When genetic testing goes wrong

Reporting from The New York Times reveals some prenatal test results have high level of inaccuracy

January 20, 2022

I started making dad jokes at the first doctor’s appointment for our baby in the womb. My wife’s doctor asked, “What are we hoping for?” My wife groaned when I responded, “A baby would be great, but we would settle for a velociraptor.” She often responded with something along the lines of, “We just want he or she to be healthy.” And my wife’s response is common to many parents who are faced with the mystery of pregnancy and have an innate desire for their child’s well-being. We know something amazing is happening — but we don’t really know how it’s happening, even if we understand biologically what is developing from week to week. And we are faced with the reality that we have basically no control over the process. As Louie Giglio once pointed out in a sermon, the fact that the body knows to divide skin over your eyes into eyelids at a particular point in pregnancy is an incredible mystery. 

Problems of prenatal screening

In the face of this mystery, it makes sense that parents and healthcare providers would desire and perform tests to ensure that the baby is healthy and developing as he or she should. However, recent reporting from The New York Times has cast serious doubts on the accuracy of some genetic tests and reveals concerning trends for Christians. These genetic tests, which screen for genetic diseases ranging from Down syndrome to near universally fatal conditions, were found to be accurate for some conditions (Down syndrome) and wildly incorrect for other, more rare conditions. 

In the latter cases, the Times research concluded that they were producing a false positive 85% of the time, requiring more tests to confirm or reject the diagnosis. The diagnosis brought not only a need for more tests, but often mental and emotional anguish. After more tests, many of which are expensive and often not covered by insurance, parents often learned that their unborn child was perfectly healthy. In some cases, parents took the initial test’s diagnosis as a settled issue and chose to terminate the pregnancy when they considered having a child with a disability. One study found that 6% of patients had an abortion after the positive result without further testing. This mirrors the trend in other countries such as Iceland, where parents have almost completely chosen abortion over giving birth to a child with Down syndrome.

Individual concerns for genetic testing

This all raises an important question about the morality of these tests. Should Christians be performing these tests on their unborn children? In this specific situation, the high number of false positives generated by the tests should be reason for healthcare providers to be clearer about the results and certainty parents can actually receive. Initially, the tests were used to detect Down syndrome, a condition where they can reliably provide a correct diagnosis. 

However, as the Times report notes, companies began to test for other disorders and rare conditions in an effort to sell more of their products. Often left unmentioned in their pitch to parents is the rate of false positives — which is known to the companies — or the certainty with which parents should receive the results for more obscure diseases. Thus, the mystery and wonder of pregnancy and birth has been commodified by these companies, often to disastrous results for both the child and parents. 

However, if the tests were perfectly accurate, Christians may still wonder if they should pursue genetic testing at all. There are two realities at work here, the individual and the societal. At the individual level, a Christian couple who pursues these tests may do so with the desire to prepare for any problems that may arise. And if there are ways to help the preborn baby by preventing disease or correcting issues, then accurate genetic testing could be helpful. 

Also, if a couple receives a positive diagnosis, tests such as these give them time to grieve, prepare, and lament what has occurred. A proper Christian response in the face of the brokenness that comes from some of these diseases includes weeping. We are not Stoics unmoved by circumstances and disconnected from the world and the people around us. Like our Savior, lamentation is appropriate in the face of death and sickness (John 11:36). So for the individual couple seeking only knowledge and how best to love their child, accurate genetic tests are a morally valid option. 

Genetic testing in an abortion culture 

At the same time, Christians must recognize that their decisions are not atomistic or unrelated decisions that affect only the couple. The genetic tests are part of a larger medical landscape in which abortion is an option presented regularly by many doctors and healthcare providers. The history of eliminating vulnerable individuals who are undesirable because of deformity or the idea that they will be “unproductive” members of society has an ugly and bloody history. Earlier generations looked to sterilization of the unfit to improve society. In the present, entire categories of individuals have been almost eliminated because the diagnosis of an extra chromosome leads parents to opt for abortion. 

While the tests themselves are morally neutral, the ends to which they are often employed is not. As such, Christians must recognize that we are part of a larger culture where abortion is not only legal but commonplace and encouraged. Thus, we should be wary of communicating, whether intentionally or unintentionally in word or deed, that somehow the value or life of a child is tied to their physical, mental, or genetic makeup. Participation in the larger system can create a demand for these tests, which then helps fuel their use throughout society, including by those who may not use the test solely for diagnostic and preparatory means. This does not mean that Christians err when we use these tests or are somehow morally complicit in the abortion industry by using these tools, but it does mean that we bear the responsibility for knowing this context and considering these realities when we make these type of moral decisions.

Unfortunately, we live in a time when we are able to test for more than we can treat. And in a society that often values individuals solely for what they contribute, rather than on the basis of their humanity rooted in the imago Dei (the image of God), disease and disability prove ample reason to eliminate them. But Christians must not accept this cultural narrative of the worth of any fellow human being, especially children in the womb who represent some of the most vulnerable among us. 

We can recognize the tragedy that comes from sin’s effects in the world and the myriad ways that disease can cause harm and pain. However, as theologian Josef Pieper once argued, a good summary of love is our affirmation of the statement: “It’s good that you exist.” Christians looking at sonograms and genetic test results, no matter what they are, can affirm the goodness of their child’s existence. In so doing, they reject narratives of utility and power and affirm the intrinsic worth of every individual solely because they have been created by and bear the very image of God.

Alex Ward

Alex Ward serves as the research associate and project manager for the ERLC’s research initiatives. He manages long term research projects for the organization under the leadership of the director of research. Alex is currently pursuing a PhD in History at the University of Mississippi studying evangelical political activity in … Read More

Article 12: The Future of AI

We affirm that AI will continue to be developed in ways that we cannot currently imagine or understand, including AI that will far surpass many human abilities. God alone has the power to create life, and no future advancements in AI will usurp Him as the Creator of life. The church has a unique role in proclaiming human dignity for all and calling for the humane use of AI in all aspects of society.

We deny that AI will make us more or less human, or that AI will ever obtain a coequal level of worth, dignity, or value to image-bearers. Future advancements in AI will not ultimately fulfill our longings for a perfect world. While we are not able to comprehend or know the future, we do not fear what is to come because we know that God is omniscient and that nothing we create will be able to thwart His redemptive plan for creation or to supplant humanity as His image-bearers.

Genesis 1; Isaiah 42:8; Romans 1:20-21; 5:2; Ephesians 1:4-6; 2 Timothy 1:7-9; Revelation 5:9-10

Article 11: Public Policy

We affirm that the fundamental purposes of government are to protect human beings from harm, punish those who do evil, uphold civil liberties, and to commend those who do good. The public has a role in shaping and crafting policies concerning the use of AI in society, and these decisions should not be left to those who develop these technologies or to governments to set norms.

We deny that AI should be used by governments, corporations, or any entity to infringe upon God-given human rights. AI, even in a highly advanced state, should never be delegated the governing authority that has been granted by an all-sovereign God to human beings alone. 

Romans 13:1-7; Acts 10:35; 1 Peter 2:13-14

Article 10: War

We affirm that the use of AI in warfare should be governed by love of neighbor and the principles of just war. The use of AI may mitigate the loss of human life, provide greater protection of non-combatants, and inform better policymaking. Any lethal action conducted or substantially enabled by AI must employ 5 human oversight or review. All defense-related AI applications, such as underlying data and decision-making processes, must be subject to continual review by legitimate authorities. When these systems are deployed, human agents bear full moral responsibility for any actions taken by the system.

We deny that human agency or moral culpability in war can be delegated to AI. No nation or group has the right to use AI to carry out genocide, terrorism, torture, or other war crimes.

Genesis 4:10; Isaiah 1:16-17; Psalm 37:28; Matthew 5:44; 22:37-39; Romans 13:4

Article 9: Security

We affirm that AI has legitimate applications in policing, intelligence, surveillance, investigation, and other uses supporting the government’s responsibility to respect human rights, to protect and preserve human life, and to pursue justice in a flourishing society.

We deny that AI should be employed for safety and security applications in ways that seek to dehumanize, depersonalize, or harm our fellow human beings. We condemn the use of AI to suppress free expression or other basic human rights granted by God to all human beings.

Romans 13:1-7; 1 Peter 2:13-14

Article 8: Data & Privacy

We affirm that privacy and personal property are intertwined individual rights and choices that should not be violated by governments, corporations, nation-states, and other groups, even in the pursuit of the common good. While God knows all things, it is neither wise nor obligatory to have every detail of one’s life open to society.

We deny the manipulative and coercive uses of data and AI in ways that are inconsistent with the love of God and love of neighbor. Data collection practices should conform to ethical guidelines that uphold the dignity of all people. We further deny that consent, even informed consent, although requisite, is the only necessary ethical standard for the collection, manipulation, or exploitation of personal data—individually or in the aggregate. AI should not be employed in ways that distort truth through the use of generative applications. Data should not be mishandled, misused, or abused for sinful purposes to reinforce bias, strengthen the powerful, or demean the weak.

Exodus 20:15, Psalm 147:5; Isaiah 40:13-14; Matthew 10:16 Galatians 6:2; Hebrews 4:12-13; 1 John 1:7 

Article 7: Work

We affirm that work is part of God’s plan for human beings participating in the cultivation and stewardship of creation. The divine pattern is one of labor and rest in healthy proportion to each other. Our view of work should not be confined to commercial activity; it must also include the many ways that human beings serve each other through their efforts. AI can be used in ways that aid our work or allow us to make fuller use of our gifts. The church has a Spirit-empowered responsibility to help care for those who lose jobs and to encourage individuals, communities, employers, and governments to find ways to invest in the development of human beings and continue making vocational contributions to our lives together.

We deny that human worth and dignity is reducible to an individual’s economic contributions to society alone. Humanity should not use AI and other technological innovations as a reason to move toward lives of pure leisure even if greater social wealth creates such possibilities.

Genesis 1:27; 2:5; 2:15; Isaiah 65:21-24; Romans 12:6-8; Ephesians 4:11-16

Article 6: Sexuality

We affirm the goodness of God’s design for human sexuality which prescribes the sexual union to be an exclusive relationship between a man and a woman in the lifelong covenant of marriage.

We deny that the pursuit of sexual pleasure is a justification for the development or use of AI, and we condemn the objectification of humans that results from employing AI for sexual purposes. AI should not intrude upon or substitute for the biblical expression of sexuality between a husband and wife according to God’s design for human marriage.

Genesis 1:26-29; 2:18-25; Matthew 5:27-30; 1 Thess 4:3-4

Article 5: Bias

We affirm that, as a tool created by humans, AI will be inherently subject to bias and that these biases must be accounted for, minimized, or removed through continual human oversight and discretion. AI should be designed and used in such ways that treat all human beings as having equal worth and dignity. AI should be utilized as a tool to identify and eliminate bias inherent in human decision-making.

We deny that AI should be designed or used in ways that violate the fundamental principle of human dignity for all people. Neither should AI be used in ways that reinforce or further any ideology or agenda, seeking to subjugate human autonomy under the power of the state.

Micah 6:8; John 13:34; Galatians 3:28-29; 5:13-14; Philippians 2:3-4; Romans 12:10

Article 4: Medicine

We affirm that AI-related advances in medical technologies are expressions of God’s common grace through and for people created in His image and that these advances will increase our capacity to provide enhanced medical diagnostics and therapeutic interventions as we seek to care for all people. These advances should be guided by basic principles of medical ethics, including beneficence, non-maleficence, autonomy, and justice, which are all consistent with the biblical principle of loving our neighbor.

We deny that death and disease—effects of the Fall—can ultimately be eradicated apart from Jesus Christ. Utilitarian applications regarding healthcare distribution should not override the dignity of human life. Fur- 3 thermore, we reject the materialist and consequentialist worldview that understands medical applications of AI as a means of improving, changing, or completing human beings.

Matthew 5:45; John 11:25-26; 1 Corinthians 15:55-57; Galatians 6:2; Philippians 2:4

Article 3: Relationship of AI & Humanity

We affirm the use of AI to inform and aid human reasoning and moral decision-making because it is a tool that excels at processing data and making determinations, which often mimics or exceeds human ability. While AI excels in data-based computation, technology is incapable of possessing the capacity for moral agency or responsibility.

We deny that humans can or should cede our moral accountability or responsibilities to any form of AI that will ever be created. Only humanity will be judged by God on the basis of our actions and that of the tools we create. While technology can be created with a moral use in view, it is not a moral agent. Humans alone bear the responsibility for moral decision making.

Romans 2:6-8; Galatians 5:19-21; 2 Peter 1:5-8; 1 John 2:1

Article 2: AI as Technology

We affirm that the development of AI is a demonstration of the unique creative abilities of human beings. When AI is employed in accordance with God’s moral will, it is an example of man’s obedience to the divine command to steward creation and to honor Him. We believe in innovation for the glory of God, the sake of human flourishing, and the love of neighbor. While we acknowledge the reality of the Fall and its consequences on human nature and human innovation, technology can be used in society to uphold human dignity. As a part of our God-given creative nature, human beings should develop and harness technology in ways that lead to greater flourishing and the alleviation of human suffering.

We deny that the use of AI is morally neutral. It is not worthy of man’s hope, worship, or love. Since the Lord Jesus alone can atone for sin and reconcile humanity to its Creator, technology such as AI cannot fulfill humanity’s ultimate needs. We further deny the goodness and benefit of any application of AI that devalues or degrades the dignity and worth of another human being. 

Genesis 2:25; Exodus 20:3; 31:1-11; Proverbs 16:4; Matthew 22:37-40; Romans 3:23

Article 1: Image of God

We affirm that God created each human being in His image with intrinsic and equal worth, dignity, and moral agency, distinct from all creation, and that humanity’s creativity is intended to reflect God’s creative pattern.

We deny that any part of creation, including any form of technology, should ever be used to usurp or subvert the dominion and stewardship which has been entrusted solely to humanity by God; nor should technology be assigned a level of human identity, worth, dignity, or moral agency.

Genesis 1:26-28; 5:1-2; Isaiah 43:6-7; Jeremiah 1:5; John 13:34; Colossians 1:16; 3:10; Ephesians 4:24