A NY Times opinion piece asks the question, Does Down Syndrome Justify Abortion? The answer is easy: yes. Yes it does. But then, so does having 46 chromosomes.
The only questions you should ask are whether the mother wants the child, and is well-informed about the risks. If she doesn’t, she doesn’t have to “justify” getting the abortion.
The article does mention something I don’t like: the parents chose to keep the child (and that’s something I support, too — pro-choice means what it says, it is the parents’ choice), and they got a lot of pushback, with the medical staff emphasizing the dangers and compromises to a Down syndrome child, and mildly pressuring them to get an abortion. That shouldn’t happen. Inform them of the risks, but really, it is entirely the parents’ choice.
I wonder if, when a pregnant woman is found to be carrying a healthy wild-type child with 46 chromosomes, the doctors and nurses then urge her to get an abortion because of all the dangers of pregnancy and childbirth, and the horrible excess work and worry and anxiety that having any child causes? If all we cared about was reducing harm, it’s absolutely insane that society allows women to inflict pregnancy on themselves.
But just as no one has to justify getting pregnant, no one should have to justify ending a pregnancy.
Exactly, abortion requires no justification on moral grounds.
PZ:
Exactly. The sheer amount of people who do not get this is staggering.
The NYT OpEd does not appear to actually answer the question itself, but leaves it hanging, “for thought”.
Is how I read it.
It points out the currant frequency of Down’s being used as justification, and the potential eugenic implications. Also addresses the conflicted message of forced birth vs reducing both medicare and aid for disabled.
I agree with the OP that the only justification needed for “termination” is the choice of the person involved and no one else’s. stop. full stop. end. finis.
Well, that’s what the parents say anyway. Due to confidentiality, we’ll never hear the medical staff’s side of the story.
I think that healthcare professionals that regularly deal with people who are in denial about what they are really in for develop an approach of being very blunt and frank about these issues. The pro life propaganda machine certainly puts out a lot of misinformation that minimizes the challenges of having a child with Downs. There’s fine line between “pressuring” and informing people who don’t necessarily want to be informed.
Did the staff misread the choice here as “not getting it” and reiterate too forcefully? Perhaps. Did the parents view medical advice that went against their choice more negatively than is really justified? I think, perhaps on this, also.
The question makes no sense at all to me. Can you justify forcing another person to risk their life for your religious beliefs is a better one.
slithey tove, #3
I’ve heard these two lines of reasoning from other people as well, but they don’t seem to make any sense to me.
For the first point:
Is there an maximum acceptable number of parents who are allowed to say they don’t want a child with Down Syndrome?
And for the second:
There is nothing eugenic about saying you don’t want to give birth to a baby with Down Syndrome. Saying “I don’t want to have this baby with Down Syndrome” is nothing like saying “the world should be rid of Down Syndrome human beings”.
Millions of children will grow up to be horrible people, Pittsburgh Steelers fans for example. No One ever warns potential mothers about the hazards of such an occurence.
Odd wording, PZ. The choice that was made here was to continue the pregnancy. Nowhere does the article suggest that either friends, family or doctors ever suggested that they not keep the child.
chris61,
I chose not to have children because I do not like the world. Was that immoral?
Marcus @ 10:
I chose not to have children because I don’t want them. Je m’en fous if it’s immoral to anyone else.
Chris61: If you can’t learn to read, GET THE FUCK OUT OF HERE.
From the article:
You do this all the time, and your stupidity is pissing me off.
chris61
Before you respond to PZ, have you read the new commenting rules?
https://proxy.freethought.online/pharyngula/rules/
I remember reading an article in DISCOVER magazine in the 1980s titled “Abortion of Defective Twin”, about a pregnancy which consisted of twins, including one with Down’s Syndrome, while the other was normal. The defective twin was pierced with a needle which stopped his heart, and he was later stillborn while his brother was born alive and well. This article did not bother me at all, but the following issue had at least two letters from readers outraged over the article. That was my first exposure to the abortion issue.
“the medical staff emphasizing the dangers and compromises to a Down syndrome child, and mildly pressuring them to get an abortion. That shouldn’t happen.”
IMHO some people being presented with unadorned facts will complain they’ve been put under pressure. Add the fact that they may also be hostile about abortion and that complaint is inevitable.
ranmore
A good thing that you have apparently decided that those people must be lying. Even when they say they are pro choice. Another case of “people, especially female ones, unable to understand their own lives and in serious need of professionals telling them what to do, eh?”
re Saad @6:
sorry I was not clear in my referral to the “eugenic implication” …
To clarify: I was referring to the concept that; some may eventually suggest that ALL Down Syndromes be aborted (to keep the gene line pure). Not saying that it is currently advocated. I just read that into the OpEd. maybe my reading comprehense is faling…
I may have also left ambiguous my stance on that “concept”. IE I most abhor such a concept.
as for that first point, you referred to: my phrasing was poor. The “currant frequency of Downs being used as justification” meant to refer to the OpEd referring to how often it is used as initial justification. Not whether it is correct or incorrect to do so. Simply noting its frequency.
As hard as it was, I am grateful now for the pediatrician’s shitty bedside manner (Air Force colonel in a military hospital) when my daughter with DS was born. Sugar coating the potential issues would have just made things worse down the road. I have a feeling some of the ‘pressure to abort’ scenarios are simply doctors being honest, but since I am not there hearing the conversations I don’t know this. It is just a gut feeling based on how I have heard some people respond. The pro-life and some of the DS communities have seriously downplayed what Trisomy 21 is. Yes, there are people who are damn close to ‘normal’ intelligence. But for every one of those there are several with fairly significant developmental disabilities, and a few more who are severely disabled. There are a host of health issues- 60% with heart defects, many needing open heart surgery. Something like 80% with some measure of hearing loss, some severe. Higher risks of bone and blood cancers. Potential for Alzheimers as young as age 40. GI tract and respiratory problems.
I’ve had some of these people get downright nasty when I say I am absolutely for the elimination of Down syndrome. I don’t mean by aborting every fetus- that is an individual choice. But if Trisomy 21 disappeared tomorrow it would be a good thing. “You’re being discriminatory!” Would you say the same thing if I said I am pro elimination of cancer? It’s not “eliminating diversity” it’s getting rid of a syndrome that is by it’s nature a negative impact. That doesn’t mean we should not embrace and cherish the people who are here and give them the very best opportunities we can. But pretending that they are just ‘a little different’ ignores a host of problems. Most embryos with the trisomy are miscarried. It’s not simply a character trait, like red hair.
In the end though it comes down to nobody ever having to justify why they have an abortion. Period.
Thank you for writing that (and from a position of really knowing what you’re talking about).
The last few years have been bad for Canada’s reputation: we have The Execrable Harper in office; we censor scientists; we treat our aboriginals abominably; our greenhouse-gas record is deplorable. Because of these and other issues I have not been so sanguine in declaring myself Canadian.
But we have one thing that I don’t think any other state in the world has: not a federal single law on abortion. Not one. Not a law, not a clause, not an enforced political protocol in treatment, not one. Abortion is strictly between a woman and her doctor. Period.
It’s been this way for twenty years now, long enough to see what the results of such an approach are. And it’s been JUST FINE. Our population hasn’t crashed, our daughters aren’t pimping themselves out on the street, nobody’s selling baby parts . . . And it makes reading articles like this stranger and stranger every year. Let’s hope the pendulum swings back in the US following the 2016 election.
Ranmore @ 15:
Sure, that might be the case with some people. That said, unless you were with this couple every step of the way, you don’t know that their ‘complaint’ was inevitable, or the result of not being able to cope with unadorned facts. I have a problem with your use of the word complaint, as you might have guessed. Stating the unadorned fact that they experienced opposition and pressure is not a complaint, and in using that word, you’re painting the parents in as bad a light as possible. Why do that?
I’m pro-abortion. I’m pro-choice. I’m pro-autonomy. With all that, I am very aware of the pressure often exerted on women or couples where there could be a problem with a pregnancy, let alone the pressure exerted when there is a definite problem. I’ve been there with friends, heard and felt that pressure first hand. The plain, unadorned truth of the matter is that women experience interference and pressure no matter what, when they are pregnant. There really aren’t that many people who are capable of keeping their mouths shut when it comes to a pregnancy, and allowing a pregnant person the peace of making their own choices, about everything.
slithey tove, #17
I think I should have been clearer too. I knew that’s not your stance. I wasn’t responding to you directly, but to those points in general. I quoted you since you were the one pointing them out.
I disagree with the last line of PZ’s argument. I feel strongly that one should have to justify bringing a pregnancy to term. Producing an unwanted child, or a child who you have no chance of supporting to adulthood is reprihensible.
cnocspeireag @ 23:
Being an unwanted child, I seriously sympathize. However, forcing anyone into justifying carrying a pregnancy to term is happily announcing to women everywhere: “You have no autonomy!” That’s no good, no matter which direction it comes from.
Caine@#11: exactly. Not choosing to have children at all is just an edge-case in the whole “you should carry a child to term” argument, though. If someone believes a blastula is a potential life, so is an egg. If someone believes that a blastula has rights, so does an egg. If someone believes a sperm or an egg are potential lives that must be protected then it’s immoral not to bring them all to term. That’s problematic, of course. That’s a flaw in the potential life reasoning; it’s not my problem.
When I had my vasectomy entire armies of humans never happened. Oh, the horror!
This is timely for a major argument – one of many over the past several months – in the Mensa Atheists group. There are so many of these Mensa losers who believe that all birth “anomalies” be aborted, but especially Down Syndrome embryos/fetuses. Certainly DS patients do have an increased risk of having DS children, but it’s very uncommon for a DS woman to get pregnant (only 50% are fertile to begin with) or to continue a pregnancy, and rare for a DS man to impregnate someone. In fact, there are only two documented cases of DS men having fathered a child, although there could be more. I worked as a contraception educator for the federal family planning program. Every single developmentally disabled patient I worked with chose abortion if pregnant, and sterilization as their BCM. The problem with sterilization is that many doctors refuse to perform the procedure on developmentally disabled people, fearing a lawsuit. I couldn’t find a single such lawsuit in my old state’s history, but if they don’t do the procedure, they’re never going to be liable.
Interestingly, I always knew a conservative Catholic physician would do it, even though they opposed contraception for their other patients. Apparently, their Catholicism didn’t interfere with sterilizing “retarded” people. They’re scum, but useful scum.
I agree with everything in the initial post. No fascist interference with anyone’s genitals, period. They’re our own genitals, and no one else should have a right to whatever they do or don’t do.
cnocspeireag @ 23:
To expand on what Caine @ 24 said about autonomy, consider the following questions:
To whom should one have to justify bringing a pregnancy to term? A branch of government? A religious entity? The medical profession? Your employer?
Who should have to justify bringing a pregnancy to term? Everyone? Only those who fall below a certain income? Only those who are not religiously/ethically bound to bring a pregnancy to term?
The loss of autonomy is obviously problematic when you try to consider how such a process might work.
Seconding the unacceptability of dismissing or “correcting” people’s accounts of their own lived experiences and interactions.
Abortion is already justified on the grounds of bodily autonomy. This ploy smacks of hoping to generate a new wave of outrage along the lines of ‘pro-choice people want to purge disabled people!!2!’
cnocspeireag
So all parents are reprehensible, I guess.
Because nobody can guarantee that they can support their child into adulthood. Not even tenured professors. They only have a pretty good chance of doing so.
Apart from the inherent poor-shaming, of course…
Holms
Have you actually read the piece?
Because it is clearly written from a pro-choice PoV, strongly opposing Republican attempts to outlaw abortion after the diagnosis of DS. That’s the crux of the article: This couple’s choice was to go through with the pregnancy and have a child with DS, but it was important that the coice was theirs and it’s something nobody should interfere with.
+++
Also, I’ve been pregnant three times, I’ve given birth twice, I know a lot of people who have been pregnant. I’ve seen the best and the worst of “bedside manners”*. I’ve had wonderful doctors, nurses, midwives. I’ve also had a bully who tried to make me deliver in “his” hospital and who pulled a “dead baby card” on me. I’ve also had two atheist men tell me that I was just one of those uppity people who think they know better than the doctor, a narrative for whoch they needed to ignore that my opinion was supported by this guy’s direct superior, the urology professor, the chief Ob/Gyn of the university hospital, my regular Ob/Gyn and my team of midwives (actual medical professionals).
I know women who came to the hospital because they felt there was something wrong, were told they were just hysterical first time mothers, given something to sleep and woke in the middle of a stillbirth.
I have consoled women who were sent to the university hospital without any information as to why they were actually sent there and what that meant and who were totally desperate, because since they were not an emergency, they had to wait 5 hours instead of the usualy three ’cause they didn’t have an appointment.
I have also been through the prenatal circus and looked at all the tests that are often pushed at parents without concrete benefits (except for the money being made).
Ever heard of a Tripple Test? Most useless thing ever because all it gives you is a statistical probability, but when I was pregnant many Ob/Gyns pushed it at parents because it had to be paid for in cash (insurance understanably denied coverage).
So, no, I have zero problems with beliving these people that they were being pushed, that they were being assumed incompetent. Especially not since the article isn’t written as a “pro choicers want to kill disabled babies” hack piece, but a heartfelt pro-choice account of a personal experience, pleadng to leave the choice to parents.
*Can we just drop that word? Caring for your patient as a complete human being and not just a body part vaguely attached to a head is part of your professional conduct and not some additional but non-necessary “soft skill”.
Sarah Palin wants abortion to be banned in cases where the baby will have Down Syndrome.
And of course can’t grasp the idea that just like other people, pregnant people can make their own medical decisions too:
Terribly easy for Palin, who likely leaves her child with DS in the care of a nanny when he isn’t being used as a political prop.
“I don’t think because the child has one extra chromosome they should be able to snuff that life out,” Nature usually does the work, in that trisomy 21 is the only survivable extra chromosome syndrome in general. Most embryos with a genetic anomaly are quietly miscarried very early on. Trisomy 18 fetuses may make it to term but 90% die in the first month of life, and the rest shortly thereafter. Dog forbid women decide on their own how to cope with a pregnancy, whether the festus is genetically ‘normal’ or not.
Thanks to massive medial intervention. It’s not like “requiring open heart surgery” usually means “lives to the ripe age of 85 and dies at home in bed”
So the argument is not about abortion, it’s about the competence of medical professionals. Unfortunately, every argument with “abortion” somewhere in the title or in the text, turns into an argument about abortion.
My problem with trying to outlaw abortion in this case, is that if the state does so, it should take far more responsibility for providing monies for medical, child/adult care, and rehab than it does at the present time. It should essentially pay for everything so that the parents are not punished for having the child.
@ 33 Exactly. My daughter has been extremely fortunate health-wise- a very minor hearing issue, two surgeries to correct a lazy eye, ear tubes, a bone marrow biopsy to rule out leukemia or lymphoma. She is not the norm, and even as healthy as she is her life expectancy is less than the “average” due to premature aging and such.
spamamander@36:
I find it interesting that you’ve chosen to put scare quotes (or what I take to be scare quotes) around “average”, but not around “premature”. Both words seem (to me) to be quantitative statements (albeit with a very coarse granularity) about statistical distributions, without (again, to me) any of the extra baggage of the word “normal” (baggage which doesn’t usually attach to the phrase “the norm”, as your use of it suggest). Could you expand on your reasons for your choice (if it was in fact deliberate)?
In all honesty it is force of habit. Many people are offended by any use of average in regards to persons with Down syndrome (because it implies that the people are not). Some people have gone so far in their determination to see trisomy 21 as just something “different” that insinuating in any way they are not exactly like everyone else except for a few small changes in appearance that it’s almost a denial. I’ve made some enemies in a few online communities by being realistic about my daughter, who I love with everything I am, but who will always have challenges.
Do you know how much fun explaining acute leukemia treatment is to a nice young person with the intelligence typical of a person with DS? Well, the answer is “not so much, but more than the person going through the treatment was having.”
Want to keep a fetus that has DS? Be my guest! But be prepared to have an average child with DS, not the “perfect” child that the “inspirational” media tells you you’ll have. And the average DS child requires multiple surgeries, never learns to live independently, and dies young. I don’t think that’s something I’d want to do to my child, but I’m not going to force my opinion on them. If only they’d return the favor.
That’s why part of the equation is that prospective parents should be informed of the risks.
Yep.
Honestly I have NO idea what I would have done in case of a DS diagnosis back when I was still procreating.
Now, I don’t care about the number of chromosomes, I’m done with that.
I’ve garnered a lot of hate posts by my admission that had I known I carried a fetus with trisomy 21, I likely would not have carried to term. I was 23, with one child already, living on my then-husband’s enlisted airman income. Even in better financial straits it wouldn’t have mattered, really. I was diagnosed after her birth with Major Depression, Generalized Anxiety, and ADHD, things I likely have had for a lifetime but intensified with PPD. Not an ideal candidate for raising a special needs child. Plus, horrible person as I am, I wouldn’t want to bring a child into the world with all these health risks and developmental disabilities. You’re supposed to pretend it’s all sunshine and roses and trips to Holland.
Somehow it means I hate my daughter to say I wish things had not been as they were. Have they ever been in a room where their 18 month old child is getting a bone marrow biopsy? You can hear the “crunch” as the needle goes through the pelvic bone.
This is exactly why I’m not a pediatrician. 18 and 80 year olds with AML are bad enough, but at least you can explain to them what’s going on. 18 month olds just don’t have the capacity to get it yet. All they know is that you’re hurting them.