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If a child is born with a condition that could have been detected, the presence of the test changes that outcome “from something that happened to you, to something that you participated in,” she says.

“That’s a very big burden to place on would-be parents,” she said, adding that it’s hard for a pregnant woman to refuse any test for a medical condition because it feels like the responsible thing to do.

Johnston has personal experience; she gave birth to a girl just two years ago. When offered a medical screening test for the fetus, she generally felt compelled to take it.

“At the moment these things happen, it’s just you there by yourself,” she said. Some people might like that level of control, but others “would be happier to leave things up to chance a little more.”

She said if she were pregnant again and offered a wider range of tests, she’d restrict herself to “really, really serious disabilities and disorders.”

King, who had a son 18 months ago, said she wouldn’t have wanted to know about any risk for incurable diseases that show up in adulthood. Those are “things that would have caused us to spend a lot of time worrying about what his future would look like even though there’s nothing we could do about it,” she said.

In the future, such testing could also look for other genes _ some of which aren’t yet identified _ that affect non-medical traits.

“If no limitations are put on, you can have a couple get a prenatal genetic test in the future saying their fetus has … a 60 percent chance of having breast cancer at the age of 60 and a 30 percent chance of being gay,” says Dr. Brian Skotko, a board member of the National Down Syndrome Society.

Since such information would come early enough for an abortion, Skotko says, “The ultimate question for society is, What forms of human variation are valuable?”

Then there’s the possibility of direct-to-consumer companies stepping in to fill demand, King said. Couples who go that route may miss out on getting help in understanding the nuances of what the test results really mean, said Dr. Mary Norton, a Stanford professor of obstetrics and gynecology.

Once the prenatal information is available, another question arises, King said: Should a woman be allowed to get an abortion for any reason, even a trivial one like test results about height or eye color? Some state governments have passed laws outlawing abortions on the basis of sex, she said. But it’s not clear whether those are constitutional, and a woman might simply not reveal her true reasons for wanting the abortion, King said.

Skotko points out that people use their own personal perspective in deciding what they want for their children. Some couples who are deaf from a genetic condition already use current technology to avoid having children with normal hearing. “It’s their lens by which they view the world, and they want a child who views the world through that same lens,” he said.

Greely sees other concerns. Will the testing become so routine that women won’t even realize they authorized it, and then be faced with information and an abortion decision they didn’t necessarily want? How can they be helped to make an informed decision on whether to be tested? And if offered a choice of genes to be tested, or results to be told about, who will help them sort through the long list to decide what they want to know? Few doctors are informed enough, and there aren’t enough genetic counselors go around, he said.

The same problem arises later when it comes time to help couples understand what the results really mean, he said. “How do you tell somebody about 100 different genetic things?” he asked. “Who’s going to do that? Who’s going to listen to that? Who’s going to pay for that?”

Results can be complex. For example, how is a woman supposed to balance a 25 percent increase in risk for one disease versus a 15 percent decrease in another, Darnovsky asks.

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