Offer screening only to 36+ women? In November 2003, the State Secretary of Health sent a letter with the government’s reaction to the Health Council. In the statement, several arguments

from previous years reappeared. The intention of the Population Screening Act to protect people against the potential drawbacks of screening was underscored. According to the State Secretary, the drawbacks of risk assessment screening for women under 36 years of age were considered greater than the benefits because their chance of having a foetus with Down syndrome was lower than for older women; medicalisation of childbirth for this group was to be avoided. Women over 36 years of age should be offered screening tests, as well as invasive diagnostic tests. If women under 36 years of age wanted a risk assessment test, they could ask and pay Luminespib cell line for it themselves. The State Secretary remarked that there were Citarinostat cell line ample reasons to continue the restrained government policy regarding prenatal screening. She stated it confronts us with questions such as, whether medical framing of a natural process

should be applied that ‘hardly’ raises problems for younger women, and that is seen by most of them as something positive; and whether this is a step towards a misleading ideal of a malleable humanity? (Parliamentary documentation 2003–2004a). The danger of eugenics in population screening In the arguments of the State Secretary and commentators, such as critical obstetricians, age limit surfaces as a watershed for population screening. In general, for population screening, benefit must outweigh harm (Wilson and Jungner Montelukast Sodium 1968). The Health Council weighed the benefits of having the option to obtain risk assessment against potential harm for all SCH772984 in vitro pregnant women, whereas the State Secretary and critical obstetricians split pregnant women into subsets. When weighing pros and cons for younger women, it was thought that the balance would be uneven while they would suffer from the psychological burden whereas their group risk was relatively small. However, the figures may relate to a more fundamental principle.

Pregnancy is seen as a natural phenomenon and medicalisation of pregnancy in the form of prenatal testing places pregnancy in a category of potential danger. A moral argument is added: the question whether we consider life to be malleable and appropriate for tinkering. Here, we find an echo of the fears of eugenics. Whereas testing in individual high risk cases is more or less accepted, on a population level, prenatal screening can cause discomfort. The fact that the government would organise screening added to that sentiment (as discussed in the section above). People might think that particular screening would be acceptable and advisable in the interest of public health. The government could avoid using the instrument of population screening by maintaining the age limit and not offering serum screening to all pregnant women.