07-17-2005, 06:42 PM
SEATTLE POST-INTELLIGENCER
http://seattlepi.nwsource.com/opinion/23...cus17.html
The abortion debate that wasn't
Under the radar, pregnancies increasingly are being terminated when fetuses are prenatally diagnosed with disabilities
Sunday, July 17, 2005
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 Andrew 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 Andrew 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 Peter 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 Edwards, 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. Charles 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 Stephen 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?
Andrew 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.
Charles 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.
Andrew 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."
--------------------------------------------------------------------------------
George Neumayr is executive editor of The American Spectator.
© 1998-2005 Seattle Post-Intelligencer
http://seattlepi.nwsource.com/opinion/23...cus17.html
The abortion debate that wasn't
Under the radar, pregnancies increasingly are being terminated when fetuses are prenatally diagnosed with disabilities
Sunday, July 17, 2005
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 Andrew 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 Andrew 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 Peter 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 Edwards, 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. Charles 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 Stephen 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?
Andrew 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.
Charles 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.
Andrew 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."
--------------------------------------------------------------------------------
George Neumayr is executive editor of The American Spectator.
© 1998-2005 Seattle Post-Intelligencer