A patient’s personal beliefs about abortion change the risk–benefit
determinations for genetic counseling and, to a lesser extent, for fertility
treatment. Physicians must not assume, however, that a patient who is
opposed to abortion in the abstract will not consider abortion if she is
personally faced with a high probability of giving birth to a child with a severe
defect. All women, even those who are opposed to abortion, should be offered
all appropriate testing and counseling. This does not mean that a physician
should advocate abortion. Ideally, a patient should receive the necessary
information about genetic diseases and the risks of fertility treatment without
reference to either her or her physician’s views about abortion. The woman’s
personal views about abortion should shape the risks that she is willing to
assume of conceiving a child with a genetic disease, the prenatal testing to
which she will consent, and under which circumstances, if any, she will
terminate a pregnancy.
Physicians who do not perform abortions because of personal ethical beliefs
should ensure that their beliefs do not compromise their patients’ right to
choose an abortion. In addition to providing every patient full information, the
physician should arrange an easy referral system so that a patient who
chooses an abortion can obtain it without unnecessary delay or expense.
Conversely, physicians who support abortion as a valid therapeutic technique
must not force their views on their patients. They must be prepared to respect
the wishes of a woman who, after being fully informed of the risks and benefits
of pre- or postconception testing, chooses to bear her child without regard to
potential genetic diseases.