Sunday, January 29, 2012

Genetic Testing and Abortion: Is It Ethical?

Open the New York Times or peruse any of the nation’s most prominent news publications and you’ll almost certainly cross a headline reporting on the ever-debated topic of abortion in the United States. As we narrow in on the 2012 presidential elections, those on the frontline have become even more impassioned—there’s an incredible push from the left to protect a women’s right to choose, and an equally fiery force from the right with a “right to life” belief, a stance often muddled with the anti-abortion views of the Church.

Being the Massachusetts liberal that I am, I’m the first one to defend a woman’s (and family’s) options around family planning. What if, however, a woman chooses to keep her baby, only to make it approximately 20 weeks into the 40-week gestation period and be read the abnormal results of an amniocentesis (and other genetic tests)…and then decide to abort the fetus? The marvels of modern science have made is possible for man to intervene in arenas he was formerly unable to penetrate: surrogacy, conceiving without a father, pre-implantation gender selection, reduction….and now, advanced and accurate genetic testing. But, is it ethical to terminate a pregnancy on the grounds of developmental challenges? Is it okay to say I want a child, but only a neurotypical one?

On page 47 of The Starting Gate, Troy Duster, author of Back Door to Eugenics, says: “It is no coincidence…that genetically “at risk” populations overlap with social categories of race, ethnicity, and sex. Further, Duster suggests that, when such social-genetic categories influence public health policy, eugenic tendencies develop. Referring specifically to prenatal screening, Duster writes: “This kind of screen heavily implies that if one finds what one is looking for, then termination of the pregnancy is high on the list of potential intervention strategies…””

In 2007 The New York Times published an article called “Genetic Testing + Abortion = ???.” The article addressed the ethics of aborting a genetically abnormal fetus. Where many abortion rights supporters find it morally reprehensible to use abortion to obtain a “particular baby,” 70% of Americans in a National Opinion poll voted in favor of a legal abortion where a genetic defect is known. Some hold that it is exclusively a family matter, one that the government should stay out of.

“The Problem With an Almost-Perfect Genetic World” takes a decidedly different stance. Also a New York Times article, this one published in 2005, talks to the chief of self-advocacy for the National Down Syndrome Society. Ms. Peterson has Down syndrome, and starkly opposes inutero genetic testing for the judgment that it creates. There is an expectation of a “perfect” healthy child, and it’s an image that a baby with developmental delays would not fill for most families. Since about 90% of those carrying genetically abnormal fetuses choose to abort, the communities for all sorts of mental and physical disabilities are shrinking. Andrew Imparato, the president of the American Association of People With Disabilities says, “We’re trying to make a place for ourselves in society at a time when science is trying to remove at least some of us.” Fewer children with disabilities being born certainly lessens the imperative for funding research, and schools may not feel a responsibility to provide strong academic supports and take a stance of inclusion. Is it, perhaps, a woman’s moral obligation to birth these children to maintain community and promote awareness? Is this making a martyr out of a fetus?

Personally, the only reason I see to accept genetic screening is to prepare early-intervention tactics to increase cognitive skills as an infant in the event of genetic abnormalities, perhaps even limited to the over-40 set, as risk is higher with age. I see a big difference between aborting a fetus after a rape or as a teen, and aborting a baby on the grounds that it’s not “normal,” the latter an act I find disgraceful.


  1. The Starting Gate describes how low-birth weight babies face many challenges across the course of their lifetime including being at a greater risk of infant mortality as well as experiencing many health and developmental problems during infancy, childhood, adolescence, and even adulthood. Some of these problems include severe asphyxia, neonatal meningitis, symptomatic intercranial hemorrhage, hearing problems, vision impairment, lower respiratory infection, such as bronchitis and pneumonia, cerebral palsy, mental retardation, decreased cognitive functioning, cardiovascular disease, lung disease, and other chronic illnesses. In order to screen for such problems that may be due to genetic abnormalities, more and more families are opting to have genetic testing done on their unborn fetuses. Upon reading Troy Duster’s comment that, ”…if one finds what one is looking for [genetic abnormality], then termination of the pregnancy is high on the list of potential intervention strategies. . . ,“ I was initially taken aback because I too personally believe that while abortion is a viable option in certain cases, such as rape, it is not if a family is simply not happy having an “abnormal/atypical” child (47). However, after reading how some of these problems are extremely handicapping and lead to a significantly lower quality of life, I am not so sure that terminating a pregnancy if abnormalities are found via genetic testing (or somewhat similarly deciding not to resuscitate a pre-maturely born infant if it is known that this infant will likely suffer many incapacitating, long-term problems) is an definitely immoral and improper thing to do. In the case of the parenthesized, Conley writes about how despite one family’s wishes, their prematurely born infant was resuscitated according to hospital protocol and now at the age of 10 remains unable to walk and has undergone numerous operations. Heart-wrenchingly, the father of this infant feels that his “daughter suffers the consequences of [the hospital’s] medical experimentation each day” (88). Thus, in deciding whether or not abortion or not resuscitating an infant are viable options, we should consider the long-term effects that research has shown us that low-birth weight babies suffer from as well as the sentiments of the affected families, who will directly carry the weight/feel the implications of the decision at hand.

  2. I agree that abortion should not be abused, but it's somewhat narrow minded to view these women as mere fetus shoppers--picking and choosing whichever child is most genetically adept. Consider a low-income couple who can indeed care for one, presumably healthy child but who could never adequately care for, say, a severely autistic child. If you believe in a woman's right to choose, you should believe in a woman's right to choose regardless of her personal situation--be it a rape or a financial deficiency. If said mother were to have this child without adequate resources to provide the child with early intervention speech/language/occupational therapy, she would find herself in a difficult predicament and I don't think you (or I) would be in any position to judge what that mother could/could not do with her rights to genetic testing and abortion. These tests exist to predict how a mother can better care for her child and should she find herself unable to care for the child (and perhaps a group home or difficult adoption would be the only alternative), I do not find it "reprehensible" to utilize technology to change her situation.

  3. In response to Talia's point, I agree that the choice of whether to abort a handicapped child ultimately lies with the mother, whether I view it morally reprehensible or not. There are countless other factors that a mother must grapple with in order to come to a decision, such as income levels, age of the mother, household size, and genetic predisposition, and we cannot make such an overarching judgement. That being said, when 70% of Americans "voted for in favor of a legal abortion where a genetic defect is known," the issue of what constitutes a genetic defect comes into play. Would a threshold for what is considered a "defect" is come into existence? It is possible that every person has a different standard for which disorders are acceptable to abort, and which are not. Let's say an unborn child is found to likely develop bipolar disorder or autism upon birth. While I assume most mothers would not abort that child, I can't rule out the possibility that others may take that risk, thinking that they can just try again with another child. Instead of continuing to debate whether abortion in these cases are morally corrupt, there should be more of an effort to reform governmental child support to those with medical need. With more monetary aid to assist children, perhaps this will help mothers make a more comfortable decision regarding the abortion.