Every Child Is Priceless: Debating Effective Newborn Screening Policy (Letter to the Editor‪)‬

To the Editor: "Ethics, Evidence, and Cost in Newborn Screening," by Mary Ann Baily and Thomas H. Murray, and "Expanding Newborn Screening: Process, Policy and Priorities," by Virginia Moyer, Ned A. Calonge, Steven M. Teutsch, and Jeffrey Botkin (May-June 2008) raise significant questions, but I will identify only a few that to me appear most important. Baily and Murray are very critical of the decision-making process reflected in the report issued by the American College of Medical Genetics, but some of their comments suggest that they have not carefully reviewed the report, which is over three hundred pages. For example, although the experts who drafted this report felt that benefit from newborn screening should be considered more expansively, all of the conditions recommended by the ACMG report for the core panel are serious conditions, and all are judged to benefit from specific, traditional treatments. No condition was added because of the expanded benefit espoused in the group's recommendations. In reaching these conclusions, the broadly based panel reviewed what published information exists (due to the rarity of the conditions), as well as expert opinions. It is particularly unfortunate that these authors have singled out the expansion of the excellent newborn screening panel in Mississippi and positioned this discussion in a fashion that could suggest that this expansion might have been related to the increase in infant mortality because scarce resources have been allocated to newborn screening.