“A world without people with down syndrome.” At what cost?

One of the great philosophical divisions of our time is between those who believe progress is steadily making mankind happier, healthier, and all-around better; and those who believe human nature is basically constant, with new developments just as capable of yielding evil as they are good. Both worldviews collide in a recent New York Post story on a new method of testing for Down Syndrome:

Last month, San Diego-based Sequenom released a test that allows doctors to screen for the most prevalent type of Down syndrome with only a blood test from the mother. The screening is available in 20 cities and is expected to hit New York soon. Two other companies have plans to release similar tests next year […]

Because the current methods of screening for Down syndrome, amniocentesis and chorionic villus sampling, carry a risk of inducing miscarriage, only about 2% of pregnant women in the nation undergo the screening, says Dr. Brian Skotko, of the Down syndrome program at Children’s Hospital Boston.

Sounds great…except for what expecting mothers might do with the information:

“What you end up having is a world without people with Down syndrome,” says Paul Root Wolpe, director of the center for ethics at Emory University. “And the question becomes is that a good thing or bad thing?”

[…] The safer prenatal screenings will likely mean more women will be tested, and the number of women carrying babies with Down syndrome who terminate their pregnancies could increase, if not skyrocket. Today, 92% of mothers who get a definitive diagnosis of Down choose to abort, surveys show.

It’s understandable that many mothers would be tempted by the opportunity to avoid bringing a child with serious medical issues into the world, motivated both by pity for the child’s quality of life and by the challenges of raising a special-needs child. It’s also predictable that many people would be excited by the prospect of wiping an entire disease from the face of the earth.

But the dream of a world without Down Syndrome masks an ugly reality. As difficult as the condition’s effects can make life, they hardly guarantee a life of misery and emptiness. Down patients are still capable of leading happy, rewarding lives—that is, if they’re not snuffed out in the womb first. Nobody can fully know the fruits or fulfillment of another’s life, especially one that’s barely even begun. However empathetic the intent may be, killing someone to spare him or her an uncertain future is as shortsighted as it is arrogant.

Nor would a world without Down be the result. Even if we assume a 100% abortion rate of Down babies, preventing them from passing the disease on to future generations, Down has non-hereditary factors which ensure that the disease itself would survive, leaving the wholesale aborting to be repeated in every generation in the name of eradicating Down Syndrome. In the end, we wouldn’t be wiping out the disease, just killing the patients early enough that we can fool ourselves into believing they were never here.

There is, however, one encouraging nugget in the Post story. Shocking though it may be that “92% of mothers who get a definitive diagnosis” abort, keep in mind that 98% of mothers don’t even seek a diagnosis, to avoid even the possibility of hurting their baby by current detection methods. So we can expect the number of Down abortions to rise, but not necessarily skyrocket. Many mothers will continue to choose life under challenging circumstances, demonstrating to all that the best elements of human nature sometimes shine in spite of the “easy outs” scientific progress can sometimes provide to our natural temptations.

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