraged? In: Bennett NG (ed) Sex selection of children. Academic, New YorkGoogle Scholar
  3. 3.
    Fletcher JC (1983b) Is sex selection ethical? Res Ethics 333–348Google Scholar
  4. 4.
    Harper PS, Tyler A, Smith S, Jones P (1981) Decline in the predicted incidence of Huntington’s chorea associated with systematic genetic counselling and family support. Lancet ii: 411–413CrossRefGoogle Scholar
  5. 5.
    Kaback M, Zippen D, Boyd P, Cantor R (1984) Reproductive behaviour of families with CF children. Presented at International Cystic Fibrosis Meeting, BrightonGoogle Scholar
  6. 6.
    Memorandum from a WHO Meeting (1983) Community control of hereditary anaemias. Bull WHO 61: 63–80Google Scholar
  7. 7.
    Modell B, Ward RHT, Fairweather DVI (1980) Effect of introducing antenatal diagnosis on re¬productive behaviour of families at risk for thalassaemia major. Br Med J i: 1347–Google Scholar
  8. 8.
    Stamatoyannopoulos G (1974) Problem of screening and counselling in the hemaglobinopathies. In: Motulsky AG, Lenz W (eds) Birth defects. Excerpta Medica, Amsterdam, pp 268–276Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • B. Modell
    • 1
  1. 1.School of MedicineUniversity College LondonLondonGreat Britain

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