Prenatal Testing, False Positives, and Abortion

Imagine a pregnant mother, recently informed that her baby may have a rare genetic condition. She now faces a future caring for someone with an intellectual or physical disability, perhaps financial stress, and even a shortened life. Certain dreams and hopes she has harbored for her preborn child have been dramatically altered.

To make matters worse, many women in this challenging situation face intense pressure from medical professionals and family members to have an abortion. Some have even described having to defend the decision to not have an abortion to medical professionals who assume that a disabled child should not be allowed to live.

But what if the prenatal test that sparked this whole series of events was a false positive? What if this test returns false positives 85 percent of the time? According to a shocking new expose in the New York Times, a new investigation of companies manufacturing and promoting prenatal tests for rare and serious conditions concluded that certain prenatal tests, tests which lead countless women to get abortions, are "usually wrong." Up to a third of expectant mothers in the United States will face this scenario, claims the article, telling stories of mothers who received positive test results for debilitating chromosomal conditions. Many of these mothers considered abortion until they discovered through more invasive follow-up tests that the screening results were false, and their babies were fine.

Of course, even if accurate, test results do not in any way alter the inherent value of every human being. Still, many women do not bother with follow-up testing, trusting the results of these prenatal screenings, which manufacturers advertise as "reliable" and "highly accurate."

These tests are neither "reliable" nor "highly accurate." According to an analysis conducted by The Times, screenings for several rare conditions yielded false positives 85 percent of the time. A few screenings, such as the test for Prader-Willi syndrome, were wrong 90 percent of the time.

Millions of women, conclude the authors, have "been misled by a wondrous promise that Silicon Valley technology has made…that a few vials of their blood, drawn in the first trimester, can allow companies to detect serious developmental problems…" The false promises are made via incredibly dishonest advertising. Medical giants like Quest Diagnostics and Myriad Genetics use phrases like "total confidence," "clear answers," and "information you can trust." However, they fail to publish data on how well their tests perform, and even cherry-pick numbers to make them appear more accurate than they are.

However, in one case, The New York Times appears to join in on the deception. The authors repeatedly assure readers that prenatal tests for Down syndrome are reliable. Yet, a 2014 study published in the New England Journal of Medicine shows that around half of the positive Down syndrome screenings for low-risk pregnancies turned out to be false. For trisomy 18, a similar condition, up to 60 percent of screenings yielded false positives.

The tragedy of this many false positives comes into focus in light of another number: Nearly 70 percent of babies in the US who test positive for Down syndrome in the womb are aborted. It's terrible that many of these children didn't even have the condition their parents so greatly feared. It's even more terrible that this culture has decided that people with disabilities are better off dead.

The real name for this way of thinking is eugenics, something that didn't end with Nazi death camps in Europe and forced sterilization in the United States. The deadly logic that follows the idea that some humans are "defective" and "not worthy of life" is still with us, only gussied up, sanitized, and medically justified for the 21st century.

Ours is the real-life version of the movie, GATTACA, in which a "perfect" society free is built, not by eliminating defects, but by eliminating people. While The New York Times deserves credit for exposing the eugenics underbelly of the prenatal testing industry, the authors of this article ultimately buy the same basic premise.

The problem, they suggest, is bad testing, not deciding some are "defective" and eliminating them. But both history and good science fiction warn where this kind of thinking leads. The issue is not the bad science behind modern eugenics but the bad idea behind all eugenics. It's an idea that's claimed victims throughout history and must be rejected no matter how accurate our tests are.

Christians have faced down dehumanizing cultures like ours before, since its earliest days when the persecuted church rescued abandoned Roman babies. They were inspired and animated by a better idea: that every human being is intrinsically valuable because they bear the image of God.