This post by Andrew Pollack about the new prenatal blood test for Down Syndrome, The Quandary Posed by a New Down Syndrome Test, really rubbed me the wrong way.
The new quandary is the same as the old quandary: If you learned that you were carrying a fetus with trisomy 21, would you terminate the pregnancy? An estimated 92% of women in this position choose to abort.
The only difference is that women can now know sooner, via a less invasive test.
The new test can be administered as early as 10 weeks’ gestation, before the end of the first trimester when abortions are safer and easier to obtain. The woman probably doesn’t look pregnant at 10 weeks and she may not have told her friends and family that she’s pregnant. The rule of thumb is to share the news after the first trimester.
Unlike the old test, the needle goes into a vein to capture blood, not into the woman’s belly to capture amniotic fluid. As Pollack notes in his post, a certain percentage of women skip amniocentisis even though they would like the option to terminate their pregnancy because the test carries a small risk of miscarriage.
So, the new test has the potential to make a wrenching decision significantly easier for women, emotionally and physically.
Pollack talks to advocates for people with Down Syndrome who are concerned that more women will abort because of the new test.
Undoubtedly, there will be a few more abortions among women who would have liked to have the option, but who weren’t candidates for the old test. Pollack doesn’t mention the possibility that women who find out later in their pregnancies may be less likely to abort because they are more attached to their fetus or subject to greater social pressures because they’re already visibly pregnant.
Pollack doesn’t talk to women who have endured later-term abortions after amniocentisis or scrambled to find a provider who would perform the procedure.
It is unseemly to be nostalgic for an era where a small percentage of women end up having children they wouldn’t have chosen to bear because the critical test was too dangerous, or because they’re put off by the prospect of a later-term abortion when they would have been okay with an earlier one.
The most bizarre part of the post is a complaint by a researcher who is working to cure the cognitive disabilities that go with Down Syndrom who seems almost annoyed that early screening may reduce the number of people with the disease he’s trying to fix:
There is also an upsurge in efforts to develop drugs to improve the learning ability of those with Down syndrome. One of the drug researchers, Alberto Costa, who has a daughter with the condition, told The New York Times Magazine:
“It’s like we’re in a race against the people who are promoting those early screening methods. These tests are going to be quite accessible. At that point, one would expect a precipitous drop in the rate of birth of children with Down syndrome. If we’re not quick enough to offer alternatives, this field might collapse.’’
I know the guy has a daughter with Down Syndrome, so I want to cut him some slack. But does he realize how incredibly selfish he sounds? He has a personal stake in curing his daughter and a professional stake in his research career and he’s worrying out loud that his field might collapse because more women will have the option of terminating unwanted pregnancies.
Pollack notes that 99% of people with Down Syndrome report that they are happy with their lives. He doesn’t consider that, in an age of widespread prenatal testing, these people were probably born to a self-selected group of families who were confident that they could give a child with special needs what s/he needed to thrive. In a country without universal health care, or a strong social safety net, that’s not a foregone conclusion.
Some advocates for people with Down Syndrome are concerned that the new test will send the message that life with Down Syndrome is not worth living. This is at best a non sequitur and at worst an ad hominem. The implication is that anyone who would abort a fetus with Down Syndrome, or support someone else’s right to do so, must think of people with Down Syndrome as lesser human beings.
The fact that many women don’t want to raise a child with Down Syndrome does not imply that a life with Down Syndrome is not worth living. Some women who are carrying twins or triplets choose to selectively abort because they are not up to the task of raising two or three babies at once. This says nothing about whether the lives of twins or triplets are worth living.
I’m not exactly neurotypical myself and I consider my life well worth living. But I won’t be offended if medical science comes up with a prenatal test for what I’ve got and some women decide they’d rather avoid the significant extra hardships that my parents faced in raising me.
The fact that 92% of women who get a positive result for Down Syndrome with the later test choose to abort suggests that the major impact of the earlier test will merely be to reduce women’s pain and suffering at every point in the process: A less invasive test, a shorter period of uncertainty, and an easier abortion, if desired.
That is progress.
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