Prenatal genetic screenings: when medicine anticipates the selection of lives

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Prenatal genetic screenings: when medicine anticipates the selection of lives
Illustration : Marie Yukimura Saitō

The French Academy of Medicine recommends authorizing large-scale preconception genetic testing. Under the guise of prevention, the logic of selection is established even before conception.

Context

On July 10, 2026, the National Academy of Medicine issued a favorable opinion on the generalized authorization of preconception genetic screenings, these tests that allow future parents to know, before any conception, if they are carriers of recessive genes responsible for hereditary diseases. We had addressed, on July 7, the ambiguity of the 2026 Bioethics General States on prenatal selection. The Academy's recommendation extends this trend. Selection is no longer played at the embryonic stage; it is established as early as the programming of the parental project.

The Facts

The report of the Academy of Medicine, published this July 10, recommends expanded access to preconception genetic tests for all couples planning a pregnancy. Currently reserved in France for couples with an identified family risk, these tests would be offered without a specific medical indication. The Academy invokes the prevention of rare genetic diseases (cystic fibrosis, sickle cell anemia, spinal muscular atrophy) and the reduction of family suffering. Social Security would cover the reimbursement. The opinion joins the evolutions already underway in Belgium, the Netherlands, and Israel.

Doctrinal Analysis

The Church has recalled since Donum Vitae (1987, I, 2) that prenatal diagnosis is lawful when it respects the life and integrity of the embryo and tends to its safeguarding. It condemns, however, diagnosis accompanied by an eugenic intention. Evangelium Vitae (1995, n. 63) clearly denounces "a mentality that welcomes life only under certain conditions and refuses the limit, infirmity, disease." The preconception does not destroy an embryo, but it establishes upstream a criterion for genetic selection of the desire for a child. The CEC (n. 2274) teaches that the embryo must be defended in its integrity from its conception. What applies to the embryo applies a fortiori to the parental intention: the logic of the best possible child is already a logic of selection.

Stakes for the Church and the Faithful

Generalized preconception screening is not neutral. It changes the view of the child: from a free gift received, it becomes a project to optimize. The National Consultative Ethics Committee itself has opened the door in its latest opinions. For Catholic couples, the pastoral question becomes concrete: accepting the risk of transmitting a disease, is it negligence, or trust in Providence? Dioceses will have to offer demanding medical-spiritual support.

Critical Reading and Blind Spots

The Academy's report does not address the psychological consequences of screening (anxiety, guilt in case of refusal), nor the progressive inflation of the genes tested. Israel, often cited as an example, today tests several hundred genes in preconception, with a documented demographic impact on at-risk populations. The shift from preconception to prenatal, then to preimplantation, is a sociological evidence. The argument of "prevention" masks a major anthropological change.

To Meditate and Act

Inspired by Jérôme Lejeune: do not judge the value of a life by what it promises or not. Ask your parish about the bioethical support of young couples. Support the Lejeune Foundation and associations that help families carrying genetic diseases. Pray for doctors who refuse to yield to the logic of selection.

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Isabelle de FranclieuJuriste, chroniqueuse bioéthique & société
Juriste de formation, elle suit les questions de bioéthique, de famille et de liberté de conscience, dans la perspective du droit naturel.
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