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Commentary

Expanded Newborn Screening and Genomic Sequencing in Latin America and the Resulting Social Justice and Ethical Considerations

by
Juan F. Cabello
1,2,
Fernando Novoa
2,
Hanalise V. Huff
3 and
Marta Colombo
1,2,*
1
Instituto de Nutrición y Tecnología de los Alimentos (INTA), University of Chile, Santiago 7830489, Chile
2
Pediatric Neurology Fellowship Program, University of Valparaíso, Valparaiso 2341131, Chile
3
Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Int. J. Neonatal Screen. 2021, 7(1), 6; https://doi.org/10.3390/ijns7010006
Submission received: 24 October 2020 / Revised: 14 January 2021 / Accepted: 18 January 2021 / Published: 21 January 2021
(This article belongs to the Special Issue Ethical and Psychosocial Aspects of Genomics in the Neonatal Period)

Abstract

Newborn screening (NBS) has widely been utilized in developed countries as a cost-effective public health strategy that reduces morbidity and mortality. Developing countries, however, are new to the NBS scene and have their own unique challenges, both in instituting the program as well as effectively acting on the results. NBS offers numerous ethical issues on a global scale, however, here we argue that there are unique ethical issues surrounding the development and expansion of newborn screening in Latin America given its highly heterogenous population. Once a NBS program is effectively instated, ethical considerations continue when pursuing expansion of screening to include further conditions. While Latin America grapples with the ethics of expanded newborn screening (ENBS), some developed countries discuss utility of genomic sequencing technologies in the newborn population. When the ability to detect further pathology is expanded, one must know what to do with this information. As rare diseases are identified either on ENBS or via genome sequencing, access to treatments for these rare diseases can be a real challenge. If we consider newborn screening as a global initiative, then we need more than a deontology approach to analyze these challenges; we need an approach that considers the unique characteristics of each territory and tremendous heterogeneity that exists prior to the implementation of these programs. As genomic technology advances further in the developed world, while some developing countries still lack even basic newborn screening, there is a further widening of the gap in global health disparities. The question is posed as to who has responsibility for these newborns’ lives on an international level. Without an approach towards newborn screening that accounts for the diverse global population, we believe optimal outcomes for newborns and families across the world will not be achieved.
Keywords: ethics; Chile; Latin America; newborn genome sequencing; newborn sequencing ethics; Chile; Latin America; newborn genome sequencing; newborn sequencing

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MDPI and ACS Style

Cabello, J.F.; Novoa, F.; Huff, H.V.; Colombo, M. Expanded Newborn Screening and Genomic Sequencing in Latin America and the Resulting Social Justice and Ethical Considerations. Int. J. Neonatal Screen. 2021, 7, 6. https://doi.org/10.3390/ijns7010006

AMA Style

Cabello JF, Novoa F, Huff HV, Colombo M. Expanded Newborn Screening and Genomic Sequencing in Latin America and the Resulting Social Justice and Ethical Considerations. International Journal of Neonatal Screening. 2021; 7(1):6. https://doi.org/10.3390/ijns7010006

Chicago/Turabian Style

Cabello, Juan F., Fernando Novoa, Hanalise V. Huff, and Marta Colombo. 2021. "Expanded Newborn Screening and Genomic Sequencing in Latin America and the Resulting Social Justice and Ethical Considerations" International Journal of Neonatal Screening 7, no. 1: 6. https://doi.org/10.3390/ijns7010006

APA Style

Cabello, J. F., Novoa, F., Huff, H. V., & Colombo, M. (2021). Expanded Newborn Screening and Genomic Sequencing in Latin America and the Resulting Social Justice and Ethical Considerations. International Journal of Neonatal Screening, 7(1), 6. https://doi.org/10.3390/ijns7010006

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