Genomic sequencing in newborn screening is an ethical minefield. Newborn screening started in the 1960s, initially involving only one condition: phenylketonuria. Subsequently, other diseases were added to newborn screening programs. However, newborn screening panels have evolved without true consensus of the most suitable diseases to include. Advances in genomic sequencing technologies mean that it’s now possible to test for thousands of diseases from a single newborn blood spot. But just because this technology is available, does that mean we should use it?