This is an interesting development:
A first-trimester screening test can reliably identify fetuses likely to be born with Down syndrome, providing expectant women with that information much earlier in a pregnancy than current testing allows, according to a major study being released today.
The eagerly awaited study of more than 38,000 U.S. women — the largest ever conducted — found that the screening method, which combines a blood test with an ultrasound exam, can pinpoint many fetuses with the common genetic disorder 11 weeks after conception. That allows women to decide sooner whether to undergo the riskier follow-up testing needed to confirm the diagnosis.
“This is a big deal for women. It’s going to have a big impact on care for women, not just in the United States but throughout the world,” said Fergal D. Malone of the Royal College of Surgeons in Dublin, who led the study published in today’s issue of the New England Journal of Medicine.
The obvious immediate impact will be felt strongest in the context of the abortion debate. I remember hearing a physician (a pediatrician from California, if I remember correctly) discussing how few Down Syndrome patients he sees compared to 20-30 years ago, and explained that this, in large part could be explained by couples electively choosing to abort babies who had signs of severe disability. I have, of course, no way to verify the anecdotal evidence offered by the good doctor, but it is something to think about.
While we have discussions about whether designer babies are a rubicon we want to cross, it may be that people already are making decisions simimlar to this, and it opens up a whole range of ethical and moral questions. I do remember that one of the main early opponents to studies demonstrating a genetic component to homosexuality came from within the homosexual community, for obvious reasons.
Just things to think about, and more evidence that life (or at least the tough decisions) does not necessarily get any easier with great advances in technology.
Steve
My wife was pregnant recently, and we had to decide what sort of testing we would have done. Although we are both pro-choice, we felt there was no way we could ever abort a baby because of Down’s syndrome. I’d imagine there could be a problem which was so serious we’d choose to abort, but it would have to be extremely bad (for example, something that would be fatal within the first year).
One thing we did discuss, though, is that we were glad the choice was there, for other couples who might not have the resources to raise a special-needs child.
Of course, it’s always uncomfortable making decisions about life and death, which is why I prefer to leave it all up to individual decisions, rather than a matter of government policy.
Shygetz
It is absolutely a factor in deciding to have an abortion. People who think about this have to decide–either a fetus is a human with all the rights, and therefore shouldn’t be aborted except under truly extraordinary circumstances (danger to the mother, etc.), or else a fetus is property, and can be aborted for any reason, including developmental disorders (or eye color, or gender). I don’t see how you can have it both ways.
Marcos
Just things to think about, and more evidence that life (or at least the tough decisions) does not necessarily get any easier with great advances in technology.
Hey speak for yourself, I’ve been watching a lot of ‘Ghost in the Shell’ lately, and parsonally I can’t wait to go full cyborg come 2030. I’ll be 60 by then, so it’ll be just the right time to trade up.
Steve
Let me be clear, I think anyone who would get an abortion on the basis of eye color (as if such a thing were even possible) is obviously a moral monster, but sometimes your freedom includes the freedom to make bad decisions.
The issue of whether massive numbers of people are having “abortions of convenience” reminds me of the old “welfare queen” debate, where one side fervently believes this is the exception and the other side fervently believes it is the rule. All I know is that I don’t know a single person who believes abortion is a decision to be made lightly.
I would completely be in favor of a hypothetical law that says “no one shall get an abortion unless they have a good reason,” but the problem is, I don’t want to put the government in charge of defining what a good reason is. I have my own opinion, of course, but until they make me king, I’m going to make my own decisions and let other people make theirs.
Mr Furious
I think this is a long way from “crossing the Rubicon to designer babies.”
I know my wife would not hesitate to keep a Downs baby, if we were in the position where we wanted to have a baby. I would be slightly more hesitant, but I would ultimately be fine with it.
Others perhaps not. We have friends who went through all the testing available because they were extremely concerned about it. Having a baby with birth defects or Downs is a tremendous commitment that some might be less equipped for. Financially, parenting-capability, emotionally—any number of factors that asshats in Kansas or DC should have NO say in.
Veeshir
I have a friend whose wife was pregnant. They found that the baby had spina bifida.
They decided to have the baby. I didn’t agree with that decision. That child’s life was going to be hell.
The pictures of the mother and baby were about the most depressing things I have ever seen. It was malformed and living in a cocoon of tubes, she couldn’t even pick it up.
It died less than a week after birth and after suffering terrible pain the whole time when it wasn’t drugged into a stupor.
I always wonder if a Dr or nurse took matters into their hands.
Krista
I think that a lot of people (myself included), have seen enough people with Down Syndrome who lead productive, happy lives, that we would not consider abortion. However, should the parents not have as much time as possible to emotionally prepare, do research on the condition, and basically prepare themselves as much as possible for a child with special needs?
And in response to Shygetz, there have been cases where you could have it both ways. I read an article recently about a woman whose child was born with Tay-Sachs syndrome, suffered horribly, and died at the age of 5. She said that she wishes that she had known, because she would have aborted. Not to spare herself, but to spare her child 5 years of nothing but agony.
bev
Perhaps the pediatrician you refer to is seeing fewer Down’s Syndrome babies because of better genetic counseling and a more educated populace. Oddly enough, the average age for women giving birth is getting higher. Even so, perhaps better access to more reliable birth control (at a later age) is why there are fewer Down’s Syndrome children out there.
Maybe more people have children with Down’s (it can range from almost unnoticable to severe) just aren’t showing up in his practice. If a woman discovers that she is carrying a fetus that *may* have Down’s – and amniocentesis can give false positives, as this test also does – she can then get all sorts of help from all manner of service organizations. Perhaps those organizations recommend a specific group of doctors in a given area and those are the pediatricians that are handling the Down’s caseload.
At any rate, like other posters have said, though it makes for great firey debate to go from “better genetic testing” to “fewer children with Down’s Syndrome (or other disabilities)” to “more abortions” to “designer kids,” I just don’t see it happening. Is there a study out there that says that of X number of women who tested positive for a Down’s Syndrom fetus, Y% got abortions and therefore the number of Down’s children is well, down? That’d be the data to see. Until then, correlation does not equal causation.
Lines
Once again the cries from the right of “designer babies” begins after the appointment of Alito appears more and more solid. Its the beginning of the next battle over abortion. Why do the tactics continue to remain the same? Demonizing and exageration become the main weapons in this war.
I just find the timing of this “discovery” to be very suspect. Making abortion look like a method of birth control has been a consistent mode of attack, and this is just a slightly subtle alteration of that.
Hmmm, it appears my tin-foil beany slid off to the side.. Better fix that.
Knemon
[This post has been therapeutically aborted by its author due to signs of Godwin’s Law violation]
Shygetz
Krista–How is that having it both ways? Either you admit her right to abort for whatever reason she chooses, or you deny her that right due to the fetus’s right to live, regardless of its maladies (we all agree that we cannot legally murder a Down’s child once born, I hope).
Krista
Shygetz – well, I think that in this particular instance, she saw her fetus (in retrospect, of course), as being a human being with rights, but she also thought that she should have had the say in determining whether or not her child should have been born.
It’s really the flip side of the euthenasia/assisted-suicide debate, isn’t it? Does a person’s right to life overrule their right to not be in constant pain and agony? Are there actually right-to-lifers out there who think that a child with Tay-Sachs or Spina Bifida, or what have you, should live, and suffer, and then die an agonizing death, because it’s God’s will?
fwiffo
Shygetz – your argument greatly oversimplifies the realities of pregnancy. There are more points of view than just “life/personhood begins and conception” and “life/personhood begins at birth”. It’s not a black-and-white issue as much as people would like. The most strident “pro-life” position argues that even the use of barrier-type contraceptives is immoral (e.g. Catholic doctrine against condoms). Others would argue that the merger of sperm and egg is the magic moment when a unique person is created. Of course, if that’s true, then the great majority of pregnancies are spontaneously aborted because only a fraction of fertilized eggs successfully implant (medically, implanation is usually considered the start of pregnancy.) Even if that is the case, the merger of sperm and egg isn’t an instantaneous event – it takes time.
Even after implantation – is that cluster of cells a person? It has no brain, no organs at all. If you are religious, perhaps you believe it has a soul. I’m not though – I don’t believe in souls or spirits. I have a hard time arguing that a clump of cells with no organs, no distinguishing features of any kind – is a person.
What about IVF treatments? More fertilized embryos are created than are ever used – are those persons with rights that are being tossed aside?
On the other hand, I can’t easily argue that a third-trimester fetus which could concevibly survive outside the womb is somehow magically different than a prematurely born baby. But I also know that third-trimester abortions are rare, that they can be (and are) restricted legally, even under the context of Roe, and that they are almost always done for serious medical reasons.
It’s clear to me, though unsettling, that there isn’t a magic line you can draw where you can say “Ah-ha! This is now a person and it wasn’t five minutes ago!” There is a great big gray area. It’s uncomfortable to think about the idea that there is a non-person becoming a person in some sort of gradual way.
fwiffo
A bit of a stream of conciousness rant here:
Shygetz – your argument greatly oversimplifies the realities of pregnancy. There are more points of view than just “life/personhood begins and conception” and “life/personhood begins at birth”. It’s not a black-and-white issue as much as people would like. The most strident “pro-life” position argues that even the use of barrier-type contraceptives is immoral (e.g. Catholic doctrine against condoms). Others would argue that the merger of sperm and egg is the magic moment when a unique person is created. Of course, if that’s true, then the great majority of pregnancies are spontaneously aborted because only a fraction of fertilized eggs successfully implant (medically, implanation is usually considered the start of pregnancy.) Even if that is the case, the merger of sperm and egg isn’t an instantaneous event – it takes time.
Even after implantation – is that cluster of cells a person? It has no brain, no organs at all. If you are religious, perhaps you believe it has a soul. I’m not though – I don’t believe in souls or spirits. I have a hard time arguing that a clump of cells with no organs, no distinguishing features of any kind – is a person.
What about IVF treatments? More fertilized embryos are created than are ever used – are those persons with rights that are being tossed aside?
On the other hand, I can’t easily argue that a third-trimester fetus which could concevibly survive outside the womb is somehow magically different than a prematurely born baby. But I also know that third-trimester abortions are rare, that they can be (and are) restricted legally, even under the context of Roe, and that they are almost always done for serious medical reasons.
It’s clear to me, though unsettling, that there isn’t a magic line you can draw where you can say “Ah-ha! This is now a person and it wasn’t five minutes ago!” There is a great big gray area. It’s uncomfortable to think about the idea that there is a non-person becoming a person in some sort of gradual way.
There’s also a big gray area when it comes to abnormal pregnancies. Take, for example, the case of acardiac twins. One of the twins has no head, no heart and is siphoning off blood supply from a normal, otherwise healthy twin. This twin will never survive, but to carry it to term poses a serious health risk to the mother and espescially its twin. Obviously, the moral thing to do is disconnect the abnormal twin from its sibling and allow it to “die”.
What about anencephalic fetuses? They won’t survive more than a few days after birth (if they are even born alive), and they are missing most of their brain (except a partially functioning brain stem). There are all kinds of situations in this gray area, all the way from grossly abnormal pregnancies that will never develop into anything resembling a person, to those involving less serious, but still significant disabilities like Down’s syndrome.
I know people get nervous about the idea of “designer babies”, but the technology may exist some day soon where you’ll be have a great deal of control over the genetics of your child before it’s concieved. A lot can be (and is) done with IVF already. If you found out you were a carrier for a serious genetic disease, and that you had the power to prevent your child from inheriting that disease, or even being a carrier, wouldn’t you do that? IMO, failure to take that action would be immoral. But what constitutes “disease” in this context? Would it be OK to filter out genes that make you dumb, or ugly or have a hairy back?
It would be easy (and wonderful for political extermists on both sides) if things like this were black-and-white issues, but they’re not. Real life is never simple.
Steve S
My question to pro-life Republicans…
But what choice do people really have?
Unless someone is independently wealthy, it is nearly impossible for them to afford all the specialized care that will be required. They might if there was government assistance, but that’s been gutted in the past 20 years.
Mr Furious
Mr Furious
Oops. Meant to close the blockquote.
Krista asked:
And I replied:
You bet your ass there are. And that situation will make one family or person question the existence of a God that could do that, while another will credit God for getting them through it.
Krista
Well, I’m not a mother, but hopefully I will be someday. And like all of the big issues, this one isn’t black-or-white. There is NO perfect solution. Period. If the pro-choice segment has their way, and if you leave it up to the mother to decide (with consultation from her doctor, of course), then there are going to be some fetuses aborted whose conditions may not have been that bad. But if you put the pro-lifers in charge, then you’ll have some cases where children are suffering for years, with no hope of a functional life. Which is the lesser evil?
And to try to regulate it via the government would just a logistical and ethical nightmare. At what point would the condition be considered severe enough to warrant abortion? Would the financial status of the parents (i.e. ability to pay for the extra care, meds, etc. that the child will require) come into account at all?
Krista
Mr. Furious – stop talking about my ass, already.
Steve
fwiffo, are there statistics on what percentage of fertilized eggs end up successfully implanting? I asked my wife this one and she didn’t know.
It seems to be relevant to, among other things, the Plan B issue.
Lines
Oh great, now I’m going to think about Krista’s ass all day long….
Sherard
Nice cop out there Mr. Furious. The fetus, who is the very center of this argument that they are entitled to life, gets no consideration whatsoever ? Their enduring pain and suffering is somehow inconsequential to the family and whether they view this tragic situation as positive or negative is all that matters. Do I have that right ?
How very sympathetic of you.
Krista
I found this on aiims.edu…
Lines
I’d question those statistics, as the 25% and the 17% don’t add directly. The percentage is actually around 38% (given those numbers).
Mr Furious
[blush]
Shygetz
Krista, fwiffo, et al–Regardless of when you think that a fetus becomes rights-worthy, the point is that, at any particular point in the pregnancy, you either believe the fetus has rights, or you don’t. If you believe the fetus has rights, then you cannot allow abortion in any but certain limited circumstances. If you believe the fetus does not have rights, you must allow abortions at will for any reason. Otherwise, you must state that the fetus has certain limited rights that are not human rights, but something else. There seems to be no logical foundation for such an argument.
If you believe that designer babies should be outlawed, then you seem to be asserting that the fetus has rights. As such, why should a woman be allowed to have any abortion (outside of limited circumstances, such as danger to the mother) at that point? If the fetus is the mother’s property, then the mother gets to choose. If you start saying that you cannot abort that baby just to select its gender, then you have just stated that the fetus is not property and has an inherent right to exist. As such, the mother would have to prove that her right to abort the fetus is greater than the fetus’ right to exist, which is difficult outside of limited circumstances.
My point is, if you want a pro-choice culture, then logically you have to accept the possibility of “designer babies” that stems from the exercise of that choice.
And Mr. Furious, you are forgetting those that will say that the suffering child allowed God to teach them some “valuable lesson,” thus confirming that they are the only person in the universe that matters and little children should suffer terrible pain for their enlightenment. I love those guys.
Krista
How do you get 38%? If 25% don’t implant, and 17% are lost early, that’s 42% of zygotes that don’t result in a clinically recognized pregnancy.
En tous cas, the precise numbers don’t matter so much. We can agree that if the egg is fertilized, it has pretty good chances of implanting and carrying to term.
Krista
Shygetz – I see your point. The thing is, I do agree that every woman has the right to an abortion. However, I am not always going to agree with her reason for doing so. There are some reasons that I will find useless, or abhorrent. Regardless, we can’t start down that slope, because there is too much chance of it being abused by those who would outlaw abortion in ALL circumstances. I don’t hold this position lightly or easily, and I’m not going to ignore the fact that no matter WHAT the law is, some ugly things are going to happen.
Mr Furious
Help me out here. What the hell are you talking about? Which comment and where is the cop out?
Way upthread, I mentioned that forcing the burden of a special needs child on any and every family is not fair, below I mention that enduring a painful and tragic life of a child cut short might elicit different reactions about God from different people.
WTF?
While it’s true I do not mention asking the fetus its opinion, at no point do I ever deem the family’s situation as inconsequential. In fact, in all my comments it’s the only issue I really address. Logic dictates that a thoughtful famiy making this decision would give consideration to the fetus. My point is that it is none of YOURS or James Dobson’s fucking business.
Mr Furious
Shygetz-
I’m not sure I forgot those people as much as I want to pretend they dont exist…
Krista
Get in line, darling…
Steve
The thing is, Shygetz may have a point that the fetus either has rights or it doesn’t. The problem is, pro-lifers like to propose this choice of “either you support abortion for any reason at all, or you agree that it must be outlawed” and then when you choose the former, they accuse you of taking an extreme “abortion on demand” position. Well, if you only have two choices, it’s kind of silly to call either of them extreme.
Anyway, I think the point is that I can believe someone has “rights” without necessarily agreeing with how they use those rights. Yes, people might use their abortion rights to choose eye color, and people might use their free speech rights to advocate for the genocide of Jews. I strongly disagree with how they exercise those rights, but the rights are still there.
Shygetz
Krista–I’m with you. And the numbers come from the following:
25% of all fetilizations don’t implant; 75% do
17% of those that implant terminate–17% of 75% is 12.75% 25% + 12.75% = 37.75% of all pregnancies do not implant or terminate early.
Mr. Furious–Unfortunately, those blockheads are always the ones interviewed on TV for the human interest pieces. I guess somehow I’m supposed to find it uplifting that God cares so much for me that he would make a little child suffer and die to teach me that life is precious.
I don’t.
Lines
Thanks Shy
Mr Furious
Shygetz-
Me neither.
Sherard-
Anything?
Lines
But what I meant wasn’t the specifics, just that when you get such a basic statistical fact wrong, it makes me wonder if the target of 42% wasn’t predetermined and the numbers flexed to fit it, or if the number 42% is just more striking than 38% and carries a human-factor bonus.
Oh well, 95% of all statistics are made up on the spot anyway.
ppGaz
This is why the divide-and-conquer crowd will make both sides of this “debate” into their bitches.
You “didn’t agree?” It’s none of your business. Why would you presume to agree or not agree? It’s not your decision.
If you can stop people from sticking their fucking noses into other peoples’ business, you can take away about half the power that the blowhard politicians claim for themselves.
“Secure the blessings of liberty” Not secure the right of presumption to tell other people how to conduct their lives. A phrase that a few “originalists” might want to ponder, while they are looking in the Constitution for the rights of zygotes (which are not there).
Cyrus
Shygetz-
Well, just to make the abortion debate a bit more complicated… not necessarily. A friend of mine – sorry for the cop-out but it’s true – compares developing fetuses to non-human lives, like animals. And while animals obviously don’t have the fundemental rights as humans, they do have some rights. Cruelty to animals can be a crime, for example.
So the point is, no, it’s really not as simple as you make it sound. A person can logically and honestly support abortion in some cases but not others, and even support keeping it legal in all cases while personally disapproving of it.
Shygetz
There is no logical foundation to compare a fetus to an animal, and say that they deserve the rights of animals. That’s why there is no substantive portion of the debate focusing on that. Even if there was, I can euthanize my dogs for being smelly, and it’s totally legal. So it has no bearing on the discussion.
Some might say that fetuses are like atom bombs, and thus should be regulated as nuclear weapons. I didn’t include them either.
fwiffo
Whether it’s 38% or 42% I don’t think matters a whole lot. I originally heard a much higher number (that something like only one in four fertilized eggs becomes a pregnancy), but I don’t have time to dig up the source at the moment, and the exact percentage isn’t important. There may well be conflicting data. Whether it’s 25% or 75%, it’s a substantial enough portion to make it problematic to define a pregnancy as a fertilized egg.
This is part of the reason why the arguments against Plan B contraception are so wrong and so dishonest. Even fertilization may occur days after the sex act, and even then, it doesn’t necessarily constitute a pregnancy. Plan B works by the exact same mechanisms as the pill – preventing ovulation, making the environment hazardous to sperm, and possibly preventing implanatation – though there is disagreement as to whether that even occurs. It’s not an abortificant. In fact, it’s just a larger dose of the same chemical (you get the same effect by taking something like three or four regular birth control pills at once).
Krista
fwiffo – exactly. And it burns my (oft-talked-about) ass that there are people who oppose birth control, oppose emergency contraception, opppose abortion, AND oppose social services that help financially disadvantaged parents. Do they really, truly expect everybody to wait until marriage before having sex, and then, once married, to pop out babies until the woman’s uterus gives out? Do they have any idea how archaic that is?
tzs
Well, it used to be you’d continue to pop out babies, and then watch them die from a variety of ghastly diseases…that is to say if (being female), you managed to survive the childbirth.
Childbirth used to be a really standard way for a woman to die.
Mr Furious
Krista-
I say again, you bet your ass. In fact, even once married, you are only allowed to have sex in order to pop out said babies.
BIRDZILLA
What we realy need is a way to find out if a future politician is going keep all their promeses or break every one of them like they always do
rs
I think it’s naive to think that many people with access to advance screening and abortion are not taking advantage of both to abort fetuses with defects.It’s similarly naive to think they’re sharing what much of society would deem a less than noble decision with the rest of us.I also believe that most folks who say they wouldn’t would if they were actually in that situation rather than playing what if…
Debo
I have a son with Down Syndrome. Most of the time he is a great joy. Some of the time he is a pain in the arse. Just like other “normal” kids. I also have two sons with schizophrenia….now that is a CHALLENGE! One son overdosed at age 16 on prescribed meds. Long story. End result he went to hospital, was given a drug that the FDA had required a warning letter be sent to all healthcare providers telling them that the drug was not approved for use in the US for kids, the drug was ordered by the oncall night resident doctor and given by a new grad nurse. Drug was discontinued by the attending doctor and he was successfully stabilized when his heartrate fell into the teens. Two hours later the day shift nurse came on duty and because he was “starting to wake up” she restarted the unapproved drug without a doctors order to restart the drug! His heart stopped and he suffered massive brain damage. He is now like Terri Schiavo was. So…..Down Syndrome ain’t such a big deal in the scheme of things….When you decide to have children some things are not always apparent. My two boys looked and acted normal for many years (12 and 15). My Downs child was a known factor as soon as we laid eyes on him. He had Mr Spock ears. Having children is a life changing, never ending responsibility for many and although I consider myself a prolife liberal, I would never make that decision for someone else. In my next life I want to come back as a well-loved Boston Terrier.
Don
Birdzilla – so we can abort the dishonest ones?
I guess it makes me a crap person or just a coward, but I would absolutely screen for Downs and abort if it came back positive. It’s not because I haven’t met wonderful Downs-afflicted people or think I wouldn’t love such a child every bit as much as any other – I am just not prepared to sign on to caring for a child who might never leave the home.
My own death terrifies me enough now that I don’t have to worry that I’m going to leave behind someone who still needs my care. Do I lay that responsibility on another child? A friend? No matter what, I’d worry that it wouldn’t work out. I find it equally incomprehensible when people father kids that will likely still be in high school when they die. How do you set another human being up to abandon them like that?
Cyrus
Shygetz Says:
Fine, fetuses aren’t animals. Obviously. The point is, you can’t honestly frame the discussion as a simple dichotomy between person and not-a-person. Because in between there’s something else, call it a potential person. And saying that a potential person should have all the rights of a person is a strong statement that needs to be supported. Supporting abortion in general but morally disapproving of it in some cases, or even asking for legislation forbidding it in come cases (though there are other problems with that), is a valid position. It’s not as simple as “Regardless of when you think that a fetus becomes rights-worthy, the point is that, at any particular point in the pregnancy, you either believe the fetus has [all a person’s] rights, or you don’t,” as you put it.