On-Invasive Testing, Non-Invasive Counseling (Rebouche)


Rachel Rebouché. Non-Invasive Testing, Non-Invasive Counseling. Journal of Law, Medicine and Ethics 43.2 (2015): 228-240.


This article considers the role that termination decisions play in options counseling before and after genetic counseling. Over the last several decades, scholars and clinicians have been attentive to the concern that some women feel pressure to terminate pregnancies after receiving test results. One response has been to carve out professional standards for non-directive, client-centered counseling that neither discouraged nor encouraged patients’ abortion decisions. However, the present legislative attempts to control and to limit abortion decisions after testing strip from options counseling the nuanced considerations that potential parents bring to bear as they consider both whether to test and test results.



Thinking critically about how abortion animus and counseling intersect is a vital project for those invested in defending women’s reproductive rights. Those supportive of abortion rights might focus not only on resisting their opponents’ efforts in receptive state legislatures, but also on standards for genetic counseling and on patient experiences in physicians’ offices. Part I of this article explains the use of new non-invasive prenatal genetic testing (NIPT) and its uptake by patients and providers. Part II describes state (and, to a lesser extent, federal) legislation that restricts abortion as a response to NIPT. Part III explores how abortion politics may co-opt complicated questions about the timing, content, and limitations of the genetic counseling that accompanies NIPT.