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Prenatal blood tests to diagnose Down syndrome will soon be covered by public health insurance in Germany. The issue has sparked an ethical debate, with some critics saying the change could lead to more abortions.
The Joint Federal Committee (G-BA) of Germany's health service on Thursday ruled that state health insurance should cover the costs of prenatal blood tests, but only under certain conditions.
The panel of doctors, hospitals and health insurers said pregnant mothers wanting to undergo the test would be reimbursed "in justified individual cases in pregnancies with special risks" and "after medical consultation."
The change is only expected to take effect in 2021. It still needs to be approved by Germany's Health Ministry, and specific requirements for insured women are only expected to be drawn up by the end of 2020.
Other tests come with risks
The non-invasive test analyzes so-called fetal DNA in the blood of pregnant women to detect chromosome disorders that can lead to Down syndrome and other trisomies.
G-BA chairman Josef Hecken stressed that "very strict conditions" meant the blood test would not be used as a "screening" tool. Rather, the aim was to avoid the risks associated with more invasive forms of trisomy testing.
Other methods, such as a biopsy of the placenta or amniocentesis, are already covered by the state system in certain cases — if the mother is over 35 years of age, or if she already has a child with a chromosome abnormality. Although extremely accurate, these examinations have been shown to lead to complications, including miscarriages in a small number of cases.
The blood test has been available in Germany since 2012, but women have had to cover the costs themselves.
"It seems unjustifiable to deny affected pregnant women this low-risk procedure, which is approved and available in Germany," Hecken said in a letter to lawmakers on Thursday.
Controversial ethical issue
The issue has sparked debate in Germany, with advocates, including Health Minister Jens Spahn, pointing to the blood test as a safe and reliable option. Critics, however, including the Catholic Church, warn expanding such prenatal tests could lead to more abortions, as well as increased discrimination against people with disabilities.
Sebastian Urbanski of the assistance organization "Lebenshilfe," who himself has Down syndrome, told Germany's Südwestrundfunk radio there was a danger of people with disabilities being "combed out" before they are born.
He said there should be better information and advice available to prospective parents, so that they are aware "children with Down syndrome can do everything."
nm/msh (AFP, dpa, epd, KNA)