Abortion for disabled? (long)

[Guest guest]

Sunday, July 17, 2005

http://seattlepi.nwsource.com/opinion/232776_focus17.html

The abortion debate that wasn't

Under the radar, pregnancies increasingly are being terminated when

fetuses are prenatally diagnosed with disabilities

By GEORGE NEUMAYR

GUEST COLUMNIST

Each year in America fewer and fewer disabled infants are born. The

reason is eugenic abortion. Doctors and their patients use prenatal

technology to screen unborn children for disabilities, then they use

that information to abort a high percentage of them. Without much

scrutiny or debate, a eugenics designed to weed out the disabled has

become commonplace.

Not wishing to publicize a practice most doctors prefer to keep

secret, the medical community releases only sketchy information on

the frequency of eugenic abortion against the disabled. But to the

extent that the numbers are known, they indicate that the vast

majority of unborn children prenatally diagnosed as disabled are

killed.

Medical researchers estimate that 80 percent or more of babies now

prenatally diagnosed with Down syndrome are aborted. (They estimate

that since 1989, 70 percent of Down syndrome fetuses have been

aborted.) A high percentage of fetuses with cystic fibrosis are

aborted, as evident in Kaiser Permanente's admission to The New York

Times that 95 percent of its patients in Northern California choose

abortion after they find out through prenatal screening that their

fetus will have the disease.

The frequent use of eugenic abortion also can be measured in

dwindling populations with certain disabilities. Since the '60s, the

number of Americans with anencephaly and spina bifida has markedly

declined. This dropping trend line corresponds to the rise of

prenatal screening. Owing to prenatal technology and eugenic

abortion, some rare conditions, such as the genetic disorder Tay-

Sachs, are even vanishing in America, according to doctors.

" There really isn't any entity that is charged with monitoring what

has been happening, " says Imparato, head of the American

Association of People with Disabilities. " A lot of people prefer

that that data not be collected. But we're seeing just the tip of

the iceberg. This is a new eugenics, and I don't know where it is

going to end. "

" I think of it as a commercial eugenics, " says Kimbrell,

executive director of the International Center for Technology

Assessment. " Whenever anybody thinks of eugenics, they think of

Adolf Hitler. This is a commercial eugenics. But the result is the

same, an intolerance for those who don't fit the norm. It is less

open and more subtle. Try to get any numbers on reproductive issues.

Try to get actual numbers on sex-selection abortions. They are

always difficult to get. "

Intellectual arguments in favor of eugenic abortion often generate

great public outcry. Princeton professor Singer drew fire for

saying, " It does not seem quite wise to increase any further

draining of limited resources by increasing the number of children

with impairments. " Bob , the embryologist who created the

first test-tube baby through in vitro fertilization, has also drawn

protests for predicting that " soon it will be a sin of parents to

have a child that carries the heavy burden of genetic disease. We

are entering a world where we have to consider the quality of our

children. "

But these comments, far from being unthinkable, reflect unspoken

mainstream attitudes and practice. Only through political gaffes

(and occasional news stories) is eugenic abortion ever mentioned,

such as the time in 2003 when a blundering Hillary Clinton objected

to a ban on partial-birth abortion because it didn't contain an

exemption for late-term abortions aimed at the disabled. Women

should not be " forced " to carry a " child with severe abnormalities, "

she said.

In a Spectator interview, Sen. Rick Santorum of Pennsylvania

recalled his 2003 exchange with Clinton on the Senate floor in which

she endorsed eugenic abortion. " It was pretty revealing. She was

saying there had to be an exemption for disabled children being

aborted as opposed to healthy children being aborted, " he

says. " When she realized what she was advocating for, she had to put

in the general niceties. But I don't think you can read her comments

and come to any other conclusion than that the children with

disabilities should have less constitutional protection than

children who are healthy. "

He added that " the principal reason the Democrats defended the

partial-birth abortion procedure was for pregnancies that have 'gone

awry,' which is not about something bad happening to the life of the

mother but about their finding out the child is not in the condition

that they expected, that it was somehow less than wanted and what

they had hoped for. "

What Clinton blurted out is spoken more softly, though no less

coldly, in the privacy of doctors' offices. Strom, medical

director of Quest Diagnostics, which specializes in prenatal

screening, told The New York Times last year, " People are going to

the doctor and saying, 'I don't want to have a handicapped child,

what can you do for me?' " This attitude is shared by doctors who

now view disabled infants and children as puzzling accidents that

somehow slipped through the system.

University of Chicago professor Leon Kass, in his book " Life,

Liberty and the Defense of Dignity, " writes that " at my own

university, a physician making rounds with medical students stood

over the bed of an intelligent, otherwise normal 10-year-old boy

with spina bifida. 'Were he to have been conceived today,' the

physician casually informed his entourage, 'he would have been

aborted.' "

The impulse behind prenatal screening in the '70s was eugenic. After

the Roe v. Wade decision, which pumped energy into the eugenics

movement, doctors scrambled to advance prenatal technology in

response to consumer demand, mainly from parents who didn't want the

burdens of raising children with Down syndrome. Now prenatal

screening can identify hundreds of conditions. This has made it

possible for doctors to abort children not only with chronic

disabilities but common disabilities and minor ones. Among the

aborted are children screened for deafness, blindness, dwarfism,

cleft palates and defective limbs.

In some cases, the aborted children aren't disabled at all but are

mere carriers of a disease or stand a chance of getting one later in

life. Prenatal screening has made it possible to abort children on

guesses and probabilities. The law and its indulgence of every

conceivable form of litigation have also advanced the new eugenics

against the disabled. Working under " liability alerts " from their

companies, doctors feel pressure to provide extensive prenatal

screening for every disability, lest parents or even disabled

children hit them with " wrongful birth " and " wrongful life " suits.

In a wrongful-birth suit, parents can sue doctors for not informing

them of their child's disability and seek compensation from them for

all the costs, financial and otherwise, stemming from a life they

would have aborted had they received that prenatal information.

Wrongful-life suits are brought by children (through their parents)

against doctors for all the " damages " they've suffered from being

born. (Most states recognize wrongful-birth suits, but for many

states, California and New Jersey among the exceptions, wrongful-

life suits are still too ridiculous to entertain.)

In 2003, Ob-Gyn Savita Khosla of Hackensack, N.J., agreed to pay

$1.2 million to a couple and child after she failed to flag Fragile

X syndrome, a form of mental retardation caused by a defective gene

on the X chromosome. The mother felt entitled to sue Khosla because

she indicated on a questionnaire that her sibling was mentally

retarded and autistic, and hence Khosla should have known to perform

prenatal screening for Fragile X so that she could abort the boy.

Khosla settled, giving $475,000 to the parents and $750,000 to the

child they wished they had aborted.

Had the case gone to court, Khosla would have probably lost the

suit. New Jersey has been notoriously welcoming to wrongful-birth

suits ever since Roe, after which New Jersey's Supreme Court

announced that it would not " immunize from liability those in the

medical field providing inadequate guidance to persons who would

choose to exercise their constitutional right to abort fetuses

which, if born, would suffer from genetic defects. "

According to the publication Medical Malpractice Law &

Strategy, " court rulings across the country are showing that the

increased use of genetic testing has substantially exposed

physicians' liability for failure to counsel patients about

hereditary disorders. "

The publication revealed that many wrongful-birth cases " are settled

confidentially. " And it predicted that doctors who don't give their

patients the information with which to consider the eugenic option

against disabled children will face more lawsuits as prenatal

screening becomes the norm. " The human genome has been completely

mapped, " it quotes Winnick, a lawyer who handled one of the

first-wrongful birth cases. " It's almost inevitable that there will

be an increase in these cases. "

The combination of doctors seeking to avoid lawsuits and parents

seeking burden-free children means that once prenatal screening

identifies a problem in a child, the temptation to eugenic abortion

becomes unstoppable. In an atmosphere of expected eugenics, even

queasy, vaguely pro-life parents gravitate toward aborting a

disabled child.

These parents get pressure from doctors who, without even bothering

to ask, automatically provide abortion options to them once the

prenatal screening has diagnosed a disability, and they feel

pressure from society at large, which having accepted eugenic

abortion, looks askance at parents with disabled children.

The right to abort a disabled child, in other words, is approaching

the status of a duty to abort a disabled child. Parents who abort

their disabled children won't be asked to justify their decision.

Rather, it is the parents with disabled children who must justify

themselves to a society that tacitly asks: Why did you bring into

the world a child you knew was disabled or might become disabled?

Kimbrell points out that many parents are given the

complicated information prenatal screening yields with little to no

guidance from doctors. " We're leaving parents with complete

confusion. Numerous parents are told by doctors, 'We think there is

some fault on the 50th chromosome of your child.' A number of polls

have shown that people don't understand those odds. "

" There is enormous confusion out there and nobody is out there to

help them, " he says. The new eugenics isn't slowing down but

speeding up. Not content to wait to see if a child is fit for life,

doctors are exploring the more proactive eugenics of germline

genetic engineering (which tries to create desirable traits in an

embryo) and Preimplantation Genetic Diagnosis, which is used to

select the most desirable embryos after extensive genetic testing

has been done before they are implanted in mothers' wombs.

" The next stage is to actually start tinkering genetically with

these embryos to create advantages such as height, " says Kimbrell.

PGD is a " gateway technology " that will advance the new eugenics to

the point " where children are literally selected and eventually

designed according to a parent's desires and fears, " he says.

(Meanwhile, doctors are simultaneously reporting that children born

through in vitro fertilization are experiencing higher rates of

birth defects than the average population, suggesting that for every

problem scientists try to solve through dubious means, they create

multiple new ones.)

Many countries have banned PGD. But American fertility clinics are

offering it. Two-thirds of fertility clinics using PGD in the world

are in the United States, says Kimbrell. " Reproductive technology is

an unregulated Wild West scenario where people can do pretty much

anything they want and how they want it, " he says.

Darwin's cousin, Francis Galton, coined the term eugenics in

the 1880s. Sparking off his cousin's theory of evolution, he

proposed improving the human race through eugenics, arguing

that " what nature does blindly, slowly and ruthlessly, man may do

providently, quickly and kindly. " As eugenics passes through each of

its stages, man is indeed playing God but without any of his

providence or care.

Imparato of AAPD wonders how progressives got to this point.

The new eugenics aimed at the disabled unborn tell the disabled who

are alive that " disability is a fate worse than death, " he says.

" What kind of message does this send to people living with spina

bifida and other disabilities? It is not a progressive value to

think that a disabled person is better off dead. "

Neumayr is executive editor of The American Spectator.