Disability activism and non-invasive prenatal testing: A response to Breimer.

In his recent Comment in IJME, Dr Breimer casts disability advocates as "special interest groups" and pits them against the abstracted concept of "women's autonomy." Against this, we assert that, far from only being a conflict of interest category, disability activism related to prenatal screening and testing is a robust part of bioethical debate and scholarship. Here, we disagree with Dr Breimer's characterisation of Non-invasive Prenatal Testing (NIPT) related disability activism as a threat to women's autonomy and respond to the underlying assumptions of his claims. We argue that disability need not be equated only with harm. Instead, we point out the dominant and intractable belief that disability is something to be avoided, which may lead to belief-based moral wrongs. This is the position from which disability activists make claims about the need to expand understandings of disability. Drawing on existing evidence, we find that prenatal testing does not automatically facilitate autonomy, and that NIPT may be even more of a challenge to autonomy than previous testing iterations. We suggest that NIPT should continue to be a phenomenon under close clinical scrutiny, and that ongoing debates and multiple claims-making can only add to our understanding of this phenomenon.