Republican presidential hopeful Rick Santorum took a strong position against the federal mandate that insurance companies cover prenatal genetic testing, tying it to the ever-polarizing issue of abortion. (Watch video of Santorum’s statements here, at about 3 minutes in.)

“Yes, prenatal testing, amniocentesis, does in fact result more often than not in abortion. That is a fact,” Santorum said. The candidate opposes abortion regardless of circumstance.

Santorum has made a broad over-generalization, says attorney and bioethicist Leslie Meltzer Henry, faculty member at the Johns Hopkins Berman Institute of Bioethics. “It is misleading to characterize abortion as the only outcome that follows from the detection of fetal anomalies in utero,” Meltzer Henry says. “In consultation with their physicians, many women rely on information from prenatal testing to medically manage a high-risk pregnancy and create a safe delivery plan, and to prepare financially and psychologically to care for a child with health problems.”

Santorum does not deny that women should have the choice to have prenatal testing, but that insurance companies should not be obligated to cover it, as they are under the Obama administration-authored health care law.  He accuses the mandate of encouraging more abortions that “cull the disabled in our society,” to save the cost of providing care for them.

Meltzer Henry strongly objects to Santorum’s logic. “The notion that free prenatal testing is part of a government plan to reduce the number of people with disabilities, and therefore lower health care costs, is entirely without merit. It wrongly presupposes that the government, having offered prenatal testing, can then compel women with potentially disabled fetuses to have abortions,” Meltzer Henry says.

Bioethicist Alan Regenberg, also of the Johns Hopkins Berman Institute of Bioethics, takes issue with the inherent inequality of Santorum’s proposal.  “Eliminating the policy mandate requiring insurance coverage for prenatal testing would restrict the benefits of these services to those who can afford them,” Regenberg notes, “placing an unfair burden on the economically disadvantaged.”

The issue is more than a political talking point for Santorum, who is the father of a child with a rare genetic disorder, Trisomy 18.  He says he and his wife were advised to abort and refused.

Prenatal testing’s effect on a more common chromosomal disorder, Down syndrome, is discussed in the upcoming issue of Time magazine. Bonnie Rochman reports on the decline in babies born with the condition:

“The number of babies born with Down syndrome has been shrinking for at least two decades, and new, non-invasive prenatal blood tests that can be administered as early as 10 weeks — long before a woman even looks pregnant — have the potential to diminish their ranks further.”

What Rochman leaves unsaid is that abortion is the reason for the decline in Down syndrome births.  After testing reveals Down syndrome, there is no treatment, only termination of the pregnancy.

In Rochman’s article, Johns Hopkins Berman Institute of Bioethics director Ruth Faden identifies the fine ethical distinctions that advances in prenatal testing have presented. “There is nothing wrong with saying, I’d rather my child not have this disability, as long as we don’t go from there to the view that people with disabilities are worth less,” Faden says.

Rochman’s article will appear in the February 27 issue of Time.

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Alan Regenberg
Leah Ramsay
Leslie Meltzer Henry

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