Abstract

MARQUEZ-GONZALEZ, Horacio; RAMIREZ-GARCIA, Miguel Ángel  and  VILLA-ROMERO, Antonio Rafael. Ethical considerations in the prenatal diagnosis of Huntington's disease. Perinatol. Reprod. Hum. [online]. 2014, vol.28, n.4, pp.205-210. ISSN 2524-1710.

Huntington disease is a neurodegenerative disorder caused by expanded trinucleotides which encode polyglutamine tracts. The disease is inherited as an autosomal dominant trait with onset in adult life, normally between 37 to 55 years. Once the symptoms have started, life expectancy will be 15 years. The diagnosis is clinical and molecular after the establishment of the symptomatology. It is characterized by involuntary movements, psychiatric illness and cognitive impairment. There are two ways to approach the antenatal diagnosis in couples with familial background: prenatal and preimplantation. The current posture related to antenatal diagnosis is only for couples that desire termination of the pregnancy. This essay discusses this situation through medical principlism, and arrives to the following conclusions: regarding the principles of autonomy and integrity of the human being, the carrier of the disease is not respected. It does not seem fair to perform a test to determine the behavior of ending a life during pregnancy, while there are other diseases with similar prognosis that do not have the same diagnostic possibilities. This violates the principles of beneficence and non-maleficence, promoting death. We suggest that medical participation must promote the best conditions to confirm the diagnosis, and prepare both family and patient concerning the emotional, physical and nutritional aspects for the moment of the onset of the symptomatology.

Keywords : Huntington disease; prenatal diagnosis; medical principlism; abortion.

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