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The legal framework governing bioethics in France appeared in 1994. The first laws relating to bioethics concerned respect for the human body, the gift and use of elements and products of the human body, medically assisted procreation (MAP) and prenatal diagnosis. In 2004, a new law came to revise the previous one and in 2011, the law of July 7 provided for a revision of the law by Parliament within a maximum period of 7 years, preceded by the organization of States General . The objective was to take into account advances in science and to better meet the expectations of society. In 2019, a new bill was presented by the Government and after much debate, on August 2, 2021, the new law relating to bioethics was promulgated and modified, among other things, the modalities of MAP and donation of gametes. [ABSTRACT FROM AUTHOR]

The article focuses on prenatal diagnosis of trisomy 21. It mentions the caregiver must give clear and objective information to pregnant women and couples, that can serve as a support for dialogue between the carer and the pregnant woman, between the carer and the couple and allow future parents to discuss and decide whether to commit or not in the screening process.

Background: Medical termination of pregnancy (MTP) is done because of medical conditions concerning the fetus - i.e. cardiac pathology, central nervous system malformation, genetic disorders. . .- or the mother, without any delay of restriction. In 2019, 6 848 MTP were performed in France. Prenatal diagnosis organization:MTP is part of a process initially of screening and then of prenatal diagnosis through an obstetric ultrasound. Amedical framework is necessary in order to respect all the different stages allowing a global approach for parents. Given its complexity and in order to avoid any drift, MTP is regulated by a legislative framework which has evolved over time. Deciding factors and prenatal diagnosis limits:MTP decision supposes a progressive way starting by the announcement of fetal malformation or severe maternal pathology. Intrinsic and extrinsic factors will have an impact on the patient's reflecting process and will raise many questions concerning prenatal diagnosis limits. Limits concern both the patient and the medical team. They can be due to ethical or eugenic considerations. Other factors such as the understanding of the language, the socioeducational level, the different socio-economic evolutions or even the religion will have a direct impact on the ability of the patient to decide in full awareness of the outcome of the pregnancy. Finally, another limitation relates to the sometimes fine line between voluntary termination and medical termination of pregnancy. Conclusions: MTP is a complex process which leads to wonder about life and death rights both by the request of the couple and by the acceptance of the multidisciplinary team. MTP is legally regulated in a non-exhaustive way, leaving room for the evolution of medicine, thus making it possible to adapt to each situation. MTP is and must remain a last resort for patient management. MTP must constantly be at the center of ethical debates with a continuous questioning to avoid falling in eugenic practices. Hence the importance to maintain a degree of liberty with a rigid framework. [ABSTRACT FROM AUTHOR]