Down’s Syndrome Screening

This is not something I’ve thought much about before, but the in utero screening for Down’s Syndrome (and consequent decisions to terminate pregnancies) is more of an ethical storm than I’d ever imagined. Browsing around on the issue brought a few interesting bits and pieces:

In this reference a systematic review found the proportion of pregnancies terminated post-diagnosis of Down’s syndrome was 91-93%.

In 2002, ethics committees were on the whole opposed to screening, however the authors themselves question the validity of the opinions of the ethics committees studied to the answering of the ethical question.

This blog is rightly concerned with the way Sarah Palin’s anti-abortion stance and her Down’s syndrome have stirred the media, and asks for a frank discussion of the rights of the disabled. (Godwin’s Law violations will need to be forgiven)
The writer refers to the case of Baby Doe – an American controversy from the Regan era. I’d never heard of this case, but it involved the parents of a Down’s syndrome baby born with a tracheo-oesophageal fistula (in this case relatively simple and low risk to correct surgically) refusing corrective surgery and allowing their child to die of starvation. Supreme Court intervention was sought, but it was unsuccessful and the child died. The Baby Doe Law was enacted in response.

Lastly, this. What a thing to research!

My thoughts:

• It is very tempting (but wrong) to assume the moral high ground on this one and pour contempt on the parents who feel compelled to make the tragic choice to terminate. I will not do this.
• While selective abortion in the case of Down’s syndrome will never be acceptable to my personal ethics, I think a salient and less controversial issue is the provision of excellent supportive care to parents and children with Down’s, and the sensitive, ethical and moral genetic counselling of patients. This is the cause I will direct my energy toward, without abandoning my ethical opposition to abortion.

I think your position on this issue will have something to do with how you feel about disease. When is someone so unhealthy that it would have been better had they not been born? On what basis can one make that choice?

( Note: Clearly there is more involved in the decision to terminate post Down’s Syndrome diagnosis, but the question remains relevant since the expected quality of life of the baby is surely an important factor in the decision to terminate)