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The proposal by Chen and Wasserman (2017) contributes to a long-standing debate about the scope of prenatal screening services. With realistic prospects of fetal genome-scale sequencing from noninvasive maternal blood sampling (NIPW), their framework is timely. However, we outline a number of concerns regarding this approach, ranging from the philosophical to the social and clinical. A key concern in this literature is that the framework lacks a clear philosophical foundation. Despite the long history of prenatal diagnosis (PND), a central question remains regarding the core justification for these services.