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A New York Times investigation found some non-invasive prenatal tests to be wrong up to 85 per cent of the time

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The New Years baby story is a news standard, an endearing report about the couple who planned a quiet New Years Eve at home but instead delivered a baby at 12:05 a.m. on January 1st. In smaller cities and towns, local merchants often provide gifts to the New Years baby.

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So it was a bit jarring to see The New York Times Jan. 1 feature about non-invasive prenatal testing (NIPT). It was about babies who had never been born. An NYT investigation found the non-invasive tests to be wildly inaccurate wrong up to 85 per cent of the time which often leads to abortions. Its a tale of two doleful phenomena: the widespread return of eugenics and the financial corruption of medicine.

Eugenics was a respectable, even fashionable, cause in progressive circles in the 1920s and 1930s. When I studied economics at Cambridge, I came to learn that the giants of the departments history John Maynard Keynes most prominent among them advocated for eugenics.

Closer to home, Tommy Douglas voted the greatest Canadian of all time in 2004 wrote his masters thesis on The Problems of the Subnormal Family in 1933. He advocated medical licences prior to marriage to prevent those with intellectual disabilities from being permitted to breed.

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Eugenics was a respectable cause in the 1920s and 1930s

The Nazi medical horrors put eugenics in a bad odour for a few generations. As premier of Saskatchewan from 1944 to 1961, Douglas declined to implement the policies that he had advocated years earlier.

In recent decades, eugenics has made a comeback in polite society due to two changes, one legal and one technological. Easy access to abortion and pre-natal testing for genetic abnormalities have made it possible for eugenics to be applied in utero .

Children with Down syndrome were the primary target, as the chromosomal anomaly is relatively easy to detect. Screening for Down syndrome has been very successful. In 2017, Iceland declared itself to be free of Down syndrome children, as nearly 100 per cent of them are now aborted after testing.

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In many countries, a majority of Down syndrome pregnancies are aborted. In the United States the abortion rate for Down syndrome is 67 per cent (1995-2011); in France its 77 per cent (2015); and Denmark, 98 per cent (2015).

In Canada , public health does not keep figures, but reports that despite the trend in delayed childbearing and advanced maternal age at delivery in the last several decades, rates of Down syndrome in Canada have not increased proportionately. This is due to increased use of prenatal diagnostic procedures followed by terminations of Down syndrome pregnancies.

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The NYT story looked at non-invasive prenatal testing for five other abnormalities and found startlingly high false positive rates, with 81 to 93 per cent of the tests giving wrong results.

Why would doctors prescribe tests for very rare conditions with sky-high false positive rates, when the likely consequence is catastrophic?

There is a financial incentive.

Its a little like running mammograms on kids, Mary Norton, an obstetrician and geneticist at the University of California, San Francisco, told the NYT. The chance of breast cancer is so low, so why are you doing it? I think its purely a marketing thing.

Successful marketing at that.

Why would doctors prescribe these tests?

The NYT reported that one large test maker, Natera, performed more than 400,000 screenings for just one abnormality in 2020 the equivalent of testing roughly 10 per cent of pregnant women in America.

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Americas medical-industrial complex provides built-in incentives for excessive use of unreliable tests. In other countries financial incentives might be lesser, but the phenomenon remains. Where the medical system does not encourage NIPT, individual parents can seek the tests on their own. The eugenic purpose remains the same even if pursued and paid for differently.

The simplest prenatal test is for gender. Being male or female is not a disorder, but even that can be put to eugenic purposes. Its been more than 30 years since Amartya Sens landmark article on the 100 million missing women, missing largely due to sex-selected abortion and infanticide. Testing technology has only grown more widespread since.

Abortion for gender reasons is widely denounced, but is rarely done by mistake. Eugenic abortion for disabilities is not denounced. But when done by mistake the horror is all the more grave.

National Post

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Raymond J. de Souza: The tragedy of eugenics and the babies not born - National Post