Is it better to terminate 85 pregnancies which do not have a serious defect in order to catch 15 which do? At what point is it not better to terminate 100% of pregnancies?
Your first question and answer is against medical ethics. If you’re a physician you know that terminating pregnancies based on a non-specific but sensitive screening test is inappropriate (do no harm).
However, you are correct in your second statement - there are much more specific follow up tests which improve diagnostic accuracy.
Medical utilitarianism should never be so cruel and gruesome as to eliminate 85 healthy and wanted pregnancies in order to find and eliminate 15 genetic aberrations.
> At what point is it not better to terminate 100% of pregnancies?
Everyone should decide for themselves. Having seen the long term consequences I would rather err on the side of caution, even if it were difficult to become pregnant.
Such diseases are often incurable and significantly degrade the quality of life of not only the person to be born but the whole immediate family. At least in the US the there isn't enough social safety net or support too offset the crushing costs.
Yes, it’s absolutely better to do that. Of course, the actual ratio is much better than that because we do follow-up tests after the screen.