The Japanese Society of Obstetrics and Gynaecology’s stance on prenatal paternity testing.

The Japanese Society of Obstetrics and Gynaecology takes a cautious position on prenatal paternity testing based on medical ethics.The main concerns include the effects on maternal and foetal health, legal and ethical issues, as well as the serious impact on family relationships.Below is an overview of the Japanese Society of Obstetrics and Gynaecology’s position on prenatal paternity testing.

1. Maternal and foetal safety

Prenatal paternity testing usually requires invasive methods ( such asamniocentesis orchorionic villus sampling ) to obtain foetal DNA.These methods carry certain risks (risk of miscarriage and infection) and it is important to consider their impact on the mother and the foetus.

• Amniocentesis: performed from 15 weeks’ gestation onwards, this procedure involves taking a sample of fetal amniotic fluid for DNA analysis, but carries a risk of miscarriage (approximately 0.3%).
• Chorionic villus sampling: performed at around 10-12 weeks’ gestation, this is a procedure in which part of the placenta is extracted, again with a risk of miscarriage.

The Japanese Society of Obstetrics and Gynaecology (JSGY) calls for a cautious approach in light of these risks, especially when prenatal paternity testing poses unnecessary risks to the mother and foetus, and especially when its purpose is non-medical (e.g. simply to confirm parent-child relationships).

2. Legal and ethical issues

Prenatal paternity testing also entails legal and ethical issues. The Japanese Society of Obstetrics and Genecology is concerned about the potential for prenatal paternity testing to cause family relations and social problems.

• Paternal consent: paternal consent is considered necessary for a prenatal paternity test, and failure to obtain this can lead to legal and ethical problems.
• Disruption in the family: when a paternity test reveals the paternity of a child, it can have a serious impact on family relationships.In particular, if the father is found not to be the biological father, the Japanese Society of Obstetrics and Gynaecology recommends careful decision-making as this can have a negative impact on family stability.

3. Non-invasive prenatal parentage identification

In recent years, non-invasive p renatal genetic testing (NIPT: non-invasive prenatal genetic testing ) has developed, in which the free DNA of the foetus is extracted from the mother’s blood and used for non-invasive parent-child testing.This technique involves very low risk to the mother and foetus and can safely confirm the parent-child relationship.

• Response by the Japanese Society of Obstetrics and Genecology: the Japanese Society of Obstetrics and Genecology has also taken a cautious stance towards prenatal testing using NIPT technology. In particular, it is cautious about widely allowing NIPT in the absence of medical necessity, e.g. for the sole purpose of confirming parent-child relationships, and urges careful consideration of the ethical and legal issues involved.

4. Social impact

The results of a prenatal paternity test may cause psychological and social stress for the mother and family.Doubts about the parent-child relationship may destabilise family relationships and cause social prejudice and discrimination.

• Psychological burden: for mothers and families, there is a risk of increased psychological burden due to the prenatal revelation of the parent-child relationship. There is also concern that this may have a negative impact on the health of the pregnancy.

5. The position of the Japanese Society of Obstetrics and Genecology

The Japanese Society of Obstetrics and Gynaecology has taken a cautious stance on prenatal paternity testing based on the following beliefs

• Preference for medical purposes: prenatal testing should be carried out primarily for medical purposes (e.g. to check foetal health or genetic conditions) and should not be carried out merely to confirm parent-child relationships.
• Minimising maternal and foetal risks: the report states that risk to the mother and foetus through invasive techniques should be avoided except where it is essential.
• Ethical considerations: the report states that the ethical issues need to be carefully judged, taking into account the full impact of confirming the parent-child relationship on the family and society.

Summary

The Japanese Society of Obstetrics and Genecology takes a cautious position on prenatal paternity testing, urging careful consideration of the risks to the mother and foetus, as well as the ethical and legal issues involved. In particular, it recommends that unless there is a medical need, the risks and social implications be considered for appraisals aimed at confirming parent-child relationships. Even as non-invasive technologies advance, ethical considerations must be taken into account in their use.

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Supervisor of the article

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Dr. Hiroshi Oka

Director of CAP Laboratory

Graduated from Keio University, Faculty of Medicine

Doctor of Medicine

Medical Doctor