Screening for Cystic Fibrosis and Down's syndrome is to be made available to all mothers and pregnant women under new government proposals unveiled in April by Public Health Minister Yvette Cooper (BBC News Online 2001; 30 April). Mark Barron, communications manager of the Cystic Fibrosis Trust, is not alone in hailing the proposal as 'fantastic news'. And it does sound like it.

At present only 20% of babies in the UK are screened for cystic fibrosis and earlier diagnosis must mean earlier treatment and better outcomes. A combination of therapeutic measures including mucolytics, airway clearance techniques, anti-inflammatories, antibiotics, pancreatic enzyme supplements and the advent of specialised treatment centres have meant vast improvements for CF patients' quality and indeed quantity of life. In the last 30 years alone the median lifespan of CF patients has more than tripled from eight years to 30 years (What is CF). And then there is the future potential of gene therapy.

But just a minute! Were we talking about screening of babies or screening of pregnant mothers? There have been many advances in care for Down's syndrome children too, more in the educational, supportive and surgical (for associated anomalies) fields than in CF; and yet of the 1,000 Down's syndrome children picked up on antenatal screens each year 95% are aborted.

Furthermore there is now a clear policy to search for those who have previously escaped the net through being born to younger unscreened mothers. If the government has its way, despite all the furore about not discriminating against Down's syndrome children for heart surgery, we can expect an even bigger drop in numbers born. Am I far-fetched in my concern that the same agenda might operate for cystic fibrosis; is the push for CF screening just a way of ensuring that these little people, who cost a lot emotionally and financially to care for, are going to be weeded out in a similar way to those with trisomy 21? I wonder.

If that is indeed the real agenda then as Christian doctors we must be ready to oppose it. Jesus laid down his life for the weak and the art of medicine, which he has had so much influence in shaping, is about strengthening the weak - not about eliminating them.