an article with a deeply flawed argument
patricia e. bauer, former wp reporter and bureau chief, has some strong opinions on the ethics of aborting a fetus based on the results of prenatal testing stemming, in part, from her experiences as the mother of a child with down syndrome. i fully support her right to write about her opinions, but i believe that she is conflating certain issues. she writes:
As Margaret [bauer's daughter] bounces through life, especially out here in the land of the perfect body, I see the way people look at her: curious, surprised, sometimes wary, occasionally disapproving or alarmed. I know that most women of childbearing age that we may encounter have judged her and her cohort, and have found their lives to be not worth living.
i’m not sure how bauer can be so sure that most women of childbearing age she encounters have made any such determination. has she asked them? has she seen any studies? in the preceeding paragraph, she asserts that some studies estimate that 80 to 90 percent of pregnancies are terminated because of prenatal diagnoses of down’s (i can’t help but wonder if the correct characterization is that the studies estimate that 80 to 90 percent of women with such diagnoses choose to have an abortion, which could plausibly strengthen bauer’s assertion). this would indicate that many women do not want to have a child with down’s syndrome. this says nothing about these women’s opinions on other people having children with down syndrome, and bauer cites no studies that have looked at that question.
bauer continues:
To them, Margaret falls into the category of avoidable human suffering. At best, a tragic mistake. At worst, a living embodiment of the pro-life movement. Less than human. A drain on society. That someone I love is regarded this way is unspeakably painful to me.
the fact that bauer ascribes such opinions to other people she has not met strikes me as extremely defensive. she has a daughter with down syndrome. she loves her daughter very much. it distresses her that many women choose not to have babies like her daughter. that’s fine. but i can’t help but wonder if her unsubstantiated characterization of others’ opinions stems from deeply repressed feelings that perhaps her daughter is somehow less than human, or a drain on society. or that she somehow failed society in bringing a “less than perfect” child into the world. given the undeniable social squeamishness about such children, it would be understandable if this were the case, and it would be a natural coping mechanism (i assume; i’m not a psychiatrist) to project those feelings onto others. there are probably some eugenicists out there who believe that downs babies should be aborted (and apparently some ethicists, given her subsequent paragraph), but the fact that downs babies are still being born counterbalances the implication that everyone feels that way.
(as a related aside: a study of over-35 women who choose not to have prenatal testing for downs would give a better indication of women’s opinions as to whether or not they are willing to give birth to a child with downs, but it still would say nothing about their opinions as to whether other women should do so.)
further on:
Margaret is a person and a member of our family. She has my husband’s eyes, my hair and my mother-in-law’s sense of humor. We love and admire her because of who she is — feisty and zesty and full of life — not in spite of it. She enriches our lives. If we might not have chosen to welcome her into our family, given the choice, then that is a statement more about our ignorance than about her inherent worth.
i don’t think that abortion is ever about the inherent worth of a potential child. it’s about a woman’s decision on whether she is capable of raising a child, or whether she wants to have a child. one woman contemplating abortion may believe that she should not have any child at that point in her life; another may believe that she is not capable of raising a down’s child at that point in her life. both women may be wrong; however, that decision is for them to make, not for someone else.
suppose bauer wanted to adopt a baby, and was faced with the following choice: baby A, “normal” for all intents and purposes, or baby B, with down syndrome. which would she choose? which would most women choose? while there are women who would choose baby B over baby A, i would be very surprised to find that a majority — or even a substantial minority — of women would choose baby B.
bauer’s last paragraph really ticks me off:
I have to think that there are many pro-choicers who, while paying obeisance to the rights of people with disabilities, want at the same time to preserve their right to ensure that no one with disabilities will be born into their own families. The abortion debate is not just about a woman’s right to choose whether to have a baby; it’s also about a woman’s right to choose which baby she wants to have.
while bauer obviously equates the rights of people with disabilities with the “rights” of fetuses (i disagree, but she’s entitled to her opinion), she has no reason to assume everyone else does as well. in fact, i would argue that it is implicit in the pro-choice position that a pregnant woman’s right to choose to terminate a pregnancy supercedes any right a fetus (disabled or no) might have to be born. however, there is simply no logical way to link this to any pro-choice position on the rights of people with disabilities. the pro-choice position does not pass judgment on women who choose not to have abortions, nor does it say anything about persons with disabilities (PWDs). bauer may disagree with the pro-choice position on abortion, but she does a disservice to her own position in characterizing any pro-choice individual’s opinions on PWDs as “paying obeisance” to anything without backing it up.
her last sentence, however, resonates with me. i do believe that a woman’s right to choose to have a baby extends to choosing what baby to have (within technological and legal limits). but that goes for any woman, whether she chooses to have a baby or not, and whether she chooses to have a baby with down syndrome or not. why should i care what another woman’s choice is, as long as she has made that choice? bauer’s entire thesis — that the abortion of fetuses based on the results of prenatal testing is a “significant part of what’s driving the abortion discussion in this country” — is completely unsupported by her article, a single dinner table comment notwithstanding.
UPDATE: this article at wsj (interesting in and of itself) suggests that my interpretation of the 80-90% question was correct.
October 18th, 2005 at 8:15 pm
Yeah, I agree that she is being presumptious in attributing thoughts, desires, and motives to other mothers and pro-choice people because of the actions and rights they support.
However, I think one of the points of her story is that the value of the life of a down syndrome child (1) is worth almost as much or as much to that child as a regular child’s life is worth to that child, and (2) that life is not worth less to other people (family members mostly) except in foresight. She is providing a narrative that, whatever its failings, attempts to demonstrate and expose the value of these childrens’ lives, something that is difficult for them to do themselves. That doesn’t mean it should be illegal to abort them, but it does point out that there is a loss. For us to pretend like we aren’t hurting anyone when we abort a child, down syndrom or not, is to be in bad faith.
October 18th, 2005 at 10:41 pm
Good to meet you, Jenny. I don’t think the author is looking for sympathy. I don’t think she’s dragging prenatal testing into the abortion debate.
If you believe the personal is the political, it’s there already.
When I was pregnant, I met a pregnant woman whose ob-gyn instructed her to come into the office the day after her AFP test showed a high risk for Down syndrome. He wanted an amnio done, because they only had a few days to terminate, if the results indicated the baby had Down syndrome. She was not asked her what her “choice” was. She refused.
If you think this was an isolated incident, you’re naive.
I appreciate your points, but they don’t resonate with me. My experience does not exactly parallel Patricia’s, but it’s close enough to connect with the truth of her words.
You and I differ on this issue because we start with different presuppositions. You probably realize that. I am coming from the framework of the writer of Psalm 139(esp. verses 13-16) of the Old Testament.
October 18th, 2005 at 10:53 pm
P.S. I believe God created you in His image and places a high value on you.
October 19th, 2005 at 1:02 pm
“…why then do we as a society view abortion as justified and unremarkable in the case of another class of people: children with disabilities?”
I think her first sentence is her main premise, really. It’s not about whether people should have the choice to abort, but whether people should abort fetuses diagnosed with disabilities. This is an argument against the Pro-Choice 80-90% who aborted their fetuses diagnosed with Down’s.
I believe her choice was clear in “the test” paragraph. No test? Oh poor thing, you didn’t know. Test? Oh, so you chose this pain because of your conservative, right-wing politics. Both were wrong assumptions, she said. She either did not know, and did not regret having the baby; or she did know, and chose to still have the baby. She goes on giving first-hand experience on how her choice was the right choice — not for everyone, but for her.
big picture: the choice here is much, much bigger than just a mother’s right over her womb. this choice is the choice of eugenics: tailoring life. political ramifications, given say, mandatory or readily available screening: pro-choice is pro eugenics.
October 19th, 2005 at 7:14 pm
Julana – thanks for commenting. no, i don’t think that’s an isolated incident, but i do think that what it illustrates is the need for better training of doctors and better communication between doctors and patients.
perci — from a pro-choice point of view, women have the right to choose. full stop. i do not question why a woman makes a particular choice, nor do i believe it is relevant to the debate. abortion is justified and unremarkable when a woman makes an informed choice.
October 20th, 2005 at 6:14 am
Seven Posts About Abortion, Prenatal Testing and Down Syndrome
3) If there were a prenatal test for potential obesity, I have no doubt – none whatsoever – that the large majority of expectant mothers in the U.S. would take the
October 21st, 2005 at 12:57 pm
Jenny,
How would you better train doctors? To go against their money-driven value systems?
I think the communication in these situations is pretty clear. The doctor is implying the mother should abort her child.
October 21st, 2005 at 6:30 pm
julana – the communication in your scenario is certainly clear, which is a lovely characteristic of hypotheticals: they can be tailored to whatever message you’re trying to convey. now really — exactly how does the profit motive enter into aborting a downs fetus?
ignoring, for a moment, the fact that this country was built on a “money-driven value system,” let’s address the real problem: poor doctor-patient communication. the doctor in your hypo was working under the assumption that the woman would want to abort a downs fetus. if the doctor and patient had discussed her beliefs/values/plans/what have you prior to engaging in any prenatal testing, it is unlikely the issue would’ve come up.
and it’s not just the doctors who need to be better trained to communicate. women have a responsibility in deciding the course of their medical care as well. if a woman is uncommunicative of her beliefs and expectations, there is little for a doctor to go on. the doctor, then, is caught between a rock and a hard place — does s/he bring up further tests, and risk offending the woman, or does s/he keep quiet about a potential fetal condition and risk being sued if the woman delivers a less-than-perfect baby? there’s a reason why OB-GYNs are leaving the field in droves and few young doctors are choosing it.
if the studies cited by the wsj are to be believed, women are overwhelmingly choosing to abort abnormal fetuses. is this the fault of the doctors? there may well be some who believe that is the appropriate course of action. or is it, perhaps, that the vast majority of american women want to exercise control over their reproductive lives? IMO, it is more likely the latter. and personally, i believe that is a good thing.
October 23rd, 2005 at 9:58 am
I commend you for blogging a dissenting view to Ms. Bauer’s article. So many bloggers have jumped to her side simply because it makes them feel good to declare they would never abort for fetal defects. Yet that is something they cannot know until they have faced a devastating diagnosis themselves and had a real-life opportunity to think through what that would entail for their own child and for their own family. In addition to mild to moderate retardation, Down syndrome carries with it a far higher potential for very serious health problems including major heart defects, kidney and bowel abnormalities, upper respiratory infections, serious vision problems and deafness. They also have a far greater risk (at least 30%) of developing Alzheimer’s disease in adulthood, and with it deterioration of their already limited intellectual capacities. Yet these realities are habitually glossed over by disabilities and pro-life advocates.
It is politically incorrect to admit this, but kids with Down don’t “just learn at a slower pace†as advocates love to declare. There are many things that they don’t possess the ability to accomplish, ever, no matter how aggressive we are in treatments, therapies and special education. Does that mean we should automatically abort them all? Heck no. But it should be up to the individual parents if they want to bring such a child into their family. Not everyone is emotionally or financially equipped to spend the rest of their lives meeting the demands of a special-needs child. I shudder to think of the negative repercussions of relinquishing a Down baby for adoption.
It is also politically incorrect to ask we can find all of these “Down syndrome success stories†advocates are frequently claim. Where are the adults with Down living and working, really? Do you take your dog to the vet with Down? Does the homeowner next door to you have Down? How about your manager at work? Your bank teller? Your realtor? Your child’s teacher? Your apartment complex manager? Your auto mechanic?
That doesn’t mean that people with Down can’t or don’t work. What it does mean is that the even the “high functioning†ones are likely to end up being exploited for low-wage labor at Wal-mart or McDonalds, at a wage that will surely keep them in poverty or dependent on family or welfare. Sure, plenty of chromosomally normal people work at those places too, but at least they possess within themselves the potential to attain more, should they desire it.
I understand the author’s frustration with people jumping to the conclusion that she is either a victim of circumstance or a pro-life zealot. However, she is just as guilty of jumping to conclusions about how people view her daughter, and about people’s motivations with prenatal testing. Most people who terminate following a Down syndrome diagnosis did not want “a perfect baby.†They wanted a healthy baby who would at least be born with the potential to grow up to be an independent adult. Furthermore, there are many, many excruciating or deadly fetal defects that prenatal testing can reveal. It is the blissfully ignorant person indeed who thinks Down is the worst that can happen in a pregnancy.
The author also struck me as a little dishonest in a couple of areas. She neatly sidestepped the question of whether she did in fact have prenatal testing. Those who know ahead and continue are usually quick to point out that fact (think Choosing Naia, or Expecting Adam – two books written by “pro-choice†people who continued their pregnancies following a Down diagnosis.) Chances are she did not know ahead that Margaret had Down. If she indeed is someone who never actually faced that choice, how dare she criticize those that have?
The article features a photo of her daughter in cap and gown, graduating from high school. But there is no mention of the fact that The Riverside School is a boarding school for people with disabilities. The author seems content to let us wrongly conclude that her daughter graduated from a regular high school thereby “proving†that Down syndrome is really no big deal.
It is a big deal.